Zimbabwe - Demographic and Health Survey - 2000

Publication date: 2000

Zimbabwe 1999Demographic andHealth Survey Central Statistical Office MEASURE DHS+ Macro International Inc. Z i b b 1999 D hi d H lth S World Summit for Children Indicators: Zimbabwe 1999 _________________________________________________________________________________________________ BASIC INDICATORS Value _________________________________________________________________________________________________ Childhood mortality Infant mortality rate (adjusted rate) 65 per 1,000 Under-five mortality rate 102 per 1,000 Childhood undernutrition Percent stunted 27 Percent wasted 6 Percent underweight 13 Clean water supply Percent of households within 15 minutes of a safe water supply1 63 Sanitary excreta disposal Percent of households with flush toilets or VIP latrines 60 Basic education Percent of women 15-49 with completed primary education 73 Percent of men 15-49 with completed primary education 82 Percent of girls 6-12 attending school 87 Percent of boys 6-12 attending school 86 Percent of women 15-49 who are literate 90 Children in especially Percent of children who are orphans (both parents dead) 2.1 difficult situations Percent of children who do not live with their natural mother 27 Percent of children who live in single adult households 14 _________________________________________________________________________________________________ SUPPORTING INDICATORS_________________________________________________________________________________________________ Women's Health Birth spacing Percent of births within 24 months of a previous birth2 11 Safe motherhood Percent of births with medical prenatal care 73 Percent of births with prenatal care in first trimester 21 Percent of births with medical assistance at delivery 72 Percent of births in a medical facility 62 Percent of births at high risk 42 Family planning Contraceptive prevalence rate (any method, currently married women) 54 Percent of currently married women with an unmet demand for family planning 13 Percent of currently married women with an unmet need for family planning to avoid a high-risk birth 10 Nutrition Maternal nutrition Percent of mothers with low BMI 4 Low birth weight Percent of births at low birth weight (of those reporting numeric weight) 10 Breastfeeding Percent of children under 4 months who are exclusively breastfed 38 Child Health Vaccinations Percent of children whose mothers received tetanus toxoid vaccination during pregnancy 62 Percent of children 12-23 months with measles vaccination 79 Percent of children 12-23 months fully vaccinated 75 Diarrhoea control Percent of children with diarrhoea in preceding 2 weeks who received oral rehydration therapy (sugar-salt-water solution) 69 Acute respiratory infection Percent of children with acute respiratory infection in preceding 2 weeks who were taken to a health facility or provider 50 _________________________________________________________________________________________________ 1 Excludes surface water 2 First births are excluded Zimbabwe Demographic and Health Survey 1999 Central Statistical Office Harare, Zimbabwe Macro International Inc. Calverton, Maryland, U.S.A. December 2000 Central Statistical Office Macro International Inc This report presents results from the 1999 Zimbabwe Demographic and Health Survey (ZDHS) conducted by the Central Statistical Office (CSO) of the Government of Zimbabwe. Financial assistance for the survey was provided by the U.S. Agency for International Development (USAID) and the United Nations Children’s Fund (UNICEF); Macro International Inc. provided technical assistance. The ZDHS is part of the worldwide MEASURE Demographic and Health Surveys (DHS+) project which is designed to collect, analyse and disseminate data on fertility, family planning, maternal and child health, and HIV/AIDS. Additional information about the 1999 ZDHS may be obtained from the Central Statistical Office, P.O. Box CY 342, Causeway, Harare, Zimbabwe (telephone: 706-681; fax: 708-854). Information about the MEASURE DHS+ project may be obtained from Macro International Inc., 11785 Beltsville Drive, Suite 300, Calverton, MD 20705 (telephone: 301-572-0200; fax: 301-572-0999). Suggested citation: Central Statistical Office [Zimbabwe] and Macro International Inc. 2000. Zimbabwe Demographic and Health Survey 1999. Calverton, Maryland: Central Statistical Office and Macro International Inc. Contents * iii CONTENTS Page Tables and Figures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii Summary of Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii Map of Zimbabwe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiii CHAPTER 1 INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.1 Geography and Economy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1.2 Population . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1.3 Objectives of the Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 1.4 Organisation of the Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS . . . . . 7 2.1 Household Population by Age, Sex, and Residence . . . . . . . . . . . . . . . . . . . . . . . 7 2.2 Population by Age According to Selected Sources . . . . . . . . . . . . . . . . . . . . . . . . 7 2.3 Household Composition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 2.4 Fosterhood and Orphanhood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 2.5 Educational Level of Household Members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 2.6 School Enrolment Ratios . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 2.7 Grade Repetition and Dropout Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 2.8 Housing Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 2.9 Household Durable Goods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 CHAPTER 3 CHARACTERISTICS OF RESPONDENTS . . . . . . . . . . . . . . . . . . . . . . . . . 19 3.1 Characteristics of Survey Respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 3.2 Educational Attainment by Background Characteristics . . . . . . . . . . . . . . . . . . 19 3.3 Access to Mass Media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 3.4 Women’s Employment Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 3.5 Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 3.6 Employer and Form of Earnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 3.7 Decision on Use of Earnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 3.8 Control Over Earnings by Contribution to Household Expenditures . . . . . . . . . 30 3.9 Household Decisionmaking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 3.10 Final Say in Household Decisions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 3.11 Women’s Agreement with Reasons for Wife Beating . . . . . . . . . . . . . . . . . . . . . 33 3.12 Women’s Agreement with Reasons for Refusing Sexual Relations . . . . . . . . . . . 35 iv * Contents Page CHAPTER 4 FERTILITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 4.1 Current Fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 4.2 Fertility by Background Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 4.3 Fertility Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 4.4 Trends in Age-specific Fertility Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 4.6 Birth Intervals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 4.7 Age at First Birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 4.8 Median Age at First Birth by Background Characteristics . . . . . . . . . . . . . . . . . 46 4.9 Teenage Pregnancy and Motherhood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 CHAPTER 5 FAMILY PLANNING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 5.1 Knowledge of Contraceptive Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 5.2 Knowledge of Contraceptive Methods by Background Characteristics . . . . . . . . 50 5.3 Ever Use of Contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 5.4 Current Use of Contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 5.5 Current Use of Contraception by Background Characteristics . . . . . . . . . . . . . . 56 5.6 Current Use of Contraception by Women’s Status . . . . . . . . . . . . . . . . . . . . . . . 60 5.7 Number of Children at First Use of Contraception . . . . . . . . . . . . . . . . . . . . . . . 60 5.8 Knowledge of the Fertile Period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 5.9 Source of Supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 5.10 First-year Contraceptive Discontinuation Rates . . . . . . . . . . . . . . . . . . . . . . . . 64 5.11 Reasons for Discontinuing Contraceptive Methods . . . . . . . . . . . . . . . . . . . . . . 66 5.12 Future Use of Contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 5.13 Reasons for Nonuse of Contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 5.14 Preferred Methods of Contraception for Future Use . . . . . . . . . . . . . . . . . . . . . 68 5.15 Exposure to Family Planning Messages on the Radio and Television . . . . . . . . . 68 5.16 Exposure to Family Planning Messages in the Print Media . . . . . . . . . . . . . . . . 70 5.17 Contact of Nonusers with Family Planning Providers . . . . . . . . . . . . . . . . . . . . 71 CHAPTER 6 OTHER PROXIMATE DETERMINANTS OF FERTILITY . . . . . . . . . . . . . . 73 6.1 Marital Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 6.2 Polygyny . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 6.3 Number of Co-wives and Wives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 6.4 Age at First Marriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 6.5 Median Age at First Marriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 6.6 Age at First Sexual Intercourse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 6.7 Median Age at First Sexual Intercourse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 6.8 Recent Sexual Activity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 6.9 Postpartum Amenorrhoea, Abstinence and Insusceptibility . . . . . . . . . . . . . . . . 84 6.10 Median Duration of Postpartum Insusceptibility by Background Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 6.11 Menopause . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 Contents * v Page CHAPTER 7 FERTILITY PREFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 7.1 Fertility Preference by Number of Living Children . . . . . . . . . . . . . . . . . . . . . . 87 7.2 Fertility Preference by Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 7.3 Desire to Limit Childbearing by Background Characteristics . . . . . . . . . . . . . . . 90 7.4 Need for Family Planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 7.5 Ideal Number of Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 7.6 Mean Ideal Number of Children by Background Characteristics . . . . . . . . . . . . 96 7.7 Fertility Planning Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 7.8 Wanted Fertility Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 CHAPTER 8 EARLY CHILDHOOD MORTALITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101 8.1 Background and Assessment of Data Quality . . . . . . . . . . . . . . . . . . . . . . . . . . 101 8.2 Infant and Child Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102 8.3 Background and Assessment of Data Quality . . . . . . . . . . . . . . . . . . . . . . . . . . 103 8.4 Biodemographic Differentials in Early Childhood Mortality . . . . . . . . . . . . . . 105 8.5 Perinatal Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106 8.6 High-risk Fertility Behaviour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 108 CHAPTER 9 REPRODUCTIVE AND CHILD HEALTH . . . . . . . . . . . . . . . . . . . . . . . . 111 9.1 Perceived Problems in Accessing Women’s Health . . . . . . . . . . . . . . . . . . . . . . 111 9.2 Perceived Big Problems in Accessing Women’s Health by Background Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 9.3 Antenatal Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 9.4 Number of Antenatal Care Visits and Stage of Pregnancy . . . . . . . . . . . . . . . . 115 9.5 Antenatal Care Content . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116 9.6 Place of Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 118 9.7 Assistance During Delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 9.8 Delivery Characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121 9.9 Postnatal Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123 9.10 Postnatal Care Providers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125 9.11 Use of Smoking Tobacco . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125 9.12 Childhood Vaccinations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 9.13 Prevalence and Treatment for Acute Respiratory Infection (ARI) . . . . . . . . . . 132 9.14 Possession and Use of Bednets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 9.15 Prevalence of Fever and Source of Treatment . . . . . . . . . . . . . . . . . . . . . . . . . 134 9.16 Hand-washing Facilities in the Household . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136 9.17 Appropriate Hand Washing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 9.18 Disposal of Children’s Stool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138 9.19 Prevalence of Diarrhoea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139 9.20 Knowledge of Sugar-Salt-Water Solution . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142 9.21 Diarrhoea Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142 9.22 Feeding Practices During Diarrhoea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144 9.23 Women’s Status and Children’s Health Care . . . . . . . . . . . . . . . . . . . . . . . . . . 144 vi * Contents Page CHAPTER 10 INFANT FEEDING AND CHILDHOOD AND MATERNAL NUTRITION . 145 10.1 Breastfeeding and Supplementation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145 10.2 Initial Breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145 10.3 Breastfeeding Status by Child’s Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146 10.4 Median Duration and Frequency of Breastfeeding . . . . . . . . . . . . . . . . . . . . . . 147 10.5 Foods Received by Children in the Preceding 24 Hours . . . . . . . . . . . . . . . . . . 149 10.6 Frequency of Foods Received by Children in the Preceding Seven Days . . . . . 150 10.7 Micronutrients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151 10.8 Nutritional Status of Children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151 10.9 Nutritional Status of Women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 156 CHAPTER 11 AIDS AND OTHER SEXUALLY TRANSMITTED DISEASES . . . . . . . . . . . 159 11.1 Knowledge of ways to Prevent HIV/AIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160 11.2 Knowledge of Other AIDS-related Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 11.3 Stigma Associated with AIDS and Acceptability of AIDS-related Messages in the Media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 11.4 Testing for the HIV/AIDS Virus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171 11.5 Knowledge of Other Sexually Transmitted Diseases . . . . . . . . . . . . . . . . . . . . 174 11.6 Self-reporting of Recent Sexually Transmitted Infections . . . . . . . . . . . . . . . . 177 11.7 Treatment-Seeking and Other Behaviours in Response to STIs . . . . . . . . . . . . 181 11.8 Number of Sexual Partners . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182 11.9 Payment for Sexual Relations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186 11.10 Knowledge of Sources for Male and Female Condoms . . . . . . . . . . . . . . . . . . 187 11.11 Use of Condoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190 CHAPTER 12 ADULT AND MATERNAL MORTALITY . . . . . . . . . . . . . . . . . . . . . . . . . 195 12.1 The Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195 12.2 Direct Estimates of Adult Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197 12.3 Direct Estimates of Maternal Mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199 REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201 APPENDIX A SAMPLE DESIGN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203 APPENDIX B ESTIMATES OF SAMPLING ERRORS . . . . . . . . . . . . . . . . . . . . . . . . . . . 205 APPENDIX C DATA QUALITY TABLES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209 APPENDIX D ZDHS HEAD OFFICE STAFF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217 APPENDIX E QUESTIONNAIRES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221 Tables and Figures * vii TABLES AND FIGURES Page CHAPTER 1 INTRODUCTION Table 1.1 Population size and growth rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Table 1.2 Demographic indicators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Table 1.3 Results of the household and individual interviews . . . . . . . . . . . . . . . . . . . . . . . 6 CHAPTER 2 HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS Table 2.1 Household population by age, sex, and residence . . . . . . . . . . . . . . . . . . . . . . . . 8 Table 2.2 Population by age, according to selected sources . . . . . . . . . . . . . . . . . . . . . . . . 9 Table 2.3 Household composition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Table 2.4 Fosterhood and orphanhood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Table 2.5 Educational attainment of household population . . . . . . . . . . . . . . . . . . . . . . . 11 Table 2.6 School enrolment ratios . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Table 2.7 Grade repetition and dropout rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Table 2.8 Housing characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Table 2.9 Household durable goods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Figure 2.1 Population pyramid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Figure 2.2 Net enrolment ratios by sex and residence . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Figure 2.3 Housing characteristics by residence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 CHAPTER 3 CHARACTERISTICS OF RESPONDENTS Table 3.1 Background characteristics of respondents . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Table 3.2 Educational attainment by background characteristics . . . . . . . . . . . . . . . . . . . 22 Table 3.3 Access to mass media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Table 3.4 Employment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 Table 3.5 Occupation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Table 3.6 Employer and form of earnings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 Table 3.7 Decision on use of earnings and contribution of earnings to household expenditures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Table 3.8 Control over earnings according to household expenditures . . . . . . . . . . . . . . . 30 Table 3.9 Household decisionmaking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Table 3.10 Final say in household decisions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Table 3.11 Women’s agreement with reasons for wife beating . . . . . . . . . . . . . . . . . . . . . . 34 Table 3.12 Women’s agreement with reasons for refusing sexual relations . . . . . . . . . . . . . 36 Figure 3.1 Educational attainment by sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Figure 3.2 Percent distribution of women 15-49 by employment status . . . . . . . . . . . . . . . 26 Figure 3.3 Percent distribution of employed women 15-49 who receive cash earnings by person who decides on use of earnings . . . . . . . . . . . . . . . . . . . . . 30 viii * Tables and Figures Page CHAPTER 4 FERTILITY Table 4.1 Current fertility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Table 4.2 Fertility by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Table 4.3 Trends in current fertility rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Table 4.4 Trends in age-specific fertility rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42 Table 4.5 Children ever born and living . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Table 4.6 Birth intervals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Table 4.7 Age at first birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Table 4.8 Median age at first birth by background characteristics . . . . . . . . . . . . . . . . . . . 46 Table 4.9 Teenage pregnancy and motherhood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Figure 4.1 Total fertility rates by background characteristics . . . . . . . . . . . . . . . . . . . . . . . 41 Figure 4.2 Age-specific fertility rates by urban-rural residence . . . . . . . . . . . . . . . . . . . . . . 42 Figure 4.3 Percentage of adolescent women who are mothers or pregnant with first child, by age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48 CHAPTER 5 FAMILY PLANNING Table 5.1 Knowledge of contraceptive methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Table 5.2 Knowledge of contraceptive methods by background characteristics . . . . . . . . . 51 Table 5.3 Trends in knowledge of family planning methods . . . . . . . . . . . . . . . . . . . . . . . 52 Table 5.4 Ever use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 Table 5.5 Current use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Table 5.6 Trends in current use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 Table 5.7.1 Current use of contraception by background characteristics: women . . . . . . . . 58 Table 5.7.2 Current use of contraception by background characteristics: men . . . . . . . . . . . 59 Table 5.8 Current use of contraception by women’s status . . . . . . . . . . . . . . . . . . . . . . . . 61 Table 5.9 Number of children at first use of contraception . . . . . . . . . . . . . . . . . . . . . . . . 62 Table 5.10 Knowledge of fertile period . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Table 5.11 Source of supply for modern contraceptive methods . . . . . . . . . . . . . . . . . . . . . 