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Demographic and Health Survey 1999

Kazakhstan, 1999
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Reference ID
KAZ_1999_DHS_v01_M
Producer(s)
Academy of Preventive Medicine of Kazakhstan
Metadata
DDI/XML JSON
Study website
Created on
Dec 20, 2012
Last modified
Mar 29, 2019
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  • Study Description
  • Data Dictionary
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  • Identification
  • Scope
  • Coverage
  • Producers and sponsors
  • Sampling
  • Survey instrument
  • Data collection
  • Data processing
  • Data appraisal
  • Data Access
  • Disclaimer and copyrights
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  • Metadata production
  • Identification

    Survey ID number

    KAZ_1999_DHS_v01_M

    Title

    Demographic and Health Survey 1999

    Country
    Name Country code
    Kazakhstan KAZ
    Study type

    Demographic and Health Survey (standard) - DHS IV

    Series Information

    The Kazakhstan Demographic and Health Survey 1999 is the second of its kind to be carried out in Kazakhstan. The first Demographic and Health Survey was conducted in 1995.

    Abstract

    The 1999 Kazakhstan Demographic and Health Survey (KDHS) is a nationally repre­sentative survey of 4,800 women age 15-49 and 1,440 men age 15-59. This survey is the second of its kind to be carried out in Kazakhstan. It was implemented by the Acad­emy of Preventive Medicine of Kazakhstan, with funding provided by the U.S. Agency for International Development through the MEA­SURE DHS+ program. Fieldwork for the KDHS was conducted from July to September 1999.

    The purpose of the survey is to provide cur­rent data on women's reproductive histories, knowledge and use of methods of contracep­tion, breastfeeding practices and nutrition, vaccination coverage, and episodes of diseases among their children under the age of five. The survey also provides comparable data for analysis of trends in fertility, reproductive health, child health, and nutrition. In the 1999 KDHS, information on knowledge and atti­tudes toward HIV/AIDS and sexually transmit­ted infection, as well as data on men's repro­ductive behavior were collected. The survey included measurement of hemoglobin levels in the blood to assess the prevalence of anemia, and measurements of height and weight to assess nutritional status. The components of the survey related to the anemia testing and anthropometric assessment were funded by the UNICEF Area Office for Central Asia and Kazakhstan (UNICEF/CARK).

    Since the 1999 KDHS is the second survey, it provides comparable data for analysis of trends in fertility, reproductive health, and child health and nutrition. The 1999 KDHS also contributes to the growing international database on demographic and health-related variables.

    Kind of Data

    Sample survey data

    Unit of Analysis
    • Household
    • Women age 15-49
    • Men age 15-49

    Scope

    Notes

    The Kazakhstan Demographic and Health Survey 1999 covers the following topics:

    • Abortion
    • Anemia Questions-Questions or testing assessing prevalence/severity of iron-def. anemia among women or children
    • Anemia Testing
    • Anthropometry
    • Background characteristics
    • Child immunization and episodes of diarrhea and respiratory illness
    • Child health and nutrition practices
    • Husband's background and woman's work
    • Full Pregnancy History
    • Hemoglobin measurement of women and children
    • Outcome of pregnancies, antenatal and postnatal care
    • Knowledge and use of contraception
    • Knowledge of HIV/AIDS and other sexually transmitted infections
    • Marriage and fertility preferences
    • Maternal and child anthropometry
    • Men's Survey
    • TB Questions

    Coverage

    Geographic Coverage

    The 1999 Kazakhstan Demographic and Health Survey (KDHS) is a nationally repre­sentative survey. Survey estimates are presented for six geographic regions. The six survey regions were defined as follows:
    (1) Almaty City
    (2) South Region: Almatinskaya, Zhambylskaya, Kyzylordinskaya, and South-Kazakhstanskaya oblast
    (3) West Region: Aktyubinskaya, Atyrauskaya, Mangistauskaya, and West-Kazakhstanskaya oblast
    (4) North Region: Akmolinskaya, Kostnaiskaya, Pavlodarskaya, and North-Kazakhstanskaya oblast
    (5) Central Region: Karagandinskaya oblast
    (6) East Region: East-Kazakhstanskaya oblast

