Demographic and Health Survey 2000 - Cambodia

Abstract
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The Cambodia Demographic and Health Survey 2000 (CDHS) is the first nationally representative survey ever conducted in Cambodia on population and health issues. The primary objective of the survey is to provide the Ministry of Health, 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, domestic violence, and knowledge and behavior regarding AIDS and other sexually transmitted infections (STIs). This information contributes to policy decisions, planning, monitoring, and program evaluation for the development of Cambodia, at both national- and local-government levels.

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

The CDHS 2000 survey was conducted by the National Institute of Statistics of the Ministry of Planning, and the Ministry of Health. The CDHS executive committee and technical committee were established to oversee all technical aspects of implementation. They consisted of representatives from the Ministry of Health, the Ministry of Planning, the National Institute of Statistics, the United Nations Population Fund (UNFPA), the United Nations Children’s Fund (UNICEF), and the U.S. Agency for International Development (USAID). ORC Macro provided technical assistance including sampling design, survey methodology, interviewer training, and data analysis through the MEASURE DHS+ project. Funding for the survey came from UNFPA, UNICEF, and USAID.

Geographic coverage
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National

Analysis unit
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- Household
- Children under five years
- Women age 15-49
- Men

Kind of data
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Sample survey data [ssd]

Sampling procedure
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The CDHS survey called for a nationally representative sample of 15,300 women between the ages of 15 and 49. Survey estimates are produced for 12 individual provinces (Banteay Mean Chey, Kampong Cham, Kampong Chhnang, Kampong Spueu, Kampong Thum, Kandal, Kaoh Kong, Phnom Penh, Prey Veaeng, Pousat, Svay Rieng, and Takaev) and for the following 5 groups of provinces:
- Bat Dambang and Krong Pailin
- Kampot, Krong Preah Sihanouk, and Krong Kaeb
- Kracheh, Preah Vihear, and Stueng Traeng
- Mondol Kiri and Rotanak Kiri
- Otdar Mean Chey and Siem Reab.

The master sample developed in 1998 by the National Institute of Statistics served as the sampling frame for the CDHS survey. The master sample is based on the 1998 Cambodia General Population Census and consists of 600 villages selected with probability proportional to the number of households within the village. Villages are listed with the total population count and the number of enumeration areas (EAs), households, and segments. Enumeration areas were created during the cartography conducted in preparation for the 1998 census. A segment in a village corresponds to a block of about ten households. Segments were created only for villages retained in the master sample and maps showing their boundaries were also available for all of them.

The sample for the CDHS survey is a stratified sample selected in three stages. As for the master sample, stratification was achieved by separating every reporting domain into urban and rural areas. The sample was selected independently in every stratum.

The master sample contains a small number of villages for some of the provinces. For this reason, additional villages were directly selected from the census frame in order to reach the required sample size in these provinces. In the first stage, 471 villages were selected with probability proportional to the number of households in the village. Of these 471 villages, 63 were directly selected from the 1998 census frame. In the second stage, 5 or fewer segments were retained from each of the villages selected from the master sample, while 1 EA was retained from each of the 63 villages directly selected from the 1998 census frame. Each of these EAs consists of several segments.

A household listing was carried out in all selected segments and EAs, and the resulting lists of households served as the sampling frame for the selection of households in the third stage. All women 15-49 were interviewed in selected households.

In addition, a subsample of 50 percent of households was selected for data collection of anthropometry. Anemia testing was implemented in 25 percent of the sample. Only the women identified in the households with anemia testing were eligible for the section related to women's status. In this subsample of households, only one woman was selected in each household to be interviewed on domestic violence.

Note: See detailed description of sample design in APPENDIX A of the survey report.