63 Table 5.12 First-year contraceptive discontinuation rates . . . . . . . . . . . . . . . . . . . . . . . . . . 65 Table 5.13 Reasons for discontinuing contraceptive methods . . . . . . . . . . . . . . . . . . . . . . . 66 Table 5.14 Future use of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Table 5.15 Reasons for nonuse of contraception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Table 5.16 Preferred method of contraception for future use . . . . . . . . . . . . . . . . . . . . . . . 68 Table 5.17.1 Exposure to family planning messages on radio and television: women . . . . . . 69 Table 5.17.2 Exposure to family planning messages on radio and television: men . . . . . . . . 70 Table 5.18 Exposure to family planning messages in print media . . . . . . . . . . . . . . . . . . . . 71 Table 5.19 Contact of nonusers with family planning providers . . . . . . . . . . . . . . . . . . . . . 72 Figure 5.1 Use of specific contraceptive methods among currently married women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56 Figure 5.2 Current use of family planning among currently married women 15-49 by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60 Figure 5.3 Current use of contraception by source of supply . . . . . . . . . . . . . . . . . . . . . . . 64 Figure 5.4 First-year contraceptive discontinuation rates by method . . . . . . . . . . . . . . . . . 65 Tables and Figures * ix CHAPTER 6 OTHER PROXIMATE DETERMINANTS OF FERTILITY Page Table 6.1 Current marital status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Table 6.2 Polygyny . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 Table 6.3 Number of co-wives and wives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 Table 6.4 Age at first marriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 Table 6.5 Median age at first marriage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 Table 6.6 Age at first sexual intercourse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79 Table 6.7.1 Median age at first sexual intercourse: women . . . . . . . . . . . . . . . . . . . . . . . . . 80 Table 6.7.2 Median age at first sexual intercourse: men . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 Table 6.8.1 Recent sexual activity: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82 Table 6.8.2 Recent sexual activity: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Table 6.9 Postpartum amenorrhoea, abstinence, and insusceptibility . . . . . . . . . . . . . . . . 84 Table 6.10 Median duration of postpartum insusceptibility by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 Table 6.11 Menopause . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 Figure 6.1 Percentage of currently married women whose husbands have more than one wife . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Figure 6.2 Median age at first marriage among women 25-49 . . . . . . . . . . . . . . . . . . . . . . 78 CHAPTER 7 FERTILITY PREFERENCES Table 7.1 Fertility preferences by number of living children . . . . . . . . . . . . . . . . . . . . . . . 88 Table 7.2 Fertility preferences by age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 Table 7.3 Desire to limit childbearing by background characteristics . . . . . . . . . . . . . . . . 90 Table 7.4 Need for family planning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93 Table 7.5 Ideal and actual number of children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95 Table 7.6.1 Mean ideal number of children by background characteristics: women . . . . . . 96 Table 7.6.2 Mean ideal number of children by background characteristics: men . . . . . . . . . 97 Table 7.7 Fertility planning status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98 Table 7.8 Wanted fertility rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99 Figure 7.1 Fertility preferences among currently married women 15-49 . . . . . . . . . . . . . . 89 Figure 7.2 Percentage of currently married women 15-49 who want no more children . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 Figure 7.3 Percentage of currently married women with unmet need and met need for family planning services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94 CHAPTER 8 EARLY CHILDHOOD MORTALITY Table 8.1 Early childhood mortality rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102 Table 8.2 Early childhood mortality by socioeconomic characteristics . . . . . . . . . . . . . . 104 Table 8.3 Early childhood mortality by biodemographic characteristics . . . . . . . . . . . . . 106 Table 8.4 Perinatal mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 x * Tables and Figures Page Table 8.5 High-risk fertility behaviour . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 Figure 8.1 Trends in infant and under-five mortality, 1988, 1994, and 1999 . . . . . . . . . . 103 Figure 8.2 Infant mortality by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . 105 CHAPTER 9 REPRODUCTIVE AND CHILD HEALTH Table 9.1 Perceived problems in accessing women’s health care . . . . . . . . . . . . . . . . . . . 112 Table 9.1 Perceived big problems in accessing women’s health care by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 Table 9.3 Antenatal care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114 Table 9.4 Number of antenatal care visits and stage of pregnancy . . . . . . . . . . . . . . . . . 115 Table 9.5 Antenatal care content . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117 Table 9.6 Place of delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 Table 9.7 Assistance during delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 120 Table 9.8 Delivery characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123 Table 9.9 Postnatal care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124 Table 9.10 Postnatal care providers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126 Table 9.11 Use of smoking tobacco . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127 Table 9.12 Vaccinations by source of information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128 Table 9.13 Vaccinations by background characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . 130 Table 9.14 Vaccinations in first year of life by current age . . . . . . . . . . . . . . . . . . . . . . . . 131 Table 9.15 Prevalence and treatment of acute respiratory infection . . . . . . . . . . . . . . . . 133 Table 9.16 Possession and use of bednets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134 Table 9.17 Prevalence of fever and source of treatment . . . . . . . . . . . . . . . . . . . . . . . . . . 135 Table 9.18 Hand-washing facilities in households . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Table 9.19 Appropriate hand washing by background characteristics . . . . . . . . . . . . . . . . 138 Table 9.20 Appropriate hand washing by selected household characteristics . . . . . . . . . . 139 Table 9.21 Disposal of children’s stools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140 Table 9.22 Prevalence of diarrhoea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 Table 9.23 Knowledge of sugar-salt-water solution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142 Table 9.24 Diarrhoea treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 Table 9.25 Feeding practices during diarrhoea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144 Table 9.26 Women’s status and children’s health care . . . . . . . . . . . . . . . . . . . . . . . . . . . 144 Figure 9.1 Distribution of births by number of antenatal care visits . . . . . . . . . . . . . . . . . 116 Figure 9.2 Distribution of births by timing of first antenatal care visit . . . . . . . . . . . . . . . 116 Figure 9.3 Delivery characteristics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 122 Figure 9.4 Percentage of children age 12-23 months with specific vaccinations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129 Figure 9.5 Diarrhoea prevalence by child’s age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142 Tables and Figures * xi Page CHAPTER 10 INFANT FEEDING AND CHILDHOOD AND MATERNAL NUTRITION Table 10.1 Initial breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146 Table 10.2 Breastfeeding status by child’s age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 Table 10.3 Median duration and frequency of breastfeeding . . . . . . . . . . . . . . . . . . . . . . 148 Table 10.4 Foods received by children in preceding 24 hours . . . . . . . . . . . . . . . . . . . . . 149 Table 10.5 Frequency of foods received by children in preceding 7 days . . . . . . . . . . . . 150 Table 10.6 Micronutrients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152 Table 10.7 Nutritional status of children by demographic characteristics . . . . . . . . . . . . 154 Table 10.8 Nutritional status of children by background characteristics . . . . . . . . . . . . . 156 Table 10.9 Nutritional status of women by background characteristics . . . . . . . . . . . . . . 158 Figure 10.1 Prevalence of stunting by age of child and mother’s education . . . . . . . . . . . 157 CHAPTER 11 AIDS AND OTHER SEXUALLY TRANSMITTED DISEASES Table 11.1.1 Knowledge of ways to avoid HIV/AIDS: women . . . . . . . . . . . . . . . . . . . . . . 161 Table 11.1.2 Knowledge of ways to avoid HIV/AIDS: men . . . . . . . . . . . . . . . . . . . . . . . . . 162 Table 11.2.1 Knowledge of programmatically important ways to avoid HIV/AIDS: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163 Table 11.2.2 Knowledge of programmatically important ways to avoid HIV/AIDS: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164 Table 11.3.1 Knowledge of various AIDS-related issues: women . . . . . . . . . . . . . . . . . . . . 166 Table 11.3.2 Knowledge of various AIDS-related issues: men . . . . . . . . . . . . . . . . . . . . . . . 167 Table 11.4.1 Discussion of HIV/AIDS prevention with cohabiting partner and acceptability of discussion of AIDS in the media: women . . . . . . . . . . . . . . . 168 Table 11.4.2 Discussion of HIV/AIDS prevention with cohabiting partner and acceptability of discussion of AIDS in the media: men . . . . . . . . . . . . . . . . . . 169 Table 11.5.1 Social aspects of AIDS prevention and mitigation: women . . . . . . . . . . . . . . 170 Table 11.5.2 Social aspects of AIDS prevention and mitigation: men . . . . . . . . . . . . . . . . . 171 Table 11.6.1 Testing for the HIV/AIDS virus: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172 Table 11.6.2 Testing for the HIV/AIDS virus: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173 Table 11.7.1 Knowledge of signs and symptoms of STIs in men: women . . . . . . . . . . . . . . 175 Table 11.7.2 Knowledge of signs and symptoms of STIs in men: men . . . . . . . . . . . . . . . . 176 Table 11.8.1 Knowledge of signs and symptoms of STIs in women: men . . . . . . . . . . . . . . 177 Table 11.8.2 Knowledge of signs and symptoms of STIs in women: men . . . . . . . . . . . . . . 178 Table 11.9.1 Self-reporting of sexually transmitted infections (STIs) and STI symptoms: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179 Table 11.9.2 Self-reporting of sexually transmitted infections (STIs) and STI symptoms: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180 Table 11.10 Treatment-seeking behaviour among self-reported STI cases . . . . . . . . . . . . . 181 Table 11.11 Other actions taken by respondents who reported an STI in the past 12 months . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182 Table 11.12.1 Number of sexual partners: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183 Table 11.12.2 Number of sexual partners: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184 Table 11.13 Payment for sexual relations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186 Table 11.14.1 Knowledge of source for condoms: women . . . . . . . . . . . . . . . . . . . . . . . . . . 187 Page xii * Tables and Figures Table 11.14.2 Knowledge of source for condoms: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188 Table 11.15.1 Knowledge of source for female condoms: women . . . . . . . . . . . . . . . . . . . . 189 Table 11.15.2 Knowledge of source for female condoms: men . . . . . . . . . . . . . . . . . . . . . . . 190 Table 11.16.1 Use of condoms: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191 Table 11.16.2 Use of condoms: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192 Table 11.17 Use of condoms during commercial sex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194 Figure 11.1 Percent distribution of women by number of AIDS-prevention methods known, according to level of education . . . . . . . . . . . . . . . . . . . . . . 165 Figure 11.2 Percentage of women and men by need for HIV testing services and urban-rural residence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174 Figure 11.3 Percent distribution of unmarried men by number of sexual partners in last 12 months, according to drinking pattern in last 30 days . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186 Figure 11.4 Percentage of women and men who used a condom at last sex with a noncohabiting partner, by urban-rural residence . . . . . . . . . . . . . . . . 193 CHAPTER 12 ADULT AND MATERNAL MORTALITY Table 12.1 Data on siblings: completeness of the reported data . . . . . . . . . . . . . . . . . . . 196 Table 12.2 Adult mortality rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197 Table 12.3 Direct estimates of maternal mortality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199 Figure 12.1 Trends in age-specific mortality among women 15-49 . . . . . . . . . . . . . . . . . . 198 Figure 12.2 Trends in age-specific mortality among men 15-49 . . . . . . . . . . . . . . . . . . . . 198 APPENDIX A SAMPLE IMPLEMENTATION Table A.1 Sample implementation: women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203 Table A.2 Sample implementation: men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 204 APPENDIX B ESTIMATES OF SAMPLING ERRORS Table B.1 List of selected variables for sampling errors, Zimbabwe 1999 . . . . . . . . . . . 207 Table B.2 Sampling errors - National sample: Zimbabwe 1999 . . . . . . . . . . . . . . . . . . . 208 APPENDIX C DATA QUALITY TABLES Table C.1 Household age distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209 Table C.2 Age distribution of eligible and interviewed women . . . . . . . . . . . . . . . . . . . 210 Table C.3 Age distribution of eligible and interviewed men . . . . . . . . . . . . . . . . . . . . . . 211 Table C.4 Completeness of reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212 Table C.5 Births by calendar years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213 Table C.6 Reporting of age at death in days . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214 Table C.7 Reporting of age at death in months . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215 Preface * xiii PREFACE The Central Statistical Office (CSO) conducted the third Zimbabwe Demographic and Health Survey (ZDHS) between August and November 1999. The last ZDHS was fielded in 1994. The surveys were undertaken as part of the worldwide Demographic and Health Surveys programme, which has been implemented in Africa, Asia, Latin America, and the Near East. This report represents the major findings of the 1999 ZDHS; a preliminary report was published in March 2000. The 1999 ZDHS collected information on fertility, nuptuality, fertility preferences, family planning, infant and child mortality, and health-related matters such as breastfeeding practices, antenatal care, children’s immunisations, childhood diseases, nutritional status of mothers and young children, awareness and behaviour regarding sexually transmitted diseases, including HIV/AIDS. The Central Statistical Office extends its acknowledgment and gratitude to the various agencies and individuals in the government, the donor community, and the public sector for unrelenting support that facilitated the successful implementation of the survey. Specific mention, however, is due to the following: the Ministry of Health and Child Welfare (MOH&CW) and the Centre for Population Studies of the University of Zimbabwe for their significant technical inputs; the Zimbabwe Family Planning Council (ZNFPC) for logistical and technical support; the U.S. Agency for International Development (USAID) and the United Nations Children’s Fund (UNICEF) for assisting with funding for the survey; Macro International Inc. (Maryland, USA) for providing funds and technical assistance throughout the ZDHS project; all the field personnel engaged during the survey for commitment to high-quality work under difficult conditions; and finally, the ZDHS respondents for their patience and cooperation. L. M. Machirovi Director, Census and Statistics Central Statistical Office P.O. Box CY 342 Causeway, Harare, Zimbabwe xiv * Summary of Findings * xv SUMMARY OF FINDINGS The 1999 Zimbabwe Demographic and Health Survey (ZDHS) is a nationally represen- tative survey that was implemented by the Central Statistical Office (CSO) from August to November 1999. Although significantly ex- panded in content, the 1999 ZDHS is a follow- on to the 1988 and 1994 ZDHS surveys and provides updated estimates of the basic demo- graphic and health indicators covered in the earlier surveys. The 1999 ZDHS was conducted in all of the ten provinces of Zimbabwe. The ZDHS received technical guidance from the Ministry of Health and Child Welfare (MOH&CW), the Zimbabwe National Family Planning Council (ZNFPC), and the Centre for Population Studies, University of Zimbabwe. Macro International Inc. (USA) provided techni- cal assistance throughout the course of the project in the context of the Demographic and Health Surveys (DHS) programme, while finan- cial assistance was provided by the U.S. Agency for International Development (USAID/Harare). The project received additional funding from the UNICEF office in Zimbabwe. 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 sexu- ally 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 in- tended 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. At current fertility levels, a Zimbabwean woman will have on average 4.0 children during her reproductive years, 1.5 fewer children than the number recorded in the 1988 ZDHS. In general, urban women tend to have smaller families than rural women (3.0 and 4.6 children per woman, respectively). The low level of fertility among urban women is also reflected in the lower fertility among women in the urban provinces of Harare and Bulawayo who on average have fewer than 3.0 children, com- pared with 4.0 or more children in other prov- inces. Fertility differentials by women's educa- tional status are notable; women who had no formal education have on average more than 5.0 children, while women with higher than a secondary education have fewer than 2.0 chil- dren. 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. Another indicator of later marriage among women in Zimbabwe is the decline in the proportion of women age 25-49 who were married by age 20 (62 percent in 1994 com- pared with 58 percent in 1999). Urban women marry more than one year later than rural women. Women who stay in school tend to marry later; women who have attended second- ary school generally marry almost five years later (23.5 years) than women with no educa- tion (17.8 years). The median age at first marriage varies significantly across provinces, ranging from a low of 18.3 years in Mashonaland Central to 20.6 years or older in Bulawayo and Matabeleland South. Men enter into first union at a much later age than women; the median age at first marriage for men is 24.5 years, compared with 19.4 years for women. Only 13 percent of men are married by age 20, compared with 58 percent of women. xvi * Summary of Findings Although men marry on average five years later than women, women and men become sexually active at about one year apart. The median age at first sexual intercourse is 19.7 years for men and 18.7 years for women. Polygyny. One in six women in Zimba- bwe reported being in a polygynous union. Older women and women who live in rural areas are more likely than other women to have cowives. The prevalence of polygyny varies across provinces. Bulawayo has the lowest level (5 percent), while Mashonaland Central and Manicaland show the highest levels (31 percent and 25 percent, respectively). Fertility Preferences. More than half (53 percent) of the married women in Zimba- bwe would like to have another child. Among these women, 19 percent want one child within two years and 32 percent would prefer to wait two or more years before having their next child. Two-fifths (41 percent) of married women want no more children or have been sterilised. Thus, the majority of women (73 percent) want either to space their next birth or to end childbearing altogether. This represents the proportion of women who are potentially in need of family planning services. When asked how many children they would like to have if they could live their lives over and choose exactly, currently married women and monogamous men report an aver- age ideal family size of 4.3 children. A man’s marital status influences his ideal family size. Whereas the ideal number of children among all married men is 4.5, the corresponding number for men in a monogamous union is 4.3 and the number for men in multiple unions is 6.6 children. Another measure of fertility preference is the wanted fertility rate, which is calculated in the same manner as the conventional total fertility rate, except that unwanted births are excluded from the numerator. For the three years preceding the survey, the wanted fertility rate was 3.4 children, compared with the actual average of 4 children. In other words, if all unwanted births were avoided, the fertility rate in Zimbabwe would fall from 4.0 to 3.4 children per woman. Family Planning. Since 1994, knowl- edge 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. Currently, 54 percent of currently mar- ried women are using a method of contracep- tion. Overall, there has been an upward trend in the current use of family planning methods since 1984. Moreover, use of modern methods has increased faster than overall use. The most dramatic increase in modern contraceptive use in the five years between 1994 and 1999 is shown by injectables (3 percent to 8 percent). During the same period, the use of the pill increased from 33 percent to 36 percent of married women. Use of traditional methods, however, declined from 6 percent to 3 percent. Currently married women in rural areas are less likely to use modern family planning methods than their counterparts in urban areas (44 percent as opposed to 62 percent). Use of modern family planning methods is highest in the urban provinces of Harare (63 percent) and Bulawayo (60 percent). Manicaland has the lowest level of modern contraceptive use (34 percent). Modern contraceptive use is almost twice as high among women with a secondary education (66 percent) as among women with no education (35 percent). Government-sponsored facilities remain the chief providers of contraceptive methods in Zimbabwe. The distribution of sources of con- traceptive supplies for current users shows that most users (77 percent) obtain their contracep- tives from the public sector, followed by 17 percent who obtain their methods from the private medical sector. The participation of the private medical sector in family planning ser- vice delivery increased by more than a third between 1994 and 1999 (from 12 to 17 per- cent). Summary of Findings * xvii The level of unmet need for family planning changed slightly in the past five years (15 percent in 1994 compared with 13 percent in 1999). The decline is primarily for spacing births. Combined with 54 percent of married women who are currently using a contraceptive method, the total demand for family planning comprises two-thirds of the married women in Zimbabwe. Thus, if all married women who say they want to space or limit their children were to use family planning methods, the contracep- tive prevalence rate would increase from 54 percent to 68 percent. 