Zimbabwe - Demographic and Health Survey - 2016

Publication date: 2016

Zimbabwe Demographic and Health Survey 2015 Zim babw e 2015 D em ographic and H ealth S urvey GOVERNMENT OF ZIMBABWE Zimbabwe Demographic and Health Survey 2015 Final Report Zimbabwe National Statistics Agency Harare, Zimbabwe The DHS Program ICF International Rockville, Maryland, USA November 2016 The 2015 Zimbabwe Demographic and Health Survey (2015 ZDHS) was implemented by the Zimbabwe National Statistics Agency in July through December 2015. The HIV testing component was implemented by the National Microbiology Reference Laboratory (NMRL). The funding for the ZDHS was provided by the Government of Zimbabwe, the United States Agency for International Development (USAID), the United Nations Population Fund (UNFPA), the United Nations Development Programme (UNDP), the United Nations Children’s Fund (UNICEF), the United Kingdom Department for International Development (DFID), the Royal Danish Embassy, the Australian Agency for International Development (AusAID), the European Union (EU), the Swedish International Development Cooperation (SIDA), and Irish Aid. ICF International provided technical assistance through The DHS Program, a USAID-funded project providing support and technical assistance in the implementation of population and health surveys in countries worldwide. Additional information about the 2015 ZDHS may be obtained from the Zimbabwe National Statistics Agency (ZIMSTAT), P.O. Box CY 342, Causeway, Harare, Zimbabwe; Telephone +263-4-793-971/2 and 794-757; Fax: +263-4-728-529 and 708-854; E-mail: dg@zimstat.co.zw. Information about The DHS Program may be obtained from ICF International, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA; Telephone: +1-301-407-6500; Fax: +1-301-407-6501; Email: info@DHSprogram.com; Internet: www.DHSprogram.com. Cover photo of Victoria Falls ©2016 by Ali Yuhas. Used under Creative Commons license. Recommended citation: Zimbabwe National Statistics Agency and ICF International. 2016. Zimbabwe Demographic and Health Survey 2015: Final Report. Rockville, Maryland, USA: Zimbabwe National Statistics Agency (ZIMSTAT) and ICF International. Contents • iii CONTENTS TABLES AND FIGURES . ix PREFACE . xix ADDITIONAL DHS PROGRAM RESOURCES . xxi ACRONYMS AND ABBREVIATIONS . xxiii MAP OF ZIMBABWE . xxvi 1 INTRODUCTION AND SURVEY METHODOLOGY . 1 1.1 Survey Objectives . 1 1.2 Sample Design . 1 1.3 Questionnaires . 2 1.4 Anthropometry, Anaemia Testing, and HIV Testing . 3 1.5 Training of Field Staff . 4 1.6 Fieldwork . 5 1.7 Data Processing . 5 1.8 Response Rates . 5 2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION . 7 2.1 Drinking Water Sources and Treatment . 8 2.2 Sanitation Facilities and Waste Disposal . 9 2.3 Exposure to Smoke Inside the Home and Other Housing Characteristics . 10 2.4 Household Wealth . 11 2.5 Hand Washing . 12 2.6 Household Population and Composition . 13 2.7 Birth Registration . 14 2.8 Children’s Living Arrangements, School Attendance, and Parental Survival . 14 2.9 Education . 15 2.9.1 Educational Attainment . 15 2.9.2 School Attendance . 15 3 CHARACTERISTICS OF RESPONDENTS . 35 3.1 Basic Characteristics of Survey Respondents . 35 3.2 Education and Literacy . 36 3.4 Exposure to Mass Media and Internet Usage . 37 3.5 Employment Status . 38 3.6 Occupation . 39 3.7 Health Insurance Coverage . 40 3.8 Tobacco Use . 40 4 MARRIAGE AND SEXUAL ACTIVITY . 61 4.1 Marital Status . 61 4.2 Polygyny . 62 4.3 Age at First Marriage . 63 4.4 Age at First Sexual Intercourse . 63 4.5 Recent Sexual Activity . 64 iv • Contents 5 FERTILITY . 75 5.1 Current Fertility . 76 5.2 Children Ever Born and Living . 77 5.3 Birth Intervals . 78 5.4 Insusceptibility to Pregnancy . 78 5.5 Age at First Birth . 80 5.6 Teenage Childbearing . 80 6 FERTILITY PREFERENCES . 95 6.1 Desire for Another Child . 95 6.2 Ideal Number of Children . 97 6.3 Fertility Planning Status . 98 6.4 Wanted Fertility Rates . 99 7 FAMILY PLANNING . 109 7.1 Contraceptive Knowledge and Use . 110 7.2 Source of Modern Contraceptive Methods . 112 7.3 Informed Choice . 113 7.4 Discontinuation of Contraceptives . 113 7.5 Demand for Family Planning . 113 7.6 Future Use of Contraception . 115 7.7 Exposure to Family Planning Messages in the Media . 115 7.8 Contact of Non-users with Family Planning Providers . 116 8 INFANT AND CHILD MORTALITY . 131 8.1 Infant and Child Mortality . 132 8.2 Biodemographic Risk Factors . 133 8.3 Perinatal Mortality . 134 8.4 Higher-risk Fertility Behaviour . 134 9 MATERNAL HEALTH CARE . 141 9.1 Antenatal Care Coverage and Content . 142 9.1.1 Skilled Providers . 142 9.1.2 Timing and Number of ANC Visits . 142 9.1.3 Components of ANC Visits . 143 9.2 Protection Against Neonatal Tetanus . 143 9.3 Place of Delivery . 144 9.4 Skilled Assistance during Delivery . 145 9.5 Delivery by Caesarean . 146 9.6 Postnatal Care . 146 9.6.1 Postnatal Health Check for Mothers . 146 9.6.2 Postnatal Health Checks for Newborns . 147 9.6.3 Content of Postnatal Care for Newborns . 147 9.7 Problems in Accessing Health Care . 148 9.8 Prevention of Cervical Cancer . 148 10 CHILD HEALTH . 165 10.1 Birth Weight . 165 10.2 Vaccination of Children . 166 10.3 Symptoms of Acute Respiratory Infection . 168 10.4 Fever . 168 Contents • v 10.5 Diarrhoeal Disease . 169 10.5.1 Prevalence of Diarrhoea . 169 10.5.2 Treatment of Diarrhoea . 169 10.5.3 Feeding Practices . 170 10.5.4 Knowledge of ORS Packets . 171 10.6 Disposal of Children’s Stools . 171 11 NUTRITION OF CHILDREN AND ADULTS . 185 11.1 Nutritional Status of Children . 185 11.1.1 Measurement of Nutritional Status among Young Children . 186 11.1.2 Data Collection . 187 11.1.3 Prevalence of Malnutrition in Children . 187 11.2 Infant and Young Child Feeding Practices . 188 11.2.1 Initiation of Breastfeeding . 188 11.2.2 Exclusive Breastfeeding . 189 11.2.3 Median Duration of Breastfeeding . 190 11.2.4 Complementary Feeding . 191 11.2.5 Minimum Acceptable Diet . 191 11.3 Anaemia Prevalence in Children . 193 11.4 Vitamin A Supplementation and Deworming in Children . 194 11.5 Presence of Iodised Salt in Households . 195 11.6 Adults’ Nutritional Status . 195 11.6.1 Nutritional Status of Women . 195 11.6.2 Nutritional Status of Men . 197 11.7 Anaemia Prevalence in Adults . 197 11.8 Maternal Iron and Folate Supplementation . 198 12 MALARIA . 217 12.1 Mosquito Nets and Indoor Residual Spraying . 218 12.1.1 Ownership of Insecticide-Treated Nets . 218 12.1.2 Access to Insecticide-Treated Nets (ITNs) . 219 12.1.3 Source of Mosquito Nets . 220 12.1.4 Indoor Residual Spraying (IRS) . 221 12.1.5 Use of Mosquito Nets among the De Facto Household Population . 222 12.1.6 Use of Mosquito Nets by Children . 223 12.1.7 Use of Mosquito Nets by Pregnant Women . 224 12.2 Prevalence, Diagnosis, and Prompt Treatment of Fever among Young Children . 225 13 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOUR . 237 13.1 HIV/AIDS Knowledge, Transmission, and Prevention Methods . 238 13.2 Knowledge about Mother-to-Child Transmission . 239 13.3 HIV/AIDS Attitudes . 240 13.3.1 Discriminatory Attitudes towards People Living with HIV. 240 13.3.2 Attitudes towards Negotiating Safer Sexual Relations with Husbands . 241 13.4 Multiple Sexual Partners and Condom Use . 241 13.5 Paid Sex . 242 13.6 Coverage of HIV Testing Services . 242 13.6.1 Awareness of HIV Testing Services and Experience with HIV Testing . 242 13.6.2 HIV Testing of Pregnant Women . 244 13.7 Male Circumcision . 244 13.8 Self-reporting of Sexually Transmitted Infections . 245 13.9 Injections . 245 vi • Contents 13.10 HIV/AIDS-related Knowledge and Behaviour among Young People . 245 13.10.1 Knowledge about HIV/AIDS and Source for Condoms . 245 13.10.2 First Sex . 246 13.10.3 Premarital Sex . 247 13.10.4 Multiple Sexual Partners and Condom Use . 247 13.10.5 Age-mixing in Sexual Relationships . 247 13.10.6 Coverage of HIV Testing Services . 247 14 HIV PREVALENCE . 273 14.1 Coverage Rates for HIV Testing . 273 14.2 HIV Prevalence . 274 14.2.1 HIV Prevalence among Women and Men . 274 14.2.2 HIV Prevalence among Children . 275 14.2.3 HIV Prevalence among Women and Men by Background Characteristics . 276 14.2.4 HIV Prevalence by Sexual Risk Behaviour . 277 14.2.5 HIV Prevalence among Young People . 277 14.2.6 HIV Prevalence by Other Characteristics Related to HIV Risk . 278 14.2.7 HIV Prevalence among Couples . 279 15 WOMEN’S EMPOWERMENT . 295 15.1 Married Women’s and Men’s Employment . 295 15.2 Control over Women’s Earnings . 296 15.3 Control over Men’s Earnings . 297 15.4 Women’s and Men’s Ownership of Assets . 297 15.5 Women’s Participation in Decision Making . 299 15.6 Attitudes towards Wife Beating . 300 16 DOMESTIC VIOLENCE . 315 16.1 Measurement of Violence . 316 16.1.1 The Use of Valid Measures of Violence . 316 16.1.2 Ethical Considerations . 317 16.1.3 Subsample for the Violence Module . 317 16.2 Experience of Physical Violence . 318 16.3 Experience of Sexual Violence . 319 16.4 Experience of Different Forms of Violence . 319 16.5 Violence during Pregnancy . 320 16.6 Marital Control . 320 16.7 Spousal Violence . 321 16.7.1 Prevalence of Spousal Violence . 321 16.7.2 Recent Spousal Violence . 322 16.8 Duration of Marriage and Spousal Violence . 323 16.9 Injuries due to Spousal Violence . 323 16.10 Violence Initiated by Women against Their Husbands/Partners . 323 16.11 Response to Violence . 324 16.11.1 Help-Seeking among Women Who Have Experienced Violence . 324 16.11.2 Sources for Help . 324 17 ADULT AND MATERNAL MORTALITY . 343 17.1 Data . 343 17.2 Direct Estimates of Adult Mortality . 344 17.3 Trends in Adult Mortality . 345 17.4 Direct Estimation of Maternal Mortality . 346 Contents • vii REFERENCES . 351 APPENDIX A SAMPLE DESIGN AND IMPLEMENTATION . 353 APPENDIX B HIV TESTING METHODOLOGY . 365 APPENDIX C ESTIMATES OF SAMPLING ERRORS . 371 APPENDIX D DATA QUALITY TABLES . 389 APPENDIX E SURVEY PERSONNEL . 397 APPENDIX F QUESTIONNAIRES . 399 Tables and Figures • ix TABLES AND FIGURES 1 INTRODUCTION AND SURVEY METHODOLOGY . 1 Table 1.1 Results of the household and individual interviews . 5 2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION . 7 Table 2.1 Household drinking water . 19 Table 2.2 Availability of water . 20 Table 2.3 Household sanitation facilities . 21 Table 2.4 Household characteristics . 22 Table 2.5 Wealth quintiles . 23 Table 2.6 Household possessions . 24 Table 2.7 Hand washing . 25 Table 2.8 Household population by age, sex, and residence . 26 Table 2.9 Household composition . 27 Table 2.10 Birth registration of children under age 5 . 28 Table 2.11 Children’s living arrangements and orphanhood . 29 Table 2.12 School attendance by survivorship of parents . 30 Table 2.13.1 Educational attainment of the female household population . 31 Table 2.13.2 Educational attainment of the male household population . 32 Table 2.14 School attendance ratios . 33 Table 2.15 Age-specific attendance rates of the de facto population 5 to 24 years . 34 Figure 2.1 Households with improved water source . 8 Figure 2.2 Household drinking water by residence . 8 Figure 2.3 Availability of water in the last 2 weeks before the survey . 9 Figure 2.4 Household toilet facilities by residence . 10 Figure 2.5 Household wealth by residence. 12 Figure 2.6 Population pyramid . 13 Figure 2.7 Secondary school attendance by wealth quintile . 16 Figure 2.8 Age-specific attendance rates of the de facto population 5 to 24 years . 17 3 CHARACTERISTICS OF RESPONDENTS . 35 Table 3.1 Background characteristics of respondents . 42 Table 3.2.1 Educational attainment: Women . 43 Table 3.2.2 Educational attainment: Men . 44 Table 3.3.1 Literacy: Women . 45 Table 3.3.2 Literacy: Men . 46 Table 3.4.1 Exposure to mass media: Women . 47 Table 3.4.2 Exposure to mass media: Men . 48 Table 3.5.1 Internet usage: Women . 49 Table 3.5.2 Internet usage: Men . 50 Table 3.6.1 Employment status: Women . 51 Table 3.6.2 Employment status: Men . 52 Table 3.7.1 Occupation: Women . 53 Table 3.7.2 Occupation: Men . 54 Table 3.8 Type of employment: Women . 55 Table 3.9.1 Health insurance coverage: Women . 56 Table 3.9.2 Health insurance coverage: Men . 57 x • Tables and Figures Table 3.10.1 Tobacco smoking: Women . 58 Table 3.10.2 Tobacco smoking: Men . 59 Table 3.11 Average number of cigarettes smoked daily: Men . 60 Figure 3.1 Education of survey respondents . 36 Figure 3.2 Education by wealth . 37 Figure 3.3 Women’s employment status . 38 Figure 3.4 Men’s employment status . 38 Figure 3.5 Employment status by residence . 39 4 MARRIAGE AND SEXUAL ACTIVITY . 61 Table 4.1 Current marital status . 66 Table 4.2.1 Number of women’s co-wives . 67 Table 4.2.2 Number of men’s wives . 68 Table 4.3 Age at first marriage . 69 Table 4.4 Median age at first marriage by background characteristics . 70 Table 4.5 Age at first sexual intercourse . 71 Table 4.6 Median age at first sexual intercourse by background characteristics . 72 Table 4.7.1 Recent sexual activity: Women . 73 Table 4.7.2 Recent sexual activity: Men . 74 Figure 4.1 Marital status . 62 5 FERTILITY . 75 Table 5.1 Current fertility . 82 Table 5.2 Fertility by background characteristics . 83 Table 5.3.1 Trends in age-specific fertility rates . 84 Table 5.3.2 Trends in age-specific and total fertility rates, 1985-2015 . 85 Table 5.4 Children ever born and living . 86 Table 5.5 Birth intervals . 87 Table 5.6 Postpartum amenorrhoea, abstinence, and insusceptibility . 88 Table 5.7 Median duration of amenorrhoea, postpartum abstinence, and postpartum insusceptibility . 89 Table 5.8 Menopause . 90 Table 5.9 Age at first birth . 91 Table 5.10 Median age at first birth . 92 Table 5.11 Teenage pregnancy and motherhood . 93 Figure 5.1 Trends in total fertility rate (TFR) . 76 Figure 5.2 Total fertility rate by province . 76 Figure 5.3 Trends in age-specific fertility rates . 77 Figure 5.4 Total fertility rate by wealth quintile . 77 Figure 5.5 Birth interval distribution . 78 Figure 5.6 Percentage of menopausal women by age . 79 Figure 5.7 Teenage childbearing by province . 81 6 FERTILITY PREFERENCES . 95 Table 6.1 Fertility preferences by number of living children . 101 Table 6.2.1 Desire to limit childbearing: Women . 102 Table 6.2.2 Desire to limit childbearing: Men . 103 Table 6.3 Ideal number of children by number of living children . 104 Table 6.4 Mean ideal number of children . 105 Table 6.5 Fertility planning status . 106 Table 6.6 Wanted fertility rates . 107 Tables and Figures • xi Figure 6.1 Trends in desire to limit childbearing . 96 Figure 6.2 Trends in ideal family size . 97 Figure 6.3 Ideal family size by number of living children . 98 Figure 6.4 Fertility planning status . 99 Figure 6.5 Trends in wanted and actual fertility . 99 7 FAMILY PLANNING . 109 Table 7.1 Knowledge of contraceptive methods . 118 Table 7.2 Knowledge of contraceptive methods by background characteristics . 119 Table 7.3 Current use of contraception by age . 120 Table 7.4 Current use of contraception by background characteristics . 121 Table 7.5 Source of modern contraception methods . 122 Table 7.6 Informed choice . 123 Table 7.7 Twelve-month contraceptive discontinuation rates . 124 Table 7.8 Reasons for discontinuation . 124 Table 7.9.1 Need and demand for family planning among currently married women . 125 Table 7.9.2 Need and demand for family planning for all women and for women who are not currently married . 126 Table 7.10 Future use of contraception . 128 Table 7.11 Exposure to family planning messages . 128 Table 7.12 Contact of non-users with family planning providers . 129 Figure 7.1 Contraceptive use . 110 Figure 7.2 Trends in contraceptive use . 111 Figure 7.3 Modern contraceptive use by province . 111 Figure 7.4 Modern contraceptive use by education . 112 Figure 7.5 Sources of modern contraceptive methods . 112 Figure 7.6 Demand for family planning . 114 Figure 7.7 Trends in total demand for family planning . 114 Figure 7.8 Unmet need for family planning by province . 115 8 INFANT AND CHILD MORTALITY . 131 Table 8.1 Early childhood mortality rates . 136 Table 8.2 Early childhood mortality rates according to socioeconomic characteristics . 136 Table 8.3 Early childhood mortality rates according to demographic characteristics . 137 Table 8.4 Perinatal mortality . 138 Table 8.5 High-risk fertility behaviour . 139 Figure 8.1 Trends in childhood mortality . 132 Figure 8.2 Under-5 mortality by province . 133 Figure 8.3 Under-5 mortality by mother’s education . 133 Figure 8.4 Perinatal mortality by province . 134 9 MATERNAL HEALTH CARE . 141 Table 9.1 Antenatal care . 150 Table 9.2 Number of antenatal care visits and timing of first visit . 151 Table 9.3 Components of antenatal care . 152 Table 9.4 Tetanus toxoid injections . 153 Table 9.5 Place of delivery . 154 Table 9.6 Assistance during delivery . 155 Table 9.7 Caesarean section . 156 Table 9.8 Timing of first postnatal check for the mother . 157 Table 9.9 Type of provider of first postnatal check for the mother . 158 xii • Tables and Figures Table 9.10 Timing of first postnatal check for the newborn . 159 Table 9.11 Type of provider of first postnatal check for the newborn . 160 Table 9.12 Content of postnatal care for newborns . 161 Table 9.13 Problems in accessing health care . 162 Table 9.14 Knowledge and prevention of cervical cancer . 163 Figure 9.1 Antenatal care coverage trends . 142 Figure 9.2 Trends in place of delivery . 144 Figure 9.3 Institutional deliveries by province . 144 Figure 9.4 Institutional deliveries by mother’s education . 145 Figure 9.5 Delivery assistance. 145 Figure 9.6 Delivery assistance by wealth quintile . 146 10 CHILD HEALTH . 165 Table 10.1 Child’s size and weight at birth. 173 Table 10.2 Vaccinations by source of information . 174 Table 10.3 Vaccinations by background characteristics . 175 Table 10.4 Possession and observation of vaccination cards, according to background characteristics . 176 Table 10.5 Prevalence and treatment of symptoms of ARI . 177 Table 10.6 Prevalence and treatment of fever . 178 Table 10.7 Prevalence of diarrhoea . 179 Table 10.8 Feeding practices during diarrhoea . 180 Table 10.9 Diarrhoea treatment . 181 Table 10.10 Knowledge of ORS packets or pre-packaged liquids. 182 Table 10.11 Disposal of children’s stools . 183 Figure 10.1 Childhood vaccinations . 167 Figure 10.2 Trends in childhood vaccinations . 167 Figure 10.3 Vaccination coverage by province . 168 Figure 10.4 Diarrhoea prevalence by age . 169 Figure 10.5 Treatment of diarrhoea . 170 Figure 10.6 Feeding practices during diarrhoea . 171 Figure 10.7 Prevalence and treatment of childhood illnesses . 171 11 NUTRITION OF CHILDREN AND ADULTS . 185 Table 11.1 Nutritional status of children . 200 Table 11.2 Initial breastfeeding . 202 Table 11.3 Breastfeeding status according to age . 203 Table 11.4 Median duration of breastfeeding . 204 Table 11.5 Foods and liquids consumed by children in the day or night preceding the interview . 205 Table 11.6 Infant and young child feeding (IYCF) practices . 206 Table 11.7 Prevalence of anaemia in children . 207 Table 11.8 Micronutrient intake among children . 208 Table 11.9 Presence of iodised salt in household . 209 Table 11.10.1 Nutritional status of women . 210 Table 11.10.2 Nutritional status of men . 211 Table 11.11.1 Prevalence of anaemia in women . 212 Table 11.11.2 Prevalence of anaemia in men . 213 Table 11.12 Micronutrient intake among mothers . 214 Table 11.13 Mothers living in households with iodised salt . 215 Tables and Figures • xiii Figure 11.1 Nutritional status of children . 187 Figure 11.2 Trends in nutritional status of children . 187 Figure 11.3 Stunting by province . 188 Figure 11.4 Breastfeeding practices by age . 189 Figure 11.5 IYCF breastfeeding indicators . 190 Figure 11.6 IYCF indicators on minimum acceptable diet . 192 Figure 11.7 Trends in anaemia status among children . 193 Figure 11.8 Anaemia in children by province . 194 Figure 11.9 Trends in nutritional status among women . 196 Figure 11.10 Trends in nutritional status among men . 