Demographic and Health Survey 2021-2022
Cambodia, 2021 - 2022
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KHM_2021_DHS_v01_M
Demographic and Health Survey 2021-2022
| Name | Country code |
|---|---|
| Cambodia | KHM |
Demographic and Health Survey [hh/dhs]
The 2021-22 Cambodia Demographic and Health Survey (2021-22 CDHS) is the fifth of its kind following the ones conducted in 2000, 2005, 2010, and 2014. The 2021-22 CDHS incorporated a nationally representative sample of 21,270 households selected from 709 sample clusters.
The primary objective of the 2021-22 CDHS is to provide up-to-date estimates of basic demographic and health indicators. Specifically, the survey collected information on fertility, awareness and use of family planning methods, breastfeeding practices, nutritional status of women and children, maternal and child health, adult and childhood mortality, women’s empowerment, domestic violence, awareness and behavior regarding HIV/AIDS and other sexually transmitted infections (STIs), and other health-related issues such as smoking.
The information collected through the 2021-22 CDHS is intended to assist policymakers and program managers in evaluating and designing programs and strategies for improving the health of Cambodia’s population. The survey also provides data on indicators relevant to the Sustainable Development Goals (SDGs) for Cambodia.
Sample survey data [ssd]
- Household
- Individual
- Children age 0-5
- Woman age 15-49
- Man age 15 to 49
Version
The data dictionary was generated from hierarchical data that was downloaded from the The DHS Program website (http://dhsprogram.com).
- Contract Phase: DHS-VIII
- Recode Structure: DHS-VIII
Scope
The 2021-22 Cambodia Demographic and Health Survey covered the following topics:
HOUSEHOLD
• Identification
• Usual members and visitors in the selected households
• Background information on each person listed, such as relationship to head of the household, age, sex, marital status,survivorship and residence of biological parents, educational attainment, birth registration, and disability
• Characteristics of the household's dwelling unit, such as the source of water (dry and wet seasons), type of toilet facilities and where it is located, type of fuel used for cooking, main source of light for the home, number of rooms, ownership of livestock, possessions of durable goods, any member of household has an account in a bank or other financial institution, and main material for the floor, roof and walls of the dwelling.
INDIVIDUAL WOMAN
• Identification
• Background characteristics (including age, education, and media exposure)
• Pregnancy history and child mortality
• Knowledge, use, and source of family planning methods
• Antenatal, delivery, and postnatal care
• Vaccinations and childhood illnesses
• Breastfeeding and infant feeding practices
• Women’s minimum dietary diversity
• Marriage and sexual activity
• Fertility preferences (including desire for more children and ideal number of children)
• Women’s work and husbands’ background characteristics
• Knowledge, awareness, and behavior regarding HIV/AIDS and other sexually transmitted infections (STIs)
• Knowledge, attitudes, and behavior related to other health issues (for example, smoking)
• Adult and maternal mortality
• Domestic violence
MAN
• Identification
• Background characteristics
• Reproduction
• Contraception
• Marriage and sexual activity
• Fertility preferences
• Employment and gender roles
• HIV/AIDS
• Other health issues
BIOMARKER
• Identification
• Weight, height, and hemoglobin measurement for children age 0-4
• Weight, height, and hemoglobin measurement for women age 15-49
FIELDWORKER
• Background information on each fieldworkers
Coverage
National coverage
The survey covered all de jure household members (usual residents), all women aged 15-49, all men age 15-49, and all children aged 0-4 resident in the household.
Producers and sponsors
| Name | Affiliation |
|---|---|
| National Institute of Statistics (NIS) | Royal Government of Cambodia |
| Name | Affiliation | Role |
|---|---|---|
| Cambodia Ministry of Health | Royal Government of Cambodia | Collaborated in the implementation of the survey |
| ICF | The DHS Program | Provided technical assistance through The DHS Program |
| Name | Role |
|---|---|
| Royal Government of Cambodia | Funding |
| United States Agency for International Development | Funding |
| Deutsche Gesellschaft für Internationale Zusammenarbeit | Funding |
| Australian Aid | Funding |
| United Nations Population Fund | Funding |
| United Nations Children’s Fund | Funding |
| World Food Programme | Funding |
Sampling
Sample frame
The sampling frame used for the 2021-22 CDHS is the 2019 General Population Census (GPC) of Cambodia, which was conducted by the NIS. The sampling frame is a complete list of enumeration areas (EAs) covering the entire country provided by the NIS, the implementing agency for the CDHS. An EA is a natural village-or part of a village-created for the 2019 GPC that served as the counting unit for the census.
The 2021–22 CDHS followed a two-stage sample design and was intended to allow estimates of key indicators at the national level as well as for urban and rural areas and each of Cambodia’s 25 provinces. The first stage involved the selection of sample points (clusters) consisting of EAs delineated for the 2019 GPC. A total of 709 clusters were selected, 241 in urban areas and 468 in rural areas. (The 2019 GPC reclassified about 20% of rural EAs as urban EAs.)