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. The median number of antenatal care visits is 4.7, which is fewer than the six visits recommended by the goal-oriented antenatal protocols in Zimbabwe. Furthermore, one in four women attended the first antenatal care visit during the sixth to seventh month of pregnancy, while 3 percent attended at eight months or later. Data from the 1999 ZDHS show that the percentage of mothers who had four or more antenatal visits (64 percent) is lower than that recorded in the 1994 ZDHS (75 percent). Among women who went for an antena- tal visit, nine in ten had their blood pressure measured, eight in ten gave a urine sample, three in four gave a blood sample, eight in ten received a tetanus toxoid (TT) injection, and six in ten received iron tablets. Delivery Characteristics. In 1999, the percentage of births delivered in health facilities (72 percent) was slightly higher than the per- centage recorded in the 1994 ZDHS (69 per- cent). Place of delivery varies greatly by urban- rural residence; urban women are more likely to deliver in a health facility than rural women (89 percent compared with 64 percent). This differential is also reflected by province; where- as nine in ten babies in Harare and Bulawayo were born in a health facility, four in ten babies in Manicaland were delivered at home. In the 1999 ZDHS, 73 percent of live births in the past five years were assisted by skilled personnel during delivery; 12 percent were assisted by a doctor, 61 percent were assisted by a nurse or midwife, and 18 percent were assisted by a traditional birth attendant. 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 sched- ule by the time they turned one year. Comparison with data from the 1994 ZDHS shows that there has been a decline in vaccination as well as vaccination card cover- age. For vaccination, coverage declined from 80 percent in 1994 to 75 percent in 1999. For vaccination cards, coverage declined from 79 percent in 1994 to 69 percent in 1999. The decline may be attributed to various factors including the government’s reduced capacity for financing health services. 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. Based on the mother’s report, 16 percent of the children had had the illness. One in two children with respiratory illness were taken to a health facility for treatment. Overall, 14 percent of the children under age five had experienced diarrhoea at some time in the two weeks preceding the survey. One in three of these children was taken to a health provider for treatment. A large proportion of mothers did not practice proper management of childhood disease. Only about half of the children with diarrhoea were given increased fluid intake, one-fourth were given less fluid, and one-fourth were given the same amount of fluid. xviii * Summary of Findings Since fever is the major symptom of malaria, in the ZDHS, mothers were asked whether their children under five years had had a fever in the two weeks preceding the survey. Overall, one in four children was reported to have had a fever in the two weeks before to the survey. The use of treated bednets is a principal means of health intervention to control the mosquitoes that transmit malaria. Information on the availability of bednets in the house and whether any of the children under five years in the household slept under the bednet the night before the survey was also collected in the 1999 ZDHS. Overall, only 10 percent of households have a bednet. In 3 percent of the households with children under five, the children slept under a bednet the night before the survey. Childhood Mortality. Data from sur- veys 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. From the 1999 survey, infant mortality was estimated at 65 per 1,000 and under-five mortality was estimated at 102 per 1,000 for the 1994-99 period. Previous studies found that elevated childhood mortality is associated with short birth intervals. Data from the 1999 ZDHS support this theory; children born less than two years after a preceding sibling are more than twice as likely to die in infancy as those born 2 to 3 years after a preceding sibling (112 com- pared with 44 per 1,000). There is a strong negative association between a mother’s level of education and children’s survival; whereas the under-five mortality rate of children whose mothers have had no education is 119 per 1,000 live births, that of children whose moth- ers have a secondary education is only 21 per 1,000. Adult and Maternal Mortality. As in 1994, the 1999 ZDHS collected information that allows estimation of adult and maternal mortality. Adult mortality rose sharply from the period of the late 1980s-early 1990s to the mid- late 1990s. The maternal mortality ratio referring to the 1995-1999 period is estimated to be 695 maternal deaths per 100,000 live births. This estimate is more than double the estimate from the 1994 ZDHS (283 maternal deaths per 100,000 live births). If the trend is evaluated based on sibling history data in the 1999 ZDHS, a twofold increase is observed. The proportion of all female deaths that are maternal has changed from 15 percent based on data from the pre-1995 period to about 10 percent based on the most recent estimate from the 1999 ZDHS. This change indicates that nonmaternal female mortality (e.g., AIDS-related) has risen more rapidly than overall mortality. Perceived Problems in Accessing Women’s Health Care. Women are sometimes perceived to have problems in seeking health care services for themselves. The 1999 ZDHS data indicate that urban women are, in general, less likely than rural women to perceive prob- lems in getting health care. In both rural and urban areas, the majority of women did not perceive knowing where to go, getting permis- sion, and lack of a female service provider as problems to accessing women’s health care. Whereas one in four urban women perceived getting the money needed for treatment as a problem, the corresponding proportion among rural women is 39 percent. However, rural women cited lack of a nearby facility and hav- ing to take transport as major problems (45 percent and 43 percent, respectively). It is worth noting that fear of verbal abuse by the health service provider was reported by 14 percent of women regardless of residence. Nutrition. Breastfeeding is nearly universal in Zimbabwe; 98 percent of the chil- dren born in the past five years were breastfed at some time. Overall, 63 percent of the chil- dren were breastfed within an hour of birth. In Zimbabwe, supplementation starts early and exclusive breastfeeding is not common. Within four months after birth, 27 percent of children had received water, and 34 percent were given other supplements. Half of the children under age 3 in Summary of Findings * xix Zimbabwe were breastfed until 19.6 months. Although the median duration of breastfeeding varies only slightly by the child’s sex, urban or rural residence, and mother’s education, it varies by region, ranging from 18 months in Bulawayo to 23 months in Matabeleland North. Overall, 93 percent of children under 6 months old were breastfed 6 times or more in the 24 hours preceding the interview. In the ZDHS, all female respondents and all children under five were weighed and mea- sured to obtain data for estimating the levels of undernutrition. The results indicate that 27 percent of the children under five are stunted (i.e., short for their age), a condition reflecting chronic undernutrition; 6 percent are wasted (i.e., thin for their height), a problem indicating acute or short-term food deficit; and 13 percent are underweight, which may reflect stunting, wasting, or both. There are substantial provin- cial variations in the nutritional status of chil- dren. The prevalence of stunting ranges from 35 percent in Manicaland to 16 percent in Bulawayo. Wasting varies from 19 percent in Mashonaland West to 1 percent in Bulawayo. The nutritional status of women is represented by two indices: the height and body mass index (BMI). The BMI is computed as the ratio of weight in kilograms to the square height in centimetres (kg/cm2). Women whose BMI falls below 18.5 and women whose height is below 145 cm are considered at nutritional risk. The mean BMI for women in the 1999 ZDHS sample is 23.6 and 6 percent of women have a BMI of less than 18.5. The average height of women is 159.4 cm, and less than 2 percent of women are shorter than 145 cm. AIDS-related Knowledge and Behav- iour. Although practically all Zimbabwean women and men have heard of AIDS, the qual- ity 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. The percentage of female respondents who know someone who has the AIDS virus or someone who has died from AIDS, increased from 50 percent in 1994 to 60 percent in 1999. The corresponding proportions for male respondents are 49 percent and 64 percent, respectively. For both men and women, condom use and limiting sexual activity to one partner or fewer were the two most widely cited means of avoiding HIV/AIDS. Based on 1999 ZDHS data, men are about three times more likely than women to have used a condom during their last sexual encounter with any partner (28 percent and 9 percent, respectively). Condoms are used much less frequently during sex with cohabiting partners (includes mostly spouses) for both women (4 percent) and men (7 percent), compared with sex with noncohabiting partners (women, 42 percent; men, 70 percent). It is clear that both women and men understand that sex outside of a stable relationship entails greater risk. An important and troubling finding is that one-half of the women and one-third of the men in the age group 15-19 do not know where to get a condom. Since the 1994 ZDHS, knowledge of a source for condoms has much improved in all age groups, except this most vulnerable group, within which knowledge has worsened. Between 1994 and 1999, the percentage of respondents age 15-19 not knowing a source for condoms has increased from 40 to 50 percent (women) and from 24 to 32 percent (men). ZDHS respondents were asked whether they had ever been tested for HIV or the AIDS virus. Twelve percent of women and 9 percent of men reported that they had already been tested for HIV. Respondents who said that they had not were asked whether they would like to be tested. More than six in ten women and men who have never been tested wanted to be tested. With 12 percent of women already having had the test, 17 percent of the demand for AIDS testing has been satisfied. The corresponding figure for men is lower (14 percent). Furthermore, respondents who had not been tested were asked whether they knew of a specific place where they could go to get the test for the AIDS virus. The results show xx * Summary of Findings that 63 percent of women and 67 percent of men were not aware of a place where they could be tested. The 1999 ZDHS collected information on the respondent’s drinking habits (including getting “drunk”) over the past three months, which can be analysed against patterns of sexual activity. Drinking alcoholic beverages is associated with higher rates of both extramari- tal sexual activity and multiple partnering in unmarried individuals. Men who get drunk more than once in 30 days are twice as likely to be engaged in sexuality activity outside their marriage(s) than married men who do not drink (24 percent compared with 11 percent). Among unmarried men, 5 percent who do not drink had two or more partners in the past 12 months, compared with 33 percent of those who had been drunk more than once in the past 30 days. ZIMBABWE ZAMBIA BOTSWANA SOUTH AFRICA MOZAMBIQUE 0 50 100 Kilometres Bulawayo Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Limpopo River Zambezi River Dots indicate location of sample points for 1999 ZDHS Introduction * 1 INTRODUCTION 1 1.1 GEOGRAPHY AND ECONOMY Zimbabwe lies just north of the Tropic of Capricorn between the Limpopo and the Zambezi rivers. The country is landlocked, bordered by Mozambique on the east, South Africa on the south, Botswana on the west, and Zambia on the north and northwest. It is part of a great plateau, which constitutes the major feature of the geology of southern Africa. Almost the entire surface area of Zimbabwe is more than 300 metres above sea level, with nearly 80 percent of the land lying more than 900 metres above sea level and about 5 percent lying more than 1,500 metres above sea level. About 70 percent of the surface rock in Zimbabwe is granite, schist, or igneous, and it is rich in mineral wealth. Soil types range from clay or sandy loam in the high veldt to Kalahari sands in the hot and dry western part of the country. The climate of Zimbabwe is a blend of cool, dry, sunny winters and warm, but wet summers. Average annual precipitation totals increase with increasing altitude; however, temperature drops with increasing altitude. The Eastern Highlands of the country are therefore associated with cool and wet conditions, while the Sabi, Limpopo, and Zambezi valleys are hot and dry. Mining and agriculture are the backbone of the country’s economy, even though the country is richly endowed with some of the world’s most impressive manmade and natural tourist attractions, such as the Great Zimbabwe Ruins and Victoria Falls. Zimbabwe has abundant natural resources, including 8.6 million hectares of potentially arable land and more than 5 million hectares of forests, national parks, and wildlife estates. There are adequate supplies of surface and ground water, which could be harnessed for generation of electric power, irrigation of crops, and domestic and industrial use. Mineral resources are varied and extensive, including gold, asbestos, coal, nickel, iron, copper, lithium, and precious stones such as emeralds. The economy is diversified but biased toward agriculture and mining, which are by far the country’s major foreign-currency earning sectors. Besides mineral processing, major industries include food processing, construction, chemicals, textiles, wood and furniture, and production transport equipment. The main agricultural export products are tobacco, maize, cotton, sugar, and groundnuts. The agriculture sector has well-developed commercial and communal farming systems. The communal sector’s contribution towards the production of industrial raw materials and food products has increased substantially since 1980, despite its poor physical and socioeconomic infrastructure. Zimbabwe is in the final phases of its second five-year economic development programme, the Zimbabwe Programme for Economic and Social Transformation 1996-2000 (ZIMPREST). It was envisaged that the Government of Zimbabwe would implement ZIMPREST with financial support from the World Bank, the International Monetary Fund, and other international organisations. However, the financial aid has not been received. ZIMPREST advocated adequate and sustainable economic growth and social development to reduce poverty and create a basis for all of Zimbabwe’s citizens to provide a better life for themselves and their children. These goals were to be achieved 2 * Introduction Table 1.1 Population size and growth rate Population size and annual rate of increase in the population, Zimbabwe, 1901-1997 _________________________________ Annual growth Population rate Year (thousands) (percent) _________________________________ 1901 713 -- 1911 907 2.4 1921 1,147 2.4 1931 1,464 2.5 1941 2,006 3.2 1951 2,829 3.5 1961 3,969 3.5 1969 5,134 3.3 1982 7,608 3.0 1992 10,412 3.1 1997 11,789 2.5_________________________________ Source: Central Statistical Office, 1999 Table 1.2 Demographic indicators Selected demographic indicators, Zimbabwe 1992 and 1997 __________________________________________________ 1992 1997 Indicator Census IDS __________________________________________________ Total population (thousands) 10,412 11,789 Distribution by ethnic group (percent) African 98.8 99.0 European 0.8 u Coloured 0.3 u Asian 0.1 u Distribution by age group (percent) 0-14 45.1 43.0 15-64 51.3 53.0 65+ 3.3 4.0 Not stated 0.3 0.0 Crude birth rate (CBR) births per 1,000 population 34.5 34.7 Crude death rate (CDR) deaths per 1,000 population 9.5 12.2 Number of males per 100 females in the total population 95 92 Life expectancy at birth 61.0 57.0 __________________________________________________ U = Unknown (not available) Source: Central Statistical Office, 1999 through policy changes to encourage the use of labour- intensive technologies and market-friendly initiatives that enhance access to productive resources for a large part of the population. The government has been restructured for efficient delivery of key services to achieve economic growth targets. 1.2 POPULATION In 1997, the population of Zimbabwe was 11.8 million, an increase of 1.4 million from 10.4 million in 1992. Estimates rather than actual counts of the total population are available from the beginning of the century through 1951, when the census began to include nonAfri- cans. Table 1.1 shows that the average annual growth in the population reached a peak of 3.5 percent in 1951 and 1961 then dropped to 3.0 percent in 1982. The annual population growth rate between 1992 and 1997 was 2.5 percent. Table 1.2 shows that the popula- tion of people of African descent was 99 percent in 1997. The population of Euro- peans, Asians, and Coloureds made up the remaining 1 percent in 1997. The 1997 Intercensal Demographic Survey (IDS) estimated the crude birth rate (CBR) and the crude death rate (CDR) to be about 35 births per thousand popula- tion and 12 deaths per thousand popula- tion, respectively, yielding a natural in- crease rate of about 23 per thousand. Forty-three percent of the population of Zimbabwe was below age 15, 53 percent was between the ages of 15 and 64, and a very small proportion (4 percent) was age 65 or more. 1.3 OBJECTIVES OF THE SURVEY The 1999 Zimbabwe Demographic and Health Survey (ZDHS) is one of a series of surveys undertaken by the Cen- tral 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 Introduction * 3 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 followup 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. 1.4 ORGANISATION OF THE SURVEY SAMPLE DESIGN AND IMPLEMENTATION 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). Details concerning the ZDHS sample design are provided in Appendix A and estimations of sampling errors are included in Appendix B. 4 * Introduction QUESTIONNAIRES 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. 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. 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. 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. 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. Introduction * 5 TRAINING AND FIELDWORK 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. DATA PROCESSING 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. RESPONSE RATES Table 1.3 shows response rates for the ZDHS. 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. 6 * Introduction Table 1.3 Results of the household and individual interviews Number of households, number of interviews and response rates, according to urban-rural residence, Zimbabwe 1999 ___________________________________________________ Residence _______________ Result Urban Rural Total ___________________________________________________ FEMALE ___________________________________________________ Household interviews Households sampled Households found Households interviewed Household response rate Individual interviews: women Number of eligible women Number of eligible women interviewed Eligible woman response rate 2,058 4,952 7,010 1,988 4,524 6,512 1,923 4,446 6,369 96.7 98.3 97.8 1,940 4,268 6,208 1,809 4,098 5,907 93.2 96.0 95.2 ___________________________________________________ MALE ___________________________________________________ Household interviews Households sampled Households found Households interviewed Household response rate Individual interviews: men Number of eligible men Number of eligible men interviewed Eligible man response rate 1,021 2,467 3,488 977 2,270 3,247 942 2,227 3,169 96.4 98.1 97.6 1,009 1,961 2,970 845 1,764 2,609 83.7 90.0 87.8 1 A household refers to a person or group of related and unrelated persons who live together in the same dwelling unit(s), who acknowledge one adult male or female as head of household, who share the same housekeeping arrangements, and who are considered one unit. A member of the household is any person who usually lives in the household and a visitor is someone who is not a usual member of the household but had slept in the household the night before the interview date. The household population presented in this chapter includes, unless otherwise stated, all usual members of the household who slept in the household the night before the survey and visitors (de facto population). 