Zimbabwe ZW: Current Health Expenditure: % of GDP data was reported at 10.317 % in 2015. This records an increase from the previous number of 8.886 % for 2014. Zimbabwe ZW: Current Health Expenditure: % of GDP data is updated yearly, averaging 9.114 % from Dec 2010 (Median) to 2015, with 6 observations. The data reached an all-time high of 11.607 % in 2010 and a record low of 7.676 % in 2013. Zimbabwe ZW: Current Health Expenditure: % of GDP data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Zimbabwe – Table ZW.World Bank.WDI: Health Statistics. Level of current health expenditure expressed as a percentage of GDP. Estimates of current health expenditures include healthcare goods and services consumed during each year. This indicator does not include capital health expenditures such as buildings, machinery, IT and stocks of vaccines for emergency or outbreaks.; ; World Health Organization Global Health Expenditure database (http://apps.who.int/nha/database).; Weighted average;

Zimbabwe ZW: Women Participating in the Three Decisions: Own Health Care, Major Household Purchases, and Visiting Family: % of Women Aged 15-49 data was reported at 72.100 % in 2015. This records a decrease from the previous number of 74.500 % for 2011. Zimbabwe ZW: Women Participating in the Three Decisions: Own Health Care, Major Household Purchases, and Visiting Family: % of Women Aged 15-49 data is updated yearly, averaging 73.300 % from Dec 1999 (Median) to 2015, with 4 observations. The data reached an all-time high of 74.900 % in 2006 and a record low of 40.500 % in 1999. Zimbabwe ZW: Women Participating in the Three Decisions: Own Health Care, Major Household Purchases, and Visiting Family: % of Women Aged 15-49 data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Zimbabwe – Table ZW.World Bank: Health Statistics. Women participating in the three decisions (own health care, major household purchases, and visiting family) is the percentage of currently married women aged 15-49 who say that they alone or jointly have the final say in all of the three decisions (own health care, large purchases and visits to family, relatives, and friends).; ; Demographic and Health Surveys (DHS); ;

The current healthcare spending in Zimbabwe was forecast to continuously decrease between 2024 and 2029 by in total **** million U.S. dollars (-*** percent). After the eighth consecutive decreasing year, the spending is estimated to reach ****** million U.S. dollars and therefore a new minimum in 2029. According to Worldbank health spending includes expenditures with regards to healthcare services and goods. The spending refers to current spending of both governments and consumers.The shown data are an excerpt of Statista's Key Market Indicators (KMI). The KMI are a collection of primary and secondary indicators on the macro-economic, demographic and technological environment in up to *** countries and regions worldwide. All indicators are sourced from international and national statistical offices, trade associations and the trade press and they are processed to generate comparable data sets (see supplementary notes under details for more information).Find more key insights for the current healthcare spending in countries like Uganda and Rwanda.

Abstract

The 2015 Zimbabwe Demographic and Health Survey (2015 ZDHS) is the sixth in a series of Demographic and Health Surveys conducted in Zimbabwe. As with prior surveys, the main objective of the 2015 ZDHS is to provide up-to-date information on fertility and child mortality levels; maternal mortality; fertility preferences and contraceptive use; utilization of maternal and child health services; women’s and children’s nutrition status; knowledge, attitudes and behaviours related to HIV/AIDS and other sexually transmitted diseases; and domestic violence. All women age 15-49 and all men age 15-54 who are usual members of the selected households and those who spent the night before the survey in the selected households were eligible to be interviewed and for anaemia and HIV testing. All children age 6-59 months were eligible for anaemia testing, and children age 0-14 for HIV testing. In all households, height and weight measurements were recorded for children age 0-59 months, women age 15-49, and men age 15-54. The domestic violence module was administered to one selected woman selected in each of surveyed households.

The 2015 ZDHS sample is designed to yield representative information for most indicators for the country as a whole, for urban and rural areas, and for each of Zimbabwe’s ten provinces (Manicaland, Mashonaland Central, Mashonaland East, Mashonaland West, Matabeleland North, Matebeleland South, Midlands, Masvingo, Harare, and Bulawayo).

Geographic coverage

National coverage

Analysis unit

• Household
• Individual
• Children age 0-5
• Woman age 15-49
• Man age 15-54

Universe

The survey covered all de jure household members resident in the household, all women age 15-49 years, men age 15-54 years and their young children.

Kind of data

Sample survey data [ssd]

Sampling procedure

The 2015 ZDHS sample was designed to yield representative information for most indicators for the country as a whole, for urban and rural areas, and for each of Zimbabwe’s ten provinces: Manicaland, Mashonaland Central, Mashonaland East, Mashonaland West, Matabeleland North, Matabeleland South, Midlands, Masvingo, Harare, and Bulawayo. The 2012 Zimbabwe Population Census was used as the sampling frame for the 2015 ZDHS.

Administratively, each province in Zimbabwe is divided into districts, and each district is divided into smaller administrative units called wards. During the 2012 Zimbabwe Population Census, each ward was subdivided into convenient areas, which are called census enumeration areas (EAs). The 2015 ZDHS sample was selected with a stratified, two-stage cluster design, with EAs as the sampling units for the first stage. The 2015 ZDHS sample included 400 EAs-166 in urban areas and 234 in rural areas.

The second stage of sampling included the listing exercises for all households in the survey sample. A complete listing of households was conducted for each of the 400 selected EAs in March 2015. Maps were drawn for each of the clusters and all private households were listed. The listing excluded institutional living arrangements such as army barracks, hospitals, police camps, and boarding schools. A representative sample of 11,196 households was selected for the 2015 ZDHS.

For further details on sample selection, see Appendix A of the final report.

Mode of data collection

Face-to-face [f2f]

Research instrument

Four questionnaires were used for the 2015 ZDHS: - Household Questionnaire, - Woman’s Questionnaire, - Man’s Questionnaire, and - Biomarker Questionnaire.

These questionnaires were adapted from model survey instruments developed for The DHS Program to reflect the population and health issues relevant to Zimbabwe. Issues were identified at a series of meetings with various stakeholders from government ministries and agencies, research and training institutions, non-governmental organisations (NGOs), and development partners. In addition to English, the questionnaires were translated into two major languages, Shona and Ndebele. All four questionnaires were programmed into tablet computers to facilitate computer assisted personal interviewing (CAPI) for data collection, with the option to choose English, Shona, or Ndebele for each questionnaire.

Cleaning operations

CSPro was used for data editing, weighting, cleaning, and tabulation. In ZIMSTAT’s central office, data received from the supervisor’s tablets were registered and checked for inconsistencies and outliers. Data editing and cleaning included structure and internal consistency checks to ensure the completeness of work in the field. Any anomalies were communicated to the respective team through the technical team and the team supervisor. The corrected results were then re-sent to the central office.

Response rate

A total of 11,196 households were selected for inclusion in the 2015 ZDHS and of these, 10,657 were found to be occupied. A total of 10,534 households were successfully interviewed, yielding a response rate of 99 percent.

