The 1994 Zimbabwe Demographic and Health Survey (ZDHS) is the third DHS survey carried out in Zimbabwe. Previous DHS were conducted in 1988, 1994 and 1999.
The Central Statistical Office (CSO) conducted the third Zimbabwe Demographic and Health Survey (ZDHS) between August and November 1999. The 1999 Zimbabwe Demographic and Health Survey (ZDHS) is a nationally representative survey that was implemented by the Central Statistical Office (CSO) from August to November 1999. Although significantly expanded in content, the 1999 ZDHS is a follow-on to the 1988 and 1994 ZDHS surveys and provides updated estimates of the basic demographic and health indicators covered in the earlier surveys. The 1999 ZDHS was conducted in all of the ten provinces of Zimbabwe.
The 1999 Zimbabwe Demographic and Health Survey (ZDHS) is one of a series of surveys undertaken by the Central Statistical Office (CSO) as part of the Zimbabwe National Household Survey Capability Programme (ZNHSCP) and the worldwide MEASURE DHS+ programme. The Zimbabwe National Family Planning Council (ZNFPC), the Department of Population Studies of the University of Zimbabwe (UZ), the National AIDS Coordinating Programme (NACP), and the Ministry of Health and Child Welfare (MOH&CW) contributed significantly to the design, implementation, and analysis of the ZDHS results. The U.S. Agency for International Development (USAID) provided funds for the implementation of the 1999 ZDHS. Macro International Inc. provided technical assistance through its contract with USAID. UNICEF/Zimbabwe supported the survey by providing additional funds for fieldwork transportation.
The primary objectives of the 1999 ZDHS were to provide up-to-date information on fertility levels, nuptiality, sexual activity, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutritional status of mothers and young children, early childhood mortality and maternal mortality, maternal and child health, and awareness and behaviour regarding AIDS and other sexually transmitted diseases.
The 1999 ZDHS is a follow-up of the 1988 and 1994 ZDHS surveys, also implemented by CSO. The 1999 ZDHS is significantly expanded in scope and provides updated estimates of basic demographic and health indicators covered in the earlier surveys.
Like the 1988 ZDHS and the 1994 ZDHS, the 1999 ZDHS was designed to provide information on levels and trends in fertility, family planning knowledge and use, infant and child mortality, and maternal and child health. Specific questions were also asked about the respondent's knowledge, attitude, and practice regarding the HIV/AIDS virus and other sexually transmitted diseases. Like the1994 ZDHS, the 1999 ZDHS also collected data on mortality related to pregnancy and childbearing (i.e., maternal mortality). The ZDHS data are intended for use by programme managers and policymakers to evaluate and improve family planning and health programmes in Zimbabwe.
- Fertility. The 1988, 1994, and 1999 ZDHS results show that Zimbabwe continues to experience a fairly rapid decline in fertility.
- Marriage. The median age at first marriage in Zimbabwe has risen slowly over the past 30 years. Women age 20-24 marry about one year later than women 40-49 (19.7 years and 18.8 years, respectively). The proportion of women married by age 15 declined from 9 percent among those age 45-49 to 2 percent among women age 15-19 years.
- Polygyny. One in six women in Zimbabwe reported being in a polygynous union.
- Fertility Preferences. More than half (53 percent) of the married women in Zimbabwe would like to have another child.
- Family Planning. Since 1994, knowledge of family planning in Zimbabwe has been universal and has not varied across subgroups of the population. The pill, condoms, and injectables are the most widely known methods.
- Antenatal Care. Utilisation of antenatal services is high in Zimbabwe; in the five years before the survey, mothers received antenatal care from a trained medical professional for 93 percent of their most recent births; 13 percent from a doctor and 80 percent from a trained nurse or a midwife.
- Delivery Characteristics. In 1999, the percentage of births delivered in health facilities (72 percent) was slightly higher than the percentage recorded in the 1994 ZDHS (69 percent).
- Childhood Vaccination. Three in four children 12-23 months have been vaccinated against six diseases (tuberculosis, diphtheria, pertussis, tetanus, polio, and measles). Two in three children completed the vaccination schedule by the time they turned one year.
- Childhood Diseases. In the 1999 ZDHS, mothers were asked whether their children under the age of five years had been ill with a cough accompanied by short, rapid breathing in the two weeks preceding the survey.
- Childhood Mortality. Data from surveys since 1988 indicate that early childhood mortality in Zimbabwe declined until the late 1980s, after which there was stagnation and an upward trend in the past five years.
- Adult and Maternal Mortality. As in 1994, the 1999 ZDHS collected information that allows estimation of adult and maternal mortality.
- Perceived Problems in Accessing Women's Health Care. Women are sometimes perceived to have problems in seeking health care services for themselves.
- Nutrition. Breastfeeding is nearly universal in Zimbabwe; 98 percent of the children born in the past five years were breastfed at some time.