Mode of data collection
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Face-to-face

Research instrument
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Two types of questionnaires were used in the CDHS 2000 survey: the Household Questionnaire and the Women’s questionnaire. The contents of these questionnaires were based on the international MEASURE DHS+ model. They were modified according to the situation in Cambodia and were designed to provide information needed by health and family planning program managers and policymakers, mainly the Ministry of Health, the Ministry of Planning, and other relevant institutions and organizations. The agencies involved in developing these questionnaires were the National Institute of Public Health/MoH, the National Institute of Statistics/MoP, UNFPA, UNICEF, USAID, WHO, Hellen Keller International, Marie Stopes International, the Ministry of Women’s Affairs, Project Against Domestic Violence, and the Demographic and Health Surveys (DHS) project of ORC Macro. The questionnaires were developed in English and then translated into Khmer. Back translation of the questionnaires, from Khmer to English, was also conducted.

The Household Questionnaire enumerated all the usual members and visitors of the selected households and collected information on the socioeconomic status of the households. The first part of the questionnaire collected information on the relationship of the persons to the head of household and items such as residence, sex, age, marital status, and level of education. This information was used to identify women who were eligible for the individual interview. The Household Questionnaire also contained information on the prevalence of accidents, physical impairment, illness, and health expenditures. Information was also collected on the dwelling units, including source of water, type of toilet facilities, fuels used for cooking, materials used for the house’s floor and roof, and ownership of a variety of consumer goods. In addition, during the household survey, anthropometry and anemia testing were carried out to determine nutritional status among children less than five years old and women age 15-49.

The Women’s Questionnaire collected information from all women age 15-49 on the following topics:-• Respondent’s background characteristics
- Reproduction
- Contraceptin (knowledge and use of family planning)
- Pregnancy, antenatal care, delivery, and postnatal care
- Infant feeding practices, child immunization, and health
- Marriage and sexual activity
- Fertility preference
- Husband’s background characteristics and women’s work
- Knowledge of HIV/AIDS and other sexually transmitted infections
- Maternal mortality and adult mortality
- Women’s status
- Domestic violence (household relations module).

Response rate
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A total of 12,810 households were selected in the sample, of which 12,475 were occupied at the time the fieldwork was carried out. Of the 12,475 occupied households, 12,236 were successfully interviewed, resulting in a household response rate of 98.1 percent. The main reason for the noninterviewed households was that those households no longer existed in the sampled clusters at the time of the interview.

A total of 15,558 women in these households were identified as women eligible to be interviewed. Questionnaires were then completed for 15,351 of those women, which represented a response rate of 98.7 percent. The principal reason for nonresponse among eligible women was a failure to find them at home despite repeated visits to their household.

Note: See summarized response rates by residence (urban/rural) in Table 1.2 of the survey report.

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 2000 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 2000 Cambodia Demographic and Health Survey is only one of many samples that could have been selected from the same population, using the same design and expected size. Each of these samples would yield results that differ somewhat from the results of the actual sample selected. Sampling errors are a measure of the variability between all possible samples. Although the degree of variability is not known exactly, it can be estimated from the survey results.

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

If the sample of respondents had been selected as a simple random sample, it would have been possible to use straightforward formulas for calculating sampling errors. However, the 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 CDHS 2000 is the ISSA Sampling Error Module. This module used the Taylor linearization method of variance estimation for survey estimates that are means or proportions. The Jackknife repeated replication method is used for variance estimation of more complex statistics such as fertility and mortality rates.

Note: See detailed estimate of sampling error calculation 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
- Completeness of reporting
- Births by calendar years
- Reporting of age at death in days
- Reporting of age at death in months

Note: See detailed tables in APPENDIX C of the report which is presented in this documentation.