2 The dependency ratio is defined as the sum of all persons under age 15 years or over 64 years divided by the number of persons age 15 to 64, multiplied by 100. Household Population and Characteristics * 7 2HOUSEHOLD POPULATION AND HOUSING CHARACTERISTICS This chapter presents information on some socioeconomic characteristics of the household population and the individual survey respondents, such as age, sex, education, and place of resi- dence. The environmental profile of households in the ZDHS sample is also examined. Taken together, these descriptive data provide a context for the interpretation of demographic and health indices, and can furnish an approximate indication of the representativeness of the survey. 2.1 HOUSEHOLD POPULATION BY AGE, SEX, AND RESIDENCE The 1999 ZDHS household questionnaire was used to collect data on the demographic and social characteristics of all usual residents of the sampled household and on visitors who had spent the previous night in the household.1 Table 2.1 shows the distribution of the 1999 ZDHS household population by five-year age groups, according to sex and urban-rural residence. The ZDHS households constitute a population of 26,224 persons; 51 percent of the population are female and 49 percent are male. There are larger numbers of the population in the younger age groups than in the older age groups of each sex, particularly in rural areas. The age-sex structure of the population is shown by use of a population pyramid in Figure 2.1. The pyramid has a wide but tapering base, a pattern that is consistent with a population experiencing a decline in fertility. The number of children under five is less than the number age 5 to 9 years, which in turn is also less than the 10 to 14 age group, a finding that is consistent with a recent fertility decline (see Chapter 4). 2.2 POPULATION BY AGE ACCORDING TO SELECTED SOURCES The population distribution by broad age groups in Table 2.2 shows that the proportion of children under 15 years of age has declined from around 46 percent in 1994 to 42 percent in 1999, while that of persons over 65 years of age is about 4 percent. The median age of the population has increased from 16.6 years in 1994 to 17.9 in 1999. There has been a general decline in the proportion of the population under 15 years and an increase in the median age since 1982. The dependency ratio2 calculated from the 1999 ZDHS has declined to 87 from around 100 in 1994. This means that there are about 87 persons in the “dependent” age (under 15 years and over 65 years) for every 100 persons in the working force (age 15 to 64 years in Zimbabwe. 8 * Household Population and Characteristics Table 2.1 Household population by age, sex, and residence Percent distribution of the de facto household population by five-year age group, according to sex and urban-rural residence, Zimbabwe 1999____________________________________________________________________________________________________ Urban Rural Total_______________________ _______________________ _______________________ Age group Male Female Total Male Female Total Male Female Total____________________________________________________________________________________________________ 0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80 + Missing/Don't know Total Number 12.9 13.0 12.9 14.6 13.3 14.0 14.1 13.2 13.6 10.6 10.4 10.5 16.3 15.1 15.7 14.4 13.6 14.0 9.6 11.3 10.4 17.9 16.7 17.3 15.1 15.0 15.1 10.2 13.0 11.5 14.2 10.5 12.3 12.9 11.2 12.0 13.1 15.2 14.2 7.0 7.8 7.4 9.1 10.1 9.6 11.8 10.9 11.4 5.4 6.6 6.0 7.5 7.9 7.7 7.9 6.8 7.4 4.1 4.5 4.3 5.4 5.2 5.3 5.1 5.6 5.3 3.5 4.5 4.0 4.0 4.9 4.4 4.7 3.5 4.1 2.7 3.7 3.2 3.4 3.6 3.5 4.4 2.5 3.5 2.7 3.0 2.8 3.3 2.8 3.0 2.8 3.0 2.9 2.0 4.1 3.1 2.3 3.8 3.0 3.1 1.4 2.3 2.4 2.5 2.5 2.6 2.2 2.4 1.6 1.5 1.5 2.2 2.2 2.2 2.0 2.0 2.0 0.9 1.0 1.0 1.8 2.0 1.9 1.5 1.7 1.6 0.7 0.4 0.5 1.2 1.2 1.2 1.0 1.0 1.0 0.3 0.4 0.3 1.2 0.9 1.0 0.9 0.7 0.8 0.2 0.2 0.2 0.7 1.4 1.1 0.5 1.0 0.8 0.0 0.0 0.0 0.1 0.1 0.1 0.1 0.1 0.1 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 4,346 4,085 8,430 8,571 9,223 17,794 12,917 13,307 26,224 Figure 2.1 Population Pyramid, Zimbabwe 1999 70+ 65-69 60-64 55-59 50-54 45-49 40-44 35-39 30-34 25-29 20-24 15-19 10-14 5-9 0-4 Age 0246810 0 2 4 6 8 10 Percent Male Female ZDHS 1999 Household Population and Characteristics * 9 Table 2.2 Population by age, according to selected sources Percent distribution of the population by age group, according to selected sources, Zimbabwe 1999 _______________________________________________________________________ 1982 1987 1992 1994 1999 Census ICDS1 Census ZDHS ZDHS Age group (De facto) (De jure) (De facto) (De facto) (De jure) _______________________________________________________________________ <15 47.7 47.7 45.1 46.2 42.4 15-64 49.2 49.1 51.3 50.0 53.3 65+ 2.9 3.2 3.3 3.8 4.2 Missing/Don't know 0.3 - 0.3 0.0 0.1 Total 100.0 100.0 100.0 100.0 100.0 Median age 16.1 16.0 17.1 16.6 17.9 Dependency ratio 102.9 103.7 94.4 99.7 87.4 _______________________________________________________________________ 1 Intercensal Demographic Survey Table 2.3 Household composition Percent distribution of households by sex of head of household, household size, and presence of foster children in household, according to urban-rural residence, Zimbabwe 1999_________________________________________ Residence_____________ Characteristic Urban Rural Total_________________________________________ Sex of head of household Male Female Total Number of usual members 0 1 2 3 4 5 6 7 8 9+ Total Mean size Percentage with foster children 1 76.9 60.2 66.5 23.1 39.8 33.5 100.0 100.0 100.0 0.0 0.1 0.0 21.0 12.2 15.6 17.9 10.8 13.5 18.4 14.2 15.8 14.1 15.3 14.8 11.2 14.6 13.3 7.3 11.8 10.1 4.3 8.3 6.8 2.4 5.2 4.1 3.4 7.6 6.0 100.0 100.0 100.0 3.5 4.6 4.2 11.2 27.4 21.2 _______________________________________ Note: Table is based on de jure members; i.e., usual residents. 1 Foster children are children under age 15 living in households with neither their mother nor their father present. 2.3 HOUSEHOLD COMPOSITION Table 2.3 shows that a female heads about one in three households in Zimbabwe (34 percent). The proportion of female-headed households has increased slightly since 1994 from 39 to 40 percent and 19 to 23 percent in rural and urban areas, respectively. The average household size has declined slightly from 4.7 persons in 1994 to 4.2 persons in 1999. Urban households are on average smaller (3.5 persons) than rural households (4.6 persons). Overall, 21 percent of households have foster children, as do 11 percent of urban households and 27 percent of rural households. Foster children are those persons under 15 years of age that have no natural parent in the household. 2.4 FOSTERHOOD AND ORPHANHOOD Detailed information on fosterhood and orphanhood of children under 15 years of age is presented in Table 2.4. Less than half (46 percent) of children under 15 years of age are living with both their parents, 26 percent are living with their mother (but not with their father), 5 percent with their father (but not their mother), and 20 percent are living with neither their natural mother nor their natural father. A higher proportion of children lives with both parents in urban areas (58 percent) than in rural areas (42 percent). Whereas 19 percent of children in urban areas live with their mother and 8 percent live 10 * Household Population and Characteristics Table 2.4 Fosterhood and orphanhood Percent distribution of de jure children under age 15 by survival status of parents and child's living arrangements, according to background characteristics, Zimbabwe 1999______________________________________________________________________________________________________ Living Living with mother with father but not father but not mother Not living with either parent____________ _______________________________________ Missing Living Father Mother informa- with alive/ alive/ tion on Number Background both Father Father Mother Mother Both Mother Father Both father/ of characteristic parents alive dead alive dead alive dead dead dead mother Total children______________________________________________________________________________________________________ Age 0-2 3-5 6-9 10-14 Sex Male Female Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo Total 57.8 30.1 2.5 0.9 0.3 5.2 0.6 0.5 0.2 2.0 100.0 2,156 50.4 22.2 4.1 1.8 0.6 13.3 0.7 2.4 0.9 3.3 100.0 2,115 42.1 18.7 6.3 4.3 1.1 15.3 1.7 4.1 2.2 4.1 100.0 3,023 39.0 15.8 8.4 5.5 2.0 14.1 1.9 5.1 3.6 4.5 100.0 4,018 46.9 20.3 5.6 3.8 1.2 12.2 1.2 3.5 1.9 3.3 100.0 5,659 44.3 20.7 6.2 3.5 1.1 12.9 1.6 3.4 2.2 4.1 100.0 5,653 57.6 13.9 4.6 7.0 1.1 7.8 1.3 1.5 1.4 3.7 100.0 2,869 41.5 22.8 6.4 2.5 1.2 14.2 1.4 4.1 2.3 3.7 100.0 8,444 43.0 24.4 7.0 1.6 1.8 10.8 1.0 3.8 2.8 3.9 100.0 1,967 55.0 17.4 5.2 2.4 0.7 10.2 1.3 2.9 2.5 2.4 100.0 1,028 40.6 23.4 4.6 4.5 0.4 14.9 2.7 4.6 1.7 2.7 100.0 1,089 49.2 12.9 7.4 4.9 3.0 11.8 1.0 3.3 2.3 4.1 100.0 1,114 39.7 23.4 5.5 2.3 0.6 16.8 1.0 3.5 1.3 5.9 100.0 693 32.1 27.2 5.8 2.0 0.8 18.5 1.4 3.2 1.1 7.9 100.0 691 42.1 18.3 6.8 4.3 1.0 15.2 2.0 4.2 1.9 4.1 100.0 1,504 40.8 26.2 7.0 1.7 0.7 14.2 0.9 4.2 3.3 1.1 100.0 1,382 60.2 13.2 3.2 7.7 1.0 6.6 1.1 1.9 1.1 4.0 100.0 1,284 50.9 18.9 5.1 6.3 1.3 10.7 1.7 0.8 1.0 3.2 100.0 561 45.6 20.5 5.9 3.6 1.2 12.6 1.4 3.4 2.1 3.7 100.0 11,313 ___________________________________________________________________________________________________________ Note: By convention, foster children are those who are not living with either biological parent. This includes orphans, i.e., children with both parents dead. with their father, in rural areas, the corresponding percentages are 29 percent and 4 percent, respectively. Of the children under 15 years of age, 11 percent have lost their father and 5 percent have lost their mother. The proportion of children who have lost both parents has increased from 1 percent in 1994 to 2 percent in 1999. Children in Harare are the most likely to live with both parents, while those in Matabeleland South are the least likely. Children in Matabelaland South are also more likely than other children to live apart from their parents although the parents are still alive. 2.5 EDUCATIONAL LEVEL OF HOUSEHOLD MEMBERS Table 2.5 shows the distribution of female and male household members age 6 and above by the highest level of education ever attended (even if they did not complete that level) and the median number of years of education completed, according to age, urban-rural residence, and province. Generally, educational attainment is slightly higher for males than for females. Nine in ten males have attended school versus 86 percent of females. Household Population and Characteristics * 11 Table 2.5 Educational attainment of household population Percent distribution of the de facto male and female household populations age six and over by highest level of education attained, and the median number of years of schooling, according to selected background characteristics, Zimbabwe 1999___________________________________________________________________________________________________________ Level of education Number Median _________________________________________________ of number Background No Some Some Don’t know/ women/ of years of characteristic education primary secondary Higher missing Total men schooling____________________________________________________________________________________________________________ MALE___________________________________________________________________________________________________________ Age 6-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+ Missing/Don't know Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo Total 27.2 71.9 0.0 0.0 0.9 100.0 1,523 0.1 1.5 89.0 9.4 0.0 0.1 100.0 1,955 4.0 1.3 32.7 65.1 0.6 0.3 100.0 1,663 7.8 1.5 26.5 66.4 5.5 0.1 100.0 1,169 10.1 1.5 22.7 68.7 7.1 0.0 100.0 972 10.2 2.7 20.1 63.9 13.1 0.3 100.0 695 10.3 4.6 42.6 41.2 10.2 1.4 100.0 519 7.8 9.3 52.7 30.0 6.9 1.0 100.0 440 6.6 7.9 61.9 25.6 3.6 1.1 100.0 421 6.4 12.5 61.4 20.8 5.1 0.2 100.0 294 6.0 15.1 60.4 18.5 4.8 1.1 100.0 341 5.5 23.7 58.9 12.0 4.6 0.8 100.0 257 4.1 39.5 49.5 7.5 2.9 0.7 100.0 512 1.9 10.0 12.6 25.0 0.0 52.4 100.0 8 8.1 4.0 33.1 55.0 7.3 0.6 100.0 3,689 8.8 11.6 61.2 25.1 1.7 0.4 100.0 7,079 4.9 9.3 57.7 30.0 2.9 0.0 100.0 1,669 5.5 12.3 58.7 27.3 1.4 0.4 100.0 923 4.9 12.5 56.0 29.2 1.3 1.0 100.0 1,030 5.4 12.5 57.3 27.9 1.8 0.5 100.0 1,116 5.3 11.0 57.7 29.0 1.8 0.5 100.0 593 5.5 9.3 63.1 24.0 2.9 0.7 100.0 554 5.0 8.3 55.4 31.5 4.4 0.5 100.0 1,290 6.0 9.6 59.4 28.5 2.5 0.0 100.0 1,150 5.2 3.5 27.8 59.2 8.6 0.9 100.0 1,727 10.0 4.8 36.8 53.1 5.0 0.3 100.0 716 8.2 9.0 51.6 35.4 3.6 0.5 100.0 10,768 6.2 ____________________________________________________________________________________________________________ FEMALE___________________________________________________________________________________________________________ Age 6-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+ Missing/Don't know Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo Total 26.5 72.7 0.0 0.0 0.8 100.0 1,475 0.3 1.4 86.6 11.9 0.0 0.2 100.0 2,002 4.2 2.0 31.7 65.9 0.2 0.2 100.0 1,497 8.1 1.9 31.7 62.1 4.0 0.3 100.0 1,339 9.1 3.7 33.0 58.7 4.5 0.0 100.0 1,054 8.6 6.0 37.8 51.0 5.0 0.1 100.0 692 8.1 17.5 58.2 20.2 3.9 0.1 100.0 646 5.7 21.8 62.4 11.8 2.9 1.0 100.0 480 4.8 22.8 63.0 11.6 2.2 0.5 100.0 374 4.6 33.3 54.1 9.3 2.9 0.4 100.0 503 3.2 38.4 52.2 4.5 3.4 1.6 100.0 290 2.0 44.8 44.8 8.5 2.0 0.0 100.0 264 1.1 56.5 38.7 2.4 0.9 1.5 100.0 583 0.0 90.5 0.0 0.0 0.0 9.5 100.0 10 0.0 5.5 37.1 52.6 4.4 0.5 100.0 3,480 8.0 18.2 60.8 19.8 0.9 0.3 100.0 7,730 4.2 16.9 61.0 20.0 1.9 0.1 100.0 1,787 4.5 22.2 55.7 21.5 0.4 0.3 100.0 936 3.9 15.7 60.3 22.5 1.0 0.6 100.0 1,022 4.6 20.0 56.6 22.1 0.5 0.8 100.0 1,074 4.3 17.8 57.4 23.1 1.5 0.3 100.0 630 4.5 13.7 58.5 26.0 1.4 0.5 100.0 663 5.1 13.1 55.3 29.2 1.9 0.4 100.0 1,438 5.2 16.5 58.0 23.7 1.7 0.1 100.0 1,330 4.6 3.7 34.7 56.7 4.4 0.5 100.0 1,620 8.4 5.5 39.6 50.6 4.0 0.3 100.0 710 7.7 14.2 53.5 29.9 2.0 0.4 100.0 11,209 5.4 12 * Household Population and Characteristics In Zimbabwe, although most of the population has a formal education, only a relatively small proportion goes beyond secondary school. The median number of years of schooling completed for females and males is 5.4 and 6.2 years, respectively. Among females, 32 percent have reached the secondary level of education and 2 percent have gone to higher education. The corresponding percentages for males are 39 percent and 4 percent, respectively. This trend toward increasing educational attainment is encouraging since the percentages of females and males who had gone to secondary or higher education in 1994 were 24 percent and 31 percent, respectively. As expected, educational attainment is greater in urban than in rural areas. 2.6 SCHOOL ENROLMENT RATIOS In Table 2.6, school enrolment ratios by level of schooling, sex, residence, and province for the population age 6 to 24 years are presented. The Net Enrolment Ratio (NER) is an indicator of participation in schooling among children of official school age and the Gross Enrolment Ratio (GER) indicates the participation of all children between the ages of 7 and 18. Data in Table 2.6 show that, among persons age 7 to 12, 65 percent are enrolled in primary school and 77 percent of persons 13 to 18 are enrolled in secondary school. For primary education, females are more likely to be enrolled in school than males. On the other hand, for secondary education, among persons 13 to 18, males are more likely to be in school than females (81 percent compared with 73 percent). At the primary level, NERs in urban areas are higher than in rural areas, but in the secondary level the pattern is reversed (see Figure 2.2). Consistent with this finding, enrolment in primary education in the urban provinces (Harare and Bulawayo) is higher than in other provinces, but enrolment in secondary education is lower than in other provinces. With reference to GER, the ratios are much higher than 100 for primary education, indicating that a large proportion of children over the age of 12 are still enrolled in primary school. For secondary education, the percentages are much lower than 100, indicating that many people age 13 to 18 are not currently enrolled in secondary education. Household Population and Characteristics * 13 Table 2.6 School enrolment ratios Net enrolment ratios (NER) and gross enrolment ratios (GER) for the de facto household population age 7-18 years, by level of schooling, sex, residence, and province, Zimbabwe 1999 ________________________________________________________________________________________ Net enrolment ratio1 Gross enrolment ratio2 Residence ____________________________ ___________________________ and province Male Female Total Male Female Total ________________________________________________________________________________________ PRIMARY SCHOOL ________________________________________________________________________________________ Residence Urban 78.6 75.9 77.2 128.4 126.3 127.4 Rural 60.4 64.0 62.2 143.4 134.6 139.0 Province Manicaland 60.2 60.0 60.1 149.0 141.3 145.3 Mashonaland Central 60.2 62.9 61.6 141.2 133.7 137.4 Mashonaland East 64.8 67.3 66.0 133.7 130.7 132.2 Mashonaland West 62.4 62.7 62.5 138.4 134.9 136.8 Matabeleland North 61.0 71.4 66.1 132.4 128.6 130.4 Matabeleland South 62.4 67.8 65.0 136.3 130.2 133.3 Midlands 61.4 68.4 65.0 140.9 126.2 133.1 Masvingo 61.8 63.2 62.4 148.7 142.4 145.6 Harare 83.7 76.9 80.0 130.4 126.8 128.5 Bulawayo 78.2 79.0 78.7 128.4 119.6 123.6 Total 63.9 66.5 65.2 140.0 132.7 136.3 ________________________________________________________________________________________ SECONDARY SCHOOL ________________________________________________________________________________________ Residence Urban 77.9 65.3 71.0 72.8 57.7 64.5 Rural 81.9 78.2 80.2 39.7 34.1 37.1 Province Manicaland 91.8 78.0 85.5 48.1 35.5 42.1 Mashonaland Central 78.0 66.4 71.8 38.4 29.6 33.8 Mashonaland East 79.4 81.6 80.4 46.0 39.2 42.9 Mashonaland West 74.2 79.9 77.1 36.0 35.5 35.7 Matabeleland North 74.2 75.0 74.6 34.0 39.0 36.2 Matabeleland South 66.7 74.0 70.4 32.5 41.5 36.8 Midlands 75.3 72.3 73.9 43.4 41.0 42.3 Masvingo 89.1 76.5 83.1 43.6 37.3 40.7 Harare 79.8 63.7 71.2 81.9 56.8 67.9 Bulawayo 75.8 66.5 70.9 70.2 61.3 65.5 Total 80.5 72.5 76.6 47.4 41.2 44.4 ________________________________________________________________________________________ 1 The NER for primary school is the percentage of the primary-school-age (7-12 years) population that is enrolled in primary school. The NER for secondary school is the percentage of the secondary-school-age (13-18 years) population that is enrolled in secondary school. By definition the NER cannot exceed 100%. 2 The GER for primary school is the total number of primary school students, regardless of age, expressed as the percentage of the official primary-school-age population. The GER for secondary school is the total number of secondary school students, regardless of age, expressed as the percentage of the official secondary-school-age population. If there are significant numbers of overage and underage students at a given level of schooling, the GER can exceed 100%. 14 * Household Population and Characteristics Figure 2.2 Net Enrolment Ratios by Sex and Residence, Zimbabwe 1999 79% 76% 78% 65% 60% 64% 82% 78% Male Female Male Female Urban Rural PRIMARY SCHOOL SECONDARY SCHOOL ZDHS 1999 2.7 REPETITION AND DROPOUT RATES Repetition and dropout rates describe the flow of students through the school system. Table 2.7 shows the repetition and dropout rates by grade and form, according to sex and residence. Repetition rates are high at the lowest and highest levels. The rates do not vary much by urban-rural residence except in form 4. However, they vary across provinces. Repetition rates in grades 1 and 2 are highest in Midlands and Matabeleland South, respectively. The repetition rates are highest in form 4 in Mashonaland Central, Matabeleland South and Masvingo. Overall, dropout rates in grade 7 and in forms 3 and 4 are high for both males and females throughout the country. In general, the rates are higher in rural than in urban areas. Girls are more likely than boys to drop out of school after grade 5. Household Population and Characteristics * 15 Table 2.7 Repetition and dropout rates Repetition and dropout rates for the de facto household population age 7-18 years by school grade/form, sex, residence, and province, Zimbabwe 1999 __________________________________________________________________________________________________________ Grade Form __________________________________________________ __________________________ Characteristic 1 2 3 4 5 6 7 1 2 3 4 __________________________________________________________________________________________________________ REPETITION RATE1 __________________________________________________________________________________________________________ Sex Male 6.1 5.5 3.2 3.3 2.1 1.9 3.6 1.4 3.5 1.1 7.6 Female 5.9 3.5 4.2 2.8 1.1 2.9 4.0 0.7 2.1 2.8 9.5 Residence Urban 3.3 2.4 4.6 0.3 0.0 0.0 1.9 1.2 1.4 2.1 12.1 Rural 6.7 5.1 3.4 3.8 2.1 3.0 4.3 1.0 3.7 1.7 5.4 Province Manicaland 8.6 3.8 2.4 2.9 2.2 3.5 1.1 0.0 4.6 3.4 5.1 Mashonaland Central 9.0 6.9 4.1 0.0 2.2 3.3 2.7 2.4 2.4 0.0 12.2 Mashonaland East 1.3 4.6 1.0 1.2 1.2 1.3 5.9 0.0 1.8 0.0 8.3 Mashonaland West 6.7 3.3 4.1 4.4 3.7 0.0 1.7 0.0 0.0 0.0 3.9 Matabeleland North 1.2 0.7 0.0 0.9 1.1 1.9 3.3 0.0 6.6 0.0 6.9 Matabeleland South 7.7 12.2 7.7 3.3 3.4 3.1 4.9 0.0 4.6 3.2 11.8 Midlands 12.2 4.1 5.6 6.0 1.0 4.9 5.1 0.0 0.0 2.0 5.8 Masvingo 3.7 4.8 6.1 5.8 0.9 2.1 7.5 3.5 7.1 3.4 12.4 Harare 2.0 3.0 2.6 0.0 0.0 0.0 3.1 2.9 2.2 0.0 9.8 Bulawayo 0.0 2.4 0.0 1.9 0.0 0.0 0.0 0.0 1.6 3.6 9.0 Total 6.0 4.5 3.7 3.0 1.6 2.4 3.8 1.1 2.9 1.9 8.5 __________________________________________________________________________________________________________ DROPOUT RATE2 __________________________________________________________________________________________________________ Sex Male 2.3 1.9 1.2 3.1 4.4 2.8 13.5 3.0 8.3 6.7 73.3 Female 2.2 1.8 2.2 1.7 2.6 5.5 20.2 5.7 10.3 15.4 71.8 Residence Urban 0.0 0.0 0.0 1.4 1.0 2.4 11.9 3.1 10.5 10.6 64.0 Rural 2.8 2.3 2.2 2.7 4.2 4.5 18.6 4.8 8.5 11.3 84.6 Province Manicaland 4.4 1.9 2.9 2.1 3.4 3.4 18.0 4.6 7.1 8.7 83.7 Mashonaland Central 3.5 1.9 4.7 2.2 6.3 8.5 18.2 2.4 12.7 12.3 76.5 Mashonaland East 2.3 2.0 1.2 1.1 1.3 0.0 8.5 1.8 2.2 0.0 50.0 Mashonaland West 2.1 2.2 1.1 5.6 4.4 8.2 11.7 7.3 12.3 6.9 95.0 Matabeleland North 0.7 0.8 1.7 1.1 1.8 3.3 20.4 4.4 9.9 16.1 89.6 Matabeleland South 0.8 1.6 1.6 0.0 3.0 2.0 28.0 7.1 6.2 20.1 58.4 Midlands 3.5 3.7 0.0 4.5 6.4 8.5 27.2 8.3 9.8 18.1 85.9 Masvingo 0.0 1.5 2.4 0.9 2.8 4.1 12.7 3.2 7.6 11.1 76.5 Harare 0.0 0.0 0.0 2.4 2.2 0.0 14.6 2.1 10.3 8.5 61.0 Bulawayo 0.0 0.0 0.0 1.8 0.0 0.0 5.9 1.6 18.2 11.4 57.6 Total 2.3 1.9 1.7 2.4 3.5 4.1 16.8 4.2 9.2 11.0 72.7 __________________________________________________________________________________________________________ 1 The repetition rate is the percentage of students in a given grade/form that are repeating that grade/form. 2 The dropout rate is the percentage of students in a given grade/form in the previous school year who are not attending school. 