The 2000 Cambodia Demographic and Health Survey is the first survey of this type conducted in Cambodia.
The Cambodia Demographic and Health Survey 2000 (CDHS) is the first nationally representative survey ever conducted in Cambodia on population and health issues. The primary objective of the survey is to provide the Ministry of Health, Ministry of Planning (MoP), and other relevant institutions and users with updated and reliable data on infant and child mortality, fertility preferences, family planning behavior, maternal mortality, utilization of maternal and child health services, health expenditures, women’s status, domestic violence, and knowledge and behavior regarding AIDS and other sexually transmitted infections (STIs). This information contributes to policy decisions, planning, monitoring, and program evaluation for the development of Cambodia, at both national- and local-government levels.
The long-term objectives of the survey are to technically strengthen the capacity both of the Ministry of Health and the National Institute of Statistics (NIS) of MoP for planning, conducting, and analyzing the results of further surveys.
The CDHS 2000 survey was conducted by the National Institute of Statistics of the Ministry of Planning, and the Ministry of Health. The CDHS executive committee and technical committee were established to oversee all technical aspects of implementation. They consisted of representatives from the Ministry of Health, the Ministry of Planning, the National Institute of Statistics, the United Nations Population Fund (UNFPA), the United Nations Children’s Fund (UNICEF), and the U.S. Agency for International Development (USAID). ORC Macro provided technical assistance including sampling design, survey methodology, interviewer training, and data analysis through the MEASURE DHS+ project. Funding for the survey came from UNFPA, UNICEF, and USAID.
Kind of Data
Sample survey data [ssd]
Unit of Analysis
- Children under five years
- Women age 15-49
The 2000 Cambodia Demographic and Health Survey covers the following topics:
- Anemia Questions–Questions or testing assessing prevalence/severity of iron-def. anemia among women or children
- Anemia Testing
- Birth Registration
- Domestic Violence
- HIV Behavior
- HIV Knowledge–Questions assess knowledge/sources of knowledge/ways to avoid HIV
- Iodine salt test
- Maternal Mortality
- Vitamin A Questions
- Women's Status–Questions: women's autonomy (household decisionmaking/free movement/access money) & Dom. violence
Producers and sponsors
National Institute of Statistics
Ministry of Planning
Ministry of Health
United Nations Population Fund
United Nations Children's Fund
United State Agency for International Development
The CDHS survey called for a nationally representative sample of 15,300 women between the ages of 15 and 49. Survey estimates are produced for 12 individual provinces (Banteay Mean Chey, Kampong Cham, Kampong Chhnang, Kampong Spueu, Kampong Thum, Kandal, Kaoh Kong, Phnom Penh, Prey Veaeng, Pousat, Svay Rieng, and Takaev) and for the following 5 groups of provinces:
- Bat Dambang and Krong Pailin
- Kampot, Krong Preah Sihanouk, and Krong Kaeb
- Kracheh, Preah Vihear, and Stueng Traeng
- Mondol Kiri and Rotanak Kiri
- Otdar Mean Chey and Siem Reab.
The master sample developed in 1998 by the National Institute of Statistics served as the sampling frame for the CDHS survey. The master sample is based on the 1998 Cambodia General Population Census and consists of 600 villages selected with probability proportional to the number of households within the village. Villages are listed with the total population count and the number of enumeration areas (EAs), households, and segments. Enumeration areas were created during the cartography conducted in preparation for the 1998 census. A segment in a village corresponds to a block of about ten households. Segments were created only for villages retained in the master sample and maps showing their boundaries were also available for all of them.
The sample for the CDHS survey is a stratified sample selected in three stages. As for the master sample, stratification was achieved by separating every reporting domain into urban and rural areas. The sample was selected independently in every stratum.
The master sample contains a small number of villages for some of the provinces. For this reason, additional villages were directly selected from the census frame in order to reach the required sample size in these provinces. In the first stage, 471 villages were selected with probability proportional to the number of households in the village. Of these 471 villages, 63 were directly selected from the 1998 census frame. In the second stage, 5 or fewer segments were retained from each of the villages selected from the master sample, while 1 EA was retained from each of the 63 villages directly selected from the 1998 census frame. Each of these EAs consists of several segments.
A household listing was carried out in all selected segments and EAs, and the resulting lists of households served as the sampling frame for the selection of households in the third stage. All women 15-49 were interviewed in selected households.
In addition, a subsample of 50 percent of households was selected for data collection of anthropometry. Anemia testing was implemented in 25 percent of the sample. Only the women identified in the households with anemia testing were eligible for the section related to women's status. In this subsample of households, only one woman was selected in each household to be interviewed on domestic violence.
Note: See detailed description of sample design in APPENDIX A of the survey report.
A total of 12,810 households were selected in the sample, of which 12,475 were occupied at the time the fieldwork was carried out. Of the 12,475 occupied households, 12,236 were successfully interviewed, resulting in a household response rate of 98.1 percent. The main reason for the noninterviewed households was that those households no longer existed in the sampled clusters at the time of the interview.
A total of 15,558 women in these households were identified as women eligible to be interviewed. Questionnaires were then completed for 15,351 of those women, which represented a response rate of 98.7 percent. The principal reason for nonresponse among eligible women was a failure to find them at home despite repeated visits to their household.
Note: See summarized response rates by residence (urban/rural) in Table 1.2 of the survey report.
