Demographic and Health Survey 2014 - Cambodia

Abstract
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The 2014 Cambodia Demographic and Health Survey (CDHS) is the fourth nationally representative survey conducted in Cambodia on population and health issues. It uses the same methodology as its predecessors, the 2000, 2005, and 2010 Cambodia Demographic and Health Surveys, allowing policymakers to use these surveys to assess trends over time.

The primary objective of the CDHS is to provide the Ministry of Health (MOH), Ministry of Planning (MOP), and other relevant institutions and users with updated and reliable data on infant and child mortality, fertility preferences, family planning behavior, maternal mortality, utilization of maternal and child health services, health expenditures, women’s status, and knowledge and behavior regarding HIV/AIDS and other sexually transmitted infections. This information contributes to policy decisions, planning, monitoring, and program evaluation for the development of Cambodia at both the national and local government levels.

The long-term objectives of the survey are to build the capacity of the Ministry of Health and the National Institute of Statistics (NIS) of the Ministry of Planning for planning, conducting, and analyzing the results of further surveys.

Geographic coverage
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National

Analysis unit
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- Household
- Individual
- Children age 0-5
- Woman age 15-49
- Man age 15-49

Kind of data
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Sample survey data [ssd]

Sampling procedure
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The 2014 CDHS sample is a nationally representative sample of women and men between age 15 and 49 who completed interviews. To achieve a balance between the ability to provide estimates at the subnational level and limiting the sample size, 19 sampling domains were defined, 14 of which correspond to individual provinces and 5 of which correspond to grouped provinces:
• Fourteen individual provinces: Banteay Meanchey, Kampong Cham, Kampong Chhnang, Kampong Speu, Kampong Thom, Kandal, Kratie, Phnom Penh, Prey Veng, Pursat, Siem Reap, Svay Rieng, Takeo, and Otdar Meanchey
• Five groups of provinces: Battambang and Pailin, Kampot and Kep, Preah Sihanouk and Koh Kong, Preah Vihear and Stung Treng, and Mondul Kiri and Ratanak Kiri

The sample of households was allocated to the sampling domains in such a way that estimates of indicators could be produced with precision at the national level, as well as separately for urban and rural areas of the country and for each of the 19 sampling domains.

The sampling frame used for the 2014 CDHS was derived from the list of all enumeration areas (EAs) created for the 2008 Cambodia General Population Census (GPC), provided by NIS. The list had been updated in 2012, and it excluded 241 EAs that are special settlement areas and not ordinary residential areas. It included 28,455 EAs for the entire country. The GPC also created maps that delimited the boundaries of each EA. Overall, 4,245 EAs were designated as urban and 24,210 as rural, with an average size of 99 households per EA.

The survey used a stratified sample selected in two stages. Stratification was achieved by separating every reporting domain into urban and rural areas. Thus, the 19 domains were stratified into a total of 38 sampling strata. Samples were selected independently in every stratum through a two-stage selection process. Implicit stratifications were achieved at each of the lower geographical or administrative levels by sorting the sampling frame according to geographical/administrative order before sample selection and by using a probability proportional to size selection strategy at the first stage of selection.

For further details on sample selection, see Appendix A of the final report.

Mode of data collection
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Face-to-face [f2f]

Research instrument
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Four questionnaires were used in the 2014 CDHS: the Household Questionnaire, the Woman’s Questionnaire, the Man’s Questionnaire, and the Micronutrient Questionnaire. These questionnaires are based on the questionnaires developed by the worldwide Demographic and Health Surveys (DHS) Program and on the questionnaires used during the 2010 CDHS survey. To reflect relevant population and health issues in Cambodia, the questionnaires were adapted during a series of technical meetings with various stakeholders from government ministries and agencies, nongovernmental organizations, and international donors. The final drafts of the questionnaires were discussed at a stakeholders’ meeting organized by the National Institute of Statistics. The adapted questionnaires were translated from English into Khmer and pretested in February and March 2014.

The Household Questionnaire was used to list all of the usual members and visitors in the selected households. Basic information was collected on the characteristics of each person listed, including age, sex, education, and relationship to the head of the household. For children under age 18, parents’ survival status was determined. The Household Questionnaire was also used to identify women and men eligible for an individual interview.

The Woman’s Questionnaire was used to collect information from all women age 15-49 and the Man’s Questionnaire was administered to all men age 15-49 living in one-third of the households in the CDHS sample.

The Micronutrient Questionnaire was implemented in a subsample of one-sixth of the sampled clusters for the collection of micronutrient specimens among eligible women and children. Specimens collected included venous blood, urine, and stool samples.

Cleaning operations
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Completed questionnaires were returned from the field to NIS headquarters, where they were entered and edited by data processing personnel who were specially trained for this task and had also attended questionnaire training of field staff. Data processing personnel included a data processing chief, two assistants, four secondary editors and coordinators, 25 entry operators, and eight office editors.

