The 1995 Kazakhstan Demographic and Health Survey is the first survey of this type conducted in Kazakhstan under the international Demographic and Health Surveys (DHS) program.
The 1995 Kazakstan Demographic and Health Survey (KDHS) is part of the worldwide Demographic and Health Surveys (DHS) program, which is designed to collect data on fertility, family planning and maternal and child health. The 1995 KDHS was the first national level population and health survey in Kazakstan. The purpose of the survey was to provide the Ministry of Health of Kazakstan with information on fertility, reproductive practices of women, maternal care, child health and mortality, child nutrition practices, breastfeeding, nutritional status and anemia. This information is important for understanding the factors that influence the reproductive health of women and the health and survival of infants and young children. It can be used in planning effective policies and programs regarding the health and nutrition of women and their children. This is especially important now during this the time of economic transition which involves virtually all aspects of life for the people of Kazakstan. The survey provides data important to the assessment of the overall demographic situation in the country. It is expected that the findings of the KDHS will become a useful source of information necessary for the ongoing health care reform in Kazakstan.
Kind of Data
Sample survey data
Unit of Analysis
- Children under five years
- Women age 15-49
The 1995 Kazakstan Demographic and Health Survey covers the following topics:
- Demographic Characteristics
- Respondent's Background
- Pregnancy History
- Outcome of Pregnancies
- Child Health and Nutrition Practices
- Immunization and Health
- Fertility Preferences
- Husband's Background and Woman's Work
ANTHROPOMETRY AND HEMOGLOBIN MEASUREMENT IN THE BLOOD
- Height and Weight
- Hemoglobin Measurement in the Blood
Producers and sponsors
National Institute of Nutrition
Macro International Inc.
United States Agency for International Development
The 1995 KDHS employed a nationally representative probability sample of women age 15-49. The country was divided into five survey regions. Four survey regions consisted of groups of contiguous oblasts (except the East Kazakstanskaya oblast which is not contiguous). Almaty City constituted a survey region by itself although it is part of the Almatinskaya oblast. The five survey regions were defined as follows:
I) Almaty City
2) South Region: Taldy-Korganskaya, Almatinskaya (except Almaty city), Dzhambylskaya, South Kazakstanskaya, and Kzyl-Ordinskaya
3) West Region: Aktiubinskaya, Mangistauskaya, Atyrauskaya, and West Kazakstanskaya
4) Central Region: Semipalatinskaya, Zhezkazganskaya, and Tourgaiskaya
5) North and East Region: East Kazakstanskaya, Pavlodarskaya, Karagandinskaya, Akmolinskaya, Kokchetauskaya, North Kazakstanskaya, and Koustanaiskaya
It is important to note that the oblast composition of regions outside of Almaty City was determined on the basis of geographic proximity, and in order to achieve similarity with respect to reproductive practices within regions. The South and West Regions are comprised of oblasts which traditionally have a high proportion of Kazak population and high fertility levels. The Central Region contains three oblasts in which the fertility level is similar to the national average. The North and East Region contains seven oblasts situated in northern Kazakstan in which a relatively high proportion of the population is of Russian origin, and the fertility level is lower than the national average.
In Almaty City, the sample for the 1995 KDHS was selected in two stages. In the first stage, 40 census counting blocks were selected with equal probability from the 1989 list of census counting blocks. A complete listing of the households in the selected counting blocks was carried out. The lists of households served as the frame for second-stage sampling; i.e., the selection of the households to be visited by the KDHS interviewing teams. In each selected household, women age 15-49 were eligible to be interviewed.
In the rural areas, the primary sampling units (PSUs) were the raions which were selected with probability proportional to size, the size being the 1993 population published by Goskomstat (1993). At the second stage, one village was selected in each selected raion, from the 1989 Registry of Villages. This resulted in 50 rural clusters being selected. At the third stage, households were selected in each cluster following the household listing operation as in Almaty City.
In the urban areas other than Almaty City, the PSUs were the cities and towns themselves. In the second stage, one health block was selected from each town except in self-representing cities (large cities that were selected with certainty) where more than one health block was selected. The selected health blocks were segmented prior to the household listing operation which provided the household lists for the third stage selection of households. In total, 86 health blocks were selected.
On average, 22 households were selected in each urban cluster, and 33 households were selected in each rural cluster. It was expected that the sample would yield interviews with approximately 4,000 women between the ages of 15 and 49.
Note: See detailed description of sample design in APPENDIX B of the survey report.