In the interviewed households, 10,351 women were identified as eligible for the individual interview, and 96 percent of them were successfully interviewed. For men, 9,132 were identified as eligible for interview, with 92 percent successfully interviewed.

Sampling error estimates

Estimates from a sample survey are affected by two types of errors: non-sampling errors and sampling errors. Non-sampling errors are the results of mistakes made in implementing data collection and data processing, such as failure to locate and interview the correct household, misunderstanding of the questions on the part of either the interviewer or the respondent, and data entry errors. Although numerous efforts were made during the implementation of the 2015 Zimbabwe DHS (ZDHS) to minimize this type of error, non-sampling errors are impossible to avoid and difficult to evaluate statistically.

Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents selected in the 2015 ZDHS is only one of many samples that could have been selected from the same population, using the same design and expected size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey results.

Sampling error is usually measured in terms of the standard error for a particular statistic (mean, percentage, etc.), which is the square root of the variance. The standard error can be used to calculate confidence intervals within which the true value for the population can reasonably be assumed to fall. For example, for any given statistic calculated from a sample survey, the value of that statistic will fall within a range of plus or minus two times the standard error of that statistic in 95 percent of all possible samples of identical size and design.

If the sample of respondents had been selected as a simple random sample, it would have been possible to use straightforward formulas for calculating sampling errors. However, the 2015 ZDHS sample is the result of a multi-stage stratified design, and, consequently, it was necessary to use more complex formulae. Sampling errors are computed in either ISSA or SAS, using programs developed by ICF International. These programs use the Taylor linearization method of variance estimation for survey estimates that are means, proportions, or ratios. The Jackknife repeated replication method is used for variance estimation of more complex statistics such as fertility and mortality rates.

The Taylor linearization method treats any percentage or average as a ratio estimate, r = y x , where y represents the total sample value for variable y, and x represents the total number of cases in the group or subgroup under consideration.

Note: A more detailed description of estimates of sampling errors are presented in APPENDIX B of the survey report.

Data appraisal

Data Quality Tables - Household age distribution - Age distribution of eligible and interviewed women - Age distribution of eligible and interviewed men - Completeness of reporting - Births by calendar years - Reporting of age at death in days - Reporting of age at death in months - Nutritional status of children based on the NCHS/CDC/WHO International Reference Population - Completeness of information on siblings - Sibship size and sex ratio of siblings

Note: See detailed data quality tables in APPENDIX C of the report.

Zimbabwe ZW: Domestic Private Health Expenditure: % of Current Health Expenditure data was reported at 41.970 % in 2015. This records a decrease from the previous number of 44.833 % for 2014. Zimbabwe ZW: Domestic Private Health Expenditure: % of Current Health Expenditure data is updated yearly, averaging 53.969 % from Dec 2010 (Median) to 2015, with 6 observations. The data reached an all-time high of 55.735 % in 2012 and a record low of 41.970 % in 2015. Zimbabwe ZW: Domestic Private Health Expenditure: % of Current Health Expenditure data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Zimbabwe – Table ZW.World Bank: Health Statistics. Share of current health expenditures funded from domestic private sources. Domestic private sources include funds from households, corporations and non-profit organizations. Such expenditures can be either prepaid to voluntary health insurance or paid directly to healthcare providers.; ; World Health Organization Global Health Expenditure database (http://apps.who.int/nha/database).; Weighted Average;

Time series data for the statistic Current health expenditure per capita (current US$) and country Zimbabwe. Indicator Definition:Current expenditures on health per capita in current US dollars. Estimates of current health expenditures include healthcare goods and services consumed during each year.The indicator "Current health expenditure per capita (current US$)" stands at 70.66 usd as of 12/31/2022, the highest value since 12/31/2019. Regarding the One-Year-Change of the series, the current value constitutes an increase of 11.26 percent compared to the value the year prior.The 1 year change in percent is 11.26.The 3 year change in percent is 28.23.The 5 year change in percent is -23.09.The 10 year change in percent is -17.54.The Serie's long term average value is 86.76 usd. It's latest available value, on 12/31/2022, is 18.56 percent lower, compared to it's long term average value.The Serie's change in percent from it's minimum value, on 12/31/2020, to it's latest available value, on 12/31/2022, is +38.17%.The Serie's change in percent from it's maximum value, on 12/31/2018, to it's latest available value, on 12/31/2022, is -38.43%.

Multimorbidity, commonly defined as the co-occurrence of two-or-more long-term conditions in one individual, has been argued to be among the greatest global health challenges of our time. Health systems remain largely organised around specialist rather than generalist knowledge, which in many African nations translates into ‘siloed’ organisation of care, fuelled by ‘vertical’ single-disease programming. Multimorbidity has recently emerged on the health agendas of many lower-income countries, including in Africa. Yet with its conceptual origins in higher-income settings the global North, its meaning and utility in lower-resource settings remains abstract.

KnowM (2021-2024) was an interdisciplinary research collaboration to characterize the meaning, significance, and transformative potential of the concept of multimorbidity within a global health context, centred on a case study of Zimbabwe. In Zimbabwe, KnowM brought together stakeholders from across the country’s health system to critically interrogate the concept of multimorbidity and co-produce a formative agenda for responding to it in this setting. The specific objectives were: to understand how multimorbidity is being defined and framed as a global health challenge; to describe concepts, experiences, and responses to multimorbidity across different spaces within Zimbabwe’s health system; and to co-produce a conceptual framework and formative agenda for responding to multimorbidity in Zimbabwe.

The study was conducted in four provinces of Zimbabwe, including Harare, Bulawayo, Mashonaland East, and Matabeleland South, to represent both urban and rural settings. Within a participatory ethnographic study design, specific research methods included a health facility survey, participant-observation, in-depth interviews, audio-visual diaries, and participatory workshops. Through this holistic, bottom-up approach, KnowM sought to push thinking beyond the single disease paradigm and to open new conceptual pathways towards more integrated systems of research, training, and care in Zimbabwe, Africa, and wider field of global health.

The data deposited include the health facility health facility survey (n=30 surveys), in-depth interviews (n=45 transcripts), and fieldnote summaries from participant-observation and other stakeholder engagements during the study (n=23 fieldnote summaries). Data collection commenced with a survey of 30 health facilities at different levels of care, and included questions about services, staffing, and resources; about specific services and capacity related to multimorbidity, and more specific questions about care for particular non-communicable diseases (NCDs). Following the survey, participant-observation and in-depth interviews were conducted with a range of healthcare professionals in 10 facilities purposively sampled from the surveyed facilities. In parallel, we conducted interviews and audio-visual diaries with PLWMM (the latter not deposited for ethical reasons) to capture understandings, experiences, and challenges of (self-)managing multimorbidity and accessing care. To gain a perspective on multimorbidity beyond the patient and service delivery level, participant-observation and in-depth interviews were conducted with policymakers and public health practitioners, clinical academics and medical educators, health informaticians and data experts, and non-governmental organisation (NGO) representatives. Finally, participatory workshops (not deposited for ethical reasons) were held to collaboratively interpret and reflect on preliminary findings and draw out their significance and implications.