3 Ventilated, improved pit (VIP) toilets 16 * Household Population and Characteristics Table 2.8 Housing characteristics Percent distribution of households by housing characteristics, according to residence, Zimbabwe 1999_____________________________________________________ Residence______________ Characteristic Urban Rural Total_____________________________________________________ Electricity Yes No Missing Total Source of drinking water Piped into residence Piped into yard/plot Public tap Protected well Unprotected well Borehole Spring River/stream Pond/lake/dam Other Total Time to water source (in minutes) <15 minutes Median time to source Sanitation facility Flush toilet Traditional pit toilet (VIP) Latrine/Blair toilet No facility/bush/field Other Missing Total Main floor material Earth/sand Dung Wood planks Parquet or polished wood Vinyl or asphalt strips Ceramic tiles Cement Carpet Other Missing Total Total 87.4 8.3 38.4 12.5 91.5 61.4 0.1 0.2 0.2 100.0 100.0 100.0 49.5 2.1 20.2 41.4 4.0 18.2 7.5 11.3 9.8 0.7 12.8 8.2 0.3 17.7 11.1 0.5 41.6 25.9 0.0 0.5 0.3 0.0 8.0 5.0 0.0 1.7 1.0 0.1 0.3 0.2 100.0 100.0 100.0 98.7 42.3 63.8 0.0 14.9 4.5 93.7 2.2 37.1 2.7 22.0 14.6 2.9 35.9 23.3 0.3 39.5 24.6 0.1 0.2 0.1 0.3 0.2 0.3 100.0 100.0 100.0 1.3 24.7 15.8 0.0 20.1 12.5 1.5 0.0 0.6 0.7 0.1 0.3 0.4 0.1 0.2 3.3 0.1 1.3 81.9 54.5 64.9 10.5 0.5 4.3 0.2 0.0 0.1 0.2 0.0 0.1 100.0 100.0 100.0 2,424 3,945 6,369 2.8 HOUSING CHARACTERISTICS Information on the characteristics of the sampled households is shown in Table 2.8. The physical characteristics of the household reflect the household’s economic condition and have an important bearing on environmental exposure to disease. The proportion of households that have access to electricity in Zimbabwe has increased from 28 percent in 1994 to 38 percent in 1999. There is a significant difference in access to electricity between urban and rural areas. Although 87 percent of urban households have electricity, only 8 percent of rural households have electricity (see Figure 2.3). Piped water is available in 48 percent of all households, 98 percent in urban areas compared with 17 percent in rural areas. In rural areas, boreholes are the main source of drinking water (42 percent), followed by unprotected wells (18 percent). The median time to get to the source of drinking water is about 15 minutes in rural areas and less than a minute in urban areas. The proportion of households that have toilet facilities in Zimbabwe has increased from 65 percent in 1994 to 75 percent in 1999. Most households in urban areas (94 percent) have flush toilets. In rural areas, the most common toilet is either the Blair toilet3 (36 percent) or the traditional pit latrine (22 percent). Four in ten households in rural areas have no toilet facility. This proportion declined from 51 percent in 1994 to about 40 percent in 1999. The most commonly used flooring materials are cement (65 percent) and earth/dung (28 percent). In urban areas, 82 percent of households have cement floors compared with 55 percent in rural areas. Earth/dung floors are found in 45 percent of rural households. Household Population and Characteristics * 17 Table 2.9 Household durable goods Percentage of households possessing various durable consumer goods, by residence, Zimbabwe 1999 ____________________________________________________ Residence Durable ______________ consumer goods Urban Rural Total ____________________________________________________ Radio Television Telephone Refrigerator Bicycle Motorcycle Private car Modern oxcart None of the above Number of households 73.4 38.5 51.8 52.1 7.6 24.5 16.6 1.3 7.1 33.6 2.5 14.3 18.3 21.0 20.0 0.9 0.6 0.7 16.0 2.0 7.4 16.5 6.3 10.2 18.4 53.1 39.9 2,424 3,945 6,369 Figure 2.3 Housing Characteristics by Residence, Zimbabwe 1999 87% 98% 94% 8% 17% 2% 38% 48% 37% Electricity Piped Water Flush Toilet Urban Rural Total ZDHS 1999 2.9 HOUSEHOLD DURABLE GOODS Table 2.9 shows the percentage of households owning certain durable goods by residence. The availability of durable consumer goods is a rough measure of a household’s socioeconomic status. Among the selected durable goods, a radio is available in 52 percent, a bicycle in 20 percent, a television in 25 percent, and a modern oxcart in 10 percent of the households. The proportion of households with durable goods varies by urban-rural residence. Urban households are more likely than rural households to own modern conveniences powered by electricity, such as a radio (73 percent compared with 39 percent) and a refrigerator (34 percent compared with 3 percent). Overall, 18 percent of urban households and 53 percent of rural households have none of the selected durable goods. Characteristics of Respondents * 19 CHARACTERISTICS OF RESPONDENTS 3 This chapter presents information on some demographic and socio-economic characteristics of the survey respondents, such as age, education, and place of residence. These characteristics are for men age 15-54 and women age 15-49. This information is useful for understanding the factors that affect reproductive and contraceptive use behaviour as they provide a context for the interpretation of the demographic and health indices. 3.1 CHARACTERISTICS OF SURVEY RESPONDENTS Background characteristics of the 5,907 women and 2,609 men interviewed in the 1999 ZDHS are presented in Table 3.1. The distribution of the respondents according to age shows a similar pattern for males and females. The proportion of respondents in each age group declines with increasing age for both sexes. Forty-six percent of women and 47 percent of men are in the 15-24 age group, 29 percent of women and 27 percent of men are 25-34, and the remaining female respondents are 35-49, while the remaining male respondents are 35-54. Fifty-six percent of females compared with 46 percent of males are currently married. Male respondents were much more likely than female respondents to have never married (48 percent for males and 28 percent for females). Four percent of female respondents and 1 percent of males stated that they were widowed. Men are also less likely to be divorced than women. Although about 4 percent of women reported that they were divorced, 2 percent of men reported so. The proportion of males in urban areas (42 percent) is larger than that of females (39 percent). This is expected since men dominate in the rural-to-urban migration flows in search of work. The largest proportion of both male and female respondents (20 percent and 18 percent, respectively) is in Harare. About 15 percent of women and men are from Manicaland. The other provinces have populations ranging from 5 percent of the women and 6 percent of the men in Matabeleland North to 13 percent of women and men in Midlands. The majority of the respondents (84 percent of women and 66 percent of men) are Christians. Males, however, are more likely (17 percent) to be atheist than females (8 percent). Men are also more likely to be traditionalist (14 percent) than females (4 percent). 3.2 EDUCATIONAL ATTAINMENT BY BACKGROUND CHARACTERISTICS Overall, the level of education in Zimbabwe is high, and males are more educated than females. The proportion of women who have never been to school is more than two times greater than that of males (7 percent and 3 percent, respectively). Men are more likely to reach secondary school (60 percent) than women (50 percent). Men are also twice as likely (6 percent) to have more than a secondary education than females (3 percent) (see Figure 3.1). 20 * Characteristics of Respondents Table 3.1 Background characteristics of respondents Percent distribution of women and men by selected background characteristics, Zimbabwe 1999______________________________________________________________________________________ Number of women Number of men__________________ __________________ Background Weighted Un- Weighted Un- characteristic percent Weighted weighted percent Weighted weighted______________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 Marital status Never married Married Living together Widowed Divorced Not living together Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo Education level attained No education Primary Secondary Higher Currently attending school Yes No Religion Traditional Christian Muslim None Other Missing All women 24.5 1,447 1,468 27.3 713 761 21.9 1,294 1,232 19.4 506 506 17.5 1,034 1,011 16.5 430 376 11.3 668 650 10.8 281 271 10.8 637 672 8.4 220 218 7.9 466 492 6.8 178 184 6.1 361 382 6.8 177 173 NA NA NA 4.0 104 120 27.7 1,637 1,683 48.0 1,252 1,287 56.3 3,325 3,130 46.4 1,210 1,180 4.8 283 423 1.1 29 23 4.2 251 249 1.4 37 36 3.5 206 196 2.0 51 53 3.5 205 226 1.1 30 30 38.6 2,279 1,809 41.8 1,090 845 61.4 3,628 4,098 58.2 1,519 1,764 14.9 882 556 13.8 360 233 8.1 477 567 9.1 236 307 7.8 461 464 8.3 217 214 9.5 559 491 10.3 268 225 5.1 302 601 5.6 146 264 5.4 321 631 4.6 120 233 12.5 741 673 11.8 308 291 10.7 629 633 8.6 225 238 18.2 1,077 562 19.7 514 271 7.7 457 729 8.2 214 333 6.7 396 437 2.5 66 78 40.2 2,377 2,518 31.8 830 933 50.2 2,965 2,803 59.6 1,556 1,458 2.8 168 149 6.0 157 140 11.3 668 662 17.0 443 450 87.5 5,167 5,178 82.5 2,151 2,145 3.5 207 187 14.2 370 331 83.9 4,956 4,869 65.6 1,713 1,668 0.5 31 29 1.2 31 29 8.4 498 612 16.8 438 524 3.3 195 192 2.1 54 54 0.3 20 18 0.2 5 3 100.0 5,907 5,907 100.0 2,609 2,609 ____________________________________________________________________________________ NA = Not applicable Characteristics of Respondents * 21 Figure 3.1 Educational Attainment by Sex, Zimbabwe 1999 7% 40% 50% 3%3% 32% 60% 6% No Education Primary Secondary Higher Female Male ZDHS 1999 Presented in Table 3.2 are the percentage distributions of female and male respondents by highest level of education attended, according to age, urban-rural residence, and province. Overall, men are more likely than women to be educated. Younger people are more likely to be educated and to reach higher levels of education than older people. The proportion of women without education ranges from 1 percent for women age 15-19 years, to 21 percent for women age 45-49. These proportions range from almost zero percent for men age 15-19 years to 14 percent for men over 50 years. The majority of women age 45-49 (62 percent) have a primary education; on the other hand, the majority of women age 15-19 have a secondary education (68 percent). This pattern is similar for males. Whereas 58 percent of men 45-49 have a primary education, 70 percent of men 15-19 have gone to secondary school. Rural people are less educated than their urban counterparts. About 10 percent of rural women do not have an education, compared with 2 percent of urban women. The corresponding figures for men are 3 percent and 2 percent for rural men and urban men, respectively. Whereas only 34 percent of rural women have a secondary education or higher, 76 percent of urban women have at least a secondary education. The improvement in levels of education reflects the significant expansion and improved accessibility to the educational system after independence in 1980. The distribution of education is fairly similar across provinces with the exceptions of Harare and Bulawayo, which are urban centers, and Midlands province. Matabeleland North, Mashonaland West, and Mashonaland Central have the highest levels of women reporting no education (10 percent, 12 percent, and 16 percent, respectively). All the provinces have a majority of women who have attended primary school. In all provinces, the majority of men have gone to secondary school. 22 * Characteristics of Respondents Table 3.2 Educational attainment by background characteristics Percent distribution of women and men by highest level of schooling attended, according to selected background characteristics, Zimbabwe 1999___________________________________________________________________________________________ Highest level of schooling attended Number________________________________________ of Background No edu- women/ characteristic cation Primary Secondary Higher Total men___________________________________________________________________________________________ WOMEN___________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo All women 1.3 30.7 67.5 0.4 100.0 1,447 1.8 32.2 63.1 2.9 100.0 1,294 2.9 34.5 58.4 4.2 100.0 1,034 5.5 37.9 51.2 5.4 100.0 668 17.9 60.1 18.4 3.6 100.0 637 20.5 64.4 12.0 3.1 100.0 466 21.4 61.8 14.5 2.3 100.0 361 1.7 22.6 70.9 4.9 100.0 2,279 9.9 51.3 37.2 1.6 100.0 3,628 9.1 49.9 37.7 3.4 100.0 882 16.3 45.6 37.6 0.6 100.0 477 6.5 47.7 43.9 1.9 100.0 461 11.5 50.2 37.7 0.5 100.0 559 10.1 46.4 40.9 2.6 100.0 302 3.6 47.9 46.1 2.4 100.0 321 6.1 39.9 51.8 2.2 100.0 741 6.6 48.1 42.7 2.7 100.0 629 0.9 20.5 73.8 4.8 100.0 1,077 1.4 23.5 70.1 5.1 100.0 457 6.7 40.2 50.2 2.8 100.0 5,907 ___________________________________________________________________________________________ MEN___________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo All men 0.1 29.8 70.0 0.1 100.0 713 1.1 25.9 67.9 5.1 100.0 506 1.1 18.1 72.3 8.5 100.0 430 1.0 18.4 62.4 18.3 100.0 281 3.6 46.5 42.2 7.6 100.0 220 6.7 50.5 36.3 6.5 100.0 178 9.6 57.6 26.6 6.1 100.0 177 14.0 60.0 22.6 3.4 100.0 104 1.5 14.8 74.2 9.6 100.0 1,090 3.3 44.0 49.2 3.5 100.0 1,519 2.2 35.4 57.7 4.6 100.0 360 3.1 45.1 50.7 1.2 100.0 236 0.9 40.8 55.4 2.8 100.0 217 3.0 38.3 49.9 8.8 100.0 268 3.6 40.5 50.1 5.8 100.0 146 4.7 40.9 49.3 5.1 100.0 120 1.6 35.0 55.7 7.7 100.0 308 5.6 41.7 47.4 5.2 100.0 225 1.5 10.3 80.8 7.4 100.0 514 2.1 19.2 69.4 9.3 100.0 214 2.5 31.8 59.6 6.0 100.0 2,609 3.3 ACCESS TO MASS MEDIA Table 3.3 shows the percentage of female and male respondents who were exposed to different types of mass media by age, urban-rural residence, province, and level of education. It is important to know which types of persons are more likely to be reached by the media to plan Characteristics of Respondents * 23 Table 3.3 Access to mass media Percentage of women and men who usually read a newspaper weekly, watch television weekly, and listen to the radio daily, by selected background characteristics, Zimbabwe 1999___________________________________________________________________________________________ Number No Reads a Watches Listens to All of Background mass newspaper television the radio three women/ characteristic media weekly weekly daily media men___________________________________________________________________________________________ WOMEN___________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo Education No education Primary Secondary Higher All women 43.8 32.1 33.1 42.8 17.2 1,447 40.5 32.4 34.0 46.9 17.2 1,294 42.0 28.2 32.1 47.1 16.0 1,034 40.1 29.6 38.4 49.5 18.3 668 52.4 16.8 28.6 38.7 10.9 637 59.5 15.2 23.0 30.8 7.5 466 56.6 15.8 21.7 35.1 9.1 361 12.5 52.9 65.6 69.5 34.5 2,279 65.9 11.1 10.5 26.9 3.0 3,628 60.3 14.8 17.5 31.9 6.2 882 51.1 19.0 21.8 38.3 8.2 477 60.4 18.5 17.4 30.4 7.5 461 52.4 17.6 23.2 38.1 8.6 559 56.8 15.4 22.1 35.2 7.9 302 63.2 17.0 12.4 26.3 4.4 321 52.9 17.1 23.9 36.1 8.2 741 64.4 15.7 13.9 26.1 5.8 629 10.5 54.8 68.7 73.3 37.9 1,077 9.6 62.4 64.9 72.2 38.7 457 79.4 0.4 6.1 17.0 0.0 396 61.4 9.1 16.3 31.0 3.3 2,377 30.2 42.3 44.8 55.4 24.8 2,965 4.4 80.9 80.3 66.6 49.5 168 45.3 27.2 31.8 43.3 15.2 5,907 ___________________________________________________________________________________________ MEN___________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo Education No education Primary Secondary Higher All men 39.7 30.0 35.0 46.8 16.9 713 29.9 46.6 42.6 56.0 27.0 506 21.6 59.7 49.7 64.9 37.0 430 19.0 54.0 44.9 64.1 29.5 281 28.8 41.1 40.6 58.8 25.5 220 28.4 39.8 41.5 53.5 20.3 178 32.7 39.1 40.0 58.4 27.8 177 42.3 29.6 33.8 46.7 15.1 104 5.4 78.2 74.4 74.2 52.2 1,090 48.6 17.5 17.3 42.4 5.7 1,519 41.8 24.5 24.5 51.9 13.5 360 37.0 30.3 24.1 48.6 10.0 236 38.9 22.2 24.0 51.3 10.6 217 31.4 26.2 42.6 52.1 13.9 268 31.6 46.8 42.9 51.5 27.3 146 47.0 28.0 17.5 39.2 10.1 120 34.5 32.6 32.7 53.0 17.8 308 64.6 17.8 11.8 30.2 9.2 225 5.2 85.6 76.4 71.6 55.7 514 4.2 74.2 73.9 83.5 51.4 214 61.8 2.9 18.4 30.9 2.9 66 50.1 16.0 22.3 40.8 7.7 830 21.3 55.0 48.2 61.6 31.0 1,556 5.5 82.5 80.9 85.6 68.1 157 30.5 42.9 41.2 55.7 25.2 2,609 1 Employment is defined as receiving payment in cash or kind for work. 24 * Characteristics of Respondents programmes intended to spread information about health and family planning. Twenty-seven percent of female respondents and 43 percent of male respondents read newspapers at least once a week, 32 percent of women and 41 percent of men watch television at least once a week, and 43 percent of women and 56 percent of men listen to the radio daily. It is important to note that there are differentials by sex and residence in accessing the different forms of mass media. Generally, urban residents and men are more likely to have access to all forms of mass media than rural residents and women. Whereas 66 percent of rural women and 13 percent of urban women reported having no access to any form of mass media, 49 percent of rural males compared with 5 percent of urban males have no access to any form of media. Men and women age 20-35, those who are better educated, and persons living in Harare and Bulawayo are more likely to read newspapers, watch television, and listen to the radio than other persons. 