    Producers and sponsors

    Primary investigators
    Name
    Academy of Preventive Medicine of Kazakhstan
    Producers
    Name Role
    Macro International Inc. Technical assistance
    Funding Agency/Sponsor
    Name Role
    United States Agency for International Development Funding
    United Nations Children's Fund Funding

    Sampling

    Sampling Procedure

    The sample for the 1999 KDHS successfully interviewed 4,800 women 15-49 years of age and 1,440 men 15-59 years of age. Survey estimates are presented for six geographic regions. The six survey regions were defined as follows:
    (1) Almaty City
    (2) South Region: Almatinskaya, Zhambylskaya, Kyzylordinskaya, and South-Kazakhstanskaya oblast
    (3) West Region: Aktyubinskaya, Atyrauskaya, Mangistauskaya, and West-Kazakhstanskaya oblast
    (4) North Region: Akmolinskaya, Kostnaiskaya, Pavlodarskaya, and North-Kazakhstanskaya oblast
    (5) Central Region: Karagandinskaya oblast
    (6) East Region: East-Kazakhstanskaya oblast

    The sampling frame for the 1999 KDHS consisted of the lists of health blocks obtained from local health-care departments and the National Committee on Health (for urban areas), and of the lists of villages obtained from the National Statistical Agency.

    The 1999 KDHS sample is a stratified two-stage sample. Stratification was achieved by dividing each survey region into urban and rural areas. In the first stage of selection, 251 health blocks and villages were selected as primary sampling units (PSUs) with probability proportional to the population count. A complete listing of the households residing in the selected blocks and villages was carried out. The lists of households served as the sampling frame for the systematic selection of 6336 households in the second stage. Women age 15-49 were identified and interviewed in selected households. Every third household was identified as selected for the male survey, and in those households, all men age 15-59 were interviewed.

    SAMPLING FRAME

    Kazakhstan is divided into 14 provinces called oblasts. The oblast is divided into urban and rural areas. In urban areas, the city is divided into the urban raions (districts), and the urban raion into health blocks called therapeutic uchastoks. In rural areas, the rural raion is divided into selsovets, and the selsovet into villages.

    The sampling frame for the 1999 KDHS consisted of the lists of health blocks obtained from local health care departments and the National Committee on Health, and the lists of villages obtained from the National Statistical Agency. Health blocks and villages are listed with their respective population count.

    CHARACTERISTICS OF THE SAMPLE

    The 1999 KDHS sample is a stratified two-stage sample. Stratification was achieved by dividing every survey region into urban and rural areas. In the first stage of selection, health blocks and villages were selected as primary sampling units (PSUs) in urban and rural areas, respectively. Because of the substantial variation in the size of blocks and villages PSUs were selected with probability proportional to size, the size being the population count. A complete listing of the households residing in the selected blocks and villages was carried out. The lists of households obtained served as sampling frame for the selection of households in the second stage.

    Response Rate

    A total of 6,301 households were selected in the sample, of which 5,960 were occupied at the time the fieldwork was conducted. The main reason for the difference was that some dwell­ing units that were occupied at the time of the household listing opera­tion were either vacant or the resi­dents were away for an extended period at the time of interviewing. Of the 5,960 occupied households, 5,844 were interviewed, yielding a household response rate of 98 per­cent.

    In the interviewed house­holds, 4,906 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 4,800 of these women, yielding a response rate of 98 percent. The principal reason for nonresponse was a failure to find an eligible woman at home after re­peated visits to the household.

    A total of 1,531 eligible men (i.e., all men 15-59 years of age who were either usual residents or visitors who had spent the previous night in the household) were identified in every third household. Interviews were successfully completed with 1,440 of these men, yielding a response rate of 94 percent.