Findings suggest that multimorbidity, while a relatively new and emerging concept, revealed and amplified key tensions within the health system and wider field of global health. Participants described multimorbidity as complex, multifaceted, and rising, particularly among people living with HIV and among the elderly. However, it is currently challenging to respond to – or fully understand – due to various interconnected factors. These include disease-specific programme guidelines and monitoring and evaluation (M&E) systems; the considerably greater funding and visibility of HIV, TB and malaria compared to NCDs and mental health; and a fragmented, disenabling policy environment. While participants considered multimorbidity a meaningful and useful concept, with capacity and momentum to address multimorbidity currently concentrated within the HIV programme, there was concern that multimorbidity could itself become verticalized, undercutting its transformative potential. Participants agreed that responding to multimorbidity requires a decisive shift from vertical, disease-centred programming towards more integrated, person-centred approaches across the health system. Specific priorities included reinvigorating comprehensive chronic care at primary level; building multimorbidity into routine health information and M&E systems; fostering engagement and learning across disease programme areas; and strengthening ties between academia, policymakers, and ground-level experience to foster continuous, contextually-attuned learning.

Multimorbidity, commonly defined as two-or-more long term conditions in one person, poses a profound challenge to health systems designed around single diseases. Increasingly recognized as a global health challenge, multimorbidity has recently emerged on the health agendas of many lower-income countries, yet with its conceptual origins in higher-income settings the global North, its meaning, transformative potential, and possible limitations in lower-resource settings remains abstract. KnowM (2021-2024) was an interdisciplinary research collaboration to characterize the meaning, significance, and transformative potential of the concept of multimorbidity within the African context, centred on a case study of Zimbabwe. KnowM brought together stakeholders from across Zimbabwe’s health system to critically interrogate the concept of multimorbidity and co-produce a formative agenda for responding. Participants included people living with multimorbidity (PLWMM), healthcare professionals, public health practitioners, academics, health informaticians, and policymakers. Within a participatory ethnographic study design, specific research methods included a health facility survey, participant-observation, in-depth interviews, audio-visual diaries, and participatory workshops. Through this holistic, bottom-up approach, KnowM sought to open new conceptual pathways beyond the entrenched single disease paradigm and to facilitate the development of more integrated systems of research, training, and care better able to respond to multimorbidity and its associated complexity.

Abstract

The 2010-2011 Zimbabwe Demographic and Health Survey (2010-11 ZDHS) is one of a series of surveys undertaken by the Zimbabwe National Statistics Agency (ZIMSTAT) as part of the Zimbabwe National Household Survey Capability Programme (ZNHSCP) and the worldwide MEASURE DHS programme.

The 2010-11 ZDHS is a follow-on to the 1988, 1994, 1999, and 2005-06 ZDHS surveys and provides updated estimates of basic demographic and health indicators covered in these earlier surveys. Data on malaria prevention and treatment, domestic violence, anaemia, and HIV/AIDS were also collected in the 2010-11 ZDHS. In contrast to the earlier surveys, the 2010-11 ZDHS was carried out using electronic personal digital assistants (PDAs) rather than paper questionnaires for recording responses during interviews.

The primary objective of the 2010-11 ZDHS is to provide up-to-date information on fertility levels, nuptiality, sexual activity, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutritional status of mothers and young children, early childhood mortality and maternal mortality, maternal and child health, and knowledge and behaviour regarding HIV/AIDS and other sexually transmitted infections (STIs).

Geographic coverage

The sample for the 2010-11 ZDHS was designed to provide population and health indicator estimates at the national and provincial levels. The sample design allows for specific indicators, such as contraceptive use, to be calculated for each of Zimbabwe's 10 provinces (Manicaland, Mashonaland Central, Mashonaland East, Mashonaland West, Matabeleland North, Matabeleland South, Midlands, Masvingo, Harare, and Bulawayo).

Analysis unit

Household, individual, adult woman, adult male,

Kind of data

Sample survey data

Sampling procedure

The sample for the 2010-11 ZDHS was designed to provide population and health indicator estimates at the national and provincial levels. The sample design allows for specific indicators, such as contraceptive use, to be calculated for each of Zimbabwe’s 10 provinces (Manicaland, Mashonaland Central, Mashonaland East, Mashonaland West, Matabeleland North, Matabeleland South, Midlands, Masvingo, Harare, and Bulawayo). The sampling frame used for the 2010-11 ZDHS was the 2002 Population Census.

Administratively, each province in Zimbabwe is divided into districts and each district into smaller administrative units called wards. During the 2002 Population Census, each of the wards was subdivided into enumeration areas (EAs). The 2010-11 ZDHS sample was selected using a stratified, two-stage cluster design, and EAs were the sampling units for the first stage. Overall, the sample included 406 EAs, 169 in urban areas and 237 in rural areas.

Households were the units for the second stage of sampling. A complete listing of households was carried out in each of the 406 selected EAs in July and August 2010. Maps were drawn for each of the clusters, and all private households were listed. The listing excluded institutional living facilities (e.g., army barracks, hospitals, police camps, and boarding schools). A representative sample of 10,828 households was selected for the 2010-11 ZDHS.

All women age 15-49 and all men age 15-54 who were either permanent residents of the selected households or visitors who stayed in the household the night before the survey were eligible to be interviewed. Anaemia testing was performed in each household among eligible women and men who consented to being tested. With the parent’s or guardian’s consent, children age 6-59 months were also tested for anaemia. Also, among eligible women and men who consented, blood samples were collected for laboratory testing of HIV in each household. In addition, one eligible woman in each household was randomly selected to be asked additional questions about domestic violence.

Mode of data collection

Face-to-face

Research instrument

Three questionnaires were used for the 2010-11 ZDHS: the Household Questionnaire, the Woman’s Questionnaire, and the Man’s Questionnaire. These questionnaires were adapted from model survey instruments developed for the MEASURE DHS project to reflect population and health issues relevant to Zimbabwe. Relevant issues were identified at a series of meetings with various stakeholders from government ministries and agencies, nongovernmental organizations (NGOs), and international donors. Also, more than 30 individuals representing 19 separate stakeholders attended a questionnaire design meeting on 8-9 February 2010. In addition to English, the questionnaires were translated into two major languages, Shona and Ndebele.

The Household Questionnaire was used to list all of the usual members and visitors of selected households. Some basic information was collected on the characteristics of each person listed, including his or her age, sex, education, and relationship to the head of the household. For children under age 18, survival status of the parents was determined. The data on age and sex obtained in the Household Questionnaire were used to identify women and men who were eligible for an individual interview. Additionally, the Household Questionnaire collected information on characteristics of the household’s dwelling unit, such as the source of water, type of toilet facilities, materials used for the floor of the house, ownership of various durable goods, and ownership and use of mosquito nets (to assess the coverage of malaria prevention programmes).