197 Figure 11.11 Trends in anaemia status among women . 198 12 MALARIA . 217 Table 12.1 Household possession of mosquito nets . 227 Table 12.2 Access to an insecticide-treated net (ITN) . 227 Table 12.3 Source of mosquito nets . 228 Table 12.4 Indoor residual spraying against mosquitoes . 229 Table 12.5 Use of mosquito nets by persons in the household . 230 Table 12.6 Use of existing ITNs . 231 Table 12.7 Use of mosquito nets by children . 232 Table 12.8 Use of mosquito nets by pregnant women . 233 Table 12.9 Prevalence, diagnosis, and prompt treatment of children with fever . 234 Table 12.10 Source of advice or treatment for children with fever . 235 Figure 12.1 Malaria Annual Parasite Incidence (API), Zimbabwe 2015 . 217 Figure 12.2 2013 LLIN Coverage . 218 Figure 12.3 Trends in ownership of ITNs . 219 Figure 12.4 Differentials in household ownership of ITNs . 219 Figure 12.5 Percentage of the de facto population with access to an ITN in the household . 220 Figure 12.6 Trends in IRS household coverage . 221 Figure 12.7 Coverage of ITN and/or IRS by province . 222 Figure 12.8 Trends in ITN ownership, access, and use . 223 Figure 12.9 Trends in net use among children under age 5 . 224 Figure 12.10 Trends in net use among pregnant women . 224 13 HIV/AIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOUR . 237 Table 13.1 Knowledge of HIV or AIDS . 249 Table 13.2 Knowledge of HIV prevention methods . 250 Table 13.3.1 Comprehensive knowledge about HIV: Women . 251 Table 13.3.2 Comprehensive knowledge about HIV: Men . 252 Table 13.4 Knowledge of prevention of mother-to-child transmission of HIV . 253 Table 13.5 Discriminatory attitudes towards people living with HIV . 254 Table 13.6 Attitudes toward negotiating safer sexual relations with husband . 255 Table 13.7.1 Multiple sexual partners and higher-risk sexual intercourse in the past 12 months: Women . 256 Table 13.7.2 Multiple sexual partners and higher-risk sexual intercourse in the past 12 months: Men . 257 Table 13.8 Payment for sexual intercourse and condom use at last paid sexual intercourse . 258 Table 13.9.1 Coverage of prior HIV testing: Women . 259 Table 13.9.2 Coverage of prior HIV testing: Men . 260 Table 13.10 Pregnant women counselled and tested for HIV . 261 Table 13.11 Male circumcision . 262 xiv • Tables and Figures Table 13.12 Self-reported prevalence of sexually-transmitted infections (STIs) and STIs symptoms . 263 Table 13.13 Prevalence of medical injections . 264 Table 13.14 Comprehensive knowledge about HIV and of a source of condoms among young people . 265 Table 13.15 Age at first sexual intercourse among young people . 266 Table 13.16 Premarital sexual intercourse and condom use during premarital sexual intercourse among young people . 267 Table 13.17.1 Multiple sexual partners and higher-risk sexual intercourse in the past 12 months among young people: Women . 268 Table 13.17.2 Multiple sexual partners and higher-risk sexual intercourse in the past 12 months among young people: Men . 269 Table 13.18 Age-mixing in sexual relationships among women age 15-19 . 270 Table 13.19 Recent HIV tests among young people . 271 Figure 13.1 Trends in HIV knowledge . 238 Figure 13.2 Comprehensive knowledge of HIV by education . 239 Figure 13.3 Trends in knowledge of mother-to-child transmission of HIV . 240 Figure 13.4 Higher-risk sexual partners and condom use . 241 Figure 13.5 Trends in HIV testing . 243 Figure 13.6 Recent HIV testing by province . 243 Figure 13.7 Trends in male circumcision by age . 244 Figure 13.8 STI advice or treatment seeking behaviour . 245 Figure 13.9 Age at first sex among young people . 246 Figure 13.10 Premarital sex and condom use among young people . 247 14 HIV PREVALENCE . 273 Table 14.1.1 Coverage of HIV testing by residence and province: Women and men age 15-49 . 280 Table 14.1.2 Coverage of HIV testing by residence and province: Children age 0-14 . 281 Table 14.2.1 Coverage of HIV testing by selected background characteristics: Women and men age 15-49 . 282 Table 14.2.2 Coverage of HIV testing by age : Children age 0-14 . 283 Table 14.3.1 HIV prevalence among women age 15-49 and men age 15-54, by age . 284 Table 14.3.2 HIV prevalence among children age 0-14 years, by age . 284 Table 14.4 HIV prevalence among children age 0-14 by socioeconomic characteristics . 285 Table 14.5 HIV prevalence among children age 0-14, by orphanhood and serological status of the mother . 285 Table 14.6 HIV prevalence by socioeconomic characteristics . 286 Table 14.7 HIV prevalence by demographic characteristics . 287 Table 14.8 HIV prevalence by sexual behaviour . 288 Table 14.9 HIV prevalence among young people by background characteristics . 289 Table 14.10 HIV prevalence among young people by sexual behaviour . 290 Table 14.11 HIV prevalence by other characteristics . 290 Table 14.12 Prior HIV testing by current HIV status . 291 Table 14.13 HIV prevalence by male circumcision . 292 Table 14.14 HIV prevalence among couples . 293 Figure 14.1 HIV prevalence by age . 275 Figure 14.2 HIV prevalence among children, by province . 275 Figure 14.3 HIV prevalence by residence and sex . 276 Figure 14.4 HIV prevalence among adults, by province . 276 Tables and Figures • xv 15 WOMEN’S EMPOWERMENT . 295 Table 15.1 Employment and cash earnings of currently married women and men . 302 Table 15.2.1 Control over women’s cash earnings and relative magnitude of women’s cash earnings . 303 Table 15.2.2 Control over men’s cash earnings . 304 Table 15.3 Women’s control over their own earnings and over those of their husbands . 305 Table 15.4.1 Ownership of assets: Women . 306 Table 15.4.2 Ownership of assets: Men . 307 Table 15.5 Participation in decision making . 308 Table 15.6.1 Women’s participation in decision making by background characteristics . 308 Table 15.6.2 Men’s participation in decision making by background characteristics . 309 Table 15.7.1 Attitude toward wife beating: Women . 310 Table 15.7.2 Attitude toward wife beating: Men . 311 Table 15.8 Indicators of women’s empowerment . 312 Table 15.9 Current use of contraception by women’s empowerment . 312 Table 15.10 Ideal number of children and unmet need for family planning by women’s empowerment . 313 Table 15.11 Reproductive health care by women’s empowerment . 313 Figure 15.1 Women’s and men’s employment by age . 296 Figure 15.2 Control over women’s earnings . 297 Figure 15.3 House and land ownership . 298 Figure 15.4 Women’s participation in decision making. 299 Figure 15.5 Attitude towards wife beating . 300 16 DOMESTIC VIOLENCE . 315 Table 16.1 Experience of physical violence . 326 Table 16.2 Persons committing physical violence . 327 Table 16.3 Experience of sexual violence. 328 Table 16.4 Persons committing sexual violence . 329 Table 16.5 Age at first experience of sexual violence . 329 Table 16.6 Experience of different forms of violence . 329 Table 16.7 Experience of violence during pregnancy . 330 Table 16.8 Marital control exercised by husbands . 331 Table 16.9 Forms of spousal violence . 333 Table 16.10 Spousal violence according to background characteristics . 334 Table 16.11 Spousal violence by husband’s characteristics and empowerment indicators . 335 Table 16.12 Frequency of physical or sexual violence . 336 Table 16.13 Experience of spousal violence by duration of marriage . 337 Table 16.14 Injuries to women due to spousal violence . 337 Table 16.15 Women’s violence against their spouse according to background characteristics . 338 Table 16.16 Women’s violence against their spouse according to husband’s characteristics . 339 Table 16.17 Help seeking to stop violence . 340 Table 16.18 Sources for help to stop the violence . 341 Figure 16.1 Trends in physical violence . 318 Figure 16.2 Women’s experience of physical or sexual violence by marital status . 319 Figure 16.3 Types of spousal violence . 321 Figure 16.4 Spousal violence by husband’s alcohol consumption . 322 Figure 16.5 Help seeking by type of violence experienced . 324 xvi • Tables and Figures 17 ADULT AND MATERNAL MORTALITY . 343 Table 17.1 Completeness of information on siblings . 348 Table 17.2 Adult mortality rates . 348 Table 17.3 Adult mortality probabilities . 348 Table 17.4 Maternal mortality . 349 Figure 17.1 Adult mortality rates among women and men age 15-49 . 345 Figure 17.2 Trends in maternal mortality ratios with confidence intervals . 347 APPENDIX A SAMPLE DESIGN AND IMPLEMENTATION . 353 Table A.1 Population distribution of the 2012 census population by province and residence, Zimbabwe . 354 Table A.2 Household distribution of the 2012 census population by province and residence, Zimbabwe . 354 Table A.3 Distribution of enumeration areas (EAs) and their average size in number of households, Zimbabwe . 354 Table A.4 Sample allocation of clusters and households by province and residence, Zimbabwe 2015 . 355 Table A.5 Sample allocation of expected completed interviews with men and women by province and residence, Zimbabwe 2015 . 356 Table A.6 Number of expected HIV tests for women 15-49 and the expected precision by province, Zimbabwe 2015. 356 Table A.7 Number of expected HIV tests for men 15-54 and the expected precision by province, Zimbabwe 2015 . 357 Table A.8 Number of children 0-14 eligible for the HIV testing by province and residence, Zimbabwe 2015 . 357 Table A.9 Sample implementation: Women . 359 Table A.10 Sample implementation: Men . 360 Table A.11 Coverage of HIV testing by social and demographic characteristics: Women . 361 Table A.12 Coverage of HIV testing by social and demographic characteristics: Men . 362 Table A.13 Coverage of HIV testing by sexual behaviour characteristics: Women . 363 Table A.14 Coverage of HIV testing by sexual behaviour characteristics: Men . 364 APPENDIX B HIV TESTING METHODOLOGY . 365 Table B.1 HIV prevalence according to final and original HIV testing algorithms, by age . 368 Table B.2 HIV prevalence according to final and original HIV testing algorithms, by socioeconomic characteristics . 369 Figure B.1 Original HIV testing algorithm, participants age 2 years and older . 366 Figure B.2 Final HIV testing algorithm, participants age 2 years and older . 367 Figure B.3 Trends in HIV prevalence . 370 APPENDIX C ESTIMATES OF SAMPLING ERRORS . 371 Table C.1 List of indicators for sampling errors, 2015 Zimbabwe DHS . 373 Table C.2 Sampling errors: Total sample, 2015 Zimbabwe DHS . 374 Table C.3 Sampling errors: Urban sample, 2015 Zimbabwe DHS . 375 Table C.4 Sampling errors: Rural sample, 2015 Zimbabwe DHS . 376 Table C.5 Sampling errors: Manicaland sample, 2015 Zimbabwe DHS . 377 Table C.6 Sampling errors: Mashonaland Central sample, 2015 Zimbabwe DHS . 378 Table C.7 Sampling errors: Mashonaland East sample, 2015 Zimbabwe DHS . 379 Table C.8 Sampling errors: Mashonaland West sample, 2015 Zimbabwe DHS . 380 Table C.9 Sampling errors: Matabeleland North sample, 2015 Zimbabwe DHS . 381 Tables and Figures • xvii Table C.10 Sampling errors: Matabeleland South sample, 2015 Zimbabwe DHS . 382 Table C.11 Sampling errors: Midlands sample, 2015 Zimbabwe DHS . 383 Table C.12 Sampling errors: Masvingo sample, 2015 Zimbabwe DHS . 384 Table C.13 Sampling errors: Harare sample, 2015 Zimbabwe DHS . 385 Table C.14 Sampling errors: Bulawayo sample, 2015 Zimbabwe DHS . 386 Table C.15 Sampling errors for adult and maternal mortality rates, Zimbabwe 2015 . 387 APPENDIX D DATA QUALITY TABLES . 389 Table D.1 Household age distribution . 389 Table D.2.1 Age distribution of eligible and interviewed women . 390 Table D.2.2 Age distribution of eligible and interviewed men . 390 Table D.3 Completeness of reporting . 391 Table D.4 Births by calendar years . 391 Table D.5 Reporting of age at death in days . 392 Table D.6 Reporting of age at death in months . 392 Table D.7 Nutritional status of children based on the NCHS/CDC/WHO International Reference Population . 393 Table D.8 Completeness of information on siblings . 395 Table D.9 Sibship size and sex ratio of siblings . 395 Preface • xix PREFACE he 2015 Zimbabwe Demographic and Health Survey (2015 ZDHS) presents the major findings of a nationally representative survey with a sample of more than 11,000 households. The ZDHS was conducted by the Zimbabwe National Statistics Agency (ZIMSTAT) in collaboration with the Ministry of Health and Child Care (MoHCC) and the United Nations Population Fund (UNFPA), from July through December 2015. The 2015 ZDHS is the sixth such survey to be conducted in Zimbabwe as a follow-up to the 1988, 1994, 1999, 2005-06, and 2010-11 surveys and provides basic demographic and health indicators. Pursuant to the global trend on the use of modern technology in data collection, the 2010-11 survey, adopted the use of personal digital assistants (PDAs) rather than paper questionnaires for recording responses during interviews. In the 2015 survey, Asus tablets operating on Windows 8.1 software were used during data collection and these offer more features that the PDAs. A Key Indicators report was published in May 2016 and presents at a glance some selected findings of the survey. The primary objective of the 2015 ZDHS survey is to provide current demographic and health information for use by policymakers, planners, researchers and programme managers. Specific topics covered in the survey include: respondent demographic characteristics, reproductive and contraceptive history, fertility preferences, family planning methods, infant and child mortality, knowledge and attitudes about sexually transmitted infections, maternal health, breastfeeding and complementary feeding, anaemia prevalence in children and women, ownership of mosquito nets, knowledge of HIV prevention methods, comprehensive knowledge of HIV prevention among young people, multiple sexual partners, coverage of prior HIV testing, male circumcision, prevention of cervical cancer, domestic violence and maternal mortality. ZIMSTAT is appreciative of the significant funding and material provisions availed to the Agency by the Government of Zimbabwe, various development partners and the donor community that facilitated the successful implementation of the survey. Specific mention is due to the following: Ministry of Health and Child Care (MoHCC), United Nations Population Fund (UNFPA), National Microbiology Reference Laboratory (NMRL), the Zimbabwe National Family Planning Council (ZNFPC), United Nations Development Programme (UNDP), United Nations Children’s Fund (UNICEF), United Kingdom Department for International Development (DFID), Royal Danish Embassy, Australian Agency for International Development (AusAID), the European Union (EU), the Swedish International Development Cooperation (SIDA), and Irish Aid. ICF International provided technical assistance through The DHS Program, a USAID-funded project that provides support and technical assistance for the implementation of population and health surveys in countries worldwide. Finally, ZIMSTAT would also like to thank all field personnel for their dedication to duty and commitment to high quality work as well as the general public for the patience and cooperation during data collection. M. Dzinotizei Director General—Zimbabwe National Statistics Agency Harare, October 2016 T Additional DHS Program Resources • xxi ADDITIONAL DHS PROGRAM RESOURCES The DHS Program Website – Download free DHS reports, standard documentation, key indicator data, and training tools, and view announcements. DHSprogram.com STATcompiler – Build custom tables, graphs, and maps with data from 90 countries and thousands of indicators. Statcompiler.com DHS Program Mobile App – Access key DHS indicators for 90 countries on your mobile device (Apple, Android, or Windows). Search DHS Program in your iTunes or Google Play store DHS Program User Forum – Post questions about DHS data, and search our archive of FAQs. userforum.DHSprogram.com Tutorial Videos – Watch interviews with experts and learn DHS basics, such as sampling and weighting, downloading datasets, and How to Read DHS Tables. www.youtube.com/DHSProgram Datasets – Download DHS datasets for analysis. DHSprogram.com/Data Spatial Data Repository – Download geographically linked health and demographic data for mapping in a geographic information system (GIS). spatialdata.DHSprogram.com Social Media – Follow The DHS Program and join the conversation. Stay up to date through: Facebook www.facebook.com/DHSprogram Twitter www.twitter.com/ DHSprogram Pinterest www.pinterest.com/ DHSprogram LinkedIn www.linkedin.com/ company/dhs-program YouTube www.youtube.com/DHSprogram Blog Blog.DHSprogram.com Acronyms and Abbreviations • xxiii ACRONYMS AND ABBREVIATIONS AIDS acquired immunodeficiency syndrome ANC antenatal care API annual parasite incidence ARI acute respiratory infection ART antiretroviral therapy ASAR age-specific attendance rate AUSAID Australian Agency for International Development BMI body mass index CAPI computer-assisted personal interviewing CBD community-based distributor CBR crude birth rate CDC Centers for Diseases Control and Prevention CHTTS CSPro HIV Test Tracking System CPR contraceptive prevalence rate CSPro Census and Survey Processing System DBS dried blood spots DEFT design effect DFID United Kingdom Department of International Development DHS Demographic and Health Surveys EA enumeration area ELISA enzyme-linked immunosorbent assay EPI Expanded Programme on Immunization EU European Union GAR gross attendance ratio GFR general fertility rate GIS geographic information system GoZ Government of Zimbabwe GPI gender parity index HIV human immunodeficiency virus IFSS internet file streaming system IRS indoor residual spraying ITN insecticide-treated net IUCD intrauterine contraceptive device IYCF infant and young child feeding LAM lactational amenorrhoea method LLIN long-lasting insecticidal net LPG liquid petroleum gas xxiv • Acronyms and Abbreviations MAD minimum acceptable diet MDG Millennium Development Goal MoHCC Ministry of Health and Child Care MMR maternal mortality ratio MRCZ Medical Research Council of Zimbabwe MTCT mother-to-child transmission MUAC mid-upper-arm circumference NAR net attendance ratio NCD noncommunicable disease NGO non-governmental organisation NMRL National Microbiology Reference Laboratory ORS oral rehydration salts ORT oral rehydration therapy PDA personal digital assistant PEPFAR U.S. President’s Emergency Plan for AIDS Relief PMTCT prevention of mother-to-child transmission PPS probability proportional to size PSU primary sampling unit PY person-years RHF recommended home fluids SD standard deviation SDGs Sustainable Development Goals SE standard error SIDA Swedish International Development Cooperation STI sexually transmitted infection TB tuberculosis TFR total fertility rate TOT training of trainers UNDP United National Development Programme UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund USAID United States Agency for International Development VAD vitamin A deficiency VIP ventilated improved pit VMMC voluntary male medical circumcision WHO World Health Organization ZDHS Zimbabwe Demographic and Health Survey ZIM Asset Zimbabwe Agenda for Sustainable Socio-Economic Transformation ZIMSTAT Zimbabwe National Statistics Agency ZNFPC Zimbabwe National Family Planning Council xxvi • Map of Zimbabwe Introduction and Survey Methodology • 1 INTRODUCTION AND SURVEY METHODOLOGY 1 he 2015 Zimbabwe Demographic and Health Survey (ZDHS) was implemented by the Zimbabwe National Statistics Agency (ZIMSTAT) from July through December 2015, with a nationally representative sample of over 11,000 households. Women age 15-49 and men age 15-54 in these households were eligible for individual interviews. The 2015 ZDHS is a follow-up survey to the 1988, 1994, 1999, 2005-06, and 2010-11 ZDHS surveys that provides updated estimates of basic demographic and health indicators. Other agencies and organizations that facilitated the successful implementation of the survey with technical or financial support were the Government of Zimbabwe, the United States Agency for International Development (USAID), the United Nations Population Fund (UNFPA), the United Nations Development Programme (UNDP), the United Nations Children’s Fund (UNICEF), the United Kingdom Department for International Development (DFID), the Royal Danish Embassy, the Australian Agency for International Development (AusAID), the European Union (EU), the Swedish International Development Cooperation Agency (SIDA), and Irish Aid. ICF International provided technical assistance through The DHS Program, a USAID-funded project that provides support and technical assistance for the implementation of population and health surveys in countries around the world. 