The second stage involved systematic sampling of households. A household listing operation was undertaken in all selected EAs from April to August 2021, and households to be included in the survey were randomly selected from these lists. Thirty households were selected from each cluster, for a total sample size of 21,270 households. Because of the approximately equal sample sizes in each province, the sample is not self-weighting at the national level, and weighting factors have been calculated and added to the data file so that the results will be proportional at the national level.
All women age 15-49 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. In half of the households, all men age 15-49 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. In the subsample of households not selected for the male survey, height, weight, and mid-upper-arm circumference measurements were performed among women age 15-49 and children under age 5.
For further details on sample selection, see Appendix A of the final report.
A total of 21,270 households were selected for the CDHS sample, of which 20,967 were found to be occupied. Of the occupied households, 20,806 were successfully interviewed, yielding a response rate of 99%. In the interviewed households, 19,845 women age 15-49 were identified as eligible for individual interviews. Interviews were completed with 19,496 women, yielding a response rate of 98%. In the subsample of households selected for the male survey, 9,079 men age 15-49 were identified as eligible for individual interviews and 8,825 were successfully interviewed, yielding a response rate of 97%.
Sampling weights were adjusted for household nonresponse as well as for individual nonresponse to calculate the survey weights. A spreadsheet containing all sampling parameters and selection probabilities was prepared to facilitate the calculation of survey weights. Several sets of survey weights were calculated:
• one set for all households and for the women’s individual survey
• one set for households selected for the male survey and for the male individual survey
• one set for women selected for the domestic violence survey
The differences between the household weights and the individual weights are introduced by individual nonresponse. The domestic violence weight takes the number of eligible women in the household into account because of the selection of only one woman per household. The final survey weights were normalized so that the total number of unweighted cases was equal to the total number of weighted cases at the national level. The normalized weights are relative weights which are valid for estimating means, proportions, and ratios, but not valid for estimating population totals and for pooled data.
Sampling errors were calculated for selected indicators for the national sample, for urban and rural areas separately, and for each of the 25 provinces.
For further details on sampling weights, see Appendix A.4 of the final report.
Survey instrument
Four questionnaires were used in the 2021-22 CDHS: the Household Questionnaire, the Woman’s Questionnaire, the Man’s Questionnaire, and the Biomarker Questionnaire. The questionnaires, based on The DHS Program’s model questionnaires, were adapted to reflect the population and health issues relevant to Cambodia. In addition, a self-administered Fieldworker Questionnaire collected information about the survey’s fieldworkers.
Data collection
| Start | End |
|---|---|
| 2021-09 | 2022-02 |
- Computer Assisted Personal Interview [capi]
| Name | Affiliation |
|---|---|
| National Institute of Statistics | Royal Government of Cambodia |
Data collection was carried out by 25 field teams. Each team was provided a driver and a four-wheel-drive vehicle. Coordinators from the NIS and MoH coordinated and supervised fieldwork activities. ICF provided virtual technical assistance during the data collection period. The fieldwork began on September 15, 2021, in all 25 provinces, with each field team responsible for one province. The teams were closely monitored for quality control by the five field coordinators. There were instances when teams had to change their planned routing or to pause field activities due to COVID-19 outbreaks in their provinces. Data collection was completed on February 15, 2022.
Fieldwork monitoring was an integral part of the 2021-22 CDHS and was carried out during field data collection by the NIS, the MoH, and, virtually, ICF. NIS and MoH coordinators were equipped with monitoring guidelines. Every week the NIS and ICF generated field check tables from the completed interview data to monitor data quality and fieldwork progress. Feedback was regularly provided to the coordinators and the field teams.
Data processing
The processing of the 2021-22 CDHS data began as soon as the fieldwork started. When data collection was completed in each cluster, the electronic data files were transferred via the IFSS to the NIS central office in Phnom Penh. The data files were registered and checked for inconsistencies, incompleteness, and outliers. Errors and inconsistencies were communicated to the field teams for review and correction. Secondary editing, done by NIS data processors, was carried out in the central office and included resolving inconsistencies and coding open-ended questions. The paper Biomarker Questionnaires were collected by field coordinators and then compared with the electronic data files to assess whether any inconsistencies arose during data entry. Data processing and editing were carried out using the CSPro software package. The concurrent data collection and processing offered an advantage because it maximized the likelihood of the data being error-free. Timely generation of field check tables allowed for effective monitoring. The secondary editing of the data was completed in March 2022.