The Woman’s Questionnaire was used to collect information from all women age 15-49. These women were asked questions on the following topics: - Background characteristics (age, education, media exposure, etc.) - Birth history and childhood mortality - Knowledge and use of family planning methods - Fertility preferences - Antenatal, delivery, and postnatal care - Breastfeeding and infant feeding practices - Vaccinations and childhood illnesses - Marriage and sexual activity - Women’s work and husbands’ background characteristics - Malaria prevention and treatment - Awareness and behaviour regarding AIDS and other sexually transmitted infections (STIs) - Adult mortality, including maternal mortality - Domestic violence

The Man’s Questionnaire was administered to all men age 15-54 in each household in the 2010-11 ZDHS sample. The Man’s Questionnaire collected much of the same information found in the Woman’s Questionnaire but was shorter because it did not contain a detailed reproductive history or questions on maternal and child health.

In this survey, instead of using paper questionnaires, interviewers used personal digital assistants to record responses during interviews.

Cleaning operations

In this survey, instead of using paper questionnaires, interviewers used personal digital assistants to record responses during interviews. The PDAs were equipped with Bluetooth technology to enable remote electronic transfer of files (e.g., transfer of assignment sheets from team supervisors to interviewers and transfer of completed questionnaires from interviewers to supervisors). The PDA data collection system was developed by the MEASURE DHS project using the mobile version of CSPro. CSPro is software developed jointly by the U.S. Census Bureau, the MEASURE DHS project, and Serpro S.A.

All electronic data files for the ZDHS were returned to the ZIMSTAT central office in Harare, where they were stored on a password-protected computer. The data processing operation included secondary editing, which involved resolution of computer-identified inconsistencies and coding of open-ended questions. Two members of the data processing staff processed the data. Data editing was accomplished using CSPro software. Office editing and data processing were initiated in October 2010 and completed in May 2011.

Response rate

A total of 10,828 households were selected for the sample, of which 10,166 were found to be occupied during the survey fieldwork. The shortfall was largely due to members of some households being away for an extended period of time and to structures that were found to be vacant at the time of the interview. Of the 10,166 existing households, 9,756 were successfully interviewed, yielding a household response rate of 96 percent. A total of 9,831 eligible women were identified in the interviewed households, and 9,171 of these women were interviewed, yielding a response rate of 93 percent. Of the 8,723 eligible men identified, 7,480 were successfully interviewed (86 percent response rate). The principal reason for nonresponse among both eligible men and women was the failure to find them at home despite repeated visits to the households. The lower response rate among men than among women was due to the more frequent and longer absences of men from the households. Nevertheless, the response rates for both women and men were higher in the 2010-11 ZDHS than in the 2005-06 ZDHS (in which response rates were 90 percent for women and 82 percent for men).

Sampling error estimates

Sampling errors for the 2010-11 ZDHS are calculated for selected variables considered to be of primary interest.

The Zimbabwe Demographic and Health Survey (ZDHS) is one of a series of surveys carried out by the Central Statistical Office (CSO) as part of the Zimbabwe National Household Survey Capability Programme. Conducted immediately following the second round of the Intercensal Demographic survey in 1988, the objective of the ZDHS was to make available to policy-makers and planners current information on fertility and child mortality levels and trends, contraceptive knowledge, approval and use and basic indicators of maternal and child health. To obtain these data, a nationally representative sample of 4201 women 15-49 was interviewed in the survey between September 1988 and January 1989. The ZDHS is one of a series of surveys undertaken by the Central Statistical Office (CSO) as part of the Zimbabwe National Household Survey Capability Programme (ZNHSCP). The ZDHS was conducted immediately after the second round of the Intercensal Demographic Survey (ICDS) in 1988. The main objective of the ZDHS was to provide information on: fertility levels, trends and preferences; family planning awareness, approval and use; maternal and child health, including infant and child mortality; and other topics relating to family health. The survey was designed to obtain information on family planning use similar to that provided by the 1984 Zimbabwe Reproductive Health Survey (ZRHS) and data on fertility and mortality which would complement information collected in the two rounds of the Intercensal Demographic Survey (ICDS). In addition, participation in the worldwide Demographic and Health Survey project offered an opportunity to strengthen survey capability in Zimbabwe, as well as further comparative research by contributing to the international demographic and health database.

The current health expenditure as a share of the GDP in Zimbabwe was forecast to continuously decrease between 2024 and 2029 by in total *** percentage points. After the thirteenth consecutive decreasing year, the share is estimated to reach **** percent and therefore a new minimum in 2029. According to Worldbank health spending includes expenditures with regards to healthcare services and goods. It is depicted here in relation to the total gross domestic product (GDP) of the country or region at hand.The shown data are an excerpt of Statista's Key Market Indicators (KMI). The KMI are a collection of primary and secondary indicators on the macro-economic, demographic and technological environment in up to *** countries and regions worldwide. All indicators are sourced from international and national statistical offices, trade associations and the trade press and they are processed to generate comparable data sets (see supplementary notes under details for more information).Find more key insights for the current health expenditure as a share of the GDP in countries like Tanzania and Ethiopia.

The Coronavirus Disease 2019 (COVID-19) posed significant health policy challenges, particularly for low-income countries, where policymakers faced both direct threats from the virus and social and economic harm owing to lockdown measures. We present a holistic contextualized case study of the direct and indirect impacts on women and children, highlighting disparities across socioeconomic, age, and gender groups. We utilized multiple data sources, including primary and secondary data from 28 in-depth interviews, six focus group discussions, and 40 household interviews, as well as data from government reports, District Health Information Software version 2 (DHIS2), and published research. A conceptual framework was devised to hypothesize causal pathways and guide the analysis of results. The findings indicate that the pandemic not only had direct effects, on morbidity and mortality, but also more severe indirect impacts, including job losses and limited access to healthcare, including maternal and child healthcare services, due to measures put in place to control it, which were exacerbated by well-known but inadequately considered preexisting political and economic challenges. The most severe indirect effects on healthcare services availability and wider livelihoods fell on the poorest segments of society, further widening the age and gender inequalities. Policymakers faced significant challenges in managing the direct and indirect harm of COVID-19, including short- and long-term effects and their unequal distribution across society. We conclude that the indirect effects of COVID-19 were at least as harmful, if not more so, than the direct impacts, especially for women and children. In the future, it is highly recommended to establish specific protocols and guidance for maternal and child health service access, including strategies that reduce barriers to social support.