1.1 SURVEY OBJECTIVES The primary objective of the 2015 ZDHS survey is to provide current estimates of basic demographic and health indicators. The ZDHS collected information on fertility levels, marriage, sexual activity, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutritional status of mothers and young children, early childhood mortality, maternal mortality, maternal and child health, knowledge and behaviour related to HIV/AIDS and other sexually transmitted infections (STIs), smoking, knowledge of cervical cancer, and male circumcision. In addition, the 2015 ZDHS provides estimates of anaemia prevalence among children age 6-59 months, women age 15-49, and men age 15-54, and HIV prevalence for all females age 0-49 and all males age 0-54. The information collected through the ZDHS will assist policy makers and programme managers in evaluating and designing programmes and strategies for improving the health of the country’s population. 1.2 SAMPLE DESIGN The 2015 ZDHS sample was designed to yield representative information for most indicators for the country as a whole, for urban and rural areas, and for each of Zimbabwe’s ten provinces: Manicaland, Mashonaland Central, Mashonaland East, Mashonaland West, Matabeleland North, Matabeleland South, Midlands, Masvingo, Harare, and Bulawayo. The 2012 Zimbabwe Population Census was used as the sampling frame for the 2015 ZDHS. Administratively, each province in Zimbabwe is divided into districts, and each district is divided into smaller administrative units called wards. During the 2012 Zimbabwe Population Census, each ward was subdivided into convenient areas, which are called census enumeration areas (EAs). The 2015 ZDHS sample was selected with a stratified, two-stage cluster design, with EAs as the sampling units for the first stage. The 2015 ZDHS sample included 400 EAs—166 in urban areas and 234 in rural areas. The second stage of sampling included the listing exercises for all households in the survey sample. A complete listing of households was conducted for each of the 400 selected EAs in March 2015. Maps were drawn for each of the clusters and all private households were listed. The listing excluded institutional living arrangements such as army barracks, hospitals, police camps, and boarding schools. A representative sample of 11,196 households was selected for the 2015 ZDHS. T 2 • Introduction and Survey Methodology Women age 15-49 and men age 15-54 who were either permanent residents of the selected households or visitors who stayed in the household the night before the survey were eligible for interviewing. Anaemia testing was performed in all households among eligible women age 15-49 and men age 15-54 who consented to testing. With the parent’s or guardian’s consent, children age 6-59 months were also tested for anaemia in these households. With consent from the respondent or parental or guardian consent for minors, blood samples were collected in all households for HIV testing in the laboratory for females age 0- 49 and males age 0-54. In addition, a sub-sample of one eligible woman in each household was randomly selected to be asked additional questions about domestic violence. 1.3 QUESTIONNAIRES Four questionnaires were used for the 2015 ZDHS: the Household Questionnaire, the Woman’s Questionnaire, the Man’s Questionnaire, and the Biomarker Questionnaire. These questionnaires were adapted from model survey instruments developed for The DHS Program to reflect the population and health issues relevant to Zimbabwe. Issues were identified at a series of meetings with various stakeholders from government ministries and agencies, research and training institutions, non-governmental organisations (NGOs), and development partners. In addition to English, the questionnaires were translated into two major languages, Shona and Ndebele. All four questionnaires were programmed into tablet computers to facilitate computer assisted personal interviewing (CAPI) for data collection, with the option to choose English, Shona, or Ndebele for each questionnaire. The Household Questionnaire listed the usual members and visitors of 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, survival status of the parents was determined. Data on the age and sex of household members obtained in the Household Questionnaire was used to identify women age 15-49 and men age 15-54 who were eligible for the individual interview, anthropometry measurement, and haemoglobin and HIV testing. The Household Questionnaire was also used to identify children age 0-14 for HIV testing and children age 6-59 months for anaemia testing and age 0-59 months for anthropometry measurement. In addition, the Household Questionnaire collected information on characteristics of the household’s dwelling unit such as the source of water, type of toilet facilities, materials used for the floor, ownership of various durable goods, and ownership and use of mosquito nets (to assess the coverage of malaria prevention programmes). The Woman’s Questionnaire was used to collect information from women age 15-49 years on the following topics:  Background characteristics (age, education, media exposure, etc.)  Birth history and childhood mortality  Knowledge and use of family planning methods  Fertility preferences  Antenatal, delivery, and postnatal care  Breastfeeding and infant feeding practices  Vaccinations and childhood illnesses  Marriage and sexual activity  Women’s work and husband’s background characteristics  Malaria prevention and treatment  Awareness and behaviour related to HIV/AIDS and other sexually transmitted infections (STIs)  Adult mortality, including maternal mortality  Domestic violence The Man’s Questionnaire was administered to men age 15-54 in all households in the 2015 ZDHS sample. The Man’s Questionnaire collected much of the same information as in the Woman’s Questionnaire, but was shorter because it did not contain a detailed reproductive history or questions on maternal and child health. Introduction and Survey Methodology • 3 The Biomarker Questionnaire recorded the results of the anthropometry measurements, haemoglobin testing results, and HIV sample collection for testing in the laboratory, as well as the signatures of the fieldworker and the respondent who gave consent. Separate consent forms were administered, signed, and archived to record each respondent’s consent and signature. For this survey, interviewers used tablet computers to record all questionnaire responses during the interviews. The tablet computers were equipped with Bluetooth® technology to enable remote electronic transfer of files, such as assignment sheets from the team supervisor to the interviewers, Household Questionnaires among survey team members, and completed questionnaires from interviewers to the team supervisors. The tablet computer programming was created using the Census and Survey Processing System (CSPro) by The DHS Program, in collaboration with the U.S. Census Bureau. 1.4 ANTHROPOMETRY, ANAEMIA TESTING, AND HIV TESTING The 2015 ZDHS incorporated three “biomarkers” that included anthropometry, anaemia testing, and HIV testing. Data related to the coverage of the biomarker component, the anthropometric measures and the result of the anaemia testing were directly recorded using the tablet. The protocol for anaemia testing and for the blood specimen collection for HIV testing was reviewed and approved by the Medical Research Council of Zimbabwe (MRCZ), the Institutional Review Board of ICF International, and the Centers for Disease Control and Prevention (CDC) in Atlanta. Anthropometry Measurements: In all households, height and weight measurements were recorded for children age 0-59 months, women age 15-49, and men age 15-54. Anaemia Testing: Blood specimens were collected for anaemia testing from all children age 6-59 months, women age 15-49 and men age 15-54 who voluntarily consented to the testing. Blood samples were drawn from a drop of blood taken from a finger prick (or a heel prick for young children with small fingers) and collected in a microcuvette. Haemoglobin analysis was conducted on site with a battery-operated portable HemoCue® analyser, which produces a result in less than one minute. Results were provided verbally and in writing. Parents of children with a haemoglobin level below 7 g/dL were instructed to take the child to a health facility for follow-up care. Non-pregnant women, pregnant women, and men were referred for follow-up care if their haemoglobin level was below 7 g/dL, 9 g/dL and 9 g/dL, respectively. All households in which anthropometry and/or anaemia testing was conducted were given a brochure that explained the causes and prevention of anaemia. HIV Testing: Blood specimens for HIV testing in the laboratory were collected from females age 0-49 and males age 0-54 who consented to the testing. The protocol for the blood specimen collection and analysis was based on the anonymous linked protocol developed for The DHS Program. This protocol allows for the merging of the HIV test results with the socio-demographic data collected in the individual questionnaires after all information that could potentially identify an individual have been destroyed. The ZDHS biomarker interviewers explained the blood collection procedure, the confidentiality of the data, and the fact that the test results would not be made available to the respondent. For women age 18-49 and men age 18-54, informed consent was sought directly from the respondent. For children age 0-6 years, informed consent for HIV testing was sought from parents or guardians. In accordance with human subjects practices in Zimbabwe, for children/youth age 7-17 years parental/guardian consent and youth assent were sought for HIV testing. Minors age 13-17 who have ever been married, or who live in households in which no household members are 18 years of age or above, are considered emancipated and were able to consent to participate in the HIV test without the permission of a parent or guardian. Biomarker interviewers read informed consent statements aloud to participants and their parents or guardians and provided printed copies of the consent statements. Adults, emancipated minors, and parents or guardians provided written consent, and unemancipated minors age 7-17 provided written assent. Each household, whether individuals consented to HIV testing or not, was given an informational brochure on HIV/AIDS and a list of fixed sites providing voluntary counselling and testing services in surrounding districts within the province. 4 • Introduction and Survey Methodology If a respondent consented to the HIV testing, five blood spots from the finger prick were collected on a filter paper card to which a barcode label unique to the respondent was affixed. Respondents were asked whether they consented to having the laboratory store their blood sample for future unspecified testing. If the respondent did not consent to additional testing using their sample, it was indicated on the Biomarker Questionnaire and the Blood Sample Transmittal Form that the respondent refused additional tests using their specimen; “no additional testing” was also written on the filter paper card. Each blood sample had a barcode label, and the barcode number was entered into the Biomarker Questionnaire. A third copy of the same barcode was affixed to the Blood Sample Transmittal Form to track the blood samples from the field to the laboratory. Blood samples were dried overnight and packaged for storage the following morning. Samples were periodically collected from the field teams, along with the Blood Sample Transmittal Forms, and transported to ZIMSTAT in Harare to be logged in, and checked. Blood samples were then transported to the National Microbiology Reference Laboratory (NMRL) in Harare. Upon arrival at NMRL, each blood sample was logged into the CSPro HIV Test Tracking System (CHTTS) database, given a laboratory number, and stored at -20°C until tested. The HIV testing protocol stipulates that testing of blood can only be conducted after the questionnaire data entry is completed, verified, and cleaned, and all unique identifiers are removed from the questionnaire file except the anonymous barcode number. The original testing algorithm calls for testing all samples on the first assay test, an ELISA, the Vironostika® HIV Ag/Ab (fourth generation) (Biomerieux). A negative result is rendered negative. All samples with positive results are subjected to a second ELISA, the Enzygnost® HIV Integral II (fourth generation) (Siemens). Samples with positive results on the second test are rendered positive. If the first and second tests are discordant, the samples are re-tested on the first and second assay. If the samples are still discordant, a third confirmatory test, the INNO-LIA™ HIV I/II Score Blot Assay (Fujirebio, Zwignaard, Belgium), is administered. The final result will be rendered positive if the INNO-LIA confirms the result to be positive and rendered negative if the INNO-LIA confirms it to be negative. If the INNO-LIA results are indeterminate, the sample will be rendered indeterminate. In accordance with new recommendations, released after the 2015 ZDHS survey protocol was finalized (see UNAIDS/WHO, 2015), a decision was taken to add an additional test to the algorithm. To reduce the risk of false-positive results, all specimens that were rendered positive in the original HIV testing algorithm for the survey were tested on a highly specific confirmatory assay, Geenius HIV 1/2 (Bio-Rad, France). Further discussion on the final testing algorithm is presented in Appendix B. 1.5 TRAINING OF FIELD STAFF The ZDHS technical team, composed of ZIMSTAT staff and experts from the Ministry of Health and Child Care (MoHCC), Zimbabwe National Family Planning Council (ZNFPC), the Medical Research Council of Zimbabwe (MRCZ), UNFPA, USAID and ICF International, participated in a 3-day training of trainers (TOT), which was conducted April 20-22, 2015. Immediately following the TOT, the pretest training took place from April 23 to May 6, 2015. The pretest fieldwork was conducted May 7-9, 2015. During a 2-week period, the 15-member ZDHS technical team and 3 ICF technical specialists trained 27 participants to administer paper and electronic questionnaires with tablet computers. The ICF biomarker specialist trained the technical team and pretest participants to take anthropometric measurements, collect finger prick blood samples for haemoglobin measurement and HIV testing, and properly store the dried blood spot (DBS) specimens for HIV testing. The pretest fieldwork was conducted over 3 days, covering approximately 150 households. The ZDHS technical team conducted debriefing sessions with the pretest field staff on May 10, 2015; modifications to the questionnaires were made based on lessons learned from the exercise. ZIMSTAT recruited and trained 120 individuals (52 females and 68 males) to serve as supervisors, interviewers, biomarker interviewers, and reserve interviewers for the main fieldwork. Field staff training for the main survey was conducted June 1-24, 2015. The training course included instruction on interviewing techniques and field procedures, a detailed review of the questionnaire content, and mock interviews between participants in the classroom. The biomarker interviewers (21 females and 24 males) Introduction and Survey Methodology • 5 received additional training, including instruction in anthropometry and finger prick blood collection for haemoglobin measurement and HIV testing. Main training participants conducted practice interviews and biomarker collection with respondents in households located outside the 2015 ZDHS sample EAs. Team supervisors were trained in methods of data quality control procedures, fieldwork coordination, and the use of special programmes for the tablet computers. 1.6 FIELDWORK Fifteen interviewing teams conducted data collection for the 2015 ZDHS. Each team included one team supervisor, four interviewers, three biomarker interviewers, and one driver. Electronic data files were transferred each day from each interviewer’s tablet computer to the team supervisor’s tablet computer. The field supervisors transferred data to the central data processing office. To facilitate communication and monitoring, each field worker was assigned a unique identification number. Senior technical staff members from ZIMSTAT coordinated and supervised fieldwork activities. An ICF International technical specialist, a biomarker specialist, two data processing staff, and representatives from NMRL, MoHCC, ZNFPC, MRCZ, UNFPA, and USAID supported the fieldwork monitoring activities. Data collection took place over a 6-month period from July 6 to December 20, 2015. 1.7 DATA PROCESSING CSPro was used for data editing, weighting, cleaning, and tabulation. In ZIMSTAT’s central office, data received from the supervisor’s tablets were registered and checked for inconsistencies and outliers. Data editing and cleaning included structure and internal consistency checks to ensure the completeness of work in the field. Any anomalies were communicated to the respective team through the technical team and the team supervisor. The corrected results were then re-sent to the central office. 1.8 RESPONSE RATES Table 1.1 shows the household and individual response rates for the 2015 ZDHS. A total of 11,196 households were selected for inclusion in the 2015 ZDHS and of these, 10,657 were found to be occupied. A total of 10,534 households were successfully interviewed, yielding a response rate of 99 percent. In the interviewed households, 10,351 women were identified as eligible for the individual interview, and 96 percent of them were successfully interviewed. For men, 9,132 were identified as eligible for interview, with 92 percent successfully interviewed. The 2015 ZDHS achieved a higher response rates than the 2010-11 ZDHS for households, women, and men. The increase in the response rates is particularly notable in urban areas. Table 1.1 Results of the household and individual interviews Number of households, number of interviews, and response rates, according to residence (unweighted), Zimbabwe 2015 Residence Total Result Urban Rural Household interviews Households selected 4,646 6,550 11,196 Households occupied 4,423 6,234 10,657 Households interviewed 4,341 6,193 10,534 Household response rate1 98.1 99.3 98.8 Interviews with women age 15-49 Number of eligible women 4,753 5,598 10,351 Number of eligible women interviewed 4,521 5,434 9,955 Eligible women response rate2 95.1 97.1 96.2 Interviews with men age 15-54 Number of eligible men 3,917 5,215 9,132 Number of eligible men interviewed 3,456 4,940 8,396 Eligible men response rate2 88.2 94.7 91.9 1 Households interviewed/households occupied 2 Respondents interviewed/eligible respondents Housing Characteristics and Household Population • 7 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION 2 Key Findings  Drinking water: Access to an improved source of drinking water is 97 percent in urban households and 69 percent in rural households.  Availability of water: Among households using piped water or water from a tube well or borehole, 72 percent of households have water available to them without an interruption of at least 1 day.  Sanitation: An improved sanitation facility is used by 37 percent of Zimbabwean households.  