    Survey instrument

    Questionnaires

    Three questionnaires were used for the 1999 KDHS: the Household Questionnaire, the Women's Questionnaire, and the Men's Questionnaire. These questionnaires were based on the model survey instruments developed for the MEASURE DHS+ program and were adapted to the data needs of Kazakhstan during consultations with specialists in the areas of reproductive health and child health and nutrition in Kazakhstan. The questionnaires were developed in English and then translated into Russian and Kazakh. A pretest was conducted in April 1999. Based on the pretest experience, the questionnaires were further modified.

    a) The Household Questionnaire was used to enumerate all usual members and visitors in a sample household and to collect information relating to the socioeconomic position of the household. In the first part of the Household Questionnaire, information was collected on age, sex, educational attainment, and relationship to the head of household for each person listed as a household member or visitor. A primary objective of the first part of the Household Questionnaire was to identify women and men 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, and the type of toilet facilities, and on the availability of a variety of consumer goods.

    b) The Women's Questionnaire was used to collect information from women age 15-49 on the following major topics:

    • Background characteristics
    • Pregnancy history
    • Outcome of pregnancies, antenatal and postnatal 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
    • Knowledge of HIV/AIDS and other sexually transmitted infections
    • Maternal and child anthropometry
    • Hemoglobin measurement of women and children.

    c) The Men's Questionnaire was used to collect information from men age 15-59 on the following topics:

    • Background characteristics
    • Reproduction
    • Contraceptive knowledge and use
    • Marriage
    • Fertility preferences and attitudes about family planning
    • Knowledge of HIV/AIDS and other sexually transmitted infections.

    Data collection

    Dates of Data Collection
    Start End
    1999-07 1999-09
    Data Collection Notes

    The 1999 KDHS questionnaires were pretested in April 1999. Eight interviewers were trained during a one-week period at the Academy of Preventive Medicine of Kazakhstan. The pretest included one week of interviewing in an urban area (Almaty City) and one week in a rural area (Talgar District of Almaty Oblast). A total of 110 women were interviewed. Pretest interviewers were retained to serve as supervisors and field editors for the main survey.

    Sixty-four persons, mostly physicians, were recruited as field supervisors, editors, health investigators and interviewers for the 1999 KDHS and were trained at the Academy of Preventive Medicine for three and a half weeks in June and July 1999. Male interviewers responsible for the men's interviews were trained separately. Training consisted of lectures and practice in the classroom, as well as interviewing in the field. The training of health investigators, who were responsible for anthropometric measurements (height and weight) and hemoglobin testing of women and children, was accomplished by two days in the classroom and three days in the field.

    At the end of the training, the field staff were divided into seven groups according to their assignments to the survey teams. Nine people, including one supervisor, one editor, five female interviewers, one male interviewer, and one male health investigator, were selected for each of the seven survey teams.

    The 1999 KDHS field staff represented various medical-research and educationalinstitutions in Kazakhstan, including Kazakhstan State Medical University, Karaganda State Medical Academy, South Kazakhstan State Medical Academy, International Kazakh-Turkish University, National Research Center for Maternal and Child Health, National Research Center for Pediatrics and Pediatric Surgery, National Institute of Nutrition, Institute of Tuberculosis, School of Public Health, National Medical College, and Zhezkazgan Department of Health. The Academy of Preventive Medicine recruited five field coordinators who were responsible for facilitating the communication and coordination between the Academy and the interviewing teams.

    All seven 1999 KDHS interviewing teams began collecting data in Almaty City on July 12, 1999. On July 26, 1999, the teams began fieldwork in the remaining survey regions of Kazakhstan. Data collection was completed on September 25, 1999.

    Data processing

    Data Editing

    Questionnaires were returned to the Academy of Preventive Medicine for data processing. The office editing staff checked that questionnaires for all selected households and eligible respondents were returned from the field. The few questions that had not been precoded (e.g., occupation) were coded at this time. Data were then entered and edited on microcomputers using the Integrated System for Survey Analysis (ISSA) package, with the data entry software translated into Russian. Office editing and data entry activities began on July 12, 1999, and were completed on October 15, 1999.