The Central Statistical Office (CSO) conducted the third Zimbabwe Demographic and Health Survey (ZDHS) between August and November 1999. The 1999 Zimbabwe Demographic and Health Survey (ZDHS) is a nationally representative survey that was implemented by the Central Statistical Office (CSO) from August to November 1999. Although significantly expanded in content, the 1999 ZDHS is a follow-on to the 1988 and 1994 ZDHS surveys and provides updated estimates of the basic demographic and health indicators covered in the earlier surveys. The 1999 ZDHS was conducted in all of the ten provinces of Zimbabwe. The 1999 Zimbabwe Demographic and Health Survey (ZDHS) is one of a series of surveys undertaken by the Central Statistical Office (CSO) as part of the Zimbabwe National Household Survey Capability Programme (ZNHSCP) and the worldwide MEASURE DHS+ programme. The Zimbabwe National Family Planning Council (ZNFPC), the Department of Population Studies of the University of Zimbabwe (UZ), the National AIDS Coordinating Programme (NACP), and the Ministry of Health and Child Welfare (MOH&CW) contributed significantly to the design, implementation, and analysis of the ZDHS results. The U.S. Agency for International Development (USAID) provided funds for the implementation of the 1999 ZDHS. Macro International Inc. provided technical assistance through its contract with USAID. UNICEF/Zimbabwe supported the survey by providing additional funds for fieldwork transportation. The primary objectives of the 1999 ZDHS were to provide up-to-date information on fertility levels, nuptiality, sexual activity, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutritional status of mothers and young children, early childhood mortality and maternal mortality, maternal and child health, and awareness and behaviour regarding AIDS and other sexually transmitted diseases. The 1999 ZDHS is a follow-up of the 1988 and 1994 ZDHS surveys, also implemented by CSO. The 1999 ZDHS is significantly expanded in scope and provides updated estimates of basic demographic and health indicators covered in the earlier surveys. KEY RESULTS Like the 1988 ZDHS and the 1994 ZDHS, the 1999 ZDHS was designed to provide information on levels and trends in fertility, family planning knowledge and use, infant and child mortality, and maternal and child health. Specific questions were also asked about the respondent's knowledge, attitude, and practice regarding the HIV/AIDS virus and other sexually transmitted diseases. Like the1994 ZDHS, the 1999 ZDHS also collected data on mortality related to pregnancy and childbearing (i.e., maternal mortality). The ZDHS data are intended for use by programme managers and policymakers to evaluate and improve family planning and health programmes in Zimbabwe. Fertility. The 1988, 1994, and 1999 ZDHS results show that Zimbabwe continues to experience a fairly rapid decline in fertility. Marriage. The median age at first marriage in Zimbabwe has risen slowly over the past 30 years. Women age 20-24 marry about one year later than women 40-49 (19.7 years and 18.8 years, respectively). The proportion of women married by age 15 declined from 9 percent among those age 45-49 to 2 percent among women age 15-19 years. Polygyny. One in six women in Zimbabwe reported being in a polygynous union. Fertility Preferences. More than half (53 percent) of the married women in Zimbabwe would like to have another child. Family Planning. Since 1994, knowledge of family planning in Zimbabwe has been universal and has not varied across subgroups of the population. The pill, condoms, and injectables are the most widely known methods. Antenatal Care. Utilisation of antenatal services is high in Zimbabwe; in the five years before the survey, mothers received antenatal care from a trained medical professional for 93 percent of their most recent births; 13 percent from a doctor and 80 percent from a trained nurse or a midwife. Delivery Characteristics. In 1999, the percentage of births delivered in health facilities (72 percent) was slightly higher than the percentage recorded in the 1994 ZDHS (69 percent). Childhood Vaccination. Three in four children 12-23 months have been vaccinated against six diseases (tuberculosis, diphtheria, pertussis, tetanus, polio, and measles). Two in three children completed the vaccination schedule by the time they turned one year. Childhood Diseases. In the 1999 ZDHS, mothers were asked whether their children under the age of five years had been ill with a cough accompanied by short, rapid breathing in the two weeks preceding the survey. Childhood Mortality. Data from surveys since 1988 indicate that early childhood mortality in Zimbabwe declined until the late 1980s, after which there was stagnation and an upward trend in the past five years. Adult and Maternal Mortality. As in 1994, the 1999 ZDHS collected information that allows estimation of adult and maternal mortality. Perceived Problems in Accessing Women's Health Care. Women are sometimes perceived to have problems in seeking health care services for themselves. Nutrition. Breastfeeding is nearly universal in Zimbabwe; 98 percent of the children born in the past five years were breastfed at some time. AIDS-related Knowledge and Behaviour. Although practically all Zimbabwean women and men have heard of AIDS, the quality of that knowledge is sometimes poor; 17 percent of women and 7 percent of men could not cite a single means to avoid getting HIV/AIDS.

Zimbabwe ZW: Domestic Private Health Expenditure Per Capita: Current Price data was reported at 0.000 USD mn in 2015. This records an increase from the previous number of 0.000 USD mn for 2014. Zimbabwe ZW: Domestic Private Health Expenditure Per Capita: Current Price data is updated yearly, averaging 0.000 USD mn from Dec 2010 (Median) to 2015, with 6 observations. The data reached an all-time high of 0.000 USD mn in 2010 and a record low of 0.000 USD mn in 2013. Zimbabwe ZW: Domestic Private Health Expenditure Per Capita: Current Price data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Zimbabwe – Table ZW.World Bank: Health Statistics. Current private expenditures on health per capita expressed in current US dollars. Domestic private sources include funds from households, corporations and non-profit organizations. Such expenditures can be either prepaid to voluntary health insurance or paid directly to healthcare providers.; ; World Health Organization Global Health Expenditure database (http://apps.who.int/nha/database).; Weighted Average;

Background Routine antibiotic prophylaxis following snakebite is not recommended but evidence suggests that it may be common practice in Zimbabwe. This study set out to determine and describe the extent of this practice at Parirenyatwa Hospital, a large teaching hospital in Zimbabwe

   Methods
   A retrospective case review (1996 to 1999 inclusive) of all cases of snakebite was undertaken at Parirenyatwa Hospital. Cases with a diagnosis of snakebite, presenting within 24 hours of the bite and with no complications or concurrent illness were defined as "routine prophylactic antibiotic use".


   Results
   From 78 cases which satisfied the inclusion criteria, 69 (88.5%) received antibiotics. Ten different antibiotics from 6 different classes were used with penicillins the most commonly prescribed (benzylpenicillin in 29% of cases, alone or in combination). Over 40% of antibiotics were given parenterally although all patients were conscious on admission. The total cost of antibiotics used was estimated at US$522.98.


   Conclusion
   Routine prophylactic use of antibiotics in snakebite at Parirenyatwa Hospital is common practice. This may highlight the lack of a clearly defined policy leading to wasteful inappropriate antibiotic use which is costly and may promote bacterial antibiotic resistance. Further work is required to investigate the reasons for this practice and to design appropriate interventions to counter it.

Analysis unit

Woman, Birth, Child, Birth, Man, Household Member

Universe

Women age 15-49, Births, Children age 0-4, Men age 15-54, All persons

Kind of data

Demographic and Health Survey [hh/dhs]

Sampling procedure

MICRODATA SOURCE: Zimbabwe National Statistics Agency and ICF International.