摘要
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柬埔寨2000年人口与健康调查（CDHS）是柬埔寨首次进行的全国代表性人口与健康问题调查。该调查的主要目标是向卫生部、计划部（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、家庭规划行为、孕产妇死亡率、孕产妇和儿童健康服务的利用情况、医疗保健支出、妇女地位、家庭暴力以及关于艾滋病和其他性传播感染（STIs）的知识和行为等方面的最新和可靠数据。这些信息有助于柬埔寨在国家和地方各级制定政策、规划、监测和项目评估，以促进其发展。

调查的长期目标是加强卫生部和国家统计局（NIS）在规划、执行和分析后续调查结果的技术能力。

CDHS 2000调查由计划部的国家统计局和卫生部共同进行。CDHS执行委员会和技术委员会成立，负责监督实施的所有技术方面。委员会由卫生部、计划部、国家统计局、联合国人口基金（UNFPA）、联合国儿童基金会（UNICEF）和美国国际开发署（USAID）的代表组成。ORC Macro通过MEASURE DHS+项目提供了技术援助，包括抽样设计、调查方法、访谈员培训和数据分析。

资金由UNFPA、UNICEF和USAID提供。
地理覆盖范围
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全国
分析单元
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- 家庭
- 5岁以下儿童
- 15-49岁妇女
- 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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CDHS调查要求在全国范围内抽取15,300名15至49岁的妇女作为代表性样本。调查估计结果适用于12个单独的省份（班迭棉吉、磅湛、磅湛省、磅逊、磅吞、卡东、高孔、金边、拜林、波速、斯万雷恩和塔卡埃夫），以及以下5组省份：
- 达姆班和帕林王国
- 暔波、斯ihanouk王国和卡贝王国
- 拉查、波雷万和斯图恩特拉恩
- 蒙东基里和罗塔纳基里
- 奥达梅钦和西密雷亚布。
1998年由国家统计局开发的母本样本被用作CDHS调查的抽样框架。母本样本基于1998年柬埔寨人口普查，并包括600个村庄，这些村庄按照村庄内家庭数量的比例进行选择。村庄按照总人口数和统计区域（EA）、家庭和段落的数量进行列表。在为1998年人口普查进行的制图过程中创建了统计区域。村庄中的一个段落对应于大约十户家庭的街区。仅在保留在母本样本中的村庄中创建了段落，并且所有这些村庄的边界图也都可用。
CDHS调查的样本是一个分阶段进行的分层样本。与母本样本一样，分层是通过将每个报告领域分为城市和农村地区来实现的。在每个层中独立选择样本。
母本样本中某些省份的村庄数量较少。因此，为了在这些省份达到所需的样本量，直接从普查框架中选择了额外的村庄。在第一阶段，按照村庄内家庭数量的比例选择了471个村庄。在这471个村庄中，有63个直接从1998年普查框架中选出。在第二阶段，从母本样本中选出的每个村庄保留了5个或更少的段落，而从直接从1998年普查框架中选出的63个村庄中每个村庄保留了一个统计区域。每个统计区域由几个段落组成。
在所有选定的段落和统计区域中进行了家庭清单编制，所得的家庭清单作为第三阶段选择家庭的抽样框架。在选定的家庭中对所有15-49岁的妇女进行了访谈。
此外，还从50％的家庭样本中选择了数据收集的体格测量。在样本的25％中实施了贫血测试。只有那些在家庭中进行贫血测试的妇女才有资格进行关于妇女地位的章节。在这个家庭样本中，每个家庭只选择一名妇女进行家庭暴力访谈。