Household characteristics: Thirty-four percent of Zimbabwean households use electricity as a source of energy, and 68 percent of Zimbabwean households use wood as cooking fuel.  Household possessions: Eighty-seven percent of Zimbabwean households own mobile phones, up from 62 percent in the 2010-11 ZDHS. Ten percent of Zimbabwean households own computers.  Orphans: Sixteen percent of Zimbabwean children under age 18 are orphaned (single or both parents), 12 percent in urban areas and 17 percent in rural areas. Twenty-six percent of children do not live with either parent.  Birth registration: Births are registered with civil authorities for 44 percent of children under age 5; only one-third of children had a birth certificate.  School attendance: Ninety-one percent of females and 94 percent of males have ever attended school. his chapter presents information on demographic and socioeconomic characteristics of the household population such as age, sex, education, and place of residence. The environmental profile of households included in the 2015 ZDHS sample is also examined. Taken together, these descriptive data provide a context for the interpretation of demographic and health indices and furnish an approximate indication of the representativeness of the survey. In the 2015 ZDHS, a household refers to a person or group of related and unrelated persons who live together in the same dwelling unit(s), acknowledge one adult male or female as the head of the household, share the same housekeeping arrangements, and are considered a single unit. Information was collected from all usual residents of each selected household and visitors who stayed in the selected household the night before the interview. Those persons who stayed in the selected household the night before the interview (whether usual residents or visitors) represent the de facto population; usual residents alone constitute the de jure population. To maintain comparability with other ZDHS surveys, all tables in this report refer to the de facto population unless otherwise specified. T 8 • Housing Characteristics and Household Population 2.1 DRINKING WATER SOURCES AND TREATMENT Improved sources of drinking water Include piped water, public taps, standpipes, tube wells, boreholes, protected dug wells and springs, and rainwater. Because the quality of bottled water is not known, households using bottled water for drinking are classified as using an improved source only if their water source for cooking and handwashing are from an improved source. Sample: Households The majority of households in Zimbabwe (78 percent) have access to an improved source of water: 97 percent in urban areas and 69 percent in rural areas (Table 2.1). Improved sources protect against outside contamination so that water is more likely to be safe to drink. Figure 2.1 presents data on improved water source among the provinces. Twenty-four percent of households have water piped into the dwelling, yard, or plot, while 30 percent of households use a tube well or borehole, 17 percent a protected dug well, and 6 percent a public tap or standpipe. More than half of urban households (58 percent) drink water that is piped into the dwelling, yard, or plot compared with 6 percent rural households (Figure 2.2). In rural areas, tube wells or boreholes are the main source of drinking water (35 percent), followed by protected and unprotected dug wells (19 percent and 16 percent, respectively). In 72 percent of urban households and 20 percent of rural households, water is available on premises, within the dwelling or plot (Table 2.1). In 8 in 10 rural households obtain water from a source not on the premises; 39 percent of rural households report that it takes 30 minutes or longer (round trip) to access drinking water. Figure 2.1 Households with improved water source Figure 2.2 Household drinking water by residence 58 6 24 6 5 6 18 35 30 12 19 17 3 32 22 Urban Rural Total Unimproved source Protected dug well Tube well or borehole Public tap/standpipe Piped into dwelling/yard plot Percent distribution of households by source of drinking water Housing Characteristics and Household Population • 9 Most households (86 percent) do not treat their drinking water: 80 percent among urban households and 88 percent among rural households. In Zimbabwe, 6 percent of households boil their water, and 8 percent use bleach or chlorine. Overall, 14 percent of households in Zimbabwe are using an appropriate treatment method: 19 percent in urban areas and 11 percent in rural areas. Figure 2.3 presents information on the proportion of households using piped water or water from a tube well or borehole who reported availability of water in the last 2 weeks. Seventy-two percent of households in Zimbabwe reported having water, with no interruption of at least a single day in the last two weeks (Table 2.2). Urban households are more likely to report non- availability of water for at least one day compared with rural households (40 percent and 17 percent, respectively). Trends: The proportion of households using an improved source of water remains similar between the 2010-11 ZDHS (79 percent) and the 2015 ZDHS (78 percent). Fewer households treat their drinking water. In 2010-11, 22 percent of households used an appropriate water treatment method compared with 14 percent in 2015. 2.2 SANITATION FACILITIES AND WASTE DISPOSAL Improved toilet facilities Include any non-shared toilet of the following types: flush or pour flush into a piped sewer system, septic tank, or pit latrine; ventilated improved pit (VIP) latrines or Blair toilets; and pit latrines with a slab. Sample: Households Table 2.3 presents information on the proportion of households with access to hygienic sanitation facilities by type of toilet or latrine. Figure 2.3 Availability of water in the last 2 weeks before the survey 40 17 28 59 83 72 Urban Rural Total Available with no interruption of at least one day Not available for at least one day Percent distribution of households by water availability 10 • Housing Characteristics and Household Population Nearly 4 in 10 households in Zimbabwe usually use improved toilet facilities, which are defined as non-shared facilities that prevent people from coming into contact with human waste, and reduce the risk of transmitting cholera, typhoid, and other diseases. Shared toilet facilities, which are otherwise considered improved facilities, are especially common in urban areas (Figure 2.4). Overall, the most commonly used improved toilet facility among households in Zimbabwe is a pit latrine with a slab (13 percent). Thirty percent of Zimbabwean households have shared facilities. Urban households are more than twice as likely to have a shared facility as rural households (49 percent and 20 percent, respectively). Twenty-three percent of households do not use any toilet facility. Rural households are more likely to have an unimproved toilet facility or have no toilet at all when compared with urban households (48 percent and 5 percent, respectively). Among households in Zimbabwe that use a toilet facility, one-third (32 percent) use a toilet facility in their own dwelling, 58 percent use a toilet facility in their own yard or plot, and 10 percent use toilet facility elsewhere. Urban households are much more likely than rural households to use a facility in their own dwelling (65 percent and 7 percent, respectively). Rural households are more likely than urban households to use toilets in their yard or plot (79 percent and 31 percent, respectively). Trends: Thirty-four percent of households in rural areas have no toilet facility, a slightly lower proportion than that reported in the 2010-11 ZDHS (39 percent). The proportion of households with improved facilities is similar between the two surveys: 36 percent in 2010-11 and 37 percent in 2015. 2.3 EXPOSURE TO SMOKE INSIDE THE HOME AND OTHER HOUSING CHARACTERISTICS Table 2.4 presents information on a number of household dwelling characteristics along with the percentage of households using various types of fuel for cooking and the exposure to smoke inside the home. Information on type of fuel used for cooking and place for cooking was obtained to assess the extent to which household members may be exposed to the potentially harmful effects of smoke from cooking with solid fuels such as coal, plant materials, and animal waste. About 7 of 10 households in Zimbabwe use some type of solid fuel, a figure that is unchanged since the 2010-11 ZDHS (69 percent). Almost all households that use solid fuels cook with wood (68 percent). In rural areas, 93 percent of households use wood for cooking, compared with 18 percent in urban areas. The potential for exposure to harmful effects of smoke from using solid fuels for cooking is increased if cooking occurs within the home itself rather than outdoors or in a separate building. Forty-six percent of households in Zimbabwe cook in the house and 54 percent cook in a separate building or outdoors. Eleven percent of Zimbabwean households report that someone smokes at the home daily, a decrease from 17 percent in 2010-11 ZDHS. Someone smokes at least once a week in 4 percent of households. In 81 percent of households, smoking never occurs in the home. Overall, smoking inside the home is less frequent in urban areas than in rural areas. The survey also collected data on access to electricity, flooring materials, and the number of rooms used for sleeping. Thirty-four percent of households in Zimbabwe have access to electricity (81 percent in urban Figure 2.4 Household toilet facilities by residence 46 32 37 49 20 30 4 14 10 1 34 23 Urban Rural All No facility/bush/field Unimproved facility Shared facility Improved facility Percent distribution of households by type of toilet facilities Housing Characteristics and Household Population • 11 areas and 10 percent in rural areas), which is a slight decrease from 37 percent in the 2010-11 ZDHS. A majority of urban households use electricity for cooking (66 percent); in contrast, only 5 percent of rural households use electricity for this purpose. The most commonly used flooring material, cement, has remained at 67 percent since the previous ZDHS, followed by earth or sand (15 percent) and dung (10 percent). In urban areas, 79 percent of households have cement floors, compared with 61 percent in rural areas. Earth, sand, or dung floors are found in 37 percent of rural dwelling units. Thirty-six percent of households have one room that is used for sleeping and another 36 percent have two rooms, while 28 percent have three or more rooms. More households in urban areas (41 percent) compared with rural areas (33 percent) use one room for sleeping. 2.4 HOUSEHOLD WEALTH Wealth index Households are given scores based on the number and kinds of consumer goods they own, ranging from a television to a bicycle or a car, plus housing characteristics such as source of drinking water, toilet facilities, and flooring materials. These scores are derived using principal component analysis. National wealth quintiles are compiled by assigning the household score to each usual (de jure) household member, ranking each person in the household population by their score, and then dividing the distribution into five equal categories, each with 20 percent of the population. Thus, throughout this report, wealth quintiles are expressed in terms of quintiles of individuals in the overall population rather than quintiles of individuals at risk for any one health or population indicator. Sample: Households Table 2.5 presents wealth quintiles by urban-rural residence and province. Also included in the table is the Gini coefficient, which indicates the level of concentration of wealth, with 0 being an equal distribution and 1 a totally unequal distribution. 12 • Housing Characteristics and Household Population All of the urban population is represented in the two highest wealth quintiles (100 percent), while almost 6 in 10 households in rural areas are in the two lowest wealth quintiles (Figure 2.5). The wealth quintile distribution among provinces shows large variations. The two urban provinces, Bulawayo and Harare, have the largest proportions in the highest wealth quintile (67 percent and 58 percent, respectively). In contrast, Matabeleland North and Masvingo have the largest proportions in the lowest wealth quintile (44 percent and 31 percent, respectively). Household Durable Goods Information on household effects, means of transportation, agricultural land, and farm animals is presented in Table 2.6, by residence. Nationally, 43 percent of households have a radio, 37 percent a television, 25 percent a refrigerator, and 10 percent a computer. Urban households are more likely than rural households to own household effects that are powered by electricity, such as a television (73 percent and 19 percent, respectively), a refrigerator (61 percent and 7 percent, respectively), and a computer (24 percent and 3 percent, respectively). The most common means of transportation owned by households in both urban and rural areas is a bicycle (17 percent in urban areas and 26 percent in rural areas). Animal drawn carts, owned by 10 percent of urban households and 26 percent of rural households, are also a common means of transport. Urban households are five times more likely than rural households to own a car or truck (26 percent and 5 percent, respectively). A small proportion (2 percent) of households in both urban and rural areas owns a motorcycle or scooter. The majority of households in Zimbabwe own agricultural land (65 percent), and 66 percent own farm animals. Among urban households, 31 percent own agricultural land, compared with 82 percent in rural areas. Trends: Eight-seven percent have a mobile telephone, which is an increase from 62 percent in the 2010-11 ZDHS. Ownership of mobile telephones in rural households has risen sharply from 48 percent in 2010-11 to 82 percent in 2015. Ten percent of households in Zimbabwe own a computer, which is an increase from 4 percent in the 2010-11 ZDHS. 2.5 HAND WASHING Hand washing with soap and water is ideal. However, hand washing with a non-soap cleansing agent such as ash or sand is an improvement over not using any cleansing agent. To obtain hand-washing information, interviewers asked respondents to see the place where members of the household most often wash their hands. Table 2.7 shows that interviewers observed the place most often used for hand washing in 98 percent of households. Among households where the hand washing place was observed, the most common hand washing agent was soap and water (39 percent), followed by water only (36 percent). In 19 percent of the households, no water, soap, or any other cleansing agent was observed at the hand washing place. Lack of water and a cleansing agent decreases with an increase in household wealth. Trends: The proportion of households with soap and water observed for hand washing has decreased from what was observed in the 2010-11 ZDHS to the 2015 ZDHS from 44 percent to 39 percent. An Figure 2.5 Household wealth by residence 29 29 29 40 11 60 2 Urban Rural Percent distribution of de jure population by wealth quintiles Highest Fourth Middle Second Lowest Housing Characteristics and Household Population • 13 increase was observed in the proportion of households with water only, 33 percent in 2010-11 and 36 percent in 2015. There is an increase in the proportion of households with no water, soap, or other cleansing agent observed for hand washing from 17 percent to 19 percent in the same period. 2.6 HOUSEHOLD POPULATION AND COMPOSITION Household A person or group of related or unrelated persons who live together in the same dwelling unit(s), who acknowledged one adult male or female as the head of the household, who share the same housekeeping arrangements, and who are considered a single unit De facto population All persons who stayed in the selected households the night before the interview (whether usual residents or visitors) De jure population All persons who are usual residents of the selected households, whether or not they stayed in the households the night before the interview Table 2.8 shows the distribution of the 2015 ZDHS household population by age groups, according to sex and residence. A total of 42,586 individuals stayed overnight in 10,534 sample households in the 2015 ZDHS. Fifty-three percent (22,404) of household residents were female and 47 percent (20,181) were male. Figure 2.6 shows their distribution by five-year age groups and sex. The broad base of the pyramid indicates that Zimbabwe’s population is young, a scenario typical of countries with high fertility rates. The proportion of children under age 15 remains at 43 percent since the 2010-11 ZDHS. Half of the population in Zimbabwe is below age 18, while 5 percent are age 65 or older. Table 2.9 shows that 59 percent of households are headed by males and 41 percent are headed by females. There is no significant difference in household headship between rural and urban residence. Urban households are, on average, slightly smaller (3.7 persons) than rural households (4.3 persons). Overall, 35 percent of households in Zimbabwe are caring for foster or orphaned children. Twenty-one percent of households are caring for orphans (5 percent double orphans and 16 percent single orphans). Rural households are more likely than urban households to be caring for foster or orphaned children (41 percent versus 25 percent, respectively). Figure 2.6 Population pyramid 10 6 2 2 6 10 <5 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+ Age Percent distribution of the household population Male Female 2610 14 • Housing Characteristics and Household Population Trends: The average household size has remained at 4.1 individuals since the 2010-11 ZDHS. The proportion of female headed households decreased slightly from 45 percent in the 2010-11 ZDHS to 41 percent. 