3.4 WOMEN’S EMPLOYMENT STATUS The 1999 ZDHS collected information from women about their current employment situation.1 Table 3.4 shows that 51 percent of women are not currently employed, 23 percent are employed all year, 17 percent are employed seasonally, and 5 percent are employed occasionally (see Figure 3.2). Rural women are more likely to work in seasonal jobs (23 percent) than urban women (6 percent). On the other hand, urban women are more likely to report regular full-time employment (33 percent) than rural women (18 percent). Regular full-time work tends to increase and seasonal work decreases with increasing level of education. Substantial provincial variations exist in the employment characteristics of women. Women in Matabeleland North, Matabeleland South, and Mashonaland East are much more likely than women in other provinces to report not having been employed in the past 12 months. Seasonal work is most commonly reported in Midlands (33 percent), Masvingo (31 percent), and Mashonaland Central (24 percent). Women in Harare (32 percent) and Bulawayo (38 percent) are more likely to report working for the whole year. Characteristics of Respondents * 25 Table 3.4 Employment Percent distribution of women by employment status and continuity of employment, according to selected background characteristics, Zimbabwe 1999__________________________________________________________________________________________ Not currently employed_________________ Did not work Worked Currently employed in last in _________________________ Number Background 12 last 12 Season- Occasion- of characteristic months months All year ally ally Missing Total women__________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo Education No education Primary Secondary Higher All women 69.1 5.1 11.0 9.3 2.8 2.8 100.0 1,447 45.6 8.4 20.4 16.1 5.3 4.2 100.0 1,294 36.9 4.6 30.0 16.5 7.1 4.8 100.0 1,034 33.9 1.8 32.5 21.0 4.0 6.8 100.0 668 33.7 2.3 32.6 20.8 4.1 6.3 100.0 637 35.4 3.6 26.8 22.6 4.4 7.3 100.0 466 34.1 4.7 25.9 25.4 4.3 5.6 100.0 361 45.8 4.4 32.5 6.4 6.4 4.4 100.0 2,279 45.7 5.2 17.5 23.1 3.5 5.0 100.0 3,628 52.7 4.3 16.6 11.1 3.1 12.2 100.0 882 32.3 6.6 25.9 24.2 9.9 1.0 100.0 477 55.6 2.2 25.4 14.7 2.2 0.0 100.0 461 43.1 3.2 19.7 19.8 1.2 12.9 100.0 559 73.6 1.2 15.4 6.6 1.7 1.5 100.0 302 62.2 3.3 16.6 9.2 3.3 5.5 100.0 321 24.4 12.9 18.4 33.3 7.9 3.2 100.0 741 41.6 3.4 19.7 31.2 2.5 1.6 100.0 629 48.4 3.9 32.0 6.4 6.0 3.2 100.0 1,077 43.6 4.3 38.1 6.6 5.5 1.9 100.0 457 43.7 3.3 21.2 25.0 2.2 4.6 100.0 396 41.9 5.2 20.7 22.6 4.0 5.6 100.0 2,377 50.8 5.1 23.0 11.6 5.6 3.9 100.0 2,965 13.9 2.4 70.0 2.1 1.8 9.9 100.0 168 45.7 4.9 23.3 16.6 4.6 4.8 100.0 5,907 26 * Characteristics of Respondents Figure 3.2 Percent Distribution of Women 15-49 by Employment Status, Zimbabwe 1999 Not currenlty employed, did not work in the last 12 months 46% Missing 5% Employed occasionally 5% Employed seasonally 17% Employed all year 23% Not currently employed, worked in the last 12 months 5% ZDHS 1999 3.5 OCCUPATION Information on current occupation of employed women is shown in Table 3.5. Thirty- nine percent of women have agricultural occupations and 61 percent work in non-agricultural jobs. The majority of women who work in agriculture work on family farms, while those with nonagricultural jobs work in sales and services (38 percent) and professional, technical, and managerial occupations (11 percent). As expected, employment in nonagricultural occupations is relatively more common among women who live in urban areas and those who have a formal education. Characteristics of Respondents * 27 Table 3.5 Occupation Percent distribution of currently employed women by occupation (agricultural and nonagricultural) and type of agricultural land worked or type of nonagricultural employment, according to background characteristics, Zimbabwe 1999 _____________________________________________________________________________________________________________ Agricultural Nonagricultural ____________________________ _______________________________ Communal/ Prof./ Sales Manual Number Background Own Resettle- Rented Other Tech./ and ________________ of characteristic land ment land land Manag. services Skilled Unskilled Missing Total women _____________________________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo Education No education Primary Secondary Higher All women 27.4 1.6 0.0 13.9 2.2 47.8 5.8 0.9 0.4 100.0 374 21.7 2.4 0.7 11.3 7.4 45.9 8.9 1.8 0.0 100.0 595 20.9 1.7 0.0 11.1 13.8 38.4 13.3 0.9 0.0 100.0 605 29.8 2.1 0.9 7.2 16.9 28.9 13.5 0.8 0.0 100.0 429 25.1 3.0 0.0 8.3 10.3 37.4 13.8 2.2 0.0 100.0 407 33.5 2.2 0.8 7.1 11.4 32.5 11.3 1.2 0.0 100.0 284 33.9 2.8 0.0 10.2 10.7 27.4 12.4 2.7 0.0 100.0 222 5.0 0.1 0.4 1.1 17.8 56.5 18.4 0.8 0.0 100.0 1,134 39.3 3.5 0.3 15.8 5.9 26.5 6.8 1.8 0.1 100.0 1,782 25.4 3.2 0.4 15.3 7.2 40.5 6.2 1.2 0.4 100.0 379 29.5 2.7 0.0 27.2 2.9 27.5 8.6 1.6 0.0 100.0 291 21.4 0.5 0.0 23.0 9.2 36.7 8.1 1.0 0.0 100.0 195 31.2 3.4 0.0 26.2 6.3 27.0 4.2 1.6 0.0 100.0 300 2.2 0.0 3.1 2.2 19.4 51.0 21.5 0.6 0.0 100.0 76 6.9 0.9 0.9 6.5 16.3 50.0 13.7 4.8 0.0 100.0 111 44.2 4.4 0.7 1.4 5.1 30.8 11.4 2.0 0.0 100.0 465 53.7 3.3 0.0 2.7 8.5 21.1 9.8 0.8 0.0 100.0 346 7.1 0.0 0.4 1.5 20.1 54.9 15.3 0.7 0.0 100.0 514 1.1 0.0 0.0 0.0 18.4 56.3 22.9 1.3 0.0 100.0 238 31.5 3.0 0.0 32.0 1.4 24.1 5.8 2.3 0.0 100.0 210 35.1 3.3 0.3 13.9 1.9 36.6 7.5 1.4 0.0 100.0 1,257 19.1 1.1 0.5 3.7 12.2 45.0 16.8 1.4 0.1 100.0 1,308 0.7 1.1 0.0 1.4 85.1 9.9 1.8 0.0 0.0 100.0 141 26.0 2.2 0.3 10.1 10.5 38.2 11.3 1.4 0.1 100.0 2,916 _____________________________________________________________________________________________________________ Note: Prof./Tech./Manag. includes professional, technical, clerical, and managerial occupations. 3.6 EMPLOYER AND FORM OF EARNINGS Table 3.6 shows the percent distribution of the 2,916 women who are currently employed and their form of earnings, according to background characteristics. More than half of the women are self-employed: 47 percent earn cash, and 7 percent are not earning cash. About 46 percent of women work for others: 35 percent are employed by a nonrelative, and 11 percent work for a relative. Masvingo has the largest proportion (22 percent) of women who are employed by relatives without earning cash. On the other hand, women in Matabeleland North are the most likely to be self-employed and earning cash. In rural areas, 10 percent of employed women work for relatives without earning cash, compared with only 1 percent in urban areas. The distribution of employed women by employer and form of earnings varies by level of education, with women with a secondary or higher education being much more likely than women with less education to be employed by a nonrelative in a job for which they are paid in cash. 28 * Characteristics of Respondents Table 3.6 Employer and form of earnings Percent distribution of currently employed women by employer and type of earnings, according to background characteristics, Zimbabwe 1999____________________________________________________________________________________________________ Employed by Employed by Self-employed a nonrelative a relative_______________ ______________ _______________ Does Does Does Number Background Earns not earn Earns not earn Earns not earn of characteristic cash1 cash2 cash1 cash2 cash1 cash2 Missing Total women______________________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo Education No education Primary Secondary Higher All women 22.2 5.0 48.4 0.8 5.1 17.9 0.5 100.0 374 39.2 6.2 42.4 0.5 5.1 6.3 0.3 100.0 595 49.2 5.6 38.7 0.7 1.1 3.9 0.7 100.0 605 50.9 9.6 31.2 0.7 3.8 3.6 0.1 100.0 429 58.3 7.4 24.8 0.2 4.9 4.2 0.2 100.0 407 57.9 8.5 21.0 0.3 7.1 5.1 0.0 100.0 284 55.8 10.8 20.5 0.9 6.8 4.8 0.3 100.0 222 51.6 2.7 41.6 0.5 2.0 1.2 0.4 100.0 1,134 43.4 10.0 30.1 0.6 5.9 9.7 0.3 100.0 1,782 53.7 0.8 31.0 0.8 10.5 2.8 0.4 100.0 379 39.8 12.4 41.4 0.5 2.8 2.5 0.5 100.0 291 32.1 11.2 50.5 1.0 4.6 0.5 0.0 100.0 195 26.0 14.4 43.1 0.7 6.7 9.1 0.0 100.0 300 58.6 1.7 38.6 0.0 0.0 1.1 0.0 100.0 76 52.4 0.9 41.0 1.3 4.0 0.4 0.0 100.0 111 54.3 11.3 17.8 0.5 3.4 12.2 0.4 100.0 465 49.6 8.9 14.3 0.0 4.9 22.2 0.0 100.0 346 45.9 3.7 46.3 0.7 1.9 0.7 0.7 100.0 514 56.6 0.0 40.8 0.3 1.6 0.3 0.5 100.0 238 39.4 8.8 38.6 0.0 8.2 4.6 0.4 100.0 210 49.8 9.2 27.6 0.7 5.1 7.3 0.4 100.0 1,257 48.6 5.6 35.3 0.7 3.4 6.2 0.2 100.0 1,308 9.9 1.2 84.2 0.0 1.4 1.9 1.4 100.0 141 46.6 7.2 34.6 0.6 4.4 6.4 0.4 100.0 2,916 ____________________________________________________________________________________________________ 1 Includes both women who receive only cash and those who receive cash and in-kind payment. 2 Includes both women who receive in-kind payment and those who receive no payment. 3.7 DECISION ON USE OF EARNINGS Information on who decides how to use the cash earned by employed women can be used as a measure of the status of women. Table 3.7 shows that 63 percent of the 2,502 women who receive cash earnings decide for themselves how to spend their money and 24 percent decide jointly with their husband/partner. Only 8 percent of women who earn cash reported that their husband/partner decides how their earnings will be used (see Figure 3.3). Younger, urban women with more education are less likely to report that their husband/partner decides how to spend their earnings, but this pattern is not a strong one. Characteristics of Respondents * 29 Table 3.7 Decision on use of earnings and contribution of earnings to household expenditures Percent distribution of women receiving cash earnings by person who decides how earnings are used, according to selected background characteristics, Zimbabwe 1999 __________________________________________________________________________________________ Person who decides how earnings are used ___________________________________________ Jointly Jointly with with Number Background Self Husband/ husband/ Someone someone of characteristic only partner partner else else Total women __________________________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo Education No education Primary Secondary Higher Marital status Not married Currently married Total 59.1 7.5 10.0 19.2 4.1 100.0 285 64.0 7.2 21.0 6.1 1.7 100.0 518 60.9 10.7 26.0 0.6 1.8 100.0 541 60.4 7.5 30.7 0.6 0.7 100.0 370 66.4 6.3 26.2 0.9 0.3 100.0 359 64.7 5.9 27.1 1.0 0.8 100.0 244 61.7 11.6 26.3 0.4 0.0 100.0 185 72.6 4.7 18.7 3.2 0.9 100.0 1,084 54.8 10.7 28.1 4.5 1.9 100.0 1,419 60.6 8.1 25.0 3.4 3.0 100.0 361 54.1 14.8 23.3 6.6 1.2 100.0 246 43.3 10.0 39.2 4.1 3.5 100.0 170 56.3 10.6 30.0 2.2 0.9 100.0 228 61.8 6.0 29.9 2.3 0.0 100.0 74 73.2 5.5 14.1 6.1 1.2 100.0 108 53.5 10.1 29.5 5.5 1.1 100.0 353 64.8 9.8 17.9 5.5 1.9 100.0 238 77.6 4.3 16.1 1.6 0.4 100.0 487 69.0 2.4 23.5 4.0 1.1 100.0 237 53.4 12.4 28.1 3.6 2.5 100.0 182 58.5 9.3 26.8 4.0 1.3 100.0 1,040 68.6 6.5 19.0 4.4 1.5 100.0 1,144 53.5 6.6 39.3 0.0 0.7 100.0 136 86.9 0.2 0.3 10.2 2.4 100.0 873 49.4 12.3 36.7 0.6 0.9 100.0 1,629 62.5 8.1 24.0 3.9 1.4 100.0 2,502 30 * Characteristics of Respondents Table 3.8 Control over earnings according to household expenditures Percent distribution of women who receive cash earnings by person who decides how earnings are used and marital status, according to perceived proportion of household expenditures met by earnings, Zimbabwe 1999 _______________________________________________________________________________________________________________________ Married or separated Not married ________________________________________________ _______________________________________________ Jointly with: Jointly with: ____________ Hus- Some- ____________ Hus- Some- Contribution Hus- Some- band/ one Hus- Some- band/ one to household Self band/ one partner else Num- Self band/ one partner else Num- expenditures only partner else only only Total ber only partner else only only Total ber _______________________________________________________________________________________________________________________ All 54.9 29.0 0.5 14.2 1.4 100.0 372 90.1 0.0 0.7 0.0 9.1 100.0 207 Half or more 57.8 30.9 1.1 8.7 1.4 100.0 535 82.1 0.3 2.3 0.5 14.9 100.0 219 Less than half 45.7 40.5 0.9 12.3 0.6 100.0 860 80.5 0.7 4.4 0.2 14.2 100.0 252 None/almost none 78.4 11.8 2.1 7.0 0.7 100.0 133 89.0 0.0 2.3 0.0 8.7 100.0 167 Total 53.2 33.5 1.0 11.2 1.0 100.0 1,903 84.9 0.3 2.5 0.2 12.1 100.0 845 Figure 3.3 Percent Distribution of Employed Women 15-49 Who Receive Cash Earnings by Person Who Decides on Use of Earnings, Zimbabwe 1999 Respondent 63% Husband/ Partner 8% Someone Else 4% Jointly 25% ZDHS 1999 3.8 CONTROL OVER EARNINGS BY CONTRIBUTION TO HOUSEHOLD EXPENDITURES Table 3.8 indicates the perceived proportion of household expenditures met by earnings by marital status and the woman’s control over her earnings. Among married or separated women who stated that they decide on their own how to use their earnings, 35 percent said that the decision to use the earnings is made jointly with their husband/partner or by someone else. In addition, 11 percent said that the decision is made entirely by their husband/partner. Unmarried women are more likely to have control over the spending of the cash they earn than married women. Among women whose earnings are used to meet household expenses, those who contribute at least half of the household expenditures are more likely to have sole control over decisions about the use of their income than women who contribute less. Characteristics of Respondents * 31 Table 3.9 Household decisionmaking Percent distribution of women by person who makes specific household decisions and marital status, according to type of decision, Zimbabwe 1999 ___________________________________________________________________________________________________________________________ Married or separated Not married ________________________________________________ _______________________________________________ Jointly with: Jointly with: ____________ Hus- Some- ____________ Hus- Some- Hus- Some- band/ one Hus- Some- band/ one Household Self band/ one partner else Num- Self band/ one partner else Num- decision only partner else only only Total ber only partner else only only Total ber ___________________________________________________________________________________________________________________________ Own health care 50.5 12.0 0.3 30.0 7.2 100.0 3,802 40.0 0.7 1.6 0.4 57.4 100.0 2,094 Large household purchases 18.0 39.9 0.7 34.3 7.1 100.0 3,802 21.9 0.8 1.4 0.3 75.6 100.0 2,094 Daily household purchases 57.4 19.6 0.9 15.3 6.7 100.0 3,802 23.5 0.7 2.2 0.3 73.2 100.0 2,094 Visits to family or relatives 31.3 42.8 1.2 19.6 5.0 100.0 3,802 33.7 0.6 4.9 0.3 60.5 100.0 2,094 What food to cook each day 83.6 5.8 1.1 3.3 6.1 100.0 3,802 29.8 0.7 3.6 0.2 65.7 100.0 2,094 3.9 HOUSEHOLD DECISIONMAKING One of the indicators of women’s status is the ability to undertake specific household decisions. Table 3.9 shows the percentage distribution of women by type of decision made at household level about health care, large household purchases, daily household purchases, visits to family or relatives, and food cooked every day. Married or separated women are more likely to make their own decisions in seeking health care (51 percent), daily household purchases (57 percent), and the type of food to be cooked each day (84 percent) than non-married women. They are more likely to decide jointly with their husband when purchasing large household goods (40 percent) and when visiting family or relatives (43 percent). For 30 percent of married or separated women, decisions on seeking health care are made by the husband only. Similarly, 34 percent of women reported that their husband makes decisions about large household purchases. It is interesting to note that single women are less likely to make any of the specified decisions. The proportion of these women reporting that someone else makes decisions ranged from 57 percent for health care to 76 percent for large household purchases. These results tend to suggest that single women are still living in their parents' households where decisions are being made by other people. 3.10 FINAL SAY IN HOUSEHOLD DECISIONS Table 3.10 shows the percent distribution of women who say that they alone or jointly have the final say in decision-making in various areas by socioeconomic and demographic characteristics. In general, older women, women who have ever been married, those with a larger number of children, those who live in urban areas, those who have a better education, and those who are earning cash are more likely to have a final say in household decisions. The proportion of women reporting that they make decisions on health care alone or jointly with someone else ranges from 29 percent of women age 15-19 to 71 percent of women age 40-49. Similarly, the corresponding percentages for making decisions alone or with someone else in making large purchases ranges from 14 percent for women age 15-19 years to 69 percent for women age 40-49. For making decisions on daily purchases, the percentages range between 18 percent for women 15-19 to 85 percent for women 40-49. 32 * Characteristics of Respondents Table 3.10 Final say in household decisions Percentage of women who say that they alone or jointly have the final say in specific household decisions, according to background characteristics, Zimbabwe 1999 ______________________________________________________________________________________________________ Alone or jointly has final say in: _______________________________________________ Visits to Has final Has final Own Making Making family, What food say in all say in no Number Background health large daily relatives, to cook specified specified of characteristic care purchases purchases friends daily decisions decisions women1 ______________________________________________________________________________________________________ Age 15-19 29.2 14.4 17.9 26.2 27.2 9.3 54.5 1,445 20-29 58.6 46.7 63.4 67.2 75.8 31.8 12.1 2,326 30-39 69.2 66.8 83.0 80.8 92.9 49.3 3.3 1,298 40-49 71.0 69.0 85.1 83.9 96.0 53.1 2.0 826 Marital status Never married 32.2 11.1 12.6 26.7 21.1 8.6 56.1 1,637 Married or in union 62.1 58.9 78.8 75.4 92.1 39.6 4.0 3,597 Divorced, separated, widowed 76.5 65.1 71.4 80.9 75.2 58.5 9.5 662 Number of living children 0 34.9 19.0 22.7 33.5 31.4 12.9 48.1 1,852 1-2 62.4 53.6 70.7 71.8 82.5 37.9 8.7 2,076 3-4 65.9 64.3 82.4 79.4 93.0 46.0 3.5 1,078 5+ 69.1 64.5 82.7 80.5 96.3 48.4 1.9 890 Residence Urban 58.0 49.8 62.9 69.1 71.9 35.9 15.8 2,284 Rural 53.8 44.1 57.5 58.3 69.6 31.4 21.2 3,612 Province Manicaland 49.3 37.8 54.7 49.4 69.2 27.3 25.0 877 Mashonaland Central 49.8 46.5 62.6 68.4 75.0 24.0 11.5 470 Mashonaland East 64.9 54.5 63.6 67.5 74.0 45.9 17.9 463 Mashonaland West 71.1 62.1 70.0 75.3 78.1 51.0 12.0 567 Matabeleland North 69.0 49.4 64.8 66.7 71.9 38.7 14.0 301 Matabeleland South 57.5 53.7 57.2 55.6 65.9 37.0 26.5 323 Midlands 40.4 42.5 54.7 57.4 65.7 24.4 25.7 736 Masvingo 49.0 32.9 52.5 49.8 65.8 22.3 23.2 626 Harare 57.1 45.7 61.5 70.3 70.8 33.6 15.5 1,075 Bulawayo 62.7 53.5 60.2 69.6 70.9 39.6 16.1 458 Education No education 66.2 60.8 74.4 74.0 89.4 45.7 6.8 394 Primary 58.8 50.7 65.2 66.9 78.7 36.6 13.5 2,371 Secondary 49.7 39.5 51.9 56.1 60.6 27.2 26.0 2,963 Higher 84.6 70.8 80.8 85.1 85.0 59.3 4.7 167 Current employment Not employed 48.9 36.0 48.9 51.4 60.2 26.5 28.8 2,700 For cash 62.8 57.1 69.9 74.2 79.9 40.7 9.9 2,748 Not for cash 49.2 42.4 61.4 57.9 75.2 26.5 17.3 446 All women 55.4 46.3 59.6 62.5 70.5 33.1 19.1 5,896 ______________________________________________________________________________________________________ 1 Includes 2 women with missing information on current employment Characteristics of Respondents * 33 Divorced, separated, and widowed women are more likely to have a final say in all specified decisions than women who are either married or in union or never married. The percentages are 59 percent for divorced, separated, and widowed women compared with 40 percent for women who are either married or in union and 9 percent for single women. A woman’s number of living children influences her level of control over decisionmaking. As the number of living children increases, so does a woman’s ability to make a decision. Although only 13 percent of women with no living children have a final say in all specified decisions, 48 percent of women with more than five living children do so. It should be noted that parity increases with age. Urban residence is positively related to decisionmaking. In urban areas, 36 percent of women have a final say in all specified decisions compared with 31 percent of women in rural areas. Interestingly, there is no clear relationship between women’s education and decisionmaking. Whereas 46 percent of females with no formal education reported that they have a final say in all specified decisions, 59 percent of those with a higher education reported the same, compared with 37 percent and 27 percent of those with primary and secondary education, respectively. Decisionmaking in all specified areas varies across provinces, ranging from 22 percent in Masvingo to 51 percent in Mashonaland West. Women who were currently employed and earning cash are more likely to make decisions than women who are either unemployed or employed but not earning cash. Whereas 41 percent of those employed and earning cash have the final say in all specified decisions, 27 percent of the unemployed and those working but not earning cash reported the same. 3.11 WOMEN’S AGREEMENT WITH REASONS FOR WIFE BEATING Information on women’s agreement with reasons justifying a husband to beat his wife by socio-economic and demographic characteristics are presented in Table 3.11. The reasons justifying a husband to beat his wife included in the survey are wife burning the food, arguing with husband, going out without telling the husband, neglecting the children, and refusing sexual relations. The proportion of women in each group agreeing with at least one specified reason justifying a husband to beat his wife declines with increasing age and education. For example, 58 percent of women age 15-19 agreed with at least one specified reason compared with 47 percent of women 40-49. Although 58 percent of women with no education agreed with at least one reason for wife beating, the corresponding percentage for women with higher than secondary education is only 16 percent. Similarly, the proportion of women agreeing with none of the specified reasons increases with age and education. Marital status and number of children make a slight difference in terms of women’s perception on reasons justifying a husband beating his wife. It is interesting to note that women who have been married for less than five years are slightly more likely to agree with one of the specific reasons than other women. As expected, urban women are less likely to agree with all of the reasons for wife beating than rural women. Sixty percent of urban women agreed with none of the specified reasons justifying a husband beating his wife, compared with 42 percent of women residing in rural areas. 