注意：请参阅调查报告附录A中关于样本设计的详细描述。
数据收集方式
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面对面
研究工具
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CDHS 2000调查使用了两种类型的问卷：家庭问卷和妇女问卷。这些问卷的内容基于国际MEASURE DHS+模型，并根据柬埔寨的情况进行了修改，旨在为卫生和家庭规划计划经理以及政策制定者提供所需信息，主要是卫生部、计划部和其他相关机构和组织。参与这些问卷开发的有国家公共卫生研究所/MoH、国家统计局/MoP、UNFPA、UNICEF、USAID、世界卫生组织、海伦·凯勒国际、玛丽·斯托普斯国际、妇女部、反对家庭暴力项目以及ORC Macro的DHS项目。问卷最初用英语编写，然后翻译成高棉语。还从高棉语翻译回英语进行了问卷的后翻译。
家庭问卷列出了选定家庭的全部常驻成员和访客，并收集了关于家庭社会经济状况的信息。问卷的第一部分收集了有关个人与户主关系的个人信息，例如居住地、性别、年龄、婚姻状况和教育水平。这些信息用于识别有资格进行个人访谈的妇女。家庭问卷还包含了关于事故、身体残疾、疾病和医疗保健支出的信息。还收集了关于住宅单元的信息，包括水源、卫生设施类型、烹饪用的燃料、房屋地板和屋顶用的材料，以及各种消费品的所有权。此外，在家庭调查期间，进行了体格测量和贫血测试，以确定5岁以下儿童和15-49岁妇女的营养状况。
妇女问卷收集了所有15-49岁妇女以下主题的信息：
- 响应者的背景特征
- 生殖
- 避孕（计划生育的知识和使用情况）
- 怀孕、产前护理、分娩和产后护理
- 婴儿喂养实践、儿童免疫接种和健康
- 婚姻和性行为
- 生育偏好
- 丈夫的背景特征和妇女的工作
- 关于HIV/AIDS和其他性传播感染的知识
- 孕产妇死亡率和成人死亡率
- 妇女地位
- 家庭暴力（家庭关系模块）。
响应率
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在样本中总共选择了12,810个家庭，其中在实地工作时12,475个家庭被占用。在12,475个被占用的家庭中，12,236个家庭成功接受了访谈，家庭响应率为98.1％。未接受访谈的家庭的主要原因是在访谈时这些家庭不再存在于样本群中。
在这些家庭中，共确定了15,558名有资格接受访谈的妇女。然后对其中15,351名妇女完成了问卷，这代表了98.7％的响应率。有资格的妇女未响应的主要原因是在多次访问后仍然找不到她们。

注意：请参阅调查报告第1.2表中的按居住地（城市/农村）汇总的响应率。
抽样误差估计
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样本调查的估计结果受到两种类型误差的影响：1）非抽样误差，2）抽样误差。非抽样误差是实施数据收集和数据处理过程中出现的错误的结果，例如未能找到和访谈正确的家庭、访谈员或受访者对问题的误解，以及数据输入错误。尽管在实施2000年柬埔寨人口与健康调查（CDHS）期间做出了巨大努力以最大限度地减少此类错误，但非抽样误差是无法避免且难以从统计上进行评估的。
另一方面，抽样误差可以通过统计方法进行评估。2000年柬埔寨人口与健康调查（CDHS）中选定的受访者样本只是从同一人群中选择、使用相同设计和预期规模的可能众多样本之一。这些样本中的每一个都会产生与实际选定的样本结果略有不同的结果。抽样误差是衡量所有可能样本之间变异性的指标。尽管变异的程度无法准确得知，但可以从调查结果中进行估计。
抽样误差通常以特定统计量（平均数、百分比等）的标准误差来衡量，它是方差的平方根。标准误差可以用来计算置信区间，在此区间内可以合理地假定总体真实值。例如，对于从样本调查中计算出的任何给定统计量，该统计量的值将在95％的所有可能样本的相同大小和设计范围内加减两倍标准误差。
如果受访者样本被选为简单随机样本，则可以使用简单的公式来计算抽样误差。然而，CDHS样本是分层多阶段设计的产物，因此有必要使用更复杂的公式。用于计算CDHS 2000抽样误差的计算机软件是ISSA抽样误差模块。该模块使用泰勒线性化方法对均值或比例的调查估计进行方差估计。对于更复杂的统计量，如生育率和死亡率，使用Jackknife重复复制法进行方差估计。

注意：请参阅调查报告附录B中关于抽样误差计算的详细估计。
数据评估
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数据质量表
- 家庭年龄分布
- 有资格和接受访谈的妇女年龄分布
- 报告的完整性
- 按日历年份的出生
- 报告死亡时的年龄
- 报告死亡时的月份

注意：请参阅报告附录C中提供的详细表格，该文档包含这些信息。