2.7 BIRTH REGISTRATION Registered birth Child has a birth certificate or his/her birth has been registered with the civil authority. Sample: De jure children under 5 Table 2.10 shows the percentage of de jure children under age 5 whose births were officially registered and the percentage with a birth certificate. At the time of the survey, 44 percent of children under age 5 had their births registered with the civil authority; 33 percent of children had a birth certificate and 10 percent had their birth registered but did not have a birth certificate. There are rural and urban differences in birth certification, with children in urban areas more than twice as likely as children in rural areas to have a birth certificate (57 percent versus 24 percent, respectively); overall, two-thirds (67 percent) of children in urban areas have had their birth registered compared with one-third (34 percent) of children in rural areas. Birth registration does not vary by sex, but varies widely by province, ranging from a low of 27 percent in Manicaland to a high of 68 percent in Harare. The proportion of children whose birth has been registered increases dramatically with wealth, ranging from 24 percent in the lowest wealth quintile to 79 percent in the highest wealth quintile. Trends: The proportion of de jure children whose births were registered has decreased during the last 10 years. According to the 2005-06 ZDHS, 74 percent of children’s births were registered, but this dropped to 49 percent in the 2010-11 ZDHS, and 44 percent in the 2015 ZDHS. 2.8 CHILDREN’S LIVING ARRANGEMENTS, SCHOOL ATTENDANCE, AND PARENTAL SURVIVAL Orphan A child with one or both parents dead Sample: De jure children under 18 Table 2.11 presents the proportion of de jure children under age 18 who are not living with one or both parents, either because the parent(s) died or for other reasons. Twenty-six percent of Zimbabwean children under age 18 are not living with a biological parent. Sixteen percent of children under age 18 have lost one or both parents (single or double orphans). Rural children (17 percent) are more likely to be orphans than urban children (12 percent). There are notable disparities across provinces. Table 2.12 presents data on school attendance rates and parental survivorship among de jure children age 10-14. The school attendance ratio in the final column of the table allows an assessment of the extent to which orphaned children are disadvantaged in terms of access to education. Ratios below 1.0 indicate that access to education is more limited for double orphans. Ninety-two percent of the proportion of de jure children age 10-14, who have both parents deceased, are currently attending school; 96 percent of children with both parents alive and who are living with a least one parent are attending school. Housing Characteristics and Household Population • 15 2.9 EDUCATION 2.9.1 Educational Attainment Median educational attainment Half the population has completed less than the median number of years of schooling and half the population has completed more than the median number of years of schooling. Sample: De facto household population age 6 and older The majority of Zimbabweans have attained some education. Overall, 94 percent of males age 6 and older have ever attended school, compared with 91 percent of females (Tables 2.13.1 and 2.13.2). The median number of years of educational attainment is similar for males (6.7 years) and females (6.5 years). Educational attainment rises with wealth quintile, and peaks in the highest wealth quintile for both sexes. As expected, regardless of sex, educational attainment is higher among urban than rural residents. Among both males and females, the median number of years of schooling is highest in Harare (9.8 for females and 10.2 for males). Trends: During the last 10 years, educational attainment at the household level has increased. The proportion of females and males with more than a secondary level education in surveyed households has increased from 2 percent of women and 4 percent of men in the 2005-06 ZDHS to 5 percent of women and 6 percent of men in the 2015 ZDHS. Likewise, over the same period, the proportion of women and men with no education has decreased from 12 percent of women and 9 percent of men in 2005-06 to 9 percent of women and 6 percent of men in 2015. 2.9.2 School Attendance Net attendance ratio (NAR) Percentage of school-age population that attends primary or secondary school Sample: Children age 6-12 for primary school NAR and children age 13-18 for secondary school NAR Table 2.14 shows that 91 percent of children age 6-12 attend primary school and 50 percent of children age 13-18 attend secondary school. Patterns by background characteristics  Few differences are observed in the net attendance ratios (NARs) for girls and boys at either the primary or secondary school level.  At the primary school level, the NAR in urban areas is slightly higher than in rural areas (93 percent and 91 percent, respectively); there is a much wider gap in the NAR between urban and rural areas at the secondary school level (64 percent and 45 percent, respectively). 16 • Housing Characteristics and Household Population  By province, no notable differences in NARs are observed at the primary school level. At the secondary school level, there is a greater variation in NARs. Harare (62 percent) has the highest NAR and Matabeleland South the lowest (39 percent).  The NARs increase with household wealth at both the primary and secondary school levels. Girls and boys in the highest wealth quintile are about two times more likely to attend secondary school than those in the lowest wealth quintile (Figure 2.7). Other Measures of School Attendance Gross attendance ratio (GAR) The total number of students attending primary and secondary school— regardless of age—expressed as a percentage of the official primary school- age population Sample: All children in primary school, regardless of age, for primary school GAR. All children in secondary school, regardless of age, for secondary school GAR. Gender Parity Index (GPI) The ratio of female to male attendance rates at the primary and secondary levels that indicates the magnitude of the gender gap Sample: Children age 6-12 for primary school, and children age 13-18 for secondary school The ZDHS education data allow the calculation of two more education indicators: the gross attendance ratio (GAR), and the gender parity index (GPI) (Table 2.14). At the primary school level, the GAR is 108 percent. This figure exceeds the primary school NAR (91 percent) by 17 percentage points, indicating that a number of children outside the official school age population are attending primary school. At the secondary school level, the GAR is also higher (58 percent) than the NAR (50 percent), which indicates that there are children outside of the official school age population who are attending secondary school. The Gender Parity Index (GPI) measures sex-related differences in school attendance ratios, and is the ratio of female to male attendance. A GPI of 1 indicates parity or equality between the school participation ratios for males and females. A GPI lower than 1 indicates a gender disparity in favour of males, with a higher proportion of males than females attending that level of schooling. A GPI higher than 1 indicates a gender disparity in favour of females. At the primary level, the GPIs for the NAR and GAR are 1.01 and 0.96, respectively. At the secondary level, the GPIs for the NAR and GAR are 1.03 and 1.02, respectively. This indicates that there is relatively Figure 2.7 Secondary school attendance by wealth quintile 31 43 46 58 73 50 35 44 53 56 64 51 Lowest Second Middle Fourth Highest Total Female Male RichestPoorest Net attendance ratio for secondary school among children age 13-18 Housing Characteristics and Household Population • 17 little difference in overall school attendance by girls and boys at either the primary or secondary school level. Patterns by background characteristics At the primary school level, the GPI for the GAR did not differ much by area of residence (0.97 for urban and 0.95 rural); by province, the GPI ranges from a low of 0.92 in Masvingo and Matebeleland South to a high of 1.01 in Manicaland.  The GPI for the GAR shows that the fewer girls than boys attend secondary school in urban areas (GPI=0.84), while more girls than boys attend secondary school (GPI=1.08) in rural areas.  By province, the GPI for the GAR is widest in Matebeleland South (1.49), followed by Matebeleland North (1.38) and Masvingo (1.33), with more girls than boys attending secondary school. The GPI for the GAR is lowest in Bulawayo (0.76) and Harare (0.81) with fewer girls attending secondary school than boys.  By wealth quintile, the GPI for the secondary school GAR shows no clear pattern, but the gender gap is greatest in the highest (0.88) and middle (1.12) wealth quintiles. Age-specific attendance rate Children in any specific age group attending school, irrespective of whether they are attending the appropriate stages in the school Sample: De facto household population age 5-24 years attending school Age-specific attendance rates (ASARs) for the population age 5 to 24 are presented in Figure 2.8 by age and sex. The ASARs indicate participation in schooling at any level, from primary to higher levels of education. The trends are generally the same for males and females. Approximately half of children attend school by age 6. In the age groups 6-7 and 9-13, the ASARs are higher for females than for males. In the 8-13 age group, more than 90 percent of children attend school. The attendance rate declines rapidly from age 14 to 19, with a slower decline observed from age 20 to 24. The decline in ASARs is more rapid for females than males from age 16 and older. Figure 2.8 Age-specific attendance rates of the de facto population 5 to 24 years 0 10 20 30 40 50 60 70 80 90 100 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Female Male Age Percent 18 • Housing Characteristics and Household Population LIST OF TABLES For detailed information on household population and housing characteristics, see the following tables:  Table 2.1 Household drinking water  Table 2.2 Availability of water  Table 2.3 Household sanitation facilities  Table 2.4 Household characteristics  Table 2.5 Wealth quintiles  Table 2.6 Household possessions  Table 2.7 Hand washing  Table 2.8 Household population by age, sex, and residence  Table 2.9 Household composition  Table 2.10 Birth registration of children under age 5  Table 2.11 Children’s living arrangements and orphanhood  Table 2.12 School attendance by survivorship of parents  Table 2.13.1 Educational attainment of the female household population  Table 2.13.2 Educational attainment of the male household population  Table 2.14 School attendance ratios  Table 2.15 Age-specific attendance rates Housing Characteristics and Household Population • 19 Table 2.1 Household drinking water Percent distribution of households and de jure population by source of drinking water, time to obtain drinking water, and treatment of drinking water, according to residence, Zimbabwe 2015 Households Population Characteristic Urban Rural Total Urban Rural Total Source of drinking water Improved source 97.2 68.5 78.1 97.1 67.2 76.3 Piped into dwelling/yard/plot 58.3 5.9 23.5 57.6 4.9 20.9 Piped to neighbour 1.2 1.1 1.1 1.1 1.0 1.1 Public tap/standpipe 6.3 5.1 5.5 6.5 4.2 4.9 Tube well or borehole 18.2 35.3 29.6 18.5 35.8 30.6 Protected dug well 11.5 19.3 16.7 11.9 19.4 17.1 Protected spring 0.6 1.7 1.3 0.6 1.7 1.4 Rain water 0.0 0.1 0.0 0.0 0.0 0.0 Bottled water, improved source for cooking/handwashing1 1.2 0.1 0.4 1.0 0.0 0.3 Unimproved source 2.6 31.4 21.8 2.6 32.8 23.6 Unprotected dug well 1.7 15.5 10.9 1.7 16.1 11.7 Unprotected spring 0.3 4.8 3.3 0.3 4.9 3.5 Tanker truck/cart with small tank 0.4 0.2 0.3 0.3 0.1 0.2 Surface water 0.2 10.8 7.3 0.3 11.7 8.2 Bottled water, unimproved source for cooking/handwashing1 0.0 0.1 0.0 0.0 0.0 0.0 Other 0.2 0.1 0.1 0.3 0.0 0.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 Time to obtain drinking water (round trip) Water on premises2 72.0 20.3 37.6 71.1 18.9 34.8 Less than 30 minutes 19.2 40.4 33.3 19.5 39.7 33.5 30 minutes or longer 8.1 38.9 28.6 8.8 41.2 31.4 Don’t know 0.7 0.4 0.5 0.6 0.2 0.3 Total 100.0 100.0 100.0 100.0 100.0 100.0 Water treatment prior to drinking3 Boiled 9.4 3.9 5.8 8.9 4.0 5.5 Bleach/chlorine added 10.7 7.2 8.4 11.3 7.3 8.5 Strained through cloth 0.1 0.3 0.2 0.1 0.3 0.2 Ceramic, sand or other filter 0.5 0.2 0.3 0.5 0.3 0.3 Let it stand and settle 0.1 1.1 0.8 0.1 1.0 0.8 Other 0.1 0.1 0.1 0.1 0.1 0.1 No treatment 80.4 88.0 85.5 80.3 88.0 85.6 Percentage using an appropriate treatment method4 19.3 10.7 13.6 19.4 10.8 13.4 Number 3,531 7,003 10,534 13,034 29,856 42,890 1 Because the quality of bottled water is not known, households using bottled water for drinking are classified as using an improved or unimproved source according to their water source for cooking and handwashing. 2 Includes water piped to neighbour 3 Respondents may report multiple treatment methods, so the sum of treatment may exceed 100 percent. 4 Appropriate water treatment methods include boiling, bleaching, filtering, and solar disinfecting. 20 • Housing Characteristics and Household Population Table 2.2 Availability of water Among households and de jure population using piped water or water from a tube well or borehole, percentage with lack of availability of water in the last 2 weeks, according to residence, Zimbabwe 2015 Availability of water in last 2 weeks Households Population Urban Rural Total Urban Rural Total Not available for at least one day 40.0 17.1 28.0 40.7 17.6 27.9 Available with no interruption of at least one day 59.1 82.7 71.5 58.6 82.2 71.7 Don’t know 0.9 0.2 0.5 0.7 0.2 0.4 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number using piped water or water from a tube well1 3,002 3,321 6,324 11,025 13,723 24,748 1 Households reporting piped water or water from a tube well or borehole as their main source of drinking water. Households reporting bottled water as their main source of drinking water are also included if their main source of water for cooking and handwashing is piped water or water from a tube well or borehole. Housing Characteristics and Household Population • 21 Table 2.3 Household sanitation facilities Percent distribution of households and de jure population by type and location of toilet/latrine facilities, according to residence, Zimbabwe 2015 Type and location of toilet/latrine facility Households Population Urban Rural Total Urban Rural Total Improved facility 46.4 32.2 37.0 52.3 34.5 39.9 Flush/pour flush to piped sewer system 35.6 0.7 12.4 40.3 0.8 12.8 Flush/pour flush to septic tank 6.6 1.5 3.2 7.6 1.3 3.2 Flush/pour flush to pit latrine 1.0 0.1 0.4 0.9 0.2 0.4 Ventilated improved pit (VIP) latrine 0.6 11.9 8.1 0.8 12.3 8.8 Pit latrine with slab 2.6 17.9 12.8 2.7 19.8 14.6 Shared facility1 48.8 20.1 29.8 43.3 16.6 24.7 Flush/pour flush to piped sewer system 39.5 0.6 13.7 35.3 0.5 11.1 Flush/pour flush to septic tank 4.7 0.6 2.0 3.8 0.5 1.5 Flush/pour flush to pit latrine 1.4 0.2 0.6 1.4 0.2 0.5 Ventilated improved pit (VIP) latrine 0.3 7.1 4.8 0.2 5.5 3.9 Pit latrine with slab 2.9 11.6 8.7 2.6 9.9 7.7 Unimproved facility 4.7 47.6 33.2 4.4 49.0 35.5 Flush/pour flush not to sewer/septic tank/pit latrine 1.2 0.1 0.5 1.0 0.1 0.4 Pit latrine without slab/open pit 1.9 13.5 9.6 1.8 14.4 10.6 Bucket 0.7 0.0 0.3 0.8 0.0 0.3 No facility/bush/field 0.8 33.8 22.7 0.6 34.4 24.1 Other 0.1 0.1 0.1 0.2 0.1 0.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number 3,531 7,003 10,534 13,034 29,856 42,890 Location of toilet facility In own dwelling 65.4 6.9 32.1 66.0 6.8 30.4 In own yard/plot 31.1 79.0 58.4 30.7 81.2 61.1 Elsewhere 3.4 14.2 9.6 3.2 12.0 8.5 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number of households/population with a toilet/latrine facility 3,504 4,637 8,141 12,960 19,583 32,543 1 Facilities that would be considered improved if they were not shared by two or more households. 22 • Housing Characteristics and Household Population Table 2.4 Household characteristics Percent distribution of households by housing characteristics, percentage using solid fuel for cooking, and percent distribution by frequency of smoking in the home, according to residence, Zimbabwe 2015 Residence Total Housing characteristic Urban Rural Electricity Yes 81.2 9.7 33.7 No 18.8 90.3 66.3 Total 100.0 100.0 100.0 Flooring material Earth/sand 1.1 21.7 14.8 Dung 0.2 15.5 10.4 Wood planks 1.1 0.0 0.4 Parquet or polished wood 1.4 0.0 0.5 Vinyl or asphalt strips 0.2 0.0 0.1 Ceramic tiles 13.8 0.9 5.2 Cement 79.2 61.4 67.4 Carpet 2.5 0.2 1.0 Other 0.5 0.1 0.2 Total 100.0 100.0 100.0 Rooms used for sleeping One 41.0 33.4 35.9 Two 33.0 37.8 36.2 Three or more 25.9 28.8 27.9 Total 100.0 100.0 100.0 Place for cooking In the house 80.2 28.0 45.5 In a separate building 3.1 56.5 38.6 Outdoors 16.6 15.3 15.7 No food cooked in household 0.1 0.1 0.1 Other 0.0 0.1 0.1 Total 100.0 100.0 100.0 Cooking fuel Electricity 66.3 5.2 25.7 LPG/natural gas/biogas 7.9 0.9 3.3 Kerosene/paraffin 6.5 0.8 2.7 Coal/lignite 0.1 0.0 0.0 Charcoal 0.5 0.1 0.2 Wood 18.4 92.6 67.7 Straw/shrubs/grass 0.0 0.2 0.1 Animal dung 0.0 0.1 0.1 Other 0.0 0.0 0.0 No food cooked in household 0.1 0.1 0.1 Total 100.0 100.0 100.0 Percentage using solid fuel for cooking1 19.1 93.0 68.2 Frequency of smoking in the home Daily 6.0 13.3 10.8 Weekly 2.8 5.0 4.3 Monthly 1.1 2.3 1.9 Less than once a month 1.6 2.5 2.2 Never 88.5 76.9 80.8 Total 100.0 100.0 100.0 Number 3,531 7,003 10,534 LPG = Liquefied petroleum gas 1 Includes coal/lignite, charcoal, wood, straw/shrubs/grass, and animal dung Housing Characteristics and Household Population • 23 Table 2.5 Wealth quintiles Percent distribution of the de jure population by wealth quintiles, and the Gini coefficient, according to residence and province, Zimbabwe 2015 Wealth quintile Total Number of persons Gini coefficient Residence/province Lowest Second Middle Fourth Highest Residence Urban 0.0 0.0 0.0 39.7 60.3 100.0 13,034 0.19 Rural 28.7 28.7 28.7 11.4 2.4 100.0 29,856 0.33 Province Manicaland 20.5 25.2 30.0 17.1 7.2 100.0 6,168 0.36 Mashonaland Central 28.7 28.7 26.0 12.3 4.2 100.0 4,139 0.38 Mashonaland East 12.3 26.1 32.3 19.4 10.0 100.0 4,367 0.31 Mashonaland West 23.1 22.8 18.7 20.1 15.3 100.0 5,117 0.40 Matabeleland North 44.3 27.5 14.5 7.8 5.8 100.0 2,248 0.49 Matabeleland South 21.1 25.5 28.6 16.9 7.8 100.0 2,086 0.42 Midlands 24.9 21.6 19.8 18.4 15.3 100.0 5,388 0.42 Masvingo 30.7 22.3 22.1 10.6 14.3 100.0 5,290 0.44 Harare 0.0 0.5 2.0 39.6 57.9 100.0 6,095 0.08 Bulawayo 0.0 0.0 0.0 32.7 67.3 100.0 1,992 0.19 Total 20.0 20.0 20.0 20.0 20.0 100.0 42,890 0.38 24 • Housing Characteristics and Household Population Table 2.6 Household possessions Percentage of households possessing various household effects, means of transportation, agricultural land, and livestock/farm animals by residence, Zimbabwe 2015 Residence Total Possession Urban Rural Household effects Radio 44.3 42.0 42.8 Television 73.4 19.2 37.4 Mobile phone 96.5 82.1 86.9 Computer 24.1 3.2 10.2 Non-mobile telephone 8.5 0.6 3.3 Refrigerator 61.0 6.6 24.8 Means of transport Bicycle 17.4 26.2 23.2 Animal drawn cart 10.0 26.0 20.7 Motorcycle/scooter 1.6 1.7 1.7 Car/truck 25.9 5.3 12.2 Boat with a motor 0.8 0.3 0.5 Ownership of agricultural land 30.8 81.5 64.5 Ownership of farm animals1 37.0 80.9 66.2 Number 3,531 7,003 10,534 1 Cattle, horses, donkeys, mules, goats, sheep, chickens or other poultry, rabbits, and pigs Housing Characteristics and Household Population • 25 Table 2.7 Hand washing Percentage of households in which the place most often used for washing hands was observed, and among households in which the place for hand washing was observed, percent distribution by availability of water, soap and other cleansing agents, Zimbabwe 2015 Percentage of households in which place for washing hands was observed1 Number of households Among households where place for hand washing was observed, percentage with: Number of households with place for hand washing observed Background characteristic Soap and water2 Water and cleansing agent3 other than soap only Water only Soap but no water4 Cleansing agent other than soap only3 No water, no soap, no other cleansing agent Total Residence Urban 96.4 3,531 49.8 0.2 30.1 4.6 0.1 15.3 100.0 3,404 Rural 98.0 7,003 32.9 1.5 39.6 4.2 0.6 21.3 100.0 6,863 Province Manicaland 99.5 1,484 32.2 0.9 52.7 2.7 0.2 11.3 100.0 1,477 Mashonaland Central 98.5 952 56.8 1.3 23.6 3.8 0.0 14.6 100.0 938 Mashonaland East 98.3 1,171 40.8 0.5 46.2 4.6 0.4 7.5 100.0 1,151 Mashonaland West 98.9 1,209 53.3 0.7 33.1 2.7 0.4 9.8 100.0 1,195 Matabeleland North 99.4 527 27.0 4.6 35.2 5.2 0.1 27.8 100.0 524 Matabeleland South 94.3 530 28.6 2.1 45.5 1.4 0.3 22.1 100.0 500 Midlands 98.5 1,271 24.7 1.2 21.0 5.5 1.6 46.1 100.0 1,251 Masvingo 96.9 1,244 26.7 1.4 40.0 5.9 0.4 25.7 100.0 1,205 Harare 92.7 1,604 37.9 0.2 34.6 6.8 0.1 20.4 100.0 1,486 Bulawayo 99.2 542 66.5 0.0 26.5 1.2 0.0 5.7 100.0 538 Wealth quintile Lowest 98.4 1,996 25.0 2.2 41.5 4.8 1.1 25.5 100.0 1,965 Second 97.6 1,983 31.5 1.7 39.3 4.4 0.6 22.4 100.0 1,934 Middle 97.9 2,000 33.8 1.0 41.3 3.7 0.1 20.2 100.0 1,957 Fourth 96.4 2,398 39.3 0.5 36.5 4.2 0.2 19.3 100.0 2,312 Highest 97.2 2,158 61.0 0.1 24.4 4.5 0.1 10.0 100.0 2,097 Total 97.5 10,534 38.5 1.1 36.4 4.3 0.4 19.3 100.0 10,266 1 Includes fixed and mobile place 2 Soap includes soap or detergent in bar, liquid, powder or paste form. This column includes households with soap and water only, as well as those that had soap and water and another cleansing agent. 