- AIDS-related Knowledge and Behaviour. Although practically all Zimbabwean women and men have heard of AIDS, the quality of that knowledge is sometimes poor; 17 percent of women and 7 percent of men could not cite a single means to avoid getting HIV/AIDS.
Kind of Data
Sample survey data
Unit of Analysis
- Women age 15-49
- Men age 15-54
- Children under five years
The 1999 Zimbabwe Demographic and Health Survey covers the following topics:
- Alcohol Consumption
- Anemia Testing
- Early Childhood Education
- GPS/Georeferenced–Global Positioning System or Georeferenced Data
- HIV Behavior
- HIV Knowledge–Questions assess knowledge/sources of knowledge/ways to avoid HIV
- Iodine salt test
- Maternal Mortality
- Men's Survey
- Reproductive Calendar
- Tobacco Use
- Vitamin A Questions
- Women's Status–Questions: women's autonomy (household decisionmaking/free movement/access money) & Dom. violence
The 1999 Zimbabwe Demographic and Health Survey (ZDHS) is a nationally representative survey that was implemented by the Central Statistical Office (CSO) from August to November 1999. The survey was conducted in all of the ten provinces of Zimbabwe.
The population covered by the 1994 ZDHS is defined as the universe of all women age 15-49 in Zimbabwe and all men age 15-54 living in the household.
Producers and sponsors
Central Statistical Office
Macro International Inc.
U.S. Agency for International Development
United Nations Children's Fund
Zimbabwe National Family Planning Council (ZNFPC)
Contributor to the design, implementation, and analysis
Department of Population Studies of the University of Zimbabwe (UZ)
Contributor to the design, implementation, and analysis
National AIDS Coordinating Programme (NACP)
Contributor to the design, implementation, and analysis
Ministry of Health and Child Welfare (MOH&CW)
Contributor to the design, implementation, and analysis
The sampling frame used for the 1999 ZDHS was the 1992 Zimbabwe Master Sample (ZMS92) developed by the CSO after the 1992 Population Census. The same enumeration areas (EAs) of the 1994 ZDHS were used in the 1999 ZDHS. The ZMS92 included 395 enumeration areas stratified by province and land use sector. For purposes of the ZDHS, 18 sampling strata were identified: urban and rural strata for each of the eight provinces, and Harare (including Chitungwiza) and Bulawayo provinces, which are exclusively urban strata.
The sample for the 1999 ZDHS was selected in two stages. In the first stage, 230 EAs were selected with equal probability. Then, within each of these 230 EAs, a complete household listing and mapping exercise was conducted in May 1999, forming the basis for the second-stage sampling. For the listing exercise, permanent CSO enumerators were trained in listing and cartographic methods. All private households were listed. The list excluded people living in institutional households (army barracks, hospitals, police camps, etc.).
Households to be included in the ZDHS were selected from the EA household lists, with the sample being proportional to the total number of households in the EA. All women age 15-49 years in those households were eligible to be interviewed in the ZDHS. Furthermore, a 50 percent systematic subsample of these households was selected, within which interviews with all males age 15-54 years were to be conducted as well.
Since the objective of the survey was to produce estimates of specific demographic and health indicators for each of the 10 provinces, the sample design allowed for an oversample of smaller strata. The overall target sample was 6,208 women and 2,970 men. The ZDHS sample is not self-weighting at the national level (i.e., weights are required to estimate national-level indicators).
A total of 7,010 households were selected in the sample, of which 6,512 were currently occupied. The shortfall was largely due to some households no longer existing in the sampled clusters at the time of the interview. Of the 6,512 existing households, 6,369 were interviewed, yielding a household response rate of 97.8 percent.
In the interviewed households, 6,208 eligible women were identified and of these, 5,907 were interviewed, yielding a response rate of 95.2 percent. In a 50 percent subsample of households, 2,970 eligible men were identified, of which 2,609 were successfully interviewed (87.8 percent response). The principal reason for nonresponse among both eligible men and women was the failure to find them at home despite repeated visits to the household. The lower response rate among men than among women was due to the more frequent and longer absences of men.
Dates of Data Collection
Data Collection Mode
During the training period, field editors and team supervisors were provided with additional training in methods of field editing, data quality control procedures, and coordination of fieldwork.
Six permanent senior CSO staff coordinated and supervised fieldwork activities.
Data Collection Notes
The ZDHS questionnaires were pretested in April 1999. Eleven qualified nurses and university graduates were trained to implement the pretest during a two-week training period. Three language versions of the questionnaires were produced: Shona, Ndebele, and English. The pretest fieldwork was conducted over a one-week period in areas surrounding Bulawayo and Gweru, where both Shona and Ndebele households could easily be identified. Approximately 150 pretest interviews were conducted, debriefing sessions were subsequently held with the pretest field staff, and modifications to the questionnaire were made based on lessons drawn from the exercise. Pretest interviewers were retained to serve as field editors and team supervisors during the main survey.
