| Author(s) |
Zambia Statistics Agency (Formerly Central Statistical Office), Lusaka, Zambia Ministry of Health, Lusaka, Zambia University Teaching Hospital Virology Laboratory, Lusaka, Zambia The DHS Program, ICF, Rockville, Maryland, USA |
| Date |
2020-01-01 |
| Country |
Zambia |
| Language |
English |
| Table of contents |
TABLES AND FIGURES ........................................................................................................................... ix
FOREWORD ............................................................................................................................................. xix
ACRONYMS AND ABBREVIATIONS .................................................................................................. xxi
SUSTAINABLE DEVELOPMENT GOAL (SDG) INDICATORS ................................................... xxiii
READING AND UNDERSTANDING TABLES FROM THE 2018 ZAMBIA
DEMOGRAPHIC AND HEALTH SURVEY (ZDHS) ............................................................ xxv
MAP OF ZAMBIA ................................................................................................................................. xxxii
1 INTRODUCTION AND SURVEY METHODOLOGY .............................................................. 1
1.1 Survey Objectives ................................................................................................................ 1
1.2 Sample Design ..................................................................................................................... 1
1.3 Questionnaires ..................................................................................................................... 2
1.4 Anthropometry, Anaemia Testing, and HIV Testing .......................................................... 3
1.4.1 Anthropometry Measurements ............................................................................... 3
1.4.2 Anaemia Testing .................................................................................................... 4
1.4.3 HIV Testing ........................................................................................................... 4
1.5 Pretest .................................................................................................................................. 5
1.6 Training of Field Staff ......................................................................................................... 6
1.7 Fieldwork ............................................................................................................................. 7
1.8 Data Processing ................................................................................................................... 7
1.9 Response Rates .................................................................................................................... 7
2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION ................................ 9
2.1 Housing Characteristics ....................................................................................................... 9
2.1.1 Drinking Water Sources and Treatment ................................................................. 9
2.1.2 Sanitation ............................................................................................................. 10
2.1.3 Exposure to Smoke inside the Home ................................................................... 11
2.1.4 Other Housing Characteristics ............................................................................. 11
2.1.5 Household Wealth ................................................................................................ 12
2.1.6 Handwashing ....................................................................................................... 12
2.2 Household Population and Composition ........................................................................... 12
2.3 Children’s Living Arrangements and Parental Survival .................................................... 13
2.4 Birth Registration .............................................................................................................. 14
2.5 Education ........................................................................................................................... 15
2.5.1 Educational Attainment ....................................................................................... 15
2.5.2 School Attendance and Orphanhood .................................................................... 16
3 CHARACTERISTICS OF RESPONDENTS ............................................................................. 33
3.1 Basic Characteristics of Survey Respondents .................................................................... 33
3.2 Education and Literacy ...................................................................................................... 34
3.3 Mass Media Exposure ....................................................................................................... 35
3.4 Employment ...................................................................................................................... 36
3.5 Occupation ......................................................................................................................... 37
3.6 Health Insurance Coverage ................................................................................................ 37
3.7 Tobacco Use ...................................................................................................................... 37
3.8 Surgery .............................................................................................................................. 38
4 MARRIAGE AND SEXUAL ACTIVITY .................................................................................. 61
4.1 Marital Status ..................................................................................................................... 61
4.2 Polygyny ............................................................................................................................ 62
4.3 Age at First Marriage ......................................................................................................... 63
4.4 Age at First Sexual Intercourse ......................................................................................... 63
4.5 Recent Sexual Activity ...................................................................................................... 64
5 FERTILITY ................................................................................................................................... 73
5.1 Current Fertility ................................................................................................................. 73
5.2 Children Ever Born and Living ......................................................................................... 74
5.3 Birth Intervals .................................................................................................................... 75
5.4 Insusceptibility to Pregnancy ............................................................................................. 76
5.5 Menopause ......................................................................................................................... 77
5.6 Age at First Birth ............................................................................................................... 77
5.7 Teenage Childbearing ........................................................................................................ 78
5.8 Sexual and Reproductive Behaviours before Age 15 ........................................................ 78
6 FERTILITY PREFERENCES ..................................................................................................... 89
6.1 Desire for Another Child ................................................................................................... 89
6.2 Ideal Family Size ............................................................................................................... 90
6.3 Fertility Planning Status .................................................................................................... 91
6.4 Wanted Fertility Rates ....................................................................................................... 92