3 Cleansing agents other than soap include locally available materials such as ash, mud or sand 4 Includes households with soap only as well as those with soap and another cleansing agent 26 • Housing Characteristics and Household Population Table 2.8 Household population by age, sex, and residence Percent distribution of the de facto household population by age groups, according to sex and residence, Zimbabwe 2015 Urban Rural Male Female Total Age Male Female Total Male Female Total <5 15.1 14.1 14.5 16.6 15.7 16.1 16.1 15.2 15.6 5-9 12.7 10.8 11.7 16.6 14.3 15.4 15.4 13.2 14.3 10-14 10.5 10.0 10.2 16.0 13.8 14.8 14.3 12.6 13.4 15-19 9.3 10.2 9.8 11.8 9.7 10.7 11.1 9.9 10.4 20-24 9.0 10.7 9.9 6.6 7.0 6.8 7.3 8.2 7.8 25-29 8.5 9.8 9.2 5.3 6.4 5.9 6.3 7.5 6.9 30-34 8.8 9.7 9.3 5.1 6.1 5.6 6.2 7.2 6.7 35-39 7.2 7.4 7.3 4.2 5.3 4.8 5.1 6.0 5.6 40-44 6.1 4.8 5.4 3.7 4.0 3.8 4.4 4.2 4.3 45-49 4.1 2.8 3.4 2.7 2.5 2.6 3.1 2.6 2.9 50-54 2.3 3.3 2.8 1.9 3.3 2.6 2.0 3.3 2.7 55-59 2.5 2.2 2.4 2.3 3.2 2.8 2.3 2.9 2.6 60-64 2.0 1.5 1.7 1.9 2.5 2.2 2.0 2.2 2.1 65-69 1.0 1.1 1.0 1.6 2.1 1.8 1.4 1.8 1.6 70-74 0.4 0.6 0.5 1.1 1.4 1.3 0.9 1.2 1.0 75-79 0.5 0.4 0.4 1.1 1.1 1.1 0.9 0.8 0.9 80 + 0.4 0.5 0.4 1.3 1.8 1.6 1.0 1.4 1.2 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Dependency age groups 0-14 38.2 34.9 36.4 49.1 43.7 46.3 45.9 41.0 43.3 15-64 59.6 62.5 61.2 45.7 49.9 47.9 49.8 53.9 52.0 65+ 2.2 2.6 2.4 5.2 6.3 5.8 4.3 5.1 4.7 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Child and adult populations 0-17 43.5 40.9 42.1 57.1 50.2 53.5 53.0 47.2 50.0 18+ 56.5 59.1 57.9 42.9 49.8 46.5 47.0 52.8 50.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Number of persons 6,011 7,077 13,088 14,170 15,328 29,498 20,181 22,404 42,586 Housing Characteristics and Household Population • 27 Table 2.9 Household composition Percent distribution of households by sex of head of household and by household size; mean size of households; and percentage of households with orphans and foster children under age 18, according to residence, Zimbabwe 2015 Residence Total Characteristic Urban Rural Household headship Male 61.7 58.3 59.4 Female 38.3 41.7 40.6 Total 100.0 100.0 100.0 Number of usual members 0 0.1 0.1 0.1 1 14.5 11.3 12.4 2 15.4 12.4 13.4 3 19.6 16.7 17.7 4 18.6 18.1 18.3 5 15.3 15.5 15.4 6 8.6 10.6 9.9 7 4.5 6.4 5.8 8 2.1 3.8 3.2 9+ 1.4 5.0 3.8 Total 100.0 100.0 100.0 Mean size of households 3.7 4.3 4.1 Percentage of households with orphans and foster children under 18 years of age Double orphans 2.9 6.2 5.1 Single orphans1 10.5 18.4 15.8 Foster children2 20.9 36.3 31.2 Foster and/or orphan children 24.7 40.8 35.4 Number of households 3,531 7,003 10,534 Note: Table is based on de jure household members, i.e., usual residents. 1 Includes children with one dead parent and an unknown survival status of the other parent. 2 Foster children are those under age 18 living in households with neither their mother nor their father present, and the mother and/or the father are alive. 28 • Housing Characteristics and Household Population Table 2.10 Birth registration of children under age 5 Percentage of de jure children under age 5 whose births are registered with the civil authorities, according to background characteristics, Zimbabwe 2015 Children whose births are registered Number of children Background characteristic Percentage who had a birth certificate Percentage who did not have birth certificate Percentage registered Age <2 25.3 11.7 37.0 2,425 2-4 37.8 9.4 47.2 4,190 Sex Male 33.1 9.7 42.8 3,224 Female 33.4 10.7 44.1 3,390 Residence Urban 57.2 9.5 66.7 1,876 Rural 23.8 10.5 34.3 4,739 Province Manicaland 24.5 2.6 27.2 1,026 Mashonaland Central 26.2 24.6 50.8 631 Mashonaland East 33.5 12.7 46.1 613 Mashonaland West 25.2 18.9 44.2 839 Matabeleland North 34.9 8.6 43.5 341 Matabeleland South 30.2 10.3 40.5 310 Midlands 28.5 3.7 32.2 874 Masvingo 30.8 4.7 35.6 849 Harare 55.4 12.6 68.0 870 Bulawayo 61.1 5.3 66.4 260 Wealth quintile Lowest 13.4 10.8 24.2 1,581 Second 19.5 11.4 30.9 1,378 Middle 29.2 10.2 39.4 1,211 Fourth 42.2 12.1 54.3 1,384 Highest 73.6 5.4 79.0 1,060 Total 33.2 10.2 43.5 6,614 Housing Characteristics and Household Population • 29 Table 2.11 Children’s living arrangements and orphanhood Percent distribution of de jure children under age 18 by living arrangements and survival status of parents, the percentage of children not living with a biological parent, and the percentage of children with one or both parents dead, according to background characteristics, Zimbabwe 2015 Living with both parents Living with mother but not with father Living with father but not with mother Not living with either parent Missing informa- tion on father/ mother Total Percent- age not living with a bio- logical parent Percent- age with one or both parents dead1 Number of children Background characteristic Father alive Father dead Mother alive Mother dead Both alive Only father alive Only mother alive Both dead Age 0-4 55.6 26.3 1.7 1.2 0.1 11.9 0.5 0.9 0.3 1.5 100.0 13.6 3.6 6,614 <2 61.1 31.5 1.5 0.4 0.0 4.3 0.1 0.2 0.0 0.8 100.0 4.6 1.9 2,425 2-4 52.4 23.3 1.9 1.6 0.2 16.3 0.8 1.3 0.4 1.8 100.0 18.7 4.6 4,190 5-9 43.5 20.4 3.7 2.6 0.5 19.2 1.7 4.1 1.2 3.0 100.0 26.2 11.5 6,074 10-14 35.4 16.5 6.7 3.3 1.7 17.9 2.8 6.6 5.3 3.8 100.0 32.5 23.9 5,714 15-17 26.5 12.4 8.6 2.7 1.7 20.6 4.3 9.7 9.8 3.7 100.0 44.4 34.8 2,815 Sex Male 42.2 20.4 4.7 2.7 0.8 16.6 2.0 4.3 3.3 2.8 100.0 26.3 15.7 10,689 Female 43.4 19.8 4.3 2.0 0.9 16.9 1.9 4.7 3.0 2.9 100.0 26.5 15.3 10,528 Residence Urban 51.8 20.0 3.7 2.9 1.0 12.7 1.7 2.7 2.1 1.4 100.0 19.2 11.5 5,430 Rural 39.7 20.2 4.8 2.2 0.9 18.1 2.0 5.2 3.5 3.4 100.0 28.8 16.9 15,788 Province Manicaland 38.3 22.3 6.4 2.4 1.0 17.5 2.1 5.2 2.9 1.9 100.0 27.7 18.1 3,284 Mashonaland Central 54.4 13.6 3.8 2.0 0.9 14.9 1.9 4.0 2.5 1.9 100.0 23.4 13.4 2,108 Mashonaland East 42.8 20.5 4.1 2.9 1.7 15.2 1.3 4.9 3.3 3.3 100.0 24.8 15.9 2,115 Mashonaland West 49.3 15.9 5.2 3.1 0.7 13.8 2.3 3.6 3.9 2.2 100.0 23.5 15.9 2,568 Matabeleland North 34.7 21.1 3.8 2.2 0.5 20.3 1.7 6.1 4.4 5.1 100.0 32.5 17.3 1,181 Matabeleland South 20.1 24.9 4.9 2.0 0.6 27.2 2.5 7.5 3.4 7.0 100.0 40.6 19.6 1,088 Midlands 42.8 20.5 4.6 2.2 0.7 17.0 2.0 4.0 2.8 3.5 100.0 25.8 14.4 2,749 Masvingo 33.9 24.7 4.0 2.2 0.7 19.6 2.0 5.7 3.7 3.5 100.0 30.9 16.6 2,836 Harare 59.1 17.1 3.3 2.1 1.0 10.7 1.6 1.8 2.3 1.0 100.0 16.4 10.2 2,460 Bulawayo 35.0 24.5 4.5 2.8 0.4 20.2 2.6 4.9 2.6 2.4 100.0 30.3 16.1 829 Wealth quintile Lowest 43.6 21.7 7.3 1.4 0.9 12.6 1.7 4.0 3.4 3.4 100.0 21.7 17.8 4,828 Second 40.2 20.2 3.8 1.9 0.6 18.4 2.4 5.4 3.5 3.6 100.0 29.6 16.2 4,653 Middle 34.5 18.5 4.5 2.2 1.0 23.3 1.9 6.8 3.7 3.5 100.0 35.7 18.4 4,439 Fourth 47.0 22.0 3.5 3.0 0.9 14.0 2.0 3.1 2.7 1.9 100.0 21.7 12.5 3,862 Highest 51.3 17.8 2.9 3.9 1.1 15.0 1.8 2.7 2.2 1.2 100.0 21.8 11.0 3,436 Total <15 45.3 21.3 3.9 2.3 0.8 16.2 1.6 3.7 2.1 2.7 100.0 23.6 12.5 18,402 Total <18 42.8 20.1 4.5 2.4 0.9 16.7 2.0 4.5 3.2 2.9 100.0 26.4 15.5 21,218 Note: Table is based on de jure members, i.e., usual residents. 1 Includes children with father dead, mother dead, both dead and one parent dead but missing information on survival status of the other parent. 30 • Housing Characteristics and Household Population Table 2.12 School attendance by survivorship of parents For de jure children age 10-14, the percentage attending school by parental survival, and the ratio of the percentage attending, by parental survival, according to background characteristics, Zimbabwe 2015 Percentage attending school by survivorship of parents Ratio1 Background characteristic Both parents deceased Number of children Both parents alive and living with at least one parent Number of children Sex Male 90.6 166 95.7 1,614 0.95 Female 93.6 137 97.1 1,542 0.96 Residence Urban 89.0 50 98.5 877 0.90 Rural 92.5 253 95.5 2,279 0.97 Province Manicaland (81.4) 42 96.9 484 (0.84) Mashonaland Central * 22 95.4 354 * Mashonaland East (96.0) 36 97.0 345 (0.99) Mashonaland West (92.7) 45 97.2 395 (0.95) Matabeleland North (90.6) 24 95.0 158 (0.95) Matabeleland South (92.7) 16 93.6 118 (0.99) Midlands (97.2) 35 96.7 391 (1.01) Masvingo (97.6) 47 93.9 390 (1.04) Harare * 29 97.6 411 * Bulawayo * 6 99.1 110 * Wealth quintile Lowest 91.8 79 91.9 690 1.00 Second 89.1 73 95.1 680 0.94 Middle 95.7 78 98.4 600 0.97 Fourth (87.4) 40 97.4 584 (0.90) Highest (95.2) 33 99.8 602 (0.95) Total 91.9 303 96.3 3,156 0.95 Notes: Table is based on children who usually live in the household. Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 1 Ratio of the percentage attending school for children with both parents deceased to the percentage attending school with both parents alive and living with at least one parent Housing Characteristics and Household Population • 31 Table 2.13.1 Educational attainment of the female household population Percent distribution of the de facto female household population age 6 and over by highest level of schooling attended or completed and median years completed, according to background characteristics, Zimbabwe 2015 Background characteristic No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Don’t know/ missing Total Number Median years completed Age 6-9 21.6 78.2 0.0 0.1 0.0 0.0 0.1 100.0 2,278 0.2 10-14 0.7 77.4 7.6 14.3 0.0 0.0 0.0 100.0 2,824 4.4 15-19 0.5 10.9 11.4 75.4 1.0 0.7 0.2 100.0 2,212 8.4 20-24 1.1 9.5 12.9 65.4 3.6 6.8 0.6 100.0 1,830 9.9 25-29 0.9 10.1 15.5 62.1 2.4 8.8 0.1 100.0 1,674 9.7 30-34 1.5 8.6 16.7 60.6 1.9 10.4 0.4 100.0 1,616 10.0 35-39 2.5 11.6 17.4 57.5 1.1 9.3 0.5 100.0 1,345 9.2 40-44 3.6 13.2 16.1 55.8 0.8 9.6 0.9 100.0 946 8.8 45-49 5.3 19.3 12.5 52.4 1.0 8.5 0.8 100.0 583 8.7 50-54 19.6 29.0 21.1 20.8 0.3 7.8 1.4 100.0 739 6.0 55-59 26.4 33.1 19.9 14.0 0.5 4.4 1.8 100.0 648 4.4 60-64 24.6 38.4 19.0 12.4 0.3 3.7 1.6 100.0 485 4.0 65+ 38.1 42.8 9.0 5.8 0.2 1.4 2.7 100.0 1,152 1.8 Residence Urban 3.0 20.9 7.4 54.0 2.7 11.3 0.7 100.0 5,894 9.7 Rural 11.1 39.9 14.0 32.8 0.3 1.4 0.5 100.0 12,436 5.8 Province Manicaland 12.1 37.6 13.6 33.2 0.7 2.4 0.5 100.0 2,529 6.0 Mashonaland Central 11.9 43.4 12.8 29.5 0.1 2.2 0.2 100.0 1,674 5.3 Mashonaland East 9.2 34.9 13.7 37.8 0.7 2.6 1.1 100.0 1,916 6.3 Mashonaland West 8.4 35.5 10.9 39.8 0.4 4.1 0.9 100.0 2,092 6.4 Matabeleland North 9.0 40.2 18.0 30.5 0.3 1.8 0.2 100.0 935 6.0 Matabeleland South 9.0 37.5 15.7 34.0 1.1 2.4 0.4 100.0 909 6.2 Midlands 7.7 33.2 12.9 41.4 0.7 3.8 0.3 100.0 2,285 6.6 Masvingo 10.6 37.5 10.0 37.0 0.6 3.8 0.5 100.0 2,337 6.1 Harare 2.6 20.2 7.4 55.0 3.3 10.5 1.0 100.0 2,712 9.8 Bulawayo 3.5 21.6 8.8 51.5 3.0 11.5 0.1 100.0 940 9.5 Wealth quintile Lowest 16.3 44.6 14.8 24.0 0.0 0.1 0.2 100.0 3,497 4.7 Second 11.9 42.2 14.0 31.1 0.1 0.1 0.6 100.0 3,589 5.5 Middle 8.9 38.2 14.5 36.6 0.3 0.8 0.7 100.0 3,630 6.1 Fourth 4.1 26.5 10.3 53.1 1.0 4.3 0.6 100.0 3,665 8.3 Highest 2.1 19.1 6.4 51.6 3.7 16.4 0.7 100.0 3,949 10.1 Total 8.5 33.8 11.9 39.7 1.1 4.6 0.6 100.0 18,330 6.5 1 Completed grade 7 at the primary level 2 Completed grade 6 at the secondary level 32 • Housing Characteristics and Household Population Table 2.13.2 Educational attainment of the male household population Percent distribution of the de facto male household population age 6 and over by highest level of schooling attended or completed and median years completed, according to background characteristics, Zimbabwe 2015 Background characteristic No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Don’t know/ missing Total Number Median years completed Age 6-9 25.1 74.8 0.0 0.1 0.0 0.0 0.0 100.0 2,369 0.0 10-14 1.1 82.8 6.0 9.9 0.0 0.1 0.1 100.0 2,895 4.1 15-19 0.4 15.9 12.9 68.8 1.0 0.7 0.3 100.0 2,237 8.1 20-24 0.4 9.8 10.9 65.1 5.3 8.0 0.5 100.0 1,480 10.1 25-29 0.5 8.7 12.8 59.7 5.8 12.2 0.3 100.0 1,264 10.2 30-34 0.5 7.1 12.7 61.6 4.2 13.3 0.6 100.0 1,252 10.3 35-39 0.2 7.9 11.8 62.3 2.1 15.3 0.5 100.0 1,033 10.3 40-44 1.7 7.7 12.6 58.9 3.8 14.2 1.3 100.0 889 10.3 45-49 1.1 7.4 10.7 59.0 2.4 17.3 2.0 100.0 633 10.3 50-54 6.3 16.4 15.5 44.6 1.0 15.3 0.9 100.0 404 8.9 55-59 9.1 30.0 21.9 26.5 1.9 8.7 1.9 100.0 473 6.5 60-64 9.5 34.6 22.7 23.9 0.2 6.4 2.7 100.0 394 6.2 65+ 18.1 43.9 16.6 13.5 0.6 4.8 2.4 100.0 863 4.4 Residence Urban 2.5 22.2 4.7 49.9 4.7 15.3 0.7 100.0 4,925 10.1 Rural 7.3 41.7 12.5 34.8 0.8 2.4 0.6 100.0 11,261 6.1 Province Manicaland 7.3 40.0 9.8 37.7 1.2 3.3 0.7 100.0 2,346 6.2 Mashonaland Central 8.1 41.8 10.4 35.6 0.9 3.1 0.1 100.0 1,596 6.0 Mashonaland East 6.3 33.3 12.7 40.9 1.3 4.5 1.0 100.0 1,690 6.7 Mashonaland West 4.8 35.7 11.8 39.5 1.2 6.1 0.8 100.0 1,980 6.7 Matabeleland North 5.7 44.5 20.3 25.7 1.0 2.4 0.3 100.0 827 5.9 Matabeleland South 7.6 44.0 14.0 29.9 1.2 2.7 0.7 100.0 793 5.7 Midlands 4.9 37.7 10.6 39.3 1.9 5.1 0.6 100.0 1,965 6.6 Masvingo 8.5 41.9 8.2 35.1 1.3 4.9 0.2 100.0 1,910 5.9 Harare 2.1 20.7 4.6 51.3 5.1 15.1 1.0 100.0 2,325 10.2 Bulawayo 3.5 23.6 6.8 48.0 3.4 14.7 0.1 100.0 754 9.7 Wealth quintile Lowest 11.1 50.7 13.7 23.8 0.2 0.2 0.3 100.0 2,919 4.6 Second 8.4 42.4 13.4 34.6 0.4 0.3 0.6 100.0 3,207 5.9 Middle 5.3 40.6 12.2 39.1 0.7 1.5 0.6 100.0 3,420 6.3 Fourth 3.4 25.6 8.4 51.6 2.8 7.4 0.8 100.0 3,237 8.9 Highest 1.6 21.6 3.9 45.9 5.3 21.1 0.6 100.0 3,404 10.3 Total 5.8 35.8 10.2 39.4 1.9 6.3 0.6 100.0 16,186 6.7 1 Completed grade 7 at the primary level 2 Completed grade 6 at the secondary level Housing Characteristics and Household Population • 33 Table 2.14 School attendance ratios Net attendance ratios (NAR) and gross attendance ratios (GAR) for the de facto household population by sex and level of schooling; and the Gender Parity Index (GPI), according to background characteristics, Zimbabwe 2015 Net attendance ratio1 Gross attendance ratio2 Background characteristic Male Female Total Gender Parity Index3 Male Female Total Gender Parity Index3 PRIMARY SCHOOL Residence Urban 93.1 92.3 92.7 0.99 107.8 104.3 106.0 0.97 Rural 89.9 91.0 90.5 1.01 111.4 106.4 109.0 0.95 Province Manicaland 89.1 91.4 90.1 1.03 110.7 111.6 111.1 1.01 Mashonaland Central 91.9 91.9 91.9 1.00 113.6 105.7 109.6 0.93 Mashonaland East 90.4 90.6 90.5 1.00 105.6 103.5 104.6 0.98 Mashonaland West 90.2 91.2 90.7 1.01 108.7 104.6 106.7 0.96 Matabeleland North 93.3 92.2 92.8 0.99 113.1 108.5 110.8 0.96 Matabeleland South 89.9 89.4 89.7 1.00 107.2 99.1 103.3 0.92 Midlands 90.9 92.2 91.6 1.01 114.5 110.0 112.3 0.96 Masvingo 88.4 90.6 89.5 1.02 112.1 103.6 107.8 0.92 Harare 93.9 91.4 92.6 0.97 106.3 100.7 103.4 0.95 Bulawayo 92.5 93.9 93.2 1.02 116.6 111.8 114.1 0.96 Wealth quintile Lowest 87.1 89.5 88.2 1.03 109.8 106.0 108.0 0.97 Second 89.5 91.0 90.2 1.02 111.0 107.8 109.4 0.97 Middle 91.7 91.7 91.7 1.00 113.8 106.8 110.4 0.94 Fourth 91.0 92.4 91.7 1.02 105.0 104.5 104.7 1.00 Highest 95.7 92.9 94.3 0.97 112.1 103.3 107.7 0.92 Total 90.7 91.4 91.0 1.01 110.6 105.9 108.3 0.96 SECONDARY SCHOOL Residence Urban 68.9 59.4 63.5 0.86 82.0 69.2 74.8 0.84 Rural 43.7 47.3 45.4 1.08 49.8 53.7 51.6 1.08 Province Manicaland 45.6 45.5 45.5 1.00 53.1 47.6 50.5 0.90 Mashonaland Central 42.8 41.5 42.2 0.97 47.0 45.5 46.3 0.97 Mashonaland East 54.5 50.0 52.2 0.92 61.7 59.0 60.3 0.96 Mashonaland West 52.0 53.2 52.5 1.02 59.4 61.8 60.5 1.04 Matabeleland North 35.3 48.8 41.9 1.38 40.8 56.2 48.3 1.38 Matabeleland South 32.9 45.8 38.8 1.39 36.0 53.5 44.0 1.49 Midlands 49.6 49.3 49.4 0.99 55.6 54.6 55.1 0.98 Masvingo 47.0 60.4 53.4 1.29 54.2 72.1 62.6 1.33 Harare 68.6 57.4 62.4 0.84 83.9 68.3 75.2 0.81 Bulawayo 67.7 54.3 60.1 0.80 84.9 64.3 73.1 0.76 Wealth quintile Lowest 30.6 35.4 33.0 1.16 33.4 37.3 35.4 1.11 Second 43.1 43.7 43.4 1.01 49.0 50.9 49.9 1.04 Middle 45.5 52.8 48.8 1.16 52.2 58.6 55.1 1.12 Fourth 57.6 55.7 56.6 0.97 67.0 64.2 65.6 0.96 Highest 73.3 64.3 68.4 0.88 87.5 77.1 81.9 0.88 Total 49.7 51.1 50.4 1.03 57.4 58.5 58.0 1.02 1 The NAR for primary school is the percentage of the primary-school age (6-12 years) population that is attending primary school. The NAR for secondary school is the percentage of the secondary-school age (13-18 years) population that is attending secondary school. By definition the NAR cannot exceed 100 percent. 2 The GAR for primary school is the total number of primary school students, expressed as a percentage of the official primary-school- age population. The GAR for secondary school is the total number of secondary school students, expressed as a 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 GAR can exceed 100 percent. 3 The Gender Parity Index for primary school is the ratio of the primary school NAR (GAR) for females to the NAR (GAR) for males. The Gender Parity Index for secondary school is the ratio of the secondary school NAR (GAR) for females to the NAR (GAR) for males. 34 • Housing Characteristics and Household Population Table 2.15 Age-specific attendance rates of the de facto population 5 to 24 years Percentage of the de facto household population age 5-24 years attending school, by age and sex, Zimbabwe 2015 Age Percent attending N de facto MALE 5 11.4 744 6 45.0 5,634 7 84.3 623 8 95.3 582 9 96.6 600 10 96.7 602 11 97.3 562 12 93.4 592 13 93.6 551 14 87.5 588 15 79.3 505 16 74.8 466 17 64.8 472 18 43.7 434 19 33.5 360 20 20.7 389 21 17.9 311 22 13.8 265 23 12.4 260 24 5.6 255 FEMALE 5 10.2 678 6 50.5 549 7 86.3 598 8 94.0 558 9 97.2 572 10 98.7 574 11 98.8 534 12 98.5 581 13 95.5 565 14 86.4 569 15 79.7 498 16 68.8 488 17 53.9 420 18 34.7 434 19 19.1 372 20 11.3 402 21 10.0 358 22 9.1 326 23 8.8 373 24 5.9 372 Characteristics of Respondents • 35 CHARACTERISTICS OF RESPONDENTS 3 Key Findings  Education: Most adults have at least some secondary education—73 percent of women age 15-49 and 77 percent of men age 15-49 have attended or completed secondary school or higher.  Literacy: Literacy is nearly universal with 94 percent of women and men able to read.  Exposure to mass media: Almost half of women and a third of men do not regularly access mass media.  Employment: Forty-one percent of women and 65 percent of men age 15-49 are currently employed.  Health insurance: Eighty-nine percent of women and 88 percent of men do not have health insurance.  Tobacco use: Ninety-nine percent of women and 83 percent of men age 15-49 reported that they do not use tobacco. his chapter presents information on demographic and socioeconomic characteristics of the survey respondents such as age, education, place of residence, marital status, employment, and wealth status. This information is useful for understanding the factors that affect the use of reproductive health services, contraceptive use, and other health behaviours, as they provide a context for the interpretation of demographic and health indices. 3.1 BASIC CHARACTERISTICS OF SURVEY RESPONDENTS A total of 9,955 women age 15-49 and 8,396 men age 15-54 were interviewed in the 2015 ZDHS (Table 3.1). The distribution of respondents by age shows a similar pattern for men and women. The proportion of respondents in each age group declines with increasing age for both sexes. The majority of respondents are Christians with the highest proportion in the Apostolic Sect (42 percent of women and 32 percent of men). A quarter of women have never married while 45 percent of men report themselves as having never married. Among the 15-49 age group, women are much more likely than men to be either currently or previously married. Fifty-eight percent of women are currently married compared with 49 percent of men. Three percent of women and 1 percent of men are living together (as if married). Nine percent of women are divorced or separated, compared with 4 of men. Four percent of women are widows, while less than 1 percent of men are widowers. The majority of women and men age 15-49 live in the rural areas (62 and 64 percent, respectively). The largest proportions of both women and men live in Harare (18 percent each) and the smallest proportions live in Matabeleland South (4 percent each). T 36 • Characteristics of Respondents 3.2 EDUCATION AND LITERACY Literacy Respondents who attended higher than secondary school are assumed to be literate. All other respondents were given a sentence to read, and they were considered to be literate if they could read all or part of the sentence. Sample: Women and men age 15-49 Education is an important factor which has an influence on an individual’s attitude and outlook on various aspects of life. Educational attainment in Zimbabwe is high (Tables 3.2.1 and 3.2.2). Most adults have at least some secondary education. Seventy-three percent of women and 77 percent of men have attended secondary school or higher, while only 1 percent of both women and men have never attended school (Figure 3.1). Literacy is nearly universal with 94 percent of women and men able to read (Tables 3.3.1 and 3.3.2). Trends: Since 2010-11, the median number of years of schooling completed has changed slightly. In 2010-11, women completed 9.0 years of education compared with 9.1 years in 2015. For men, the median number of years of school was 10.0 in 2010- 11 and 9.8 in 2015. Literacy among women (94 percent) remains constant since 2010-11. For men, literacy has decreased slightly from 96 percent in 2010-11 to 94 percent in 2015. Patterns by background characteristics  Younger respondents are more likely to be educated and to have reached higher levels of education than older respondents. For example, the proportion of women with no education ranges from less than 1 percent among those age 15-19 to 6 percent among those age 45-49 (Tables 3.2.1 and 3.2.2).  