34 * Characteristics of Respondents Table 3.11 Women's agreement with reasons for wife beating Percentage of women who agree with specific reasons justifying a husband beating his wife and percentage who agree with at least one or with none of the reasons, according to background characteristics, Zimbabwe 1999______________________________________________________________________________________________________ Reasons justifying a husband beating his wife________________________________________________ Agrees Agrees Goes out with at with none Burns Argues without Neglects Refuses least one of the Number Background the with telling the sexual specified specified of characteristic food him him children relations reason reasons women1______________________________________________________________________________________________________ Age 15-19 20-29 30-39 40-49 Marital status Never married Married or in union <5 years 5+ years Divorced, separated, widowed Number of living children 0 1-2 3-4 5+ Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo Education No education Primary Secondary Higher Current employment Not employed For cash Not for cash Number of decisions in which woman has final say 0-1 2-3 4-5 All women 15.7 34.7 32.1 36.8 16.9 57.9 42.1 1,445 11.4 32.0 27.5 31.8 22.9 51.2 48.8 2,326 9.8 28.1 24.7 27.5 25.1 45.4 54.6 1,298 10.5 30.7 25.8 25.5 25.5 46.5 53.5 826 11.8 28.3 25.7 32.5 13.6 49.7 50.3 1,637 12.1 33.6 28.7 31.0 25.8 52.0 48.0 3,597 12.9 37.6 30.7 34.7 23.7 55.9 44.1 1,089 11.8 31.8 27.8 29.4 26.7 50.3 49.7 2,508 11.5 29.1 27.8 29.1 24.6 47.8 52.2 662 12.0 29.8 27.1 32.7 15.7 50.9 49.1 1,852 11.6 32.1 27.4 30.1 22.8 50.2 49.8 2,076 12.0 29.7 27.3 30.3 27.4 50.4 49.6 1,078 12.7 36.5 30.5 31.7 28.6 53.3 46.7 890 7.0 21.2 19.1 24.4 14.4 39.8 60.2 2,284 15.1 38.2 33.2 35.4 27.3 57.9 42.1 3,612 10.0 28.7 24.9 26.3 21.6 45.9 54.1 877 18.6 41.9 30.2 37.8 26.7 63.3 36.7 470 12.8 28.5 31.9 26.3 27.0 50.0 50.0 463 19.4 35.0 31.3 34.8 33.2 56.6 43.4 567 15.4 37.8 23.9 41.5 19.9 54.8 45.2 301 13.7 44.6 39.2 48.3 19.2 67.3 32.7 323 11.3 39.6 37.0 36.2 22.9 61.3 38.7 736 14.4 39.9 33.2 33.1 33.1 55.1 44.9 626 7.6 19.7 19.9 24.0 14.9 38.4 61.6 1,075 3.2 16.1 12.8 21.5 6.0 34.3 65.7 458 18.9 43.0 32.7 34.0 32.3 57.7 42.3 394 15.6 38.4 31.7 34.2 29.4 56.6 43.4 2,371 8.7 26.2 25.3 29.5 16.0 47.4 52.6 2,963 2.6 5.1 4.2 11.5 7.9 16.1 83.9 167 12.4 32.2 28.3 33.1 20.4 51.5 48.5 2,700 10.3 29.2 25.1 28.1 22.5 48.3 51.7 2,748 19.6 42.2 41.1 38.5 32.4 62.9 37.1 446 13.8 33.0 29.4 35.1 18.3 54.0 46.0 1,719 14.0 36.7 31.3 34.3 26.3 56.3 43.7 1,301 9.9 28.5 25.2 27.4 22.9 46.6 53.4 2,876 12.0 31.6 27.8 31.2 22.3 50.9 49.1 5,896 ____________________________________________________________________________________________________________ 1 Includes 2 women with missing information on current employment Characteristics of Respondents * 35 Significant variation exists at the provincial level, with Bulawayo province having the smallest proportion of women agreeing with at least one of the specified reasons justifying a husband beating his wife (34 percent) and Matabeleland South province have the largest proportion (67 percent). Women who are financially independent are less likely to agree with wife beating. Women who are employed and earning cash are the least likely (48 percent) to agree with any specified reasons justifying wife beating compared with women who are not earning cash (63 percent) and those who are unemployed (52 percent). Women who have more areas in which they make decisions are somewhat less likely to agree with at least one of the specified reasons for wife beating compared with those who have fewer areas in which they make decisions. The corresponding percentages are 47 percent for women who have four to five decisions compared with 54 percent for women who have zero to one decision. 3.12 WOMEN’S AGREEMENT WITH REASONS FOR REFUSING SEXUAL RELATIONS Women’s ability to refuse sex shows their power to bargain sexual behaviour, which in turn affects their chances of getting infected with sexually transmitted infections (STIs). In the ZDHS, respondents were asked whether they think that the specified reasons are justified for a wife to refuse having sex with her husband or partner. The reasons listed in the survey are tiredness or not in the mood, recently gave birth, knows that her husband has sexual relations with other women, and knows that her husband has an STI. In general, older women, formerly married women, urban women, better-educated women, and women who earn cash are less likely to agree with any reason for refusing sexual relations. Older women are less likely to report tiredness, knowledge of husband having sexual relations with other women, and knowledge of husband having an STI as reasons for refusing sexual relations. However, they are more likely to report having given birth recently as a reason for refusing sexual relations. Marital status also influences women’s reasons for refusing sexual relations. Women who have never been married are more likely (40 percent) to agree with all of the specified reasons for refusing sex, compared with women who are married or in union (33 percent) or women who are divorced, separated, or widowed (35 percent). Women who have been married for more than five years are less likely to agree with all of the specified reasons for refusing sex; 31 percent compared with 38 percent of those who were married for less than five years. There is a negative relationship between the proportion of women agreeing with all of the reasons for refusing sex and the number of children a woman has. Urban women are more likely than rural women to agree with all of the specified reasons for refusing sexual relations with a partner or husband. For instance, 58 percent of urban women gave tiredness or not in the mood as a reason for refusing sex, compared with 50 percent of rural women. There are variations between provinces; the percentage of women who agreed with all of the specified reasons for refusing sexual relations with a partner or husband ranges from 22 percent for Mashonaland West to 51 percent for Matabeleland North. 36 * Characteristics of Respondents Table 3.12 Women's agreement with reasons for refusing sexual relations Percentage of women who agree with specific reasons justifying a wife refusing to have sexual relations with her husband and percentages who agree with all and with none of the reasons, according to background characteristics, Zimbabwe 1999______________________________________________________________________________________________________ Reasons justifying a wife refusing sexual relations with husband__________________________________________ Knows Agrees Agrees husband has with all with none Tired, Gave sexual rela- Knows of the of the Number Background not in birth tions with husband specified specified of characteristic mood recently other women has STD reasons reasons women1______________________________________________________________________________________________________ Age 15-19 20-29 30-39 40-49 Marital status Never married Married or in union <5 years 5+ years Divorced, separated, widowed Number of living children 0 1-2 3-4 5+ Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo Education No education Primary Secondary Higher Current employment Not employed For cash Not for cash Number of decisions in which woman has final say 0-1 2-3 4-5 Number of reasons wife beating justified 0 1-3 4-5 All women 52.3 70.5 64.6 72.9 37.3 14.7 1,445 55.1 83.6 64.4 71.2 36.4 7.4 2,326 51.7 85.5 64.3 72.7 35.8 6.3 1,298 47.7 85.3 57.7 66.0 27.9 7.7 826 54.1 72.3 67.6 74.9 40.3 14.6 1,637 51.6 84.5 61.6 69.7 33.1 6.8 3,597 57.0 83.8 65.2 71.8 37.5 6.6 1,089 49.2 84.9 60.1 68.8 31.2 6.9 2,508 54.7 83.8 63.4 70.2 35.0 7.1 662 53.4 72.7 66.1 72.5 37.9 13.7 1,852 56.4 84.2 65.1 72.4 37.8 6.8 2,076 50.3 85.7 59.4 69.2 31.7 6.7 1,078 45.1 85.5 59.2 68.2 28.4 7.0 890 57.5 82.5 69.4 74.4 41.4 6.7 2,284 49.5 80.1 59.7 69.2 31.4 10.4 3,612 43.7 78.7 58.6 73.1 28.7 10.0 877 59.1 83.0 58.0 66.9 32.7 6.8 470 54.5 74.4 56.5 59.9 32.3 13.1 463 44.4 67.0 46.3 46.8 21.8 21.5 567 63.3 88.8 72.9 80.7 50.7 6.7 301 59.7 95.1 78.7 89.6 49.4 1.8 323 51.7 86.8 66.0 74.4 33.6 3.5 736 45.3 78.9 63.9 73.5 31.3 11.5 626 57.1 80.1 68.3 73.8 40.6 7.5 1,075 60.6 88.6 73.7 80.3 46.2 4.9 458 48.3 80.9 47.3 60.8 23.8 10.7 394 46.8 80.1 57.7 66.8 29.3 11.0 2,371 56.4 81.0 69.4 75.5 40.2 7.5 2,963 77.7 95.6 79.3 83.7 61.3 1.8 167 53.4 78.5 65.4 72.3 37.6 10.7 2,700 52.1 83.0 62.3 70.7 33.9 7.8 2,748 51.7 84.4 59.7 68.2 30.1 6.2 446 51.7 72.2 64.3 73.2 37.2 14.5 1,719 52.1 86.2 62.1 71.2 33.3 5.3 1,301 53.5 84.0 63.6 70.0 35.1 7.4 2,876 53.8 78.8 63.1 69.4 37.5 11.6 2,894 52.5 83.5 64.4 73.8 34.0 6.1 2,306 48.3 82.2 62.0 70.3 30.5 7.5 695 52.6 81.0 63.5 71.2 35.3 9.0 5,896 ____________________________________________________________________________________________________________ 1 Includes 2 women with missing information on current employment Characteristics of Respondents * 37 There is a positive relationship between education and women’s agreement with various reasons for refusing sexual relations with a husband or partner. For example, 78 percent of women with a higher than secondary education agreed that a woman is justified in refusing to have sex with a partner because they were tired or not in the mood, the percentage for women with a primary education is 47 percent, and the percentage for women with a secondary education is 56 percent. This pattern holds for other reasons for refusing sexual relations with a partner or husband. Women who are unemployed are more likely to agree with all of the specified reasons cited for refusing sexual relations with a husband or partner (38 percent), compared with those who were employed and earning cash (34 percent) and those who were working but not earning cash (30 percent). Women who have fewer areas in which they have final say in making decisions are slightly more likely to agree with all of the specified reasons for refusing sex compared with those who have more areas in which they have final say. The corresponding percentages are 37 percent for women with zero to one area and to 35 percent for women with four to five areas. The proportion of women agreeing with all of the specified reasons for refusing sex is negatively associated with the number of reasons justifying wife beating. While 38 percent of women who agreed with all of the specified reasons for refusing sex found no reason that justified wife beating, 31 percent of women who cited more than four reasons that justified wife beating agreed with all the reasons for refusing sex. 1 Numerators for the age-specific fertility rates are calculated by summing the number of live births that occurred in the 1 to 36 months preceding the survey (determined by the date of interview and birth date of the child), and classifying them by age (in five-year groups) of the mother at the time of birth (determined by the mother’s birth date). The denominators of the rates are the number of woman-years lived in each of the specified five-year age groups during the 1 to 36 months preceding the survey. Fertility * 39 Table 4.1 Current fertility Age-specific and cumulative fertility rates and the crude birth rate and general fertility rate for the three years preceding the survey, by urban-rural residence, Zimbabwe 1999_________________________________________________ Residence______________ Age group Urban Rural Total_________________________________________________ 15-19 20-24 25-29 30-34 35-39 40-44 45-49 TFR 15-49 TFR 15-44 GFR CBR 93 125 112 170 224 199 147 202 180 87 161 135 68 128 108 (27) (54) 46 * * 15 2.96 4.57 3.96 2.96 4.47 3.89 116 157 141 31.3 30.5 30.8 _________________________________________________ TFR: Total Fertility Rate for ages 15-49 expressed per woman GFR: General Fertility Rate (births divided by the number of women 15-44) expressed per 1,000 women CBR: Crude Birth Rate expressed per 1,000 population Note: Rates are for the period 1-36 months preceding the survey. Rates for age group 45-49 may be slightly biased due to truncation. Rates in parentheses are based on 125 to 249 woman-years of exposure. An asterisk indicates that the rate is based on less than 125 woman-years of exposure and has been suppressed. FERTILITY 4 In the 1999 ZDHS, data were collected on current and completed fertility. Drawing from the birth histories of women interviewed in the survey, the chapter begins with a description of current fertility, followed by differentials in fertility. Attention is next focused on trends in fertility, including examination of age-specific fertility rates in time periods going back 15 to 20 years. The chapter concludes with a presentation of information on age of women at their first birth and patterns of adolescent childbearing. The fertility indicators presented in this chapter are based on reports provided by women age 15-49 years regarding their reproductive histories. As in the previous ZDHS surveys, each woman was asked to provide information on the total number of sons and daughters to whom she had given birth who were living with her, the number living elsewhere, and the number who had died. In the birth history, women reported on the detailed history of each live birth separately, including such information as name, month and year of birth, sex, and survival status. For children who had died, information on age at death was collected. 4.1 CURRENT FERTILITY The most widely used measures of current fertility are the total fertility rate (TFR) and its component age-specific fertility rates (ASFRs). The TFR is defined as the number of children a woman would have by the end of her childbearing years if she were to pass through those years bearing children at the currently observed age- specific rates.1 Table 4.1 shows the age-specific and aggregate fertility measures calculated from the 1999 ZDHS data. The total fertility rate for Zim- babwe is four children per woman. Peak child- bearing occurs during ages 20-24 and 25-29, dropping sharply after age 34. Fertility among 40 * Fertility Table 4.2 Fertility by background characteristics Total fertility rate for the three years preceding the survey, percentage currently pregnant, and mean number of children ever born to women age 40-49 years, by selected background characteristics, Zimbabwe 1999___________________________________________________ Mean number of children Total Percentage ever born Background fertility currently to women characteristic rate1 pregnant age 40-49___________________________________________________ Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo Education No education Primary Secondary Higher Total 2.96 7.1 4.54 4.57 8.2 6.40 4.68 8.8 6.40 4.86 8.6 6.52 4.15 8.4 5.90 4.10 8.6 5.45 4.10 7.8 6.19 4.81 9.1 5.66 4.05 7.4 5.97 3.94 6.2 6.48 2.98 7.3 4.81 2.98 6.2 4.81 5.21 7.0 6.33 4.48 8.0 6.12 3.41 7.9 4.61 1.87 5.8 2.58 3.96 7.8 5.87 ___________________________________________________ 1 Rate for women age 15-49 years urban women is substantially lower (three children per woman) than among rural women (4.6 children per woman). This pattern of lower fertility in urban areas is evident in every age group. 4.2 FERTILITY BY BACKGROUND CHARACTERISTICS Table 4.2 and Figure 4.1 show differ- entials in fertility by urban-rural residence and level of education. The TFR ranges from three births per woman in the urban prov- inces of Harare and Bulawayo to 4.9 births per woman in Mashonland Central. Educational attainment is closely linked to a woman's fertility; the TFR for women with no formal education and women with a primary education is four or more children per woman, while that for women with at least some secondary educa- tion is three or fewer children per woman. Table 4.2 also allows a general as- sessment of differential trends in fertility over time among population subgroups. The mean number of children ever born to wom- en age 40-49 is a measure of fertility in the past. A comparison of current (total) fertility with past (completed) fertility shows that there have been substantial and roughly equivalent declines in both urban and rural areas and within all provincial and educa- tion categories. Overall, the comparison of past and present fertility indicators suggests a decline of about two children per woman, from 5.9 to 4.0 children per woman. At the time of the survey, 8 percent of interviewed women reported that they were pregnant. This percentage is an underestimate of the true percent pregnant because many women at early durations of pregnancy will not yet know for sure that they are pregnant and some women may not want to declare that they are pregnant. Differentials in pregnancy status closely parallel differentials in current fertility. Fertility * 41 Table 4.3 Trends in current fertility rates Age-specific fertility rates and total fertility rates, Zimbabwe, 1984-1999 __________________________________________ 1988 1994 1999 ZDHS ZDHS ZDHS _______ _______ _______ Age group 1984-88 1991-94 1996-99 __________________________________________ 15-19 103 99 112 20-24 247 210 199 25-29 247 194 180 30-34 219 172 135 35-39 160 117 108 40-44 86 52 46 45-49 36 14 15 Figure 4.1 Total Fertility Rates by Background Characteristics, Zimbabwe 1999 4.0 3.0 4.6 4.7 4.9 4.2 4.1 4.1 4.8 4.1 3.9 3.0 3.0 5.2 4.5 3.4 1.9 ZIMBABWE RESIDENCE Urban Rural PROVINCE Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo EDUCATION No education Primary Secondary Higher Total Fertility Rate (Births per Woman) ZDHS 1999 4.3 FERTILITY TRENDS Table 4.3 examines trends in fertility in Zimbabwe by comparing the results of the 1999 ZDHS with the two earlier ZDHS surveys (1988 and 1994). This comparison is appropriate because the methods of data collection and rate calculation were identical in all the surveys. The TFR calculated from the 1988 ZDHS was 5.5 children per woman, compared with 4.3 derived from the 1994 ZDHS and 4.0 from the 1999 ZDHS. This change in the TFR demonstrates a decline in fertility of 27 percent during the period between 1984-88 and 1996-99. Examina- tion of changes in age-specific fertility rates in Figure 4.2 shows large absolute declines in fertility at all ages above 15-19 years. These similar absolute declines, however, translate to a greater proportional decline at older ages. 42 * Fertility Table 4.4 Trends in age-specific fertility rates Age-specific fertility rates for five-year periods preceding the survey by mother's age at the time of the birth, Zimbabwe 1999______________________________________________ Number of years preceding survey Mother's _________________________________ age at birth 0-4 5-9 10-14 15-19______________________________________________ 15-19 20-24 25-29 30-34 35-39 40-44 45-49 108 107 118 152 201 224 261 298 182 209 263 282 145 190 237 [298] 112 152 [225] - 49 [122] - - [18] - - - ______________________________________________ Note: Age-specific fertility rates are per 1,000 women. Estimates in brackets are truncated. Figure 4.2 Age-Specific Fertility Rates by Urban-Rural Residence, Zimbabwe 1999 " " " " " " " + + + + + + + $ $ $ $ $ $ $ 15-19 20-24 25-29 30-34 35-39 40-44 45-49 Age Group 0 50 100 150 200 250 300 Births per 1,000 Women 1988 ZDHS 1994 ZDHS 1999 ZDHS$ + " 1984-88 1991-94 1996-99 ZDHS 1999 4.4 TRENDS IN AGE-SPECIFIC FERTILITY RATES The data in Table 4.4 provide further evidence of a substantial fertility decline in Zimbabwe. Table 4.4 shows the age-specific fertility rates for five-year periods preceding the survey. Because women age 50 and above were not interviewed in the survey, the rates are successfully truncated as the number of years before the survey increases. Within Wmong women under age 35, substantial and sustained declines in ASFRs are observed from 15 to 19 years before the survey to 0 to 4 years before the survey. 4.5 CHILDREN EVER BORN AND LIVING The distribution of women by the number of children ever born is presented in Table 4.5 for all women and for currently married women. The table also shows the mean number of children ever born (CEB) to women in each five-year age group. On average, women in their early twenties have given birth to about one child, women in their early thirties have had more than three children, and women currently at the end of their childbearing years have had more than six children. Of the more than six children ever born to women age 45-49, 5.5 have survived. Fertility * 43 Table 4.5 Children ever born and living Percent distribution of all women and currently married women by number of children ever born, and mean number of children ever born and mean number of living children, according to age group, Zimbabwe 1999 ______________________________________________________________________________________________________ Mean Mean number Number of children ever born Number number of __________________________________________________________ of of living Age 0 1 2 3 4 5 6 7 8 9 10+ Total women CEB children ______________________________________________________________________________________________________ ALL WOMEN ______________________________________________________________________________________________________ 15-19 20-24 25-29 30-34 35-39 40-44 45-49 All ages 83.8 14.3 1.7 0.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 1,447 0.18 0.17 30.7 41.0 22.2 5.0 0.7 0.3 0.1 0.0 0.0 0.0 0.0 100.0 1,294 1.06 0.97 7.7 25.1 32.6 21.5 9.0 2.7 1.2 0.1 0.1 0.0 0.0 100.0 1,034 2.13 1.92 5.2 11.7 20.2 25.8 18.6 9.5 6.3 2.4 0.4 0.0 0.0 100.0 668 3.09 2.85 3.7 5.5 7.7 13.8 20.6 19.0 11.8 8.4 5.4 1.9 2.1 100.0 637 4.52 4.18 2.7 3.4 6.2 8.5 13.5 12.9 16.9 15.3 7.8 8.1 4.7 100.0 466 5.54 5.01 1.9 2.5 6.6 7.8 6.9 10.9 16.6 12.7 10.9 11.8 11.3 100.0 361 6.29 5.54 29.9 19.2 15.0 10.5 7.5 5.4 4.6 3.2 1.9 1.6 1.3 100.0 5,907 2.31 2.10 ______________________________________________________________________________________________________ CURRENTLY MARRIED WOMEN ______________________________________________________________________________________________________ 15-19 20-24 25-29 30-34 35-39 40-44 45-49 All ages 42.3 49.9 6.7 1.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 314 0.66 0.60 13.6 48.2 29.6 6.9 0.9 0.5 0.2 0.0 0.0 0.0 0.0 100.0 820 1.36 1.25 3.5 21.2 34.9 24.2 11.1 3.5 1.3 0.1 0.1 0.0 0.0 100.0 788 2.35 2.14 2.8 9.0 19.8 27.9 20.6 9.7 6.8 3.0 0.4 0.0 0.0 100.0 543 3.29 3.05 2.4 3.3 7.0 11.9 20.9 20.6 13.5 9.3 6.4 1.9 2.7 100.0 495 4.83 4.47 2.2 3.2 5.1 6.3 12.7 13.3 17.0 17.5 9.4 8.4 5.0 100.0 375 5.77 5.23 1.9 2.4 7.0 6.0 6.6 9.4 16.9 13.2 11.9 12.8 11.9 100.0 272 6.46 5.72 8.7 22.3 19.9 13.9 10.4 7.3 6.3 4.6 2.8 2.1 1.8 100.0 3,609 3.13 2.85 ______________________________________________________________________________________________________ CEB = Children ever born The results for younger women who are currently married differ from those for the sample as a whole because of the large number of young unmarried women with minimal fertility. Differences at older ages generally reflect the impact of marital dissolution (either divorce or widowhood). Close to 2 percent of married women age 45-49 have never had a child. Under the proposition that desire for children is universal in Zimbabwe, this percentage represents a rough measure of primary infertility or the inability to bear children. 4.6 BIRTH INTERVALS Information on the length of birth intervals provides insight into birth spacing patterns. Research has shown that children born too soon after a previous birth are at increased risk of poor health, particularly when the interval is less than 24 months. Table 4.6 shows the distribution of births in the five years before the survey by the interval since the previous birth, according to various background and biodemographic variables. 