SAMPLE UNIT: Woman SAMPLE SIZE: 9955

SAMPLE UNIT: Birth SAMPLE SIZE: 20791

SAMPLE UNIT: Child SAMPLE SIZE: 6132

SAMPLE UNIT: Man SAMPLE SIZE: 8396

SAMPLE UNIT: Member SAMPLE SIZE: 43706

Mode of data collection

Face-to-face [f2f]

Abstract

The program has three components: (i) results-based contracting; (ii) management and capacity building; and (iii) monitoring.

Under the first component, a portion of financing received by health facilities depends on the quantity and quality of services, with a focus on maternal and child health. User fees have also been abolished on a package of services in districts, with the aim of improving access to care.

The impact evaluation was designed to inform several policy questions including the effects of the RBF pilot program on the utilization and quality of maternal and child health services as well as its effects on health system functioning. The impact evaluation comprised quantitative and qualitative approaches. The evaluation investigated the impact of RBF over a broad range of targeted and non-incentivized services related to maternal and child health services.

Geographic coverage

National

Analysis unit

• Household
• Facility

Universe

The 32 districts were purposively sampled from a universe of 64 districts in Zimbabwe and then pair-matched on predetermined, observable characteristics.

Kind of data

Sample survey data [ssd]

Sampling procedure

The process evaluation applied a retrospective study design and a theory-based evaluation approach that made use of sequential mixed methods. The retrospective design allowed for classification of observations according to the outcomes of interest and retrospectively assessing their exposure and interaction with specific study factors, e.g., contextual factors and intervention design factors. This is facilitated by the theory-based evaluation approach, which examines the interaction between the context, the actors, and the intervention, and then attempts to explain how this interaction works to produce the outcomes of the intervention by interrogating the intervention’s formal theory of change. The theory-driven approach sought to explore the influence of contextual factors on interventions and its outcomes through tracking and validating the program impact pathways.

The DHE (District Health Executives) team members, facility managers, health workers, HCCs and health facility catchment communities within World Bank funded RBF districts constituted the sampling frame from which respondents were purposively drawn to participate in a qualitative inquiry. A multistage sampling approach was used to select the Province, Districts, Facilities and Community Members with each using Purposive Sampling although each had varying “purposes” or specific reasons for selection. The cascade sampling first selected three provinces from the eight rural provinces in which RBF operated. The criteria for selection was based on geographic spread to ensure representation from each geo-region. Then within each of the three selected provinces, one or two districts were selected based on their identification as cases of interest by the project implementing entity. A total of four districts were selected.

Finally, the third stage of sampling involved the selection of one high- and one low-performing facility from each selected district. Of note is that the facilities were in part selected based on performance as defined by their actual earnings relative to expected earnings. The classification of performance therefore entailed initially assessing facility performance using quantitative methods and then proceeding to obtain primary qualitative data. The research team collected primary data through in-depth interviews, focus group discussions, and group interviews. The basic principles of analyzing qualitative data were applied. In particular, the processing of data for each facility made use of a desktop matrix analysis of themes drawn from both the conceptual framework and others emerging from transcripts. A comparison of these qualitative data across facilities enabled the research team to identify trends across facilities and to interpret the findings.

Mode of data collection

Face-to-face [f2f]

Research instrument

Zimbabwe's Health Results-Based Financing Impact Evaluation (Household Survey) 2014 has two structured questionnaires (available in English and downloadable under the "Resources" tab):

1. Woman Questionnaire a. Cover page b. Table of contents c. Consent d. Knowledge on maternal health e. Reproduction f. Contraception g. Trust in health services h. HIV/AIDS and other i. Pregnancy and postnatal care j. Maternal mental health k. Interviewer's Observations

2. Household Questionnaire a. Cover page b. Table of contents c. Consent form d. HH roster e. Economic activities f. HH characteristics g. Health status and utilization h. Growth monitoring i. Child immunization, health and nutrition j. Weight, height and MUAC measurement k. Interviewer's observation

Abstract

The Central Statistical Office (CSO) conducted the third Zimbabwe Demographic and Health Survey (ZDHS) between August and November 1999. The 1999 Zimbabwe Demographic and Health Survey (ZDHS) is a nationally representative survey that was implemented by the Central Statistical Office (CSO) from August to November 1999. Although significantly expanded in content, the 1999 ZDHS is a follow-on to the 1988 and 1994 ZDHS surveys and provides updated estimates of the basic demographic and health indicators covered in the earlier surveys. The 1999 ZDHS was conducted in all of the ten provinces of Zimbabwe.

The 1999 Zimbabwe Demographic and Health Survey (ZDHS) is one of a series of surveys undertaken by the Central Statistical Office (CSO) as part of the Zimbabwe National Household Survey Capability Programme (ZNHSCP) and the worldwide MEASURE DHS+ programme. The Zimbabwe National Family Planning Council (ZNFPC), the Department of Population Studies of the University of Zimbabwe (UZ), the National AIDS Coordinating Programme (NACP), and the Ministry of Health and Child Welfare (MOH&CW) contributed significantly to the design, implementation, and analysis of the ZDHS results. The U.S. Agency for International Development (USAID) provided funds for the implementation of the 1999 ZDHS. Macro International Inc. provided technical assistance through its contract with USAID. UNICEF/Zimbabwe supported the survey by providing additional funds for fieldwork transportation.

The primary objectives of the 1999 ZDHS were to provide up-to-date information on fertility levels, nuptiality, sexual activity, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutritional status of mothers and young children, early childhood mortality and maternal mortality, maternal and child health, and awareness and behaviour regarding AIDS and other sexually transmitted diseases.

The 1999 ZDHS is a follow-up of the 1988 and 1994 ZDHS surveys, also implemented by CSO. The 1999 ZDHS is significantly expanded in scope and provides updated estimates of basic demographic and health indicators covered in the earlier surveys.

KEY RESULTS

Like the 1988 ZDHS and the 1994 ZDHS, the 1999 ZDHS was designed to provide information on levels and trends in fertility, family planning knowledge and use, infant and child mortality, and maternal and child health. Specific questions were also asked about the respondent's knowledge, attitude, and practice regarding the HIV/AIDS virus and other sexually transmitted diseases. Like the1994 ZDHS, the 1999 ZDHS also collected data on mortality related to pregnancy and childbearing (i.e., maternal mortality). The ZDHS data are intended for use by programme managers and policymakers to evaluate and improve family planning and health programmes in Zimbabwe.