Rural respondents are less educated than their urban counterparts. Only 62 percent of rural women have attended secondary school or higher compared with 90 percent of urban women; similarly, 69 percent of rural women have attended secondary school or higher compared with 94 percent of urban men.  Harare and Bulawayo, which are predominantly urban, have the most educated populations with more than 9 in 10 women and men having attended secondary school or higher. Mashonaland Central (55 percent) and Matabeleland North (52 percent) have the lowest proportions of women and men with at least some secondary schooling. Figure 3.1 Education of survey respondents 1 1 26 22 66 67 7 11 Women Men Percent distribution of women and men age 15-49 by highest level of schooling attended or completed More than secondary Secondary Primary No education Characteristics of Respondents • 37  Higher wealth status is associated with greater educational attainment. The proportion of women who have attended secondary school or higher increases from 44 percent in the lowest quintile to 94 percent in the highest (Figure 3.2).  The literacy rate varies from 89 percent among women age 45-49 to 95 percent among women age 15-34. For men the rate varies from 91 percent among those age 15-19 to 96 percent among men age 30-44 (Tables 3.2.1 and 3.2.2).  There is not much variation in literacy by residence or province. Bulawayo and Harare have the highest literacy rates for both women and men while Mashonaland Central has the lowest for women and Matabeleland North for men.  As with educational attainment, literacy correlates positively with increasing wealth. 3.4 EXPOSURE TO MASS MEDIA AND INTERNET USAGE Exposure to mass media Respondents were asked how often they read a newspaper, listened to the radio, or watched television. Those who responded at least once a week are considered to be regularly exposed to that form of media. Respondents were also asked if and how often they use the Internet. Sample: Women and men age 15-49 Mass media often convey messages on family planning, HIV/AIDS awareness, and other health topics. Radio and television are the most commonly accessed forms of media, although almost half of women and a third of men do not regularly access any mass media. Thirty-five percent of women and 49 percent of men listen to the radio at least once a week. However, significant proportions of women and men do not access any of the three media on a weekly basis; 45 percent of women and 34 percent of men do not access any of the media types at least once a week (Tables 3.4.1 and 3.4.2). Overall, 26 percent of women and 41 percent of men age 15-49 have ever used the internet; 24 percent of women and 38 percent of men have used the internet in the past 12 months (Tables 3.5.1 and 3.5.2). Among women and men who have used the internet in the past 12 months, seven in 10 report that they have used it nearly every day in the past month. Patterns by background characteristics  Urban residents are much more likely to be exposed to all forms of mass media than rural residents (Table 3.4.1 and 3.4.2).  Seventy-nine percent of women with no education report that they are not exposed to any mass media, compared with 15 percent of women with more than a secondary education. A similar pattern is seen among men. Figure 3.2 Education by wealth  44 59 70 84 94 49 65 74 87 97 Lowest Second Middle Fourth Highest Percent distribution by wealth quintile of men and women with secondary education or higher Women Men 38 • Characteristics of Respondents  Media exposure among women and men is also associated with wealth. Thirty-five percent of women in the highest wealth quintile read a newspaper at least once a week, compared with only 3 percent of women in the lowest wealth quintile.  Internet usage is more common in urban areas than rural areas. In urban areas, 48 percent and 71 percent women and men, respectively, have used the internet in the past 12 months compared to 9 percent and 19 percent women and men respectively in the rural areas.  Internet use rises sharply with increasing education and wealth. For example, in the past 12 months, only 1 percent of women with no education have used the internet compared with 86 percent of women with more than secondary education. Similarly, only 2 percent of women in the lowest wealth quintile have used the internet in the past 12 months compared with 57 percent in the highest wealth quintile. 3.5 EMPLOYMENT STATUS Currently employed Respondents who were employed in the seven days before the survey Sample: Women and men age 15-49 Men are more likely to be employed than women; 41 percent of women age 15-49 are currently employed, compared with 65 percent of men age 15-49 (Figures 3.3 and 3.4 and Tables 3.6.1 and 3.6.2). An additional 9 percent of men and 10 percent of women reported working in the past 12 months even though they were not currently employed. Trends: Since 2010-11, current employment levels have improved. Among women, 37 percent were currently employed in 2010-11 compared with 41 percent in 2015; among men, the percentage has increased from 61 percent to 65 percent. Patterns by background characteristics  Employment for women and men generally increases with age (Tables 3.6.1 and 3.6.2).  Currently or formerly married women and men are more likely to be employed compared with those who have never married.  A higher proportion of urban women and men are currently employed than their rural counterparts (Figure 3.5).  The proportion of women and men who are currently employed generally increases with increasing wealth quintile. Figure 3.3 Women’s employment status Figure 3.4 Men’s employment status Currently employed 41% Not currently employed but worked in last 12 months 10% Not employed in last 12 months 49% Percentage of women age 15-49 employed in the past 12 months Currently employed 65% Not currently employed but worked in last 12 months 9% Not employed in last 12 months 26% Percentage of men age 15-49 employed in the past 12 months Characteristics of Respondents • 39 Figure 3.5 Employment status by residence 3.6 OCCUPATION Occupation Categorised as professional/technical/managerial, clerical, sales and services, skilled manual, unskilled manual, domestic service and agriculture Sample: Women and men age 15-49 who were currently employed or had worked in the 12 months before the survey Most women are employed in sales and services (49 percent), followed by agriculture (18 percent). Men age 15-49 are most commonly employed in skilled manual labour (27 percent), agriculture (25 percent), and sales and services (24 percent) (Tables 3.7.1 and 3.7.2). Most women who worked in the past 12 months:  did non-agricultural work (70 percent);  were paid only in cash (78 percent);  were self-employed (56 percent); and  were employed throughout the year (57 percent) (Table 3.8). Trends: The percentage of women employed in the sales and services sector has increased over the last decade, from 31 percent in 2005-06, to 36 percent in 2010-11, to 49 percent in 2015. The percentage of women working in agriculture has decreased over time, from 34 percent in 2005-06, to 21 percent 2010- 11, to 18 percent in 2015. Similarly, the percentage of men engaged in agriculture has decreased from 34 percent in 2005-06, to 29 percent in 2010, to 25 percent in 2015. Patterns by background characteristics  Both urban women and rural women are most likely to be employed in sales and services sector (51 percent and 47 percent, respectively). However, urban women are much less likely than rural women to work in agriculture (3 percent and 32 percent, respectively).  Occupation varies with level of education. More than half of all women and men with more than a secondary education are employed in the professional, technical, and managerial sector compared with less than 1 percent of women with only a primary education. 34 62 52 71 Women Men Rural Urban Percentage of women and men age 15-49 who are currently employed by residence 40 • Characteristics of Respondents  Employed women and men in the lowest wealth quintiles are concentrated in agricultural occupations: between 32 and 39 percent of women and 40 to 43 percent of men in the lowest three wealth quintiles work in agriculture. The percentage of women and men working in the sales and services sector is consistent across all wealth quintiles. Women and men in the highest wealth quintile are most commonly employed in the professional/technical/managerial sector. 3.7 HEALTH INSURANCE COVERAGE The majority of women (89 percent) and men (88 percent) do not have health insurance. The most common source of insurance is through one’s employer (Table 3.9.1 and Table 3.9.2). Trends: The percentage of women who have insurance has increased slightly from 7 percent in 2010-11 to 11 percent in 2015. Similarly, the percentage of men with health insurance has increased from 9 percent in 2010-11 to 12 percent in 2015. 3.8 TOBACCO USE Tobacco use is rare among women age 15-49 with less than 1 percent reporting that they currently smoke cigarettes (Table 3.10.1). Among men age 15-49, 17 percent currently smoke tobacco. Among men who smoke cigarettes, the majority smoke cigarettes on a daily basis (Table 3.10.2). Trends: The percentage of men age 15-49 who do not smoke tobacco has increased from 78 percent in 2010-11 to 82 percent in 2015. Patterns by background characteristics  Among men, tobacco smoking is lowest among those under age 19 where 2 percent are current smokers, and highest among men age 30-34 where 29 percent are current smokers (Table 3.10.2).  Tobacco use among men generally decreases with increasing education levels and wealth.  Among men age 15-54 who smoke cigarettes every day, 38 percent smoke fewer than five cigarettes (<5) per day and 25 percent smoke an average between 5 and 9 cigarettes per day (Table 3.11). Characteristics of Respondents • 41 LIST OF TABLES For detailed information on respondents’ characteristics, see the following tables:  Table 3.1 Background characteristics of respondents  Table 3.2.1 Educational attainment: Women  Table 3.2.2 Educational attainment: Men  Table 3.3.1 Literacy: Women  Table 3.3.2 Literacy: Men  Table 3.4.1 Exposure to mass media: Women  Table 3.4.2 Exposure to mass media: Men  Table 3.5.1 Internet usage: Women  Table 3.5.2 Internet usage: Men  Table 3.6.1 Employment status: Women  Table 3.6.2 Employment status: Men  Table 3.7.1 Occupation: Women  Table 3.7.2 Occupation: Men  Table 3.8 Type of employment: Women  Table 3.9.1 Health insurance coverage: Women  Table 3.9.2 Health insurance coverage: Men  Table 3.10.1 Tobacco smoking: Women  Table 3.10.2 Tobacco smoking: Men  Table 3.11 Average number of cigarettes smoked daily: Men 42 • Characteristics of Respondents Table 3.1 Background characteristics of respondents Percent distribution of women and men age 15-49 by selected background characteristics, Zimbabwe 2015 Women Men Background characteristic Weighted percent Weighted number Unweighted number Weighted percent Weighted number Unweighted number Age 15-19 22.1 2,199 2,156 26.4 2,126 2,065 20-24 17.0 1,697 1,782 16.5 1,330 1,376 25-29 16.6 1,657 1,656 14.3 1,148 1,166 30-34 16.3 1,619 1,591 13.9 1,120 1,104 35-39 12.4 1,236 1,209 11.4 917 932 40-44 9.7 965 966 10.1 809 797 45-49 5.9 582 595 7.4 591 578 Religion Traditional 0.6 64 60 2.6 208 202 Roman Catholic 6.7 666 670 8.0 645 652 Protestant 15.7 1,560 1,618 15.4 1,237 1,204 Pentecostal 25.2 2,506 2,679 17.6 1,413 1,486 Apostolic sect 41.8 4,165 3,829 32.1 2,585 2,432 Other Christian 4.6 461 589 6.1 487 578 Muslim 0.4 38 30 0.7 59 50 None 4.9 489 471 17.4 1,397 1,405 Other 0.1 6 9 0.1 10 9 Marital status Never married 25.2 2,511 2,666 45.1 3,624 3,617 Married 58.7 5,841 5,700 49.1 3,948 3,931 Living together 3.1 310 315 0.8 62 68 Divorced/separated 8.6 855 844 4.4 354 350 Widowed 4.4 438 430 0.7 53 52 Residence Urban 38.5 3,829 4,521 36.1 2,900 3,297 Rural 61.5 6,126 5,434 63.9 5,140 4,721 Province Manicaland 12.7 1,266 1,019 13.3 1,072 852 Mashonaland Central 8.9 882 993 10.0 806 944 Mashonaland East 9.6 952 910 10.0 807 759 Mashonaland West 11.7 1,160 1,054 12.5 1,004 888 Matabeleland North 4.7 465 849 4.6 366 698 Matabeleland South 4.2 419 829 4.2 335 634 Midlands 12.7 1,263 1,062 12.3 986 850 Masvingo 11.9 1,187 1,046 10.5 843 747 Harare 17.9 1,783 1,235 17.6 1,412 954 Bulawayo 5.8 577 958 5.1 409 692 Education No education 1.3 126 106 0.5 38 38 Primary 25.8 2,571 2,385 22.4 1,803 1,726 Secondary 65.6 6,527 6,637 66.5 5,349 5,359 More than secondary 7.3 731 827 10.6 849 895 Wealth quintile Lowest 17.1 1,704 1,499 15.1 1,212 1,121 Second 17.0 1,693 1,452 18.0 1,448 1,294 Middle 17.6 1,748 1,549 19.4 1,558 1,419 Fourth 23.2 2,307 2,558 23.0 1,852 1,993 Highest 25.1 2,503 2,897 24.5 1,970 2,191 Total 15-49 100.0 9,955 9,955 100.0 8,041 8,018 50-54 na na na na 355 378 Total 15-54 na na na na 8,396 8,396 Note: Education categories refer to the highest level of education attended, whether or not that level was completed. na = Not applicable Characteristics of Respondents • 43 Table 3.2.1 Educational attainment: Women Percent distribution of women age 15-49 by highest level of schooling attended or completed, and median years completed, according to background characteristics, Zimbabwe 2015 Highest level of schooling Total Median years completed Number of women Background characteristic No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Age 15-24 0.3 10.4 11.5 72.1 2.1 3.6 100.0 8.9 3,895 15-19 0.2 11.4 10.5 76.3 1.0 0.8 100.0 8.5 2,199 20-24 0.4 9.1 12.8 66.8 3.5 7.4 100.0 9.9 1,697 25-29 0.9 10.6 16.6 60.2 2.2 9.5 100.0 9.5 1,657 30-34 1.0 8.8 16.8 61.7 1.7 10.0 100.0 9.9 1,619 35-39 1.7 12.0 17.0 58.1 0.8 10.4 100.0 9.3 1,236 40-44 2.6 13.9 17.7 55.9 0.2 9.7 100.0 8.7 965 45-49 6.4 20.4 12.4 51.7 0.8 8.2 100.0 8.5 582 Residence Urban 0.3 2.6 6.8 72.0 3.2 15.1 100.0 10.3 3,829 Rural 1.9 16.7 19.4 58.9 0.6 2.5 100.0 8.0 6,126 Province Manicaland 3.0 15.4 17.9 58.5 1.1 4.2 100.0 8.1 1,266 Mashonaland Central 1.9 25.1 18.3 51.2 0.3 3.2 100.0 7.1 882 Mashonaland East 0.8 10.8 15.8 66.8 1.4 4.5 100.0 8.8 952 Mashonaland West 1.9 15.5 12.7 63.2 0.5 6.3 100.0 8.6 1,160 Matabeleland North 1.2 16.4 26.7 51.5 0.8 3.4 100.0 7.4 465 Matabeleland South 1.0 8.1 20.3 63.8 2.1 4.6 100.0 8.7 419 Midlands 0.7 9.6 18.0 64.5 0.9 6.4 100.0 9.0 1,263 Masvingo 1.6 11.7 14.8 64.8 1.0 6.2 100.0 8.9 1,187 Harare 0.2 2.6 6.1 73.4 4.2 13.5 100.0 10.3 1,783 Bulawayo 0.3 1.3 7.5 70.2 2.7 18.0 100.0 10.4 577 Wealth quintile Lowest 3.5 26.2 26.4 43.8 0.0 0.1 100.0 6.7 1,704 Second 1.4 19.0 20.4 58.5 0.3 0.3 100.0 7.5 1,693 Middle 1.6 11.4 17.3 67.6 0.7 1.4 100.0 8.5 1,748 Fourth 0.4 5.3 9.9 76.6 1.5 6.3 100.0 10.0 2,307 Highest 0.2 1.3 4.8 67.2 4.4 22.2 100.0 10.5 2,503 Total 1.3 11.3 14.5 63.9 1.6 7.3 100.0 9.1 9,955 Note: In Zimbabwe, primary level is referred to as grades 1-7. Secondary level is referred to as forms 1-6. With the primary and secondary levels combined, there is a total of 13 years of schooling. 1 Completed 7th grade at the primary level 2 Completed 6th grade at the secondary level 44 • Characteristics of Respondents Table 3.2.2 Educational attainment: Men Percent distribution of men age 15-49 by highest level of schooling attended or completed, and median years completed, according to background characteristics, Zimbabwe 2015 Highest level of schooling Total Median years completed Number of men Background characteristic No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Age 15-24 0.3 12.9 11.1 68.9 3.0 3.7 100.0 8.8 3,456 15-19 0.3 14.7 11.8 71.3 1.2 0.6 100.0 8.2 2,126 20-24 0.4 10.1 10.1 64.9 5.9 8.6 100.0 10.1 1,330 25-29 0.4 9.8 13.9 57.0 6.4 12.5 100.0 10.1 1,148 30-34 0.3 7.6 12.8 61.9 3.0 14.5 100.0 10.2 1,120 35-39 0.3 8.0 13.8 57.9 2.0 18.0 100.0 10.2 917 40-44 1.1 8.2 12.2 59.4 2.3 16.8 100.0 10.3 809 45-49 1.1 7.7 10.5 59.7 1.7 19.3 100.0 10.3 591 Residence Urban 0.1 2.2 3.6 65.5 6.6 22.0 100.0 10.6 2,900 Rural 0.7 14.9 16.9 62.1 1.3 4.1 100.0 8.5 5,140 Province Manicaland 0.8 10.0 12.7 68.1 2.1 6.3 100.0 9.2 1,072 Mashonaland Central 0.6 19.8 14.7 58.5 1.5 4.9 100.0 8.3 806 Mashonaland East 1.0 6.7 14.7 69.6 2.3 5.7 100.0 9.5 807 Mashonaland West 0.5 10.5 12.8 63.1 2.6 10.5 100.0 9.4 1,004 Matabeleland North 1.1 17.5 29.8 45.0 2.0 4.6 100.0 6.9 366 Matabeleland South 0.1 15.4 20.2 57.0 1.6 5.7 100.0 8.4 335 Midlands 0.0 13.1 13.5 62.8 2.1 8.4 100.0 9.3 986 Masvingo 1.0 14.2 10.9 61.5 2.6 9.8 100.0 9.2 843 Harare 0.0 1.8 3.8 66.5 6.8 21.0 100.0 10.6 1,412 Bulawayo 0.1 3.0 4.1 63.6 6.4 22.7 100.0 10.5 409 Wealth quintile Lowest 1.3 26.4 23.2 48.1 0.5 0.4 100.0 6.8 1,212 Second 0.6 15.4 19.4 63.3 0.7 0.6 100.0 8.1 1,448 Middle 0.5 11.2 14.7 70.3 1.1 2.1 100.0 8.9 1,558 Fourth 0.1 4.9 7.9 71.9 4.3 10.9 100.0 10.2 1,852 Highest 0.2 1.0 1.9 59.0 7.4 30.5 100.0 10.8 1,970 Total 15-49 0.5 10.3 12.1 63.3 3.2 10.6 100.0 9.8 8,041 50-54 6.0 17.4 16.4 43.2 1.2 15.9 100.0 8.7 355 Total 15-54 0.7 10.6 12.3 62.5 3.1 10.8 100.0 9.8 8,396 Note: In Zimbabwe, primary level is referred to as grades 1-7. Secondary level is referred to as forms 1-6. With the primary and secondary levels combined, there is a total of 13 years of schooling. 