Data appraisal
The estimates from a sample survey are affected by two types of errors: (1) nonsampling errors and (2) sampling errors. Nonsampling errors are errors that were made during data collection and data processing such as failure to locate and interview the correct household, misunderstanding of the questions by either the interviewer or the respondent, and data entry errors. Although numerous efforts were made during the implementation of the 2021-22 Cambodia Demographic and Health Survey (CDHS) to minimize this type of error, nonsampling errors are impossible to eliminate completely and difficult to evaluate statistically.
Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents selected in the 2021-22 CDHS is only one of many possible samples that could have been selected from the same population, using exactly the same design. Each of those 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.
A 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% 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 2021-22 CDHS sample was the result of a multistage stratified design, and, consequently, it was necessary to use more complex formulas. The computer software used to calculate sampling errors for the 2021-22 CDHS was an SAS program. This program used the Taylor linearization method for estimate variances for survey estimates that are means or proportions. The Jackknife repeated replication method is used for variance estimation of more complex statistics such as fertility and mortality rates.
A more detailed description of estimates of sampling errors are presented in APPENDIX B of the survey report.
Data Quality Tables
- Household age distribution
- Age distribution of eligible and interviewed women
- Age distribution of eligible and interviewed men
- Age displacement at age 14/15
- Age displacement at age 49/50
- Pregnancy outcomes by years preceding the survey
- Completeness of reporting
- Height and weight data completeness and quality for children
- Height measurements from random subsample of measured children
- Interference in height and weight measurements of children
- Interference in height and weight measurements of women
- Heaping in anthropometric measurements for children (digit preference)
- Observation of handwashing facility
- School attendance by single-year age
- Vaccination cards photographed
- Number of enumeration areas completed by month and province
- Sibship size and sex ratio of siblings
- Pregnancy-related mortality trends
- Pregnancy-related mortality
See details of the data quality tables in Appendix C of the final report.
Data Access
| Name | URL |
|---|---|
| The DHS Program | http://dhsprogram.com |
Request Dataset Access
The following applies to DHS, MIS, AIS and SPA survey datasets (Surveys, GPS, and HIV).
To request dataset access, you must first be a registered user of the website. You must then create a new research project request. The request must include a project title and a description of the analysis you propose to perform with the data.
The requested data should only be used for the purpose of the research or study. To request the same or different data for another purpose, a new research project request should be submitted. The DHS Program will normally review all data requests within 24 hours (Monday - Friday) and provide notification if access has been granted or additional project information is needed before access can be granted.
DATASET ACCESS APPROVAL PROCESS
Access to DHS, MIS, AIS and SPA survey datasets (Surveys, HIV, and GPS) is requested and granted by country. This means that when approved, full access is granted to all unrestricted survey datasets for that country. Access to HIV and GIS datasets requires an online acknowledgment of the conditions of use.
Required Information
A dataset request must include contact information, a research project title, and a description of the analysis you propose to perform with the data.
Restricted Datasets
A few datasets are restricted and these are noted. Access to restricted datasets is requested online as with other datasets. An additional consent form is required for some datasets, and the form will be emailed to you upon authorization of your account. For other restricted surveys, permission must be granted by the appropriate implementing organizations, before The DHS Program can grant access. You will be emailed the information for contacting the implementing organizations. A few restricted surveys are authorized directly within The DHS Program, upon receipt of an email request.
When The DHS Program receives authorization from the appropriate organizations, the user will be contacted, and the datasets made available by secure FTP.
GPS/HIV Datasets/Other Biomarkers
Because of the sensitive nature of GPS, HIV and other biomarkers datasets, permission to access these datasets requires that you accept a Terms of Use Statement. After selecting GPS/HIV/Other Biomarkers datasets, the user is presented with a consent form which should be signed electronically by entering the password for the user's account.
Dataset Terms of Use
Once downloaded, the datasets must not be passed on to other researchers without the written consent of The DHS Program. All reports and publications based on the requested data must be sent to The DHS Program Data Archive in a Portable Document Format (pdf) or a printed hard copy.
Download Datasets
Datasets are made available for download by survey. You will be presented with a list of surveys for which you have been granted dataset access. After selecting a survey, a list of all available datasets for that survey will be displayed, including all survey, GPS, and HIV data files. However, only data types for which you have been granted access will be accessible. To download, simply click on the files that you wish to download and a "File Download" prompt will guide you through the remaining steps.
Disclaimer and copyrights
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
Contacts
| Name | Affiliation | |
|---|---|---|
| Information about The DHS Program | The DHS Program | reports@DHSprogram.com |
| General Inquiries | The DHS Program | info@dhsprogram.com |
| Data and Data Related Resources | The DHS Program | archive@dhsprogram.com |
Metadata production
DDI_KHM_2021_DHS_v01_M_WB
| Name | Affiliation | Role |
|---|---|---|
| Development Economics Data Group | The World Bank | Documentation of the DDI |
2023-04-05
Metadata version
Version 01 (April 2023). Metadata is excerpted from "Cambodia Demographic and Health Survey 2021 - 2022" final report.