• Fertility. The 1988, 1994, and 1999 ZDHS results show that Zimbabwe continues to experience a fairly rapid decline in fertility.
• Marriage. The median age at first marriage in Zimbabwe has risen slowly over the past 30 years. Women age 20-24 marry about one year later than women 40-49 (19.7 years and 18.8 years, respectively). The proportion of women married by age 15 declined from 9 percent among those age 45-49 to 2 percent among women age 15-19 years.
• Polygyny. One in six women in Zimbabwe reported being in a polygynous union.
• Fertility Preferences. More than half (53 percent) of the married women in Zimbabwe would like to have another child.
• Family Planning. Since 1994, knowledge of family planning in Zimbabwe has been universal and has not varied across subgroups of the population. The pill, condoms, and injectables are the most widely known methods.
• Antenatal Care. Utilisation of antenatal services is high in Zimbabwe; in the five years before the survey, mothers received antenatal care from a trained medical professional for 93 percent of their most recent births; 13 percent from a doctor and 80 percent from a trained nurse or a midwife.
• Delivery Characteristics. In 1999, the percentage of births delivered in health facilities (72 percent) was slightly higher than the percentage recorded in the 1994 ZDHS (69 percent).
• Childhood Vaccination. Three in four children 12-23 months have been vaccinated against six diseases (tuberculosis, diphtheria, pertussis, tetanus, polio, and measles). Two in three children completed the vaccination schedule by the time they turned one year.
• Childhood Diseases. In the 1999 ZDHS, mothers were asked whether their children under the age of five years had been ill with a cough accompanied by short, rapid breathing in the two weeks preceding the survey.
• Childhood Mortality. Data from surveys since 1988 indicate that early childhood mortality in Zimbabwe declined until the late 1980s, after which there was stagnation and an upward trend in the past five years.
• Adult and Maternal Mortality. As in 1994, the 1999 ZDHS collected information that allows estimation of adult and maternal mortality.
• Perceived Problems in Accessing Women's Health Care. Women are sometimes perceived to have problems in seeking health care services for themselves.
• Nutrition. Breastfeeding is nearly universal in Zimbabwe; 98 percent of the children born in the past five years were breastfed at some time.
• AIDS-related Knowledge and Behaviour. Although practically all Zimbabwean women and men have heard of AIDS, the quality of that knowledge is sometimes poor; 17 percent of women and 7 percent of men could not cite a single means to avoid getting HIV/AIDS.

Geographic coverage

The 1999 Zimbabwe Demographic and Health Survey (ZDHS) is a nationally representative survey that was implemented by the Central Statistical Office (CSO) from August to November 1999. The survey was conducted in all of the ten provinces of Zimbabwe.

Analysis unit

• Household
• Women age 15-49
• Men age 15-54
• Children under five years

Universe

The population covered by the 1994 ZDHS is defined as the universe of all women age 15-49 in Zimbabwe and all men age 15-54 living in the household.

Kind of data

Sample survey data

Sampling procedure

The sampling frame used for the 1999 ZDHS was the 1992 Zimbabwe Master Sample (ZMS92) developed by the CSO after the 1992 Population Census. The same enumeration areas (EAs) of the 1994 ZDHS were used in the 1999 ZDHS. The ZMS92 included 395 enumeration areas stratified by province and land use sector. For purposes of the ZDHS, 18 sampling strata were identified: urban and rural strata for each of the eight provinces, and Harare (including Chitungwiza) and Bulawayo provinces, which are exclusively urban strata.

The sample for the 1999 ZDHS was selected in two stages. In the first stage, 230 EAs were selected with equal probability. Then, within each of these 230 EAs, a complete household listing and mapping exercise was conducted in May 1999, forming the basis for the second-stage sampling. For the listing exercise, permanent CSO enumerators were trained in listing and cartographic methods. All private households were listed. The list excluded people living in institutional households (army barracks, hospitals, police camps, etc.).

Households to be included in the ZDHS were selected from the EA household lists, with the sample being proportional to the total number of households in the EA. All women age 15-49 years in those households were eligible to be interviewed in the ZDHS. Furthermore, a 50 percent systematic subsample of these households was selected, within which interviews with all males age 15-54 years were to be conducted as well.

Since the objective of the survey was to produce estimates of specific demographic and health indicators for each of the 10 provinces, the sample design allowed for an oversample of smaller strata. The overall target sample was 6,208 women and 2,970 men. The ZDHS sample is not self-weighting at the national level (i.e., weights are required to estimate national-level indicators).

Mode of data collection

Face-to-face

Research instrument

Four types of questionnaires were used for the ZDHS: the Household Questionnaire, the Women's Questionnaire, the Men's Questionnaire, and the Cluster Location form. The contents of these questionnaires were based on the DHS Model “A” Questionnaire, which is designed for use in countries with moderate to high levels of contraceptive use.

a) The Household Questionnaire was used to list all the usual members and visitors of selected households. Some basic information was collected on characteristics of each person listed, including his/her age, sex, education, and relationship to the head of the household. The main purpose of the Household Questionnaire was to identify women and men who were eligible for the individual interview. The Household Questionnaire also collected information on characteristics of the household's dwelling units, such as the source of water, type of toilet facilities, materials used for the floor of the house, and ownership of various consumer and durable goods.

b) The Women's Questionnaire was used to collect information on women age 15-49 years. These women were asked questions on the following topics: Background characteristics (education, residential history, etc.) Reproductive history Knowledge and use of family planning methods Fertility preferences Antenatal and delivery care Breastfeeding and weaning practices Vaccinations and health of children under age five Marriage and sexual activity Woman's status and husband's occupation Awareness and behaviour regarding AIDS and other sexually transmitted diseases Adult mortality including maternal

Abstract

The 1994 Zimbabwe Demographic and Health Survey (ZDHS) is a nationally representative survey of 6,128 women age 15-49 and 2,141 men age 15-54. The ZDHS was implemented by the Central Statistical Office (CSO), with significant technical guidance provided by the Ministry of Health and Child Welfare (MOH&CW) and the Zimbabwe National Family Planning Council (ZNFPC). Macro International Inc. (U.S.A.) provided technical assistance throughout the course of the project in the context of the Demographic and Health Surveys (DHS) programme, while financial assistance was provided by the U.S, Agency for International Development (USAID/Harare). Data collection for the ZDHS was conducted from July to November 1994.

As in the 1988 ZDHS, the 1994 ZDHS was designed to provide information on levels and trends in fertility, family planning knowledge and use, infant and child mortality, and maternal and child health. How- ever, the 1994 ZDHS went further, collecting data on: compliance with contraceptive pill use, knowledge and behaviours related to AIDS and other sexually transmitted diseases, and mortality related to pregnancy and childbearing (i.e., maternal mortality). The ZDHS data are intended for use by programme managers and policymakers to evaluate and improve family planning and health programmes in Zimbabwe.

The primary objectives of the 1994 ZDHS were to provide up-to-date information on: fertility levels; nuptiality; sexual activity; fertility preferences; awareness and use of family planning methods; breastfeeding practices; nutritional status of mothers and young children; early childhood mortality and maternal mortality; maternal and child health, and awareness and behaviour regarding AIDS and other sexually transmitted diseases. The 1994 ZDHS is a follow-up of the 1988 ZDHS, also implemented by CSO. While significantly expanded in scope, the 1994 ZDHS provides updated estimates of basic demographic and health indicators covered in the earlier survey.

MAIN RESULTS

FERTILITY

Survey results show that Zimbabwe has experienced a fairly rapid decline in fertility over the past decade.

Despite the decline in fertility, childbearing still begins early for many women. One in five women age 15-19 has begun childbearing (i.e., has already given birth or is pregnant with her first child). More than half of women have had a child before age 20.

