The 1996 Zambia Demographic and Health Survey (ZDHS) is a nationally representative survey conducted by the Central Statistical Office at the request of the Ministry of Health, with the aim of gathering reliable information on fertility, childhood and maternal mortality rates, maternal and child health indicators, contraceptive knowledge and use, and knowledge and prevalence of sexually transmitted diseases (STDs) including AIDS. The survey is a follow-up to the Zambia DHS survey carried out in 1992. The primary objectives of the ZDHS are: To collect up-to-date information on fertility, infant and child mortality and family planning; To collect information on health-related matters such as breastfeeding, antenatal care, children's immunisations and childhood diseases; To assess the nutritional status of mothers and children; iv) To support dissemination and utilisation of the results in planning, managing and improving family planning and health services in the country; and To enhance the survey capabilities of the institutions involved in order to facilitate the implementation of surveys of this type in the future. SUMMARY OF FINDINGS FERTILITY Fertility Trends. The 1996 ZDHS survey results indicate that the level of fertility in Zambia is continuing to decline. Fertility Differentials. Some women are apparently leading the fertility decline. Moreover, women who have received some secondary education have the lowest level of fertility. Age at First Birth. Childbearing begins early in Zambia, with over one-third of women becoming mothers by the time they reach age 18 and around two-thirds having had a child by the time they reach age 20. Birth Intervals. The majority of Zambian children (81 percent) are born after a "safe" birth interval (24 or more months apart), with 36 percent born at least 36 months after a prior birth. Nevertheless, 19 percent of non-first births occur less than 24 months after the preceding birth. The overall median birth interval is 32 months. Fertility Preferences. Survey data indicate that there is a strong desire for children and a preference for large families in Zambian society. Unplanned Fertility. Despite the increasing level of contraceptive use, ZDHS data indicate that unplanned pregnancies are still common. FAMILY PLANNING Increasing Use of Contraception. The contraceptive prevalence rate in Zambia has increased significantly over the past five years, rising from 15 percent in 1992 to 26 percent in 1996. Differentials in Family Planning Use. Differentials in current use of family planning by province are large. Source of Contraception. Six in ten users obtain their methods from public sources, while 24 percent use non-governmental medical sources and shops and friends account for the remaining 13 percent. Government health centres (41 percent) and government hospitals (16 percent) are the most common sources of contraceptive methods. Knowledge of Contraceptive Methods. Knowledge of contraceptive methods is nearly universal, with 96 percent of all women and men knowing at least one method of family planning. Family Planning Messages. One reason for the increase in level of contraceptive awareness is that family planning messages are prevalent. Unmet Need for Family Planning. ZDHS data show that there is a considerable unmet need for family planning services in Zambia. MATERNAL AND CHILD HEALTH Maternal Health Care. ZDHS data show some encouraging results regarding maternal health care, as well as to some areas in which improvements could be made. Results show that most Zambian mothers receive antenatal care, 3 percent from a doctor and 93 percent from a nurse or trained midwife. High Childhood Mortality. One of the more disturbing findings from the survey is that child survival has not improved over the past few years. Childhood Vaccination Coverage. Vaccination coverage against the most common childhood illnesses has increased recently. Childhood Health. ZDHS data indicate that Zambian mothers are reasonably well-informed about childhood illnesses and that a high proportion are treated appropriately. Breastfeeding Practices. The ZDHS results indicate that breastfeeding is almost universally practised in Zambia, with a median duration of 20 months. Knowledge and Behaviour Regarding AIDS. Survey results indicate that virtually all respondents had heard of AIDS. Common sources of information were friends/relatives, the radio, and health workers. The vast majority of respondents80 percent of women and 94 percent of mensay they have changed their behaviour in order to avoid contracting AIDS, mostly by restricting themselves to one sexual partner.