Training of field staff for the main survey was conducted over a four-week period, in July 1999. Permanent CSO staff, as well as staff of ZNFPC, UZ, and Macro International Inc., trained 90 interviewer trainees, most of whom were trained nurses or university graduates. The training course consisted of instruction in general interviewing techniques, field procedures, a detailed review of items on the questionnaires, instruction and practice in weighing and measuring children, mock interviews between participants in the classroom, and practice interviews with real respondents in areas outside the 1999 ZDHS sample points. Trainees who performed satisfactorily in the training programme were selected as interviewers, while the remainder were retained to assist in office operations. During this period, field editors and team supervisors were provided with additional training in methods of field editing, data quality control procedures, and coordination of fieldwork.
Ten interviewing teams carried out the fieldwork for the 1999 ZDHS; one team was designated for each province. Each team consisted of one team supervisor, one field editor, five or six female interviewers, one or two male interviewers, and one driver. In total, there were 10 team supervisors, 10 field editors, 54 female interviewers, 12 male interviewers, 7 data capture clerks, and 10 drivers. Six permanent senior CSO staff coordinated and supervised fieldwork activities. Data collection took place over a four-month period, from 15 August to 30 November 1999.
Central Statistical Office
Four types of questionnaires were used for the ZDHS: the Household Questionnaire, the Women's Questionnaire, the Men's Questionnaire, and the Cluster Location form. The contents of these questionnaires were based on the DHS Model “A” Questionnaire, which is designed for use in countries with moderate to high levels of contraceptive use.
a) The Household Questionnaire was used to list all the usual members and visitors of selected households. Some basic information was collected on characteristics of each person listed, including his/her age, sex, education, and relationship to the head of the household. The main purpose of the Household Questionnaire was to identify women and men who were eligible for the individual interview. The Household Questionnaire also collected information on characteristics of the household's dwelling units, such as the source of water, type of toilet facilities, materials used for the floor of the house, and ownership of various consumer and durable goods.
b) The Women's Questionnaire was used to collect information on women age 15-49 years. These women were asked questions on the following topics:
Background characteristics (education, residential history, etc.) Reproductive history Knowledge and use of family planning methods Fertility preferences Antenatal and delivery care Breastfeeding and weaning practices Vaccinations and health of children under age five Marriage and sexual activity Woman's status and husband's occupation Awareness and behaviour regarding AIDS and other sexually transmitted diseases Adult mortality including maternal mortality.
As in the 1994 ZDHS, a “calendar” was used in the 1999 ZDHS to collect information on the respondent's history since January 1994 concerning reproduction, contraceptive use, reasons for discontinuation of contraception, marriage, and migration. In addition, interviewing teams measured the height and weight of all children under the age of five years and of all women age 15-49.
c) The Men's Questionnaire was administered to all men age 15-54 living in every second household in the ZDHS sample (i.e., a 50 percent sample). The Men's Questionnaire collected much of the same information found in the Women's Questionnaire, but was shorter because it did not contain questions on reproductive history and maternal and child health.
d) CSO Provincial Supervisors administered the Cluster Location Form. This exercise was carried out in January 2000. Global Positioning System (GPS) receivers were used to calculate the position (in terms of latitude and longitude) of each of the 230 clusters in the ZDHS. These positions can be used to link other data about Zimbabwe (e.g., average rainfall) to the information collected during the 1999 ZDHS.
All questionnaires for the 1999 ZDHS were returned to the CSO for data processing, which consisted of office editing, coding of open-ended questions, data entry, and editing computer identified errors. The data were processed on five microcomputers. Data entry and editing were accomplished using the computer programme Integrated System for Survey Analysis (ISSA). Data processing commenced on 15 September 1999 and was completed on 21 January 2000.
Estimates of Sampling Error
Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents selected in the 1999 ZDHS 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 ZDHS sample is the result of a two-stage stratified design, and consequently, it was necessary to use more complex formulae. The computer software used to calculate sampling errors for the 1999 ZDHS is the ISSA Sampling Error Module (ISSAS). 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.
Sampling errors for the 1999 ZDHS are calculated for selected variables considered to be of primary interest. The results are presented in this appendix for the country as a whole. For each variable, the type of statistic (mean, proportion, or rate) and the base population are given in Table
In general, the relative standard error for most estimates for the country as a whole is small, except for estimates of very small proportions.
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 2.3 and its standard error is .04. Therefore, to obtain the 95 percent confidence limits, one adds and subtracts twice the standard error to the sample estimate, i.e., 2.3±.04. 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 2.2 and 2.4.
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 1999 ZDHS to minimize this type of error, nonsampling errors are impossible to avoid and difficult to evaluate statistically.
Data and Data Related Resources
Central Statistical Office (CSO)
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