Births that occur too soon after a previous birth face higher risks of undemutrition, illness, and death. The 1994 ZDHS indicates that 12 percent of births in Zimbabwe take place less than two years after a prior birth.

Marriage. The age at which women and men marry has risen slowly over the past 20 years. Nineteen percent of currently married women are in a polygynous union (i.e., their husband has at least one other wife). This represents a small rise in polygyny since the 1988 ZDHS when 17 percent of married women were in polygynous unions.

Fertility Preferences. Around one-third of both women and men in Zimbabwe want no more children. The survey results show that, of births in the last three years, 1 in 10 was unwanted and in 1 in three was mistimed. If all unwanted births were avoided, the fertility rate in Zimbabwe would fall from 4.3 to 3.5 children per woman.

FAMILY PLANNING

Knowledge and use of family planning in Zimbabwe has continued to rise over the last several years. The 1994 ZDHS shows that virtually all married women (99 percent) and men (100 percent) were able to cite at least one modem method of contraception. Contraceptive use varies widely among geographic and socioeconomic subgroups. Fifty-eight per- cent of married women in Harare are using a modem method versus 28 percent in Manicaland. Government-sponsored providers remain the chief source of contraceptive methods in Zimbabwe. Survey results show that 15 percent of married women have an unmet need for family planning (either for spacing or limiting births).

CHILDHOOD MORTALITY

One of the main objectives of the ZDHS was to document the levels and trends in mortality among children under age five. The 1994 ZDHS results show that child survival prospects have not improved since the late 1980s. The ZDHS results show that childhood mortality is especially high when associated with two factors: short preceding birth interval and low level of maternal education.

MATERNAL AND CHILD HEALTH

Utilisation of antenatal services is high in Zimbabwe; in the three years before the survey, mothers received antenatal care for 93 percent of births. About 70 percent of births take place in health facilities; however, this figure varies from around 53 percent in Manicaland and Mashonaland Central to 94 percent in Bulawayo. It is important for the health of both the mother and child that trained medical personnel are available in cases of prolonged or obstructed delivery, which are major causes of maternal morbidity and mortality. Twenty-four percent of children under age three were reported to have had diarrhoea in the two weeks preceding the survey.

Nutrition. Almost all children (99 percent) are breastfed for some period of time; When food supplementation begins, wide disparity exists in the types of food received by children in different geographic and socioecoaomic groups. Generally, children living in urban areas (Harare and Bulawayo, in particular) and children of more educated women receive protein-rich foods (e.g., meat, eggs, etc.) on a more regular basis than other children.

AIDS

AIDS-related Knowledge and Behaviour. All but a fraction of Zimbabwean women and men have heard of AIDS, but the quality of that knowledge is sometimes poor. Condom use and limiting the number of sexual partners were cited most frequently by both women and men as ways to avoid the AIDS Virus. While general knowledge of condoms is nearly universal among both women and men, when asked where they could get a condom, 30 Percent of women and 20 percent of men could not cite a single source.

Geographic coverage

The 1994 Zimbabwe Demographic and Health Survey (ZDHS) is a nationally representative survey.

Analysis unit

• Household
• Women age 15-49
• Men age 15-54
• Children under five years

Universe

The population covered by the 1994 ZDHS is defined as the universe of all women age 15-49 in Zimbabwe and all men age 15-54 living in the household.

Kind of data

Sample survey data

Sampling procedure

SAMPLING FRAME

The area sampling frame for the ZDHS was the 1992 Zimbabwe Master Sample (ZMS92), which was developed by the Central Statistical Office (CSO) following the 1992 Population Census for use in demographic and socio-economic surveys. The sample for ZMS92 was designed to be almost nationally representative: people residing on state land (national parks, safari areas, etc.) and in institutions, which account for less than one percent of the total population, were not included. The sample was stratified and selected in two stages. With the exception of Harare and Bulawayo, each of the other eight provinces in the country was stratified into four groups according to land use: communal land, large-scale farming, urban and semi-urban areas, and small scale fanning and resettlement areas. In Harare and Bulawayo, only an urban stratum was formed.

The primary sampling unit (PSU) was the enumeration area (EA), as defined in the 1992 Population Census. A total of 395 EAs were selected with probability proportional to size, the size being the number of households enumerated in the 1992 Population Census. The selection of the EAs was a systematic, one- stage operation, carried out independently for each of 34 strata. In each stratum, implicit stratification was introduced by ordering the EAs geographically within the hierarchy of administrative units (wards and districts within provinces).

An evaluation of the ZMS92 showed that it oversampled urban areas: in the ZMS92 the proportion of urban households is about 36 percent while, according to the preliminary results of the 1992 Population Census, this proportion is about 32 percent.

CHARACTERISTICS OF THE ZDHS SAMPLE

The sample for the ZDHS was selected from the ZMS92 master sample in two stages. In the first stage, 230 EAs were selected with equal probabilities. Since the EAs in the ZMS92 master sample were selected with probability proportional to size from the sampling frame, equal probability selection of a subsample of these EAs for the ZDHS was equivalent to selection with probability proportional to size from the entire sampling frame. A complete listing of the households in the selected EAs was carried out. The list of households obtained was used as the frame for the second-stage sampling, which was the selection of the households to be visited by the ZDHS interviewing teams during the main survey fieldwork. Women between the ages of 15 and 49 were identified in these households and interviewed. In 40 percent of the households selected for the main survey, men between the ages of 15 and 54 were interviewed with a male questionnaire.

SAMPLE ALLOCATION

Stratification in the ZDHS consisted of grouping the ZMS92 strata into two main strata only: urban and rural. Thus the ZDHS rural stratum consists of communal land, large scale farming, and small scale farming and resettlement areas, while the ZDHS urban stratum corresponds exactly to the urban/semi-urban stratum of the ZMS92.

The proportional allocation would result in a completely self-weighting sample but did not allow for reliable estimates for provinces. Results of other demographic and health surveys show that a minimum sample of 1,000 women i:; required in order to obtain estimates of fertility and childhood mortality rates at an acceptable level of sampling errors. Given that the total sample

Analysis unit

Woman, Birth, Child, Birth, Man, Household Member

Universe

Women age 15-49, Births, Children age 0-4, Men age 15-54, All persons

Kind of data

Demographic and Health Survey [hh/dhs]

Sampling procedure

MICRODATA SOURCE: Zimbabwe National Statistics Agency (ZIMSTAT) and ICF International.

SAMPLE UNIT: Woman SAMPLE SIZE: 9171

SAMPLE UNIT: Birth SAMPLE SIZE: 19279

SAMPLE UNIT: Child SAMPLE SIZE: 5563

SAMPLE UNIT: Man SAMPLE SIZE: 7480

SAMPLE UNIT: Member SAMPLE SIZE: 41946

Mode of data collection

Face-to-face [f2f]

This scatter chart displays health expenditure (% of GDP) against population (people) in Zimbabwe. The data is filtered where the date is 2021. The data is about countries per year.