    Data appraisal

    Estimates of Sampling Error

    Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents selected in the 1999 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 1999 KDHS sample is the result of a multi-stage stratified design, and, consequently, it was necessary to use more complex formulae. The computer software used to calculate sampling errors for the 1999 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.

    The Jackknife repeated replication method derives estimates of complex rates from each of several replications of the parent sample, and calculates standard errors for these estimates using simple formulae. Each replication considers all but one clusters in the calculation of the estimates. Pseudo-independent replications are thus created. In the 1999 KDHS, there were 251 non-empty clusters. Hence, 251 replications were created.

    In addition to the standard error, ISSA computes the design effect (DEFT) for each estimate, which is defined as the ratio between the standard error using the given sample design and the standard error that would result if a simple random sample had been used. A DEFT value of 1.0 indicates that the sample design is as efficient as a simple random sample, while a value greater than 1.0 indicates the increase in the sampling error due to the use of a more complex and less statistically efficient design. ISSA also computes the relative error and confidence limits for the estimates.

    Sampling errors for the 1999 KDHS are calculated for selected variables considered to be of primary interest. The results are presented in an appendix to the Final report for the country as a whole, for urban and rural areas, for six survey regions, and for three ethnic groups (Kazakh, Russian, and other ethnic groups).

    The confidence interval (e.g., as calculated for children ever born to women age 15-49) can be interpreted as follows: the overall average from the national sample is 2.924 and its standard error is 0.079. Therefore, to obtain the 95 percent confidence limits, one adds and subtracts twice the standard error to the sample estimate, i.e., 2.924±2×0.079. There is a high probability (95 percent) that the true average number of children ever born to all women age 15 to 49 is between 2.765 and 3.082.

    Sampling errors are analyzed for the national woman sample and for two separate groups of estimates: (1) means and proportions, and (2) complex demographic rates. The relative standard errors (SE/R) for the means and proportions range between 0.1 and 32.3 percent with an average of 6.8 percent; the highest relative standard errors are for estimates of very low values (e.g., women currently using pills). If estimates of very low values (less than 10 percent) were removed, than the average would drop to 3.6 percent. So, in general, the relative standard errors for most estimates for the country as a whole are small, except for estimates of very small proportions. The relative standard error for the total fertility rate is small, 6.2 percent. However, for mortality rates, the average relative standard error is much higher, 18.3 percent.

    There are differentials in the relative standard error for estimates of subpopulations. For example, for the variable children ever born to women over 40, the relative standard errors as a percent of the estimated mean for the whole country, for the urban areas, and for the South region are 2.7 percent, 5.0 percent, and 5.9 percent, respectively.

    For the total sample, the value of the design effect (DEFT), averaged over all variables, is 1.21, which means that due to multistage clustering of the sample the average standard error is increased by a factor of 1.1 over that in an equivalent simple random sample.

    Data Appraisal

    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 second Kazakhstan Demographic and Health Survey (KDHS) in 1999 to minimize this type of error, nonsampling errors are impossible to avoid and difficult to evaluate statistically.

    Data Access

    Access authority
    Name Affiliation URL Email
    MEASURE DHS ICF International www.measuredhs.com archive@measuredhs.com
    Citation requirements

    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 country, acronym and year of implementation)
    • the survey reference number
    • the source and date of download

    Disclaimer and copyrights

    Disclaimer

    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

    Contacts
    Name Email URL
    General Inquiries info@measuredhs.com www.measuredhs.com
    Data and Data Related Resources archive@measuredhs.com www.measuredhs.com
    Academy of Preventive Medicine of Kazakhstan nutrit@nursat.kz http://zdrav.kz/ru/index/about/en-apm.html

    Metadata production

    DDI Document ID

    DDI_WB_KAZ_1999_DHS_v01_M

    Producers
    Name Role
    World Bank, Development Economics Data Group Generation of DDI documentation
    Date of Metadata Production

    2012-05-15

    Metadata version

    DDI Document version

    Version 1.1: (May 2011)

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