A total of 4,480 households were selected in the sample, of which 4,241 were occupied at the time of fieldwork. The main reason for the difference was that some dwelling units which were occupied at the time of the household listing operation were either vacant or the household members were away for an extended period at the time of interviewing. Of the 4,241 occupied households, 4,178 were interviewed, yielding a household response rate of 99 percent.
In the interviewed households, 3,899 women were eligible for the individual interview (i.e., all women 15-49 years of age who were either usual residents or visitors who had spent the previous night in the household). Interviews were successfully completed with 3,771 of these women, yielding a response rate of 97 percent. The principal reason for non-response was the failure to find an eligible woman at home after repeated visits to the household. The overall response rate for the survey--the product of the household and the individual response rates--was 95 percent.
Note: See summarized response rates by place of residence in Table 1.1 of the survey report .
Dates of Data Collection
Data Collection Mode
Data Collection Notes
The 1995 KDHS questionnaires were pretested in December 1994. Six female interviewers were trained over a two-week period at the Institute of Nutrition. The pretest included one week of interviewing in an urban area (AImaty City) and one week in a rural area. A total of 124 women were interviewed. Based on the pretest experience, the questionnaires were modified. Pretest interviewers were retained to serve as supervisors and field editors for the main survey.
Female nursing students of the National Medical College were recruited as interviewers and male students were recruited as medical technicians for the main survey. A total of 40 students were trained at the Medical College for four weeks from mid-April to mid-May 1995. Training consisted of in-class lectures and practice, as well as interviewing in the field. Interviewers were selected based on their performance during the training period.
The data collection was carried out by four teams. Each team consisted of eight members: the team supervisor, one editor, one household interviewer, four individual women interviewers, and one medical technician (responsible for height and weight measurement and anemia testing). All team members other than the medical technician were female. Fieldwork for the KDHS was conducted from May to September 1995.
Two questionnaires were used for the 1995 KDHS: the Household Questionnaire and the Individual Questionnaire. The questionnaires were based on the model survey instruments developed in the DHS program. They were adapted to the data needs of Kazakhstan during consultations with specialists in the areas of reproductive health, child health and nutrition in Kazakhstan.
The Household Questionnaire was used to enumerate all usual members and visitors in tile sample households and to collect information relating to the socioeconomic position of a household. In the: first part of the Household Questionnaire, information was collected on age, sex, educational attainment, marital status, and relationship to the head of household of each person listed as a household member or visitor. A primary objective of the first part of the Household Questionnaire was to identify women who were eligible for the individual interview. In the second part of the Household Questionnaire, questions were included on the dwelling unit, such as the number of rooms, the flooring material, the source of water, the type of toilet facilities, and on the availability of a variety of consumer goods.
The Individual Questionnaire was used to collect information from women age 15-49. These women were asked questions on the following major topics:
- Background characteristics
- Pregnancy history
- Outcome of pregnancies and antenatal care
- Child health and nutrition practices
- Child immunization and episodes of diarrhea and respiratory illness
- Knowledge and use of contraception
- Marriage and fertility preferences
- Husband's background and woman's work
- Anthropometry of children and mothers
- Hemoglobin measurement of women and children
One of the major efforts of the 1995 KDHS was testing women and children for iron-deficiency anemia. Testing was done by measuring hemoglobin levels in the blood using the Hemocue technique. Before collecting the blood sample, each woman was asked to sign a consent form giving permission for the collection of a finger-stick blood droplet from herself and her children. Results of anemia testing were kept confidential (as are all KDHS data); however, strictly with the consent of respondents, local health care facilities were informed of women and children who had severely low levels of hemoglobin (less than 7 g/dl).
Questionnaires were returned to the Institute of Nutrition in Almaty for data processing. The office editing staff checked that the questionnaires for all selected households and eligible respondents were returned from the field. The few questions which had not been pre-coded (e.g., occupation, type of chronic disease) were coded at this time. Data were then entered and edited on microcomputers using the ISSA (Integrated System for Survey Analysis) package, with the data entry software translated into Russian. Office editing and data entry activities began in May 1995 (i.e., the same time that fieldwork started) and were completed in September 1995.
Estimates of Sampling Error
The estimates from a sample survey are affected by two types of errors: (1) non-sampling errors, and (2) 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 KDHS 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 KDHS 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 KDHS 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 KDHS 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 description of sample design 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 survey report.
Data and Data Related Resources
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
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.