Dates of Data Collection
Data Collection Mode
Data Collection Notes
TRAINING AND FIELDWORK
Prior to the main survey, the pretest training and fieldwork were conducted in November and December 1999. Twenty-two interviewers (5 health staff from the MoH in Phnom Penh and 17 from provincial health departments) were trained to perform the pretest within three-week periods. The pretest fieldwork was carried out over a one-week period in both rural and urban areas and resulted in 240 completed pretest interviews. In addition, anemia testing and iodine testing for household salt were also included in the pretest. Debriefing sessions were held with the field staff and survey coordinators, and questionnaires were then modified based on the outcome of the pretest.
The training of the main survey was carried out from January 3 to February 9, 2000. Instruction on interviewing techniques, fieldwork procedures, and a detailed review of questionnaires section by section were thoroughly and clearly explained. In addition, in-class mock interviews among participants, anemia testing, and anthropometry practices were also performed. The practice of the main survey was conducted, in both rural and urban areas, at several locations. For practice purposes, anemia testing, weighing, and measuring children were carried out by team supervisors and field editors as well as team members at two kindergartens and an orphanage in Phnom Penh. The interviewing practices with real respondents took place in areas outside of the main sample. Moreover, during the practice period, team supervisors and field editors were additionally instructed in the procedures for contacting local authorities, editing filled-out questionnaires, and controlling data quality.
The CDHS data were collected by 17 teams, each consisting of a team supervisor, a field editor, and four female interviewers. Each team was in charge of data collection in one province or a group of provinces. Coordination and supervision of the interviewing activities were done by four survey coordinators and four supervisory staff members from the National Institute of Statistics/ MoP and the Ministry of Health. Data collection took place over a six-month period, from February to July 2000.
Two types of questionnaires were used in the CDHS 2000 survey: the Household Questionnaire and the Women’s questionnaire. The contents of these questionnaires were based on the international MEASURE DHS+ model. They were modified according to the situation in Cambodia and were designed to provide information needed by health and family planning program managers and policymakers, mainly the Ministry of Health, the Ministry of Planning, and other relevant institutions and organizations. The agencies involved in developing these questionnaires were the National Institute of Public Health/MoH, the National Institute of Statistics/MoP, UNFPA, UNICEF, USAID, WHO, Hellen Keller International, Marie Stopes International, the Ministry of Women’s Affairs, Project Against Domestic Violence, and the Demographic and Health Surveys (DHS) project of ORC Macro. The questionnaires were developed in English and then translated into Khmer. Back translation of the questionnaires, from Khmer to English, was also conducted.
The Household Questionnaire enumerated all the usual members and visitors of the selected households and collected information on the socioeconomic status of the households. The first part of the questionnaire collected information on the relationship of the persons to the head of household and items such as residence, sex, age, marital status, and level of education. This information was used to identify women who were eligible for the individual interview. The Household Questionnaire also contained information on the prevalence of accidents, physical impairment, illness, and health expenditures. Information was also collected on the dwelling units, including source of water, type of toilet facilities, fuels used for cooking, materials used for the house’s floor and roof, and ownership of a variety of consumer goods. In addition, during the household survey, anthropometry and anemia testing were carried out to determine nutritional status among children less than five years old and women age 15-49.
The Women’s Questionnaire collected information from all women age 15-49 on the following topics:-• Respondent’s background characteristics
- Contraceptin (knowledge and use of family planning)
- Pregnancy, antenatal care, delivery, and postnatal care
- Infant feeding practices, child immunization, and health
- Marriage and sexual activity
- Fertility preference
- Husband’s background characteristics and women’s work
- Knowledge of HIV/AIDS and other sexually transmitted infections
- Maternal mortality and adult mortality
- Women’s status
- Domestic violence (household relations module).
All completed questionnaires were brought to the National Institute of Statistics for data processing. Questionnaires were checked for the selected households and eligible respondents by the office editors. Moreover, the few questions that had not been precoded (e.g., occupation) were coded prior to data entry. Data were then entered and edited using the software package Integrated System for Survey Analysis (ISSA) developed specially for the Demographic and Health Survey program. Data entry and office editing commenced in February and was completed in October 2000. To provide feedback for the field teams, the office editors were instructed to report any problems found during the editing of questionnaires. These reports were reviewed by the senior staff. If serious errors were detected in one or more questionnaires from a cluster, the team’s supervisor working in the cluster was informed and advised of the measures to be taken to prevent these problems in the future.
Estimates of Sampling Error
The estimates from a sample survey are affected by two types of errors: 1) nonsampling errors, and 2) sampling errors. Nonsampling 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 2000 Cambodia Demographic and Health Survey (CDHS) to minimize this type of error, nonsampling 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 2000 Cambodia Demographic and Health Survey 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.
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 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 CDHS sample is the result of a multistage stratified design, and consequently, it was necessary to use more complex formulae. The computer software used to calculate sampling errors for the CDHS 2000 is the ISSA Sampling Error Module. This module used the Taylor linearization method of variance estimation 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.
Note: See detailed estimate of sampling error calculation in APPENDIX B of the survey report.
Data Quality Tables
- Household age distribution
- Age distribution of eligible and interviewed women
- Completeness of reporting
- Births by calendar years
- Reporting of age at death in days
- Reporting of age at death in months
Note: See detailed tables in APPENDIX C of the report which is presented in this documentation.
Use of the dataset must be acknowledged using a citation which would include:
- the Identification of the Primary Investigator
- the title of the survey (including acronym and year of implementation)
- the survey reference number
- the source and date of download of the data files (for datasets obtained on-line)
Cambodia National Institute of Statistics, Directorate General for Health, and ORC Macro. Cambodia Demographic and Health Survey (DHS) 2000. Ref. KHM_2000_DHS_v01_M. Dataset downloaded from http://www.measuredhs.com/ on [date].
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.