7 FAMILY PLANNING .................................................................................................................. 99
7.1 Contraceptive Knowledge and Use ................................................................................... 99
7.2 Source of Modern Contraceptive Methods ...................................................................... 101
7.3 Informed Choice .............................................................................................................. 101
7.4 Discontinuation of Contraceptives .................................................................................. 102
7.5 Demand for Family Planning .......................................................................................... 102
7.5.1 Decision Making about Family Planning ........................................................... 103
7.5.2 Future Use of Contraception .............................................................................. 104
7.5.3 Exposure to Family Planning Messages in the Media ....................................... 104
7.6 Contact of Nonusers with Family Planning Providers ..................................................... 104
7.7 Exposure to Specific Radio and Television Programmes ................................................ 104
8 INFANT AND CHILD MORTALITY ...................................................................................... 121
8.1 Infant and Child Mortality ............................................................................................... 122
8.2 Biodemographic Risk Factors ......................................................................................... 123
8.3 Perinatal Mortality ........................................................................................................... 124
8.4 High-risk Fertility Behaviour .......................................................................................... 124
9 MATERNAL HEALTH CARE ................................................................................................. 131
9.1 Antenatal Care Coverage and Content ............................................................................ 131
9.1.1 Skilled Providers ................................................................................................ 131
9.1.2 Timing and Number of ANC Visits ................................................................... 132
9.2 Components of ANC Visits ............................................................................................. 133
9.3 Protection against Neonatal Tetanus ............................................................................... 133
9.4 Delivery Services ............................................................................................................. 134
9.4.1 Institutional Deliveries ....................................................................................... 134
9.4.2 Skilled Assistance during Delivery .................................................................... 135
9.4.3 Delivery by Caesarean ....................................................................................... 136
9.5 Postnatal Care .................................................................................................................. 136
9.5.1 Postnatal Health Check for Mothers .................................................................. 136
9.5.2 Postnatal Health Check for Newborns ............................................................... 137
9.6 Problems in Accessing Health Care ................................................................................ 138
9.7 Obstetric Fistula ............................................................................................................... 139
10 CHILD HEALTH ........................................................................................................................ 155
10.1 Birth Weight .................................................................................................................... 155
10.2 Vaccination of Children ................................................................................................... 156
10.3 Symptoms of Acute Respiratory Infection ...................................................................... 158
10.4 Fever ................................................................................................................................ 159
10.5 Diarrhoeal Disease ........................................................................................................... 159
10.5.1 Prevalence of Diarrhoea and Treatment-seeking Behaviour .............................. 159
10.5.2 Feeding Practices ............................................................................................... 160
10.5.3 Oral Rehydration Therapy and Other Treatments .............................................. 160
10.6 Treatment of Childhood Illness ....................................................................................... 161
10.7 Disposal of Children’s Stools .......................................................................................... 162
11 NUTRITION OF CHILDREN AND WOMEN ........................................................................ 177
11.1 Nutritional Status of Children .......................................................................................... 177
11.1.1 Anthropometry Training and Data Collection ................................................... 179
11.1.2 Levels of Child Malnutrition ............................................................................. 179
11.2 Infant and Young Child Feeding Practices ...................................................................... 180
11.2.1 Early Initiation of Breastfeeding ........................................................................ 180
11.2.2 Exclusive Breastfeeding ..................................................................................... 181
11.2.3 Median Duration of Breastfeeding ..................................................................... 182
11.2.4 Bottle Feeding .................................................................................................... 183
11.2.5 Introduction of Complementary Foods .............................................................. 183
11.2.6 Minimum Dietary Diversity, Minimum Meal Frequency, and Minimum Acceptable Diet ..... 183
11.3 Anaemia Prevalence in Children ..................................................................................... 185
11.4 Micronutrient Intake and Supplementation among Children ........................................... 186
11.5 Anaemia Prevalence in Women....................................................................................... 187
11.6 Micronutrient Supplementation and Deworming During Pregnancy .............................. 188
12 MALARIA ................................................................................................................................... 201
12.1 Ownership of Insecticide-treated Nets ............................................................................. 202
12.2 Household Access to and Use of ITNs ............................................................................ 203
12.3 Use of ITNs by Children and Pregnant Women .............................................................. 205
12.4 Indoor Residual Spraying ................................................................................................ 206
12.5 Malaria in Pregnancy ....................................................................................................... 206
12.6 Case Management of Malaria in Children ....................................................................... 207
12.7 Prevalence of Low Haemoglobin in Children ................................................................. 208
13 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOUR ....................... 223
13.1 HIV/AIDS Knowledge, Transmission, and Prevention Methods .................................... 223
13.2 Knowledge about Mother-to-Child Transmission ........................................................... 224
13.3 Discriminatory Attitudes towards People Living with HIV ............................................ 225