44 * Fertility Table 4.6 Birth intervals Percent distribution of births in the five years preceding the survey by number of months since preceding birth, according to selected background characteristics, Zimbabwe 1999 _____________________________________________________________________________________________________ Median number of months Months since preceding birth Number since ____________________________________________ of preceding Characteristic 7-17 18-23 24-35 36-47 48+ Total births birth ______________________________________________________________________________________________________ Age 15-19 20-29 30-39 40+ Birth order 2-3 4-6 7 + Sex of preceding birth Male Female Survival of preceding birth Dead Living Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo Education No education Primary Secondary Higher Total (21.7) (7.7) (44.2) (23.2) (3.2) 100.0 29 28.9 4.9 8.6 32.2 27.9 26.3 100.0 1,199 37.1 2.9 5.5 24.8 21.2 45.6 100.0 905 45.2 2.4 4.9 24.2 23.7 44.7 100.0 243 44.1 3.9 6.7 28.7 26.9 33.9 100.0 1,314 39.5 5.3 6.7 28.1 21.1 38.8 100.0 736 41.6 2.4 9.4 30.5 25.0 32.6 100.0 327 39.4 5.1 7.6 27.2 24.9 35.2 100.0 1,190 40.1 3.1 6.5 30.3 24.8 35.3 100.0 1,187 39.8 20.3 16.1 28.0 16.3 19.4 100.0 245 28.5 2.2 6.0 28.8 25.8 37.1 100.0 2,131 41.3 4.9 7.2 20.4 23.5 43.9 100.0 671 43.4 3.8 7.0 32.0 25.4 31.8 100.0 1,706 38.9 4.7 10.4 33.7 22.9 28.3 100.0 426 37.0 3.0 4.2 29.9 30.3 32.6 100.0 238 40.7 4.2 7.5 28.0 22.4 37.8 100.0 213 41.6 2.1 5.9 25.1 28.8 38.2 100.0 240 43.0 2.3 4.5 27.8 28.0 37.5 100.0 130 40.8 4.6 5.7 37.6 19.7 32.3 100.0 153 36.6 6.0 8.6 29.5 26.4 29.5 100.0 313 37.8 2.6 6.6 30.2 24.9 35.6 100.0 252 39.7 4.1 5.4 21.8 25.9 42.9 100.0 282 43.1 7.7 7.7 19.1 14.8 50.7 100.0 131 48.3 2.9 8.1 31.2 26.9 30.9 100.0 233 38.9 4.6 6.6 28.8 25.4 34.6 100.0 1,209 40.1 3.7 7.7 28.3 24.0 36.2 100.0 901 39.5 (6.1) (0.0) (19.2) (13.6) (61.0) 100.0 35 - 4.1 7.1 28.7 24.9 35.2 100.0 2,377 39.9 ____________________________________________________________________________________________________ Note: First births are excluded. The interval for multiple births is the number of months since the preceding pregnancy that ended in a live birth. Figures in parentheses are based on 25-49 unweighted births. Fertility * 45 Table 4.7 Age at first birth Percent distribution of women age 15-49 by age at first birth, according to current age, Zimbabwe 1999 ____________________________________________________________________________________________________ Median Age at first birth Number age at No _____________________________________________ of first Current age birth <15 15-17 18-19 20-21 22-24 25+ Total women birth ____________________________________________________________________________________________________ 15-19 20-24 25-29 30-34 35-39 40-44 45-49 83.8 0.7 10.1 5.4 NA NA NA 100.0 1,447 a 30.7 2.8 17.2 27.6 17.3 4.5 0.0 100.0 1,294 a 7.7 2.7 20.1 24.2 22.0 17.9 5.3 100.0 1,034 20.3 5.2 3.9 19.4 23.2 21.2 17.2 9.9 100.0 668 20.3 3.7 4.4 23.5 33.3 16.0 12.3 6.8 100.0 637 19.3 2.7 6.5 21.8 23.9 23.3 15.5 6.3 100.0 466 19.8 1.9 4.5 21.3 27.9 21.1 11.0 12.2 100.0 361 19.7 ____________________________________________________________________________________________________ NA = Not applicablea Omitted in populations where less than 50 percent of the women in the age group × to × + 4 have had a birth by age × About one in nine children are born after a “too short” interval (less than 24 months). The median interval length is shorter among births to young women and when the older sibling is no longer alive. The median birth interval length is 40 months for all births, but only 29 months among children whose mother is less than 20 years old and among children whose older sibling did not survive. Birth intervals are substantially longer in urban than in rural areas. This difference could be related to the higher rates of contraceptive use (for spacing) among urban women (see Chapter 5). By province, the longest birth interval is observed in Bulawayo and the shortest in Matabeleland South. Birth intervals do not vary greatly by education. 4.7 AGE AT FIRST BIRTH Table 4.7 shows that the median age at first birth in Zimbabwe is about 20 for most age groups. Although this broad measure has not changed since the 1988 ZDHS, more detailed analysis of trends in age at first birth does reveal a decline in early childbearing. For example, whereas about 28 percent of women age 35-39 had a birth before age 18, only 23 percent of women currently age 30-34 and 20 percent of women age 20-24 had started childbearing before age 18. This slow but steady trend reflects positively on efforts to keep girls and women in school through more advanced levels to improve their social and economic status. 46 * Fertility Table 4.8 Median age at first birth by background characteristics Median age at first birth among women age 25-49 years, by current age and selected background characteristics, Zimbabwe 1999__________________________________________________________________________________ Current age Women Background ____________________________________________ age characteristic 25-29 30-34 35-39 40-44 45-49 25-49_________________________________________________________________________________ Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo Education No education Primary Secondary Higher All women 21.0 21.2 19.4 20.0 20.0 20.5 19.7 19.7 19.3 19.7 19.6 19.6 19.7 20.2 19.2 19.9 19.9 19.6 19.6 19.5 19.2 19.6 20.3 19.5 19.2 19.8 19.0 21.5 18.5 19.5 19.5 19.7 19.6 19.1 20.4 19.6 19.4 19.6 20.3 17.8 19.3 19.4 20.4 19.1 19.0 19.5 19.5 19.6 20.6 20.1 19.8 20.1 19.1 20.2 20.6 20.4 19.4 20.3 19.9 20.1 21.5 21.3 19.4 20.5 20.5 20.9 20.9 20.6 19.0 18.9 19.0 19.9 17.9 18.1 18.6 19.4 19.3 18.8 18.8 19.2 19.2 19.5 19.6 19.2 20.8 21.3 20.2 20.6 20.2 20.9 a 23.6 22.1 23.1 29.0 24.0 20.3 20.3 19.3 19.8 19.7 19.9 _________________________________________________________________________________ a Omitted because less than 50 percent of the women ages 25 to 29 have had a birth by age 25 4.8 MEDIAN AGE AT FIRST BIRTH BY BACKGROUND CHARACTERISTICS Table 4.8 summarises the median age at first birth for different age cohorts across residential and educational subgroups. For all age groups of women, the median age at first birth is higher in urban areas than in rural areas. Similarly, age at first birth increases markedly with increasing level of education; for example, within the cohort age 25-29, women without any education have their first birth around age 18, compared with age 21 for women with a secondary education. Fertility * 47 Table 4.9 Teenage pregnancy and motherhood Percentage of women age 15-19 who are mothers or pregnant with their first child, by background characteristics, Zimbabwe 1999_______________________________________________________________ Percentage who are: Percentage_________________ who have Pregnant begun Number Background with first child- of characteristic Mothers child bearing women_______________________________________________________________ Age 15 16 17 18 19 Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo Education No education Primary Secondary Total 2.6 2.3 4.9 261 4.3 1.4 5.6 348 12.9 5.5 18.4 306 28.6 3.4 32.0 254 36.3 9.3 45.6 277 13.1 3.0 16.1 508 17.9 5.0 22.8 938 12.1 3.0 15.1 253 26.0 5.2 31.2 122 19.4 2.9 22.3 102 25.2 10.3 35.5 127 16.7 6.0 22.7 77 20.4 2.3 22.7 83 14.8 5.9 20.8 202 12.0 2.4 14.4 156 12.5 2.7 15.2 215 13.6 3.4 17.0 110 * * * 19 25.6 5.3 30.8 444 11.9 3.7 15.6 977 16.2 4.3 20.5 1,447 _______________________________________________________________ Note: Total includes 6 unweighted women who have higher than secondary education. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 4.9 TEENAGE PREGNANCY AND MOTHERHOOD The issue of adolescent fertility is important on both health and social grounds. Children born to very young mothers are at increased risk of sickness and death. Adolescent mothers themselves are more likely to experience adverse pregnancy outcomes and are also more constrained in their ability to pursue educational opportunities than young women who delay childbearing. Table 4.9 shows the percent distribution of women age 15-19 who have given birth or were pregnant with their first child at the time of the survey, according to selected background characteristics. The proportion of adolescents who are already mothers is 16 percent, and another 4 percent are currently pregnant with their first child. The proportion of adolescents already on the path to family formation rises rapidly with age, from 5 percent at age 15 to 46 percent at age 19 (see Figure 4.3). Rural adolescents and those with less education tend to start childbearing earlier. 48 * Fertility Figure 4.3 Percentage of Adolescent Women Who Are Mothers or Pregnant with First Child, by Age, Zimbabwe 1999 3% 4% 13% 29% 36% 2% 1% 6% 3% 9% 15 16 17 18 19 Age of Woman Mothers Pregnant with First Child ZDHS 1999 Family Planning * 49 FAMILY PLANNING 5 This chapter focuses on women who are sexually active since these women have the greatest risk of exposure to pregnancy and consideration for regulating their fertility. However, results from the interviews with men are presented alongside those of the women’s interviews since men play an equally important role in the realisation of reproductive health and family planning decisions and behaviour. Family planning methods are grouped into two broad categories, namely, modern methods and traditional methods. Modern family planning methods are further categorised into three subgroups: short-term methods (the pill, condoms, the lactational amenorrhoea method (LAM), diaphragms, foaming tablets, jelly, and the emergency contraceptive pill), long term methods (injectables, implants and IUDs) and permanent methods (female and male sterilisation). Traditional methods consist of periodic abstinence, withdrawal, and various folk methods such as strings and herbs. 5.1 KNOWLEDGE OF CONTRACEPTIVE METHODS Information on the knowledge of family planning methods was collected by asking respondents to name the various methods that a couple can use to delay or avoid a pregnancy. If the respondent could not name any method(s) spontaneously, the interviewer prompted by mentioning and describing each of the methods that had not been mentioned spontaneously and asking whether the respondent had ever heard about the particular method(s). Knowledge of family planning methods in Zimbabwe is nearly universal, meaning that men and women are well informed about the options they have for regulating births and planning their families (Table 5.1). The level of knowledge of at least one modern family planning method among currently married women is almost universal (99 percent), while that of all women 15-49 is 97 percent. Similarly, the level of knowledge of modern family planning methods is high among women who are not married but sexually active and women who reported that they did not have any sexual experience. On average, women know close to seven family planning methods, reflecting an increase in the average number of methods known by women from six methods in 1994. Women who have no sexual experience have the least knowledge of family planning methods (five). Oral contraceptives and male condoms remain the methods most widely known by women of all subgroups. For all women, the proportion who know about the pill is 94 percent, and the proportion who know about the male condom is 92 percent, while injectables are reported by 86 percent of women 15-49. Knowledge of contraception among men is higher than among women. For all groups of men, knowledge of any method and modern methods is universal. The most well-known methods among men are the condom and the pill (98 percent and 93 percent, respectively). 50 * Family Planning Table 5.1 Knowledge of contraceptive methods Percentage of all women and men, of currently married women and men, and sexually active unmarried women and men, and of women with no sexual experience who know any contraceptive method, by specific method, Zimbabwe 1999___________________________________________________________________________________________ Women Men___________________________________ _________________________ Sexually Sexually Currently active No Currently active Contraceptive All married unmarried sexual All married unmarried method women women women1 experience2 men men men1___________________________________________________________________________________________ Any method Any modern method Pill IUD Injectables Implants Condom Female condom Diaphragm Foam/Jelly Female sterilisation Male sterilisation Lactational amenorrhoea3 Emergency contraception Any traditional method Periodic abstinence Withdrawal Other Number of women and men Mean no. of methods known 96.9 98.7 99.5 90.2 99.1 99.7 99.6 96.7 98.5 99.5 90.1 99.1 99.7 99.6 94.3 97.6 97.1 82.5 93.0 98.0 94.9 63.8 70.2 72.5 39.5 44.5 52.4 48.5 86.4 92.5 92.0 64.3 72.2 85.3 69.1 24.8 27.8 32.4 12.1 12.9 15.3 16.0 92.2 94.2 98.1 83.8 97.8 98.3 98.4 57.4 57.8 72.8 49.9 58.7 59.7 68.3 20.2 20.5 18.5 20.9 20.6 20.6 25.3 11.9 12.8 17.1 8.6 8.1 9.0 12.6 58.1 63.5 64.1 40.1 54.0 59.7 63.9 38.8 42.8 40.2 27.6 41.9 46.0 47.6 30.4 36.5 34.9 11.4 19.0 25.7 16.4 11.2 11.9 14.2 8.2 11.2 11.1 15.1 58.8 69.0 64.3 27.1 56.9 66.4 62.0 27.1 29.4 30.8 18.5 31.5 35.2 39.4 51.7 62.5 58.5 18.0 47.8 56.1 50.2 12.2 15.2 14.4 1.7 11.3 19.2 7.8 5,907 3,609 199 1,217 2,609 1,239 250 6.8 7.4 7.6 4.9 6.2 6.9 6.7 ___________________________________________________________________________________________ 1 Unmarried women/men who have had sexual intercourse in the 30 days preceding the survey2 Women who have never had sexual intercourse3 Knowledge of Lactational Amenorrhoea Method (LAM) includes women who know that to use the method a woman must be exclusively or fully breastfeeding, be less than 6 months postpartum, be postpartum amenorrhoeic and who know to use another contraceptive method when any of the previous criteria do not hold. 5.2 KNOWLEDGE OF CONTRACEPTIVE METHODS BY BACKGROUND CHARACTERISTICS Knowledge of family planning methods among women is universal without any significant variation across subgroups (Table 5.2). For all age groups, at least 94 percent of currently married women know about a modern family planning method. For men, this percentage is 100 percent in most age groups. There is little variation in knowledge of modern methods among currently married women and men by type of residence (rural and urban), age group, and province of residence. Knowledge of family planning methods is at least 98 percent for both rural and urban areas. Similarly, knowledge of any modern family planning methods for currently married women and men with no education is comparably high (95 percent and 100 percent, respectively). There has been an upward trend in the knowledge of family planning methods since 1984 (Table 5.3). The knowledge of family planning methods became nearly universal in the 1994 ZDHS. This level has been maintained over the past five years. There were also significant increases in the knowledge of specific modern family planning methods besides the pill and male Family Planning * 51 Table 5.2 Knowledge of contraceptive methods by background characteristics Percentage of currently married women and men who know at least one contraceptive method and who know at least one modern method, by selected background characteristics, Zimbabwe 1999 _______________________________________________________________________________ Women Men__________________________ _________________________ Knows Knows Knows any Number Knows any Number Background any modern of any modern of characteristic method method1 women method method1 men_______________________________________________________________________________ Age 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 Residence Urban Rural Province Manicaland Mashonaland Central Mashonaland East Mashonaland West Matabeleland North Matabeleland South Midlands Masvingo Harare Bulawayo Education No education Primary Secondary Higher Total women 95.5 94.4 314 * * 4 99.4 99.4 820 100.0 100.0 110 98.8 98.6 788 99.9 99.9 283 99.3 99.1 543 100.0 100.0 239 98.7 98.4 495 98.3 98.3 194 98.4 98.4 375 100.0 100.0 163 99.6 99.0 272 100.0 100.0 158 NA NA NA 100.0 100.0 87 99.7 99.7 1,306 99.7 99.7 546 98.2 97.8 2,303 99.7 99.7 693 97.3 96.2 561 99.0 99.0 139 99.0 98.8 325 100.0 100.0 127 97.8 97.8 310 100.0 100.0 117 97.0 96.7 367 100.0 100.0 147 98.8 98.6 180 99.3 99.3 61 99.4 99.1 170 100.0 100.0 46 100.0 100.0 444 100.0 100.0 143 99.0 98.7 367 100.0 100.0 102 99.7 99.7 667 99.3 99.3 271 100.0 100.0 217 100.0 100.0 86 95.8 94.8 310 100.0 100.0 49 98.7 98.4 1,665 99.6 99.6 461 99.3 99.2 1,523 99.7 99.7 617 100.0 100.0 111 100.0 100.0 112 98.7 98.5 3,609 99.7 99.7 1,239 ______________________________________________________________________________ Note: An asterisk indicates the figure is based on fewer than 25 cases. NA = Not applicable 1 Includes pill, IUD, injectables, vaginal methods (diaphragm/foam/jelly), female condom, male condom, female sterilisation, male sterilisation, implants, mucus/Billings/ovulation, basal body temperature, symptothermal, and lactational amenorrhoea method (LAM) condoms over the period. Significant increases are particularly associated with the methods that were introduced during the 1990s. For example, the lifting of the restricted use of Depo-Provera in 1992 resulted in increased promotional materials and information on the method that had a positive impact on the knowledge of this method. Knowledge of injectables increased by 7 percentage points among all women between 1994 and 1999. Knowledge of implants, which were introduced in the programme in 1993, increased from 14 percent in 1994 to 25 percent in 1999, while that of emergency contraception, a new and very limited method in Zimbabwe, stands at 11 percent among all women in 1999. There was a small decline in knowledge of the IUD, from 68 percent to 64 percent between 1994 and 1999. 52 * Family Planning Table 5.3 Trends in knowledge of family planning methods Percentage of all women who know specific contraceptive methods, Zimbabwe 1984-1999 ___________________________________________________________ Knowledge of contraception __________________________________ Contraceptive 1984 1988 1994 1999 method ZRHS ZDHS ZDHS ZDHS___________________________________________________________ Any method Any modern method Pill Condom Diaphragm Foam/Jelly/Foaming Tablets IUD Injectables Implants Female sterilisation Male sterilisation Any traditional method Periodic abstinence Withdrawal Other Number of women 82.8 96.3 97.8 96.9 U 95.4 97.5 96.7 80.5 93.6 96.0 94.3 48.3 76.7 93.7 92.2 U 14.0 U 20.2 17.4 a 13.5 21.1 a 11.9 40.2 51.6 67.6 63.8 62.6 62.2 79.7 86.4 U U 13.8 24.8 40.0 49.7 69.7 58.1 10.8 16.4 42.5 38.8 U 75.3 67.8 58.8 20.4 28.1 33.2 27.1 56.1 63.4 56.8 51.7 U 34.2 U 12.2 2,123 2,643 6,128 5,907 ____________________________________________________________ U = Unknown (not available)a Includes diaphragm Source: ZNFPC and WPAS, 1985; CSO and IRD, 1989; CSO and MI, 1995 5.3 EVER USE OF CONTRACEPTION All women and men interviewed in the 1999 ZDHS who said they had heard about a family planning method were asked whether they had ever used any method (with the intention of regulating their fertility). Table 5.4 shows the percentages of women who have ever used a family planning method. The top panel presents the figures for all women, the second panel shows the figures for currently married women, and the third panel shows the figures for sexually active unmarried women. Figures for men are shown at the bottom of the table. Among currently married women, 83 percent reported having ever used a method of family planning and 79 percent have used a modern method. Comparison with the 1994 ZDHS shows that ever use of modern methods among currently married women has increased from 72 percent in 1994 to 79 percent in 1999. The pill is the method most widely used by currently married women (71 percent), followed by injectables (23 percent) and male condoms (20 percent). Ever use of other modern methods is low; only 9 percent of married women have ever used LAM. Family Planning * 53 Ta bl e 5. 4 E ve r u se o f c on tra ce pt io n Pe rc en ta ge o f a ll w om en , c ur re nt ly m ar rie d w om en , u nm ar rie d se xu al ly a ct iv e w om en , a nd m en w ho h av e ev er u se d a co nt ra ce pt iv e m et ho d, b y m et ho d an d ag e, Z im ba bw e 19 99 __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ M od er n m et ho d Tr ad iti on al m et ho d __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ Em er - An y N um be r A ny Fe m al e Fe m al e M al e ge nc y tra di - Pe rio di c of An y m od er n In je ct - Im - C on - co n- D ia - Fo am / st er ili - st er ili - co nt ra - tio na l ab st i- W ith - O th er w om en / Ag e m et ho d m et ho d Pi ll IU D ab le s pl an t do m do m ph ra gm Je lly sa tio n sa tio n LA M ce pt io n m et ho d ne nc e dr aw al m et ho ds m en __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ AL L W O M EN __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ 15 -1 9 20 -2 4 25 -2 9 30 -3 4 35 -3 9 40 -4 4 45 -4 9 To ta l 15 .7 14 .8 10 .3 0. 1 1. 2 0. 1 7. 6 0. 0 0. 0 0. 6 0. 0 0. 0 0. 6 0. 1 2. 6 0. 7 2. 1 0. 2 1, 44 7 64 .8 62 .7 53 .6 0. 6 12 .3 0. 4 19 .2 0. 1 0. 0 1. 4 0. 0 0. 0 5. 4 0. 9 12 .2 3. 0 9. 8 0. 8 1, 29 4 85 .8 84 .4 76 .4 1. 3 22 .4 0. 4 27 .2 0. 3 0. 2 0. 9 0. 4 0. 0 8. 7 0. 1 18 .7 4. 8 14 .7 1. 7 1, 03 4 87 .4 85 .2 77 .5 3. 8 25 .3 1. 3 25 .4 0. 1 0. 0 2. 6 1. 5 0. 0 6. 3 0. 5 19 .0 2. 3 17 .1 1. 5 66 8 86 .6 83 .2 73 .1 5. 7 30 .9 0. 9 19 .5 0. 3 0. 4 0. 8 5. 4 0. 0 9. 8 1. 2 27 .5 4. 4 23 .7 4. 0 63 7 83 .7 76 .5 66 .6 4. 7 31 .9 0. 6 14 .8 0. 7 0. 0 2. 7 6. 9 0. 7 11 .5 1. 1 32 .6 3. 1 28 .2 4. 7 46 6 76 .3 65 .4 50 .6 6. 2 33 .2 0. 2 9. 9 1. 0 0. 0 0. 6 7. 9 0. 0 10 .3 1. 0 38 .2 7. 2 32 .3 5. 2 36 1 63 .6 60 .8 52 .6 2. 2 17 .6 0. 5 17 .6 0. 2 0. 1 1. 2 1. 9 0. 1 6. 2 0. 6 16 .6 3. 1 13 .9 1. 8 5, 90 7 __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ C U RR EN TL Y M AR RI ED W O M EN __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ 15 -1 9 20 -2 4 25 -2 9 30 -3 4 35 -3 9 40 -4 4 45 -4 9 To ta l 52

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