Data processing for the 2014 CDHS began on 25 personal computers on July 6, 2014, five weeks after the first interviews were conducted. Processing the data concurrently with data collection allowed for regular monitoring of team performance and data quality. Field check tables were generated regularly during the data processing to check various data quality parameters. As a result, feedback was given on a regular basis, encouraging teams to continue in areas of high quality and to correct areas of needed improvement. Feedback was individually tailored to each team. Data entry, which included 100 percent double entry to minimize keying errors, and data editing were completed on January 8, 2015. Data cleaning and finalization were completed on January 23, 2015.

Response rate
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All of the 611 clusters selected for the sample were surveyed in the 2014 CDHS. A total of 16,356 households were selected, of which 15,937 were found to be occupied during data collection. Among these households, 15,825 completed the Household Questionnaire, yielding a response rate of 99 percent.

In these interviewed households, 18,012 women were identified as eligible for the individual interview. Interviews were completed with 98 percent of these women. Of the 5,484 eligible men identified in every third household, 95 percent were successfully interviewed. There was little variation in response rates by urban-rural residence.

Sampling error estimates
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The estimates from a sample survey are affected by two types of errors: (1) nonsampling errors and (2) sampling errors. Nonsampling errors are the results of mistakes made in implementing data collection and data processing, such as failure to locate and interview the correct household, misunderstanding of the questions on the part of either the interviewer or the respondent, and data entry errors. Although numerous efforts were made during the implementation of the 2014 Cambodia Demographic and Health Survey (CDHS) to minimize this type of error, nonsampling errors are impossible to avoid and difficult to evaluate statistically.

Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents selected in the 2014 CDHS is only one of many samples that could have been selected from the same population, using the same design and identical size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey results.

A sampling error is usually measured in terms of the standard error for a particular statistic (mean, percentage, etc.), which is the square root of the variance. The standard error can be used to calculate confidence intervals within which the true value for the population can reasonably be assumed to fall. For example, for any given statistic calculated from a sample survey, the value of that statistic will fall within a range of plus or minus two times the standard error of that statistic in 95 percent of all possible samples of identical size and design.

If the sample of respondents had been selected as a simple random sample, it would have been possible to use straightforward formulas for calculating sampling errors. However, the 2014 CDHS sample is the result of a multistage stratified design, and, consequently, it was necessary to use more complex formulae. The computer software used to calculate sampling errors for the 2014 CDHS is an SAS program. This program used the Taylor linearization method for variance estimation for survey estimates that are means or proportions. The Jackknife repeated replication method is used for variance estimation of more complex statistics such as fertility and mortality rates.

The Taylor linearization method treats any percentage or average as a ratio estimate, r = y/x, where y represents the total sample value for variable y, and x represents the total number of cases in the group or subgroup under consideration.

Note: A more detailed description of estimate of sampling error is presented in APPENDIX B of the survey report.

Data appraisal
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Data Quality Tables
- Household age distribution
- Age distribution of eligible and interviewed women
- Age distribution of eligible and interviewed men
- Completeness of reporting
- Births by calendar years
- Reporting of age at death in days
- Reporting of age at death in months
- Nutritional status of children based on the NCHS/CDC/WHO International Reference Population

Note: See detailed data quality tables in APPENDIX C of the report.

摘要
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2014年柬埔寨人口与健康调查（CDHS）是柬埔寨在人口与健康问题上进行的第四次全国代表性调查。该调查继承了2000年、2005年和2010年柬埔寨人口与健康调查的方法论，使政策制定者能够利用这些调查评估趋势随时间的变化。

CDHS的主要目标是向卫生部（MOH）、规划部（MOP）以及其他相关机构和用户提供关于婴儿和儿童死亡率、生育偏好、计划生育行为、孕产妇死亡率、孕产妇和儿童健康服务的利用率、医疗支出、妇女地位以及关于艾滋病和其他性传播感染的知识和行为等方面的最新和可靠数据。这些信息有助于政策决策、规划、监控和项目评估，以促进柬埔寨在国家和地方政府层面的发展。

调查的长期目标是提高卫生部和国家统计局（NIS）在规划、执行和分析未来调查结果方面的能力。

地理覆盖范围
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全国

分析单元
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- 家庭
- 个人
- 0-5岁儿童
- 15-49岁女性
- 15-49岁男性

数据类型
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样本调查数据 [ssd]

抽样程序
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2014年CDHS的样本是柬埔寨全国范围内15至49岁女性和男性的代表性样本。为了在提供次国家级别估计的能力与限制样本规模之间取得平衡，定义了19个抽样区域，其中14个对应于个别省份，5个对应于分组省份：
• 十四个个别省份：班提艾梅安吉、贡布桑、贡布占安、贡布斯普、贡布吞、甘丹、克雷蒂、金边、波雷温、普斯阿特、斯莱普、暹粒、斯瓦伊仁、塔科和奥达梅安吉
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