13.4 Multiple Sexual Partners ................................................................................................. 226
13.5 Paid Sex ........................................................................................................................... 227
13.6 Coverage of HIV Testing Services .................................................................................. 227
13.6.1 Awareness of HIV Testing Services and Experience with HIV Testing ........... 228
13.6.2 HIV Testing of Pregnant Women ...................................................................... 228
13.6.3 Disclosure of HIV Test Results ......................................................................... 229
13.6.4 HIV Self-testing ................................................................................................. 229
13.7 Male Circumcision .......................................................................................................... 230
13.8 Self-reporting of Sexually Transmitted Infections .......................................................... 230
13.9 HIV/AIDS-related Knowledge and Behaviour among Young People ............................ 231
13.9.1 Knowledge ......................................................................................................... 231
13.9.2 First Sex ............................................................................................................. 232
13.9.3 Premarital Sex .................................................................................................... 232
13.9.4 Multiple Sexual Partners .................................................................................... 232
13.9.5 Coverage of HIV Testing Services .................................................................... 233
13.9.6 Age-mixing in Sexual Relationships .................................................................. 233
13.9.7 Drunkenness and Sexual Intercourse among Young People .............................. 233
14 HIV PREVALENCE ................................................................................................................... 259
14.1 Coverage Rates for HIV Testing ..................................................................................... 259
14.2 HIV Prevalence ............................................................................................................... 260
14.2.1 HIV Prevalence by Age and Sex ........................................................................ 260
14.2.2 HIV Prevalence by Sexual Risk Behaviour ....................................................... 262
14.2.3 HIV Prevalence among Young People .............................................................. 263
14.2.4 HIV Prevalence by Other Characteristics Related to HIV Risk ......................... 263
14.2.5 HIV Prevalence among Couples ........................................................................ 264
15 ADULT AND MATERNAL MORTALITY ............................................................................. 275
15.1 Data ................................................................................................................................. 275
15.2 Direct Estimates of Adult Mortality ................................................................................ 276
15.3 Trends in Adult Mortality ................................................................................................ 277
15.4 Direct Estimates of Maternal Mortality ........................................................................... 277
15.5 Trends in Pregnancy-related Mortality ............................................................................ 278
16 WOMEN’S EMPOWERMENT ................................................................................................ 283
16.1 Married Women’s and Men’s Employment .................................................................... 284
16.2 Control over Women’s Earnings ..................................................................................... 284
16.3 Control over Men’s Earnings .......................................................................................... 285
16.4 Women’s and Men’s Ownership of Assets ..................................................................... 286
16.4.1 Documentation of Ownership of Assets ............................................................ 286
16.4.2 Bank Accounts and Mobile Phones ................................................................... 286
16.5 Women’s Participation in Decision Making .................................................................... 287
16.6 Attitudes toward Wife Beating ........................................................................................ 287
16.7 Negotiating Sexual Relations .......................................................................................... 288
16.8 Widows Dispossessed of Property .................................................................................. 289
17 DOMESTIC VIOLENCE ........................................................................................................... 311
17.1 Measurement of Violence ................................................................................................ 312
17.2 Women’s Experience of Physical Violence .................................................................... 312
17.2.1 Prevalence of Physical Violence ........................................................................ 312
17.2.2 Perpetrators of Physical Violence ...................................................................... 313
17.3 Experience of Sexual Violence ........................................................................................ 313
17.3.1 Prevalence of Sexual Violence .......................................................................... 313
17.3.2 Perpetrators of Sexual Violence ......................................................................... 314
17.4 Experience of Different Forms of Violence .................................................................... 314
17.5 Marital Control by Husband ............................................................................................ 314
17.6 Forms of Spousal Violence .............................................................................................. 315
17.6.1 Prevalence of Spousal Violence ......................................................................... 315
17.6.2 Experience of Spousal Violence by Duration of Marriage ................................ 317
17.7 Injuries to Women due to Spousal Violence ................................................................... 317
17.8 Violence Initiated by Women against Husbands ............................................................. 318
17.9 Help Seeking among Women Who Have Experienced Violence .................................... 318
REFERENCES ......................................................................................................................................... 335
APPENDIX A SAMPLE DESIGN ........................................................................................................ 337
A.1 Introduction ..................................................................................................................... 337
A.2 Sample Frame .................................................................................................................. 337
A.3 Sample Design and Implementation ................................................................................ 338
A.4 Sample Probabilities and Sampling Weights ................................................................... 339
APPENDIX B ESTIMATES OF SAMPLING ERRORS ................................................................... 347
APPENDIX C DATA QUALITY TABLES ......................................................................................... 377
APPENDIX D CONTRIBUTORS TO THE 2018 ZDHS .................................................................... 385
APPENDIX E QUESTIONNAIRES ..................................................................................................... 391 |
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https://www.dhsprogram.com/pubs/pdf/FR361/FR361.pdf |