1 Completed 7th grade at the primary level 2 Completed 6th grade at the secondary level Characteristics of Respondents • 45 Table 3.3.1 Literacy: Women Percent distribution of women age 15-49 by level of schooling attended and level of literacy, and percentage literate, according to background characteristics, Zimbabwe 2015 Higher than secondary schooling No schooling, primary or secondary school Total Percentage literate1 Number of women Background characteristic Can read a whole sentence Can read part of a sentence Cannot read at all No card with required language Blind/ visually impaired Age 15-24 3.6 84.0 6.9 5.3 0.1 0.1 100.0 94.5 3,895 15-19 0.8 85.9 7.5 5.6 0.2 0.1 100.0 94.2 2,199 20-24 7.4 81.5 6.1 4.9 0.1 0.1 100.0 94.9 1,697 25-29 9.5 78.7 7.2 4.4 0.1 0.1 100.0 95.4 1,657 30-34 10.0 79.0 6.1 4.8 0.0 0.0 100.0 95.1 1,619 35-39 10.4 76.8 7.2 5.4 0.0 0.2 100.0 94.3 1,236 40-44 9.7 73.9 10.7 5.6 0.1 0.2 100.0 94.2 965 45-49 8.2 71.3 9.4 10.1 0.0 1.0 100.0 88.9 582 Residence Urban 15.1 78.2 5.1 1.5 0.0 0.0 100.0 98.5 3,829 Rural 2.5 80.6 8.8 7.8 0.1 0.2 100.0 91.8 6,126 Province Manicaland 4.2 79.7 9.6 6.5 0.0 0.0 100.0 93.5 1,266 Mashonaland Central 3.2 76.3 8.1 12.1 0.0 0.2 100.0 87.7 882 Mashonaland East 4.5 82.7 7.8 4.7 0.1 0.2 100.0 95.0 952 Mashonaland West 6.3 79.3 3.9 10.1 0.0 0.4 100.0 89.5 1,160 Matabeleland North 3.4 81.3 8.2 6.6 0.3 0.1 100.0 93.0 465 Matabeleland South 4.6 70.9 14.5 8.1 1.4 0.5 100.0 90.0 419 Midlands 6.4 83.9 6.9 2.6 0.0 0.3 100.0 97.1 1,263 Masvingo 6.2 82.0 7.6 4.2 0.0 0.1 100.0 95.7 1,187 Harare 13.5 79.4 5.2 1.8 0.0 0.0 100.0 98.2 1,783 Bulawayo 18.0 72.1 8.8 1.1 0.0 0.0 100.0 98.9 577 Wealth quintile Lowest 0.1 74.2 12.2 12.8 0.4 0.4 100.0 86.5 1,704 Second 0.3 80.1 10.8 8.6 0.0 0.2 100.0 91.2 1,693 Middle 1.4 87.2 5.9 5.4 0.1 0.1 100.0 94.5 1,748 Fourth 6.3 84.9 6.2 2.5 0.1 0.1 100.0 97.4 2,307 Highest 22.2 73.1 3.8 0.9 0.0 0.1 100.0 99.0 2,503 Total 7.3 79.7 7.4 5.4 0.1 0.2 100.0 94.4 9,955 1 Refers to women who attended schooling higher than the secondary level and women who can read a whole sentence or part of a sentence 46 • Characteristics of Respondents Table 3.3.2 Literacy: Men Percent distribution of men age 15-49 by level of schooling attended and level of literacy, and percentage literate, according to background characteristics, Zimbabwe 2015 Higher than secondary schooling No schooling, primary or secondary school Total Percentage literate1 Number of men Background characteristic Can read a whole sentence Can read part of a sentence Cannot read at all No card with required language Blind/ visually impaired Age 15-24 3.7 76.5 11.9 7.8 0.0 0.0 100.0 92.2 3,456 15-19 0.6 78.7 11.7 8.9 0.1 0.0 100.0 91.0 2,126 20-24 8.6 73.0 12.4 6.0 0.0 0.0 100.0 94.0 1,330 25-29 12.5 70.4 12.1 4.9 0.0 0.2 100.0 95.0 1,148 30-34 14.5 70.9 10.9 3.6 0.0 0.1 100.0 96.3 1,120 35-39 18.0 68.5 8.9 4.4 0.1 0.1 100.0 95.5 917 40-44 16.8 70.0 9.2 3.6 0.3 0.1 100.0 96.0 809 45-49 19.3 70.5 6.1 3.5 0.0 0.5 100.0 95.9 591 Residence Urban 22.0 72.0 4.4 1.4 0.0 0.1 100.0 98.5 2,900 Rural 4.1 73.3 14.3 8.1 0.1 0.1 100.0 91.8 5,140 Province Manicaland 6.3 77.4 11.1 5.1 0.0 0.2 100.0 94.7 1,072 Mashonaland Central 4.9 71.4 14.9 8.7 0.0 0.1 100.0 91.2 806 Mashonaland East 5.7 78.3 11.4 4.6 0.0 0.0 100.0 95.4 807 Mashonaland West 10.5 68.6 14.5 6.3 0.0 0.0 100.0 93.7 1,004 Matabeleland North 4.6 74.7 6.1 14.5 0.0 0.1 100.0 85.4 366 Matabeleland South 5.7 68.5 13.0 11.9 0.9 0.0 100.0 87.2 335 Midlands 8.4 72.4 12.5 6.4 0.0 0.3 100.0 93.3 986 Masvingo 9.8 70.0 13.5 6.7 0.0 0.1 100.0 93.2 843 Harare 21.0 72.6 5.4 0.9 0.1 0.0 100.0 99.0 1,412 Bulawayo 22.7 73.0 2.8 1.2 0.0 0.3 100.0 98.5 409 Wealth quintile Lowest 0.4 66.7 19.8 12.4 0.1 0.5 100.0 86.9 1,212 Second 0.6 74.6 15.8 8.9 0.1 0.0 100.0 91.0 1,448 Middle 2.1 78.5 13.2 6.2 0.0 0.0 100.0 93.8 1,558 Fourth 10.9 79.0 6.9 3.2 0.1 0.0 100.0 96.7 1,852 Highest 30.5 65.2 3.2 1.0 0.0 0.1 100.0 98.9 1,970 Total 15-49 10.6 72.8 10.8 5.7 0.1 0.1 100.0 94.2 8,041 50-54 15.9 63.9 11.7 8.2 0.0 0.3 100.0 91.5 355 Total 15-54 10.8 72.5 10.8 5.8 0.1 0.1 100.0 94.1 8,396 1 Refers to men who attended schooling higher than the secondary level and men who can read a whole sentence or part of a sentence Characteristics of Respondents • 47 Table 3.4.1 Exposure to mass media: Women Percentage of women age 15-49 who are exposed to specific media on a weekly basis, according to background characteristics, Zimbabwe 2015 Background characteristic Reads a newspaper at least once a week Watches television at least once a week Listens to the radio at least once a week Accesses all three media at least once a week Accesses none of the three media at least once a week Number of women Age 15-19 15.2 30.4 31.7 5.0 47.0 2,199 20-24 15.7 34.4 35.5 7.0 43.8 1,697 25-29 14.9 32.7 35.9 6.0 44.3 1,657 30-34 18.2 33.9 37.8 7.1 42.9 1,619 35-39 15.7 29.8 35.7 5.4 45.7 1,236 40-44 17.7 29.0 35.3 6.2 46.7 965 45-49 12.4 26.4 33.8 3.5 48.7 582 Residence Urban 29.8 62.1 37.7 12.6 23.8 3,829 Rural 7.2 12.5 33.3 1.7 58.6 6,126 Province Manicaland 13.3 20.4 38.6 5.7 51.2 1,266 Mashonaland Central 8.4 13.7 41.7 2.3 49.4 882 Mashonaland East 12.4 18.8 44.9 3.6 43.0 952 Mashonaland West 12.8 30.0 42.3 3.0 39.7 1,160 Matabeleland North 8.5 14.1 20.9 1.7 66.7 465 Matabeleland South 9.4 19.8 20.9 2.8 66.3 419 Midlands 11.0 28.3 27.6 3.3 53.1 1,263 Masvingo 9.0 23.6 22.1 2.4 60.2 1,187 Harare 31.6 58.7 40.5 14.7 25.9 1,783 Bulawayo 31.5 70.5 33.3 13.2 20.2 577 Education No education 0.3 5.7 17.7 0.0 79.0 126 Primary 2.3 11.9 30.6 0.5 62.2 2,571 Secondary 17.0 35.8 36.4 6.1 41.3 6,527 More than secondary 56.3 68.0 41.1 24.4 14.8 731 Wealth quintile Lowest 2.8 2.8 23.2 0.3 74.3 1,704 Second 5.4 5.4 32.0 0.7 63.6 1,693 Middle 7.1 11.2 39.9 1.4 53.8 1,748 Fourth 19.1 41.2 38.8 7.0 36.2 2,307 Highest 35.1 74.2 38.2 15.5 15.5 2,503 Total 15.9 31.6 35.0 5.9 45.2 9,955 48 • Characteristics of Respondents Table 3.4.2 Exposure to mass media: Men Percentage of men age 15-49 who are exposed to specific media on a weekly basis, according to background characteristics, Zimbabwe 2015 Background characteristic Reads a newspaper at least once a week Watches television at least once a week Listens to the radio at least once a week Accesses all three media at least once a week Accesses none of the three media at least once a week Number of men Age 15-19 16.1 26.3 41.6 5.6 43.1 2,126 20-24 26.9 33.9 51.1 11.6 33.2 1,330 25-29 30.3 33.6 50.3 13.6 32.6 1,148 30-34 31.7 33.1 53.6 13.5 28.8 1,120 35-39 38.0 34.7 48.5 14.2 28.6 917 40-44 37.0 35.9 56.1 16.3 24.7 809 45-49 37.0 36.0 49.6 16.0 30.4 591 Residence Urban 57.6 62.2 53.5 26.1 12.6 2,900 Rural 11.6 15.2 46.3 3.5 45.4 5,140 Province Manicaland 16.2 18.2 51.4 5.5 38.2 1,072 Mashonaland Central 15.5 15.7 60.4 5.0 32.1 806 Mashonaland East 17.5 20.8 56.3 6.5 34.6 807 Mashonaland West 24.7 30.6 55.3 10.0 29.7 1,004 Matabeleland North 12.5 15.3 20.1 3.7 68.0 366 Matabeleland South 16.2 22.6 38.0 6.5 49.1 335 Midlands 22.5 31.6 38.5 8.2 41.7 986 Masvingo 15.2 24.1 26.0 3.3 53.0 843 Harare 61.5 59.9 60.3 27.9 10.1 1,412 Bulawayo 64.1 73.0 56.9 35.9 9.1 409 Education No education (2.4) (13.4) (38.0) (2.4) (59.2) 38 Primary 3.6 10.2 40.7 1.1 54.4 1,803 Secondary 28.8 33.8 51.1 11.5 30.6 5,349 More than secondary 77.8 69.6 52.8 35.8 7.1 849 Wealth quintile Lowest 4.0 3.5 35.6 0.4 61.7 1,212 Second 6.9 8.9 45.1 1.3 49.8 1,448 Middle 10.4 13.1 52.7 2.8 41.7 1,558 Fourth 38.6 41.3 53.4 14.8 22.2 1,852 Highest 63.2 73.5 52.7 30.3 8.5 1,970 Total 15-49 28.2 32.2 48.9 11.7 33.6 8,041 50-54 29.2 35.5 51.8 16.0 34.7 355 Total 15-54 28.3 32.3 49.0 11.8 33.6 8,396 Note: Figures in parentheses are based on 25-49 unweighted cases. Characteristics of Respondents • 49 Table 3.5.1 Internet usage: Women Percentage of women age 15-49 who have ever used the internet, and percentage who have used the internet in the past 12 months; and among women who have used the internet in the past 12 months, percent distribution by frequency of internet use in the past month, according to background characteristics, Zimbabwe 2015 Ever used the internet Used the internet in the past 12 months Number Among women who have used the internet in the past 12 months, percentage who, in the past month, used the internet: Background characteristic Almost every day At least once a week Less than once a week Not at all Total Number Age 15-19 18.4 16.2 2,199 52.7 26.2 14.3 6.7 100.0 355 20-24 33.7 31.7 1,697 74.0 12.9 8.6 4.5 100.0 538 25-29 31.4 29.5 1,657 76.3 12.9 6.3 4.5 100.0 489 30-34 29.8 27.6 1,619 74.4 11.9 9.0 4.7 100.0 448 35-39 24.9 23.5 1,236 75.5 12.5 7.5 4.5 100.0 290 40-44 20.6 19.2 965 77.7 16.3 3.7 2.3 100.0 185 45-49 17.5 15.5 582 75.3 14.3 8.6 1.8 100.0 91 Residence Urban 50.2 47.5 3,829 75.4 14.2 6.6 3.8 100.0 1,818 Rural 10.8 9.4 6,126 61.0 17.3 14.6 7.1 100.0 579 Province Manicaland 10.8 10.3 1,266 60.8 19.7 15.3 4.2 100.0 130 Mashonaland Central 11.0 9.6 882 49.7 21.8 9.1 19.4 100.0 84 Mashonaland East 22.4 20.6 952 67.9 16.9 8.0 7.2 100.0 196 Mashonaland West 22.3 20.2 1,160 71.8 13.5 12.6 2.1 100.0 234 Matabeleland North 16.9 15.4 465 74.1 9.9 7.6 8.5 100.0 72 Matabeleland South 24.8 22.8 419 73.6 14.0 2.7 9.7 100.0 96 Midlands 21.0 19.4 1,263 68.9 11.9 16.1 3.2 100.0 245 Masvingo 16.4 14.3 1,187 65.6 20.6 11.8 1.9 100.0 170 Harare 50.8 47.9 1,783 77.2 14.5 5.8 2.6 100.0 854 Bulawayo 57.6 54.6 577 75.5 13.2 4.8 6.5 100.0 315 Education No education 1.0 1.0 126 * * * * * 1 Primary 4.7 3.8 2,571 59.9 15.2 16.6 8.3 100.0 98 Secondary 28.0 25.5 6,527 69.0 15.9 9.3 5.8 100.0 1,667 More than secondary 87.3 86.1 731 81.6 12.3 5.2 0.9 100.0 630 Wealth quintile Lowest 2.2 1.6 1,704 (61.0) (21.9) (2.1) (15.0) (100.0) 28 Second 6.2 5.2 1,693 52.6 16.2 24.4 6.8 100.0 88 Middle 11.0 9.3 1,748 60.5 11.3 21.1 7.1 100.0 162 Fourth 32.2 29.7 2,307 71.6 14.3 7.9 6.3 100.0 685 Highest 60.3 57.3 2,503 74.7 15.5 6.6 3.2 100.0 1,434 Total 26.0 24.1 9,955 71.9 15.0 8.5 4.6 100.0 2,396 Notes: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 50 • Characteristics of Respondents Table 3.5.2 Internet usage: Men Percentage of men age 15-49 who have ever used the internet, and percentage who have used the internet in the past 12 months; and among men who have used the internet in the past 12 months, percent distribution by frequency of internet use in the past month, according to background characteristics, Zimbabwe 2015 Ever used the internet Used the internet in the past 12 months Number Among men who have used the internet in the past 12 months, percentage who, in the past month, used internet: Background characteristic Almost every day At least once a week Less than once a week Not at all Total Number Age 15-19 28.9 26.2 2,126 54.0 24.9 12.7 8.4 100.0 557 20-24 51.8 49.0 1,330 68.9 14.5 7.6 9.0 100.0 652 25-29 45.0 42.8 1,148 72.8 14.6 4.4 8.3 100.0 492 30-34 46.0 42.0 1,120 76.3 12.4 6.1 5.2 100.0 470 35-39 42.6 40.4 917 77.5 13.2 5.4 3.9 100.0 370 40-44 40.2 37.8 809 73.1 15.9 5.5 5.5 100.0 306 45-49 35.4 32.6 591 73.0 15.3 7.5 4.2 100.0 193 Residence Urban 73.9 71.3 2,900 76.3 13.3 4.9 5.5 100.0 2,069 Rural 21.7 18.9 5,140 55.6 22.1 12.4 9.9 100.0 971 Province Manicaland 26.6 23.6 1,072 61.1 24.1 8.6 6.3 100.0 253 Mashonaland Central 19.6 18.1 806 53.7 24.6 13.0 8.7 100.0 146 Mashonaland East 34.2 29.9 807 67.5 18.1 10.1 4.3 100.0 241 Mashonaland West 31.0 29.5 1,004 64.6 21.3 6.9 7.2 100.0 296 Matabeleland North 24.3 22.2 366 59.3 16.4 14.8 9.4 100.0 81 Matabeleland South 34.3 30.7 335 61.2 20.7 6.0 12.1 100.0 103 Midlands 38.0 34.1 986 67.2 18.7 6.4 7.6 100.0 336 Masvingo 30.8 27.4 843 58.4 18.7 11.3 11.6 100.0 231 Harare 75.7 73.5 1,412 78.5 10.0 4.8 6.7 100.0 1,037 Bulawayo 79.0 77.1 409 77.5 13.5 6.7 2.3 100.0 315 Education No education (4.3) (4.3) 38 * * * * * 2 Primary 8.2 6.4 1,803 51.2 20.6 15.4 12.9 100.0 115 Secondary 43.5 40.3 5,349 65.4 18.3 8.0 8.4 100.0 2,155 More than secondary 92.4 90.4 849 84.5 9.3 4.2 2.0 100.0 768 Wealth quintile Lowest 8.4 5.9 1,212 42.5 28.5 14.4 14.6 100.0 72 Second 13.4 11.2 1,448 51.0 21.0 18.2 9.9 100.0 162 Middle 23.6 20.3 1,558 48.8 26.0 13.5 11.8 100.0 317 Fourth 53.8 50.3 1,852 68.2 17.1 6.2 8.5 100.0 931 Highest 81.2 79.1 1,970 78.0 12.5 5.2 4.3 100.0 1,559 Total 15-49 40.5 37.8 8,041 69.7 16.1 7.3 6.9 100.0 3,040 50-54 25.6 23.2 355 72.1 16.4 8.6 2.9 100.0 82 Total 15-54 39.9 37.2 8,396 69.7 16.1 7.3 6.8 100.0 3,122 Notes: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Characteristics of Respondents • 51 Table 3.6.1 Employment status: Women Percent distribution of women age 15-49 by employment status, according to background characteristics, Zimbabwe 2015 Employed in the 12 months preceding the survey Not employed in the 12 months preceding the survey Total Number of women Background characteristic Currently employed1 Not currently employed Age 15-19 15.3 6.7 78.0 100.0 2,199 20-24 34.6 12.4 53.0 100.0 1,697 25-29 47.6 12.6 39.8 100.0 1,657 30-34 51.9 10.3 37.8 100.0 1,619 35-39 55.5 8.6 35.9 100.0 1,236 40-44 55.1 9.4 35.5 100.0 965 45-49 57.9 9.0 33.1 100.0 582 Marital status Never married 24.8 7.8 67.5 100.0 2,511 Married or living together 44.1 10.6 45.3 100.0 6,151 Divorced/separated/ widowed 60.1 10.4 29.5 100.0 1,292 Number of living children 0 23.6 8.2 68.1 100.0 2,710 1-2 47.1 10.6 42.3 100.0 3,668 3-4 50.5 10.3 39.2 100.0 2,664 5+ 43.7 10.4 45.9 100.0 912 Residence Urban 52.4 8.5 39.0 100.0 3,829 Rural 34.3 10.7 55.0 100.0 6,126 Province Manicaland 33.3 11.7 55.0 100.0 1,266 Mashonaland Central 34.9 13.9 51.2 100.0 882 Mashonaland East 44.2 11.5 44.3 100.0 952 Mashonaland West 46.9 10.6 42.5 100.0 1,160 Matabeleland North 22.3 6.0 71.7 100.0 465 Matabeleland South 29.8 9.1 61.2 100.0 419 Midlands 43.2 9.0 47.8 100.0 1,263 Masvingo 34.1 6.8 59.1 100.0 1,187 Harare 54.1 9.6 36.3 100.0 1,783 Bulawayo 47.3 8.1 44.6 100.0 577 Education No education 35.8 7.3 56.8 100.0 126 Primary 37.4 10.0 52.6 100.0 2,571 Secondary 38.9 10.0 51.1 100.0 6,527 More than secondary 77.6 8.5 14.0 100.0 731 Wealth quintile Lowest 26.6 9.6 63.9 100.0 1,704 Second 32.1 11.2 56.7 100.0 1,693 Middle 35.7 12.1 52.2 100.0 1,748 Fourth 49.1 9.4 41.6 100.0 2,307 Highest 54.3 8.1 37.7 100.0 2,503 Total 41.3 9.9 48.9 100.0 9,955 1 “Currently employed” is defined as having done work in the past seven days. Includes persons who did not work in the past seven days but who are regularly employed and were absent from work for leave, illness, vacation, or any other such reason. 52 • Characteristics of Respondents Table 3.6.2 Employment status: Men Percent distribution of men age 15-49 by employment status, according to background characteristics, Zimbabwe 2015 Employed in the 12 months preceding the survey Not employed in the 12 months preceding the survey Total Number of men Background characteristic Currently employed1 Not currently employed Age 15-19 32.3 7.3 60.4 100.0 2,126 20-24 62.3 11.6 26.1 100.0 1,330 25-29 79.4 9.4 11.2 100.0 1,148 30-34 81.1 7.2 11.6 100.0 1,120 35-39 82.9 7.3 9.8 100.0 917 40-44 82.3 8.5 9.2 100.0 809 45-49 78.5 9.1 12.4 100.0 591 Marital status Never married 45.7 8.6 45.7 100.0 3,624 Married or living together 81.6 8.2 10.2 100.0 4,010 Divorced/separated/ widowed 73.0 11.6 15.4 100.0 407 Number of living children 0 48.0 8.8 43.2 100.0 3,969 1-2 81.5 8.8 9.7 100.0 1,957 3-4 83.3 7.6 9.1 100.0 1,523 5+ 77.1 8.6 14.3 100.0 591 Residence Urban 70.5 7.1 22.4 100.0 2,900 Rural 61.9 9.4 28.8 100.0 5,140 Province Manicaland 62.5 14.0 23.4 100.0 1,072 Mashonaland Central 59.7 9.4 30.9 100.0 806 Mashonaland East 62.4 7.8 29.8 100.0 807 Mashonaland West 74.6 5.1 20.3 100.0 1,004 Matabeleland North 61.6 12.0 26.4 100.0 366 Matabeleland South 58.4 14.0 27.6 100.0 335 Midlands 63.7 6.4 29.9 100.0 986 Masvingo 61.6 5.3 33.0 100.0 843 Harare 70.7 9.1 20.2 100.0 1,412 Bulawayo 61.7 5.1 33.2 100.0 409 Education No education (69.1) (9.6) (21.3) 100.0 38 Primary 63.3 10.0 26.7 100.0 1,803 Secondary 62.9 8.4 28.7 100.0 5,349 More than secondary 81.7 6.2 12.1 100.0 849 Wealth quintile Lowest 57.7 12.3 30.0 100.0 1,212 Second 60.2 10.2 29.6 100.0 1,448 Middle 60.4 8.4 31.2 100.0 1,558 Fourth 72.6 6.6 20.8 100.0 1,852 Highest 69.5 6.9 23.6 100.0 1,970 Total 15-49 65.0 8.6 26.5 100.0 8,041 50-54 79.4 9.2 11.4 100.0 355 Total 15-54 65.6 8.6 25.8 100.0 8,396 Note: Figures in parentheses are based on 25-49 unweighted cases. 1 “Currently employed” is defined as having done work in the past seven days. Includes persons who did not work in the past seven days but who are regularly employed and were absent from work for leave, illness, vacation, or any other such reason. Characteristics of Respondents • 53 Table 3.7.1 Occupation: Women Percent distribution of women age 15-49 employed in the 12 months preceding the survey by occupation, according to background characteristics, Zimbabwe 2015 Background characteristic Profes- sional/ technical/ managerial Clerical Sales and services Skilled manual Unskilled manual Domestic service Agriculture Other Missing Total Number of women Age 15-19 2.6 1.0 42.6 3.4 0.1 34.5 13.9 1.8 0.0 100.0 484 20-24 9.6 3.9 50.6 3.9 0.9 14.9 13.8 1.7 0.7 100.0 797 25-29 10.1 3.6 51.9 2.8 0.0 8.6 20.3 2.3 0.3 100.0 998 30-34 13.4 3.4 50.5 5.3 0.9 6.6 16.9 1.7 1.1 100.0 1,007 35-39 14.2 1.6 51.3 6.7 0.5 5.5 17.6 2.0 0.6 100.0 792 40-44 14.3 2.1 45.4 6.4 0.2 5.8 22.1 3.1 0.6 100.0 623 45-49 12.5 4.2 41.9 7.9 0.4 3.9 26.4 2.3 0.5 100.0 390 Marital status Never married 15.0 5.6 37.7 3.4 0.4 30.2 4.2 3.2 0.2 100.0 817 Married or living together 10.6 2.4 51.3 5.4 0.4 3.8 23.7 1.7 0.6 100.0 3,363 Divorced/separated/ widowed 10.6 2.5 49.9 4.8 0.6 17.3 10.9 2.5 0.9 100.0 911 Number of living children 0 14.7 5.4 39.4 3.7 0.1 27.3 5.9 3.3 0.2 100.0 863 1-2 12.7 3.4 52.0 4.2 0.6 9.8 14.5 2.0 0.6 100.0 2,115 3-4 10.1 1.7 50.3 6.2 0.5 5.0 24.1 1.6 0.5 100.0 1,619 5+ 3.2 0.5 47.4 6.1 0.3 1.9 37.0 2.3 1.4 100.0 493 Residence Urban 17.1 5.4 51.3 5.3 0.7 14.3 2.6 2.7 0.7 100.0 2,334 Rural 6.4 0.8 46.9 4.7 0.3 7.3 31.6 1.6 0.5 100.0 2,757 Province Manicaland 7.7 0.5 55.6 2.9 0.4 7.0 22.7 2.6 0.6 100.0 570 Mashonaland Central 7.4 0.6 45.7 4.9 0.2 3.5 36.1 1.7 0.0 100.0 430 Mashonaland East 6.3 1.0 44.3 2.6 0.0 7.9 35.0 2.4 0.5 100.0 531 Mashonaland West 7.5 1.7 42.4 7.7 0.3 6.7 32.3 1.2 0.3 100.0 667 Matabeleland North 15.8 3.1 52.1 3.1 0.1 18.7 5.3 1.6 0.2 100.0 131 Matabeleland South 11.5 4.0 49.2 3.3 1.3 25.4 3.4 1.8 0.2 100.0 163 Midlands 9.3 1.6 50.9 4.8 0.8 9.3 21.1 2.1 0.1 100.0 659 Masvingo 13.9 3.2 53.9 5.8 0.1 6.6 13.2 1.2 2.1 100.0 485 Harare 16.2 5.7 50.9 5.6 0.7 15.9 2.2 2.2 0.6 100.0 1,135 Bulawayo 20.0 7.7 42.1 5.5 1.2 16.2 1.6 4.6 1.2 100.0 320 Education No education (0.0) (0.0) (31.9) (5.5) (0.0) (10.6) (45.0) (3.3) (3.7) 100.0 54 Primary 1.1 0.1 43.1 5.0 0.3 13.7 34.9 1.3 0.4 100.0 1,218 Secondary 5.7 2.2 57.4 5.6 0.5 11.2 14.8 2.0 0.4 100.0 3,190 More than secondary 60.2 12.1 18.3 1.6 0.3 0.4 1.3 4.4 1.5 100.0 629 Wealth quintile Lowest 1.4 0.0 42.6 6.7 0.4 7.6 38.9 0.8 1.6 100.0 615 Second 2.9 0.4 45.0 6.2 0.3 7.3 36.3 1.3 0.4 100.0 732 Middle 4.3 0.6 50.7 2.5 0.4 7.3 31.5 2.3 0.3 100.0 836 Fourth 10.1 1.6 61.3 5.7 0.5 10.0 8.4 1.9 0.4 100.0 1,348 Highest 23.9 7.6 41.5 4.4 0.6 15.2 3.2 3.1 0.6 100.0 1,560 Total 11.3 2.9 48.9 5.0 0.5 10.5 18.3 2.1 0.6 100.0 5,091 Note: Figures in parentheses are based on 25-49 unweighted cases. 54 • Characteristics of Respondents Table 3.7.2 Occupation: Men Percent distribution of men age 15-49 employed in the 12 months preceding the survey by occupation, according to background characteristics, Zimbabwe 2015 Background characteristic Profes- sional/ technical/ managerial Clerical Sales and services Skilled manual Unskilled manual Domestic service Agriculture Other Missing Total Number of men Age 15-19 3.6 0.1 23.9 12.7 1.5 7.8 43.0 7.1 0.1 100.0 842 20-24 8.7 0.7 23.2 26.4 4.2 4.8 27.5 4.3 0.2 100.0 983 25-29 11.7 1.3 23.8 31.8 3.1 3.7 20.2 4.2 0.2 100.0 1,019 30-34 13.4 1.3 25.6 29.4 3.1 3.1 19.5 4.5 0.2 100.0 990 35-39 14.3 1.5 23.0 31.5 2.7 2.4 20.4 3.6 0.6 100.0 827 40-44 13.9 0.2 23.9 29.1 1.7 2.2 22.3 6.2 0.4 100.0 734 45-49 19.8 1.6 19.3 26.4 2.1 3.0 22.6 5.1 0.0 100.0 518 Marital status Never married 9.5 0.7 24.3 20.0 2.6 5.6 31.1 6.0 0.1 100.0 1,967 Married or living together 13.3 1.1 22.7 30.2 2.6 3.0 22.1 4.6 0.4 100.0 3,601 Divorced/separated/ widowed 7.5 0.6 27.4 32.5 4.9 3.7 21.0 2.0 0.4 100.0 344 Number of living children 0 9.3 0.9 24.0 21.6 2.8 5.1 30.4 5.7 0.1 100.0 2,255 1-2 14.0 0.8 23.1 31.0 3.8 2.9 19.5 4.5 0.3 100.0 1,767 3-4 13.9 1.2 23.6 30.5 1.5 4.1 20.3 4.5 0.4 100.0 1,385 5+ 8.0 0.9 22.8 26.5 2.4 1.7 33.2 4.2 0.4 100.0 506 Residence Urban 22.0 1.7 29.4 31.3 3.4 3.4 2.7 5.8 0.1 100.0 2,250 Rural 5.3 0.5 19.9 24.2 2.3 4.3 38.8 4.4 0.4 100.0 3,662 Province Manicaland 6.0 0.9 23.6 29.7 0.6 4.0 32.1 3.1 0.0 100.0 820 Mashonaland Central 5.6 0.7 14.3 18.9 2.9 2.8 49.8 4.6 0.2 100.0 557 Mashonaland East 6.7 0.3 26.8 24.1 2.9 2.5 32.4 4.2 0.0 100.0 566 Mashonaland West 10.5 0.3 20.2 27.2 0.5 8.4 31.3 1.6 0.0 100.0 801 Matabeleland North 7.0 0.5 32.1 19.9 1.9 5.3 22.5 10.5 0.3 100.0 270 Matabeleland South 10.1 0.8 34.6 24.5 3.1 1.3 22.9 2.6 0.3 100.0 243 Midlands 10.3 1.0 19.7 25.6 7.2 2.7 27.3 6.0 0.2 100.0 691 Masvingo 12.1 1.6 16.8 26.2 1.4 2.5 29.4 8.2 1.8 100.0 565 Harare 21.3 1.2 29.5 33.0 3.4 3.8 2.1 5.8 0.0 100.0 1,127 Bulawayo 23.8 3.1 25.6 29.0 4.1 3.9 3.9 6.3 0.4 100.0 273 Education No education (1.6) (0.0) (30.7) (14.1) (8.5) (2.1) (35.8) (7.2) (0.0) 100.0 30 Primary 1.3 0.0 21.8 22.7 2.5 6.2 42.3 2.6 0.6 100.0 1,322 Secondary 7.2 1.0 26.3 29.9 3.0 3.8 23.5 5.2 0.2 100.0 3,814 More than secondary 53.1 2.4 12.2 20.0 1.7 0.7 1.9 7.7 0.3 100.0 746 Wealth quintile Lowest 0.7 0.1 18.8 28.9 2.9 3.9 40.2 3.6 0.9 100.0 848 Second 2.1 0.0 20.5 23.9 2.2 3.9 42.7 4.7 0.0 100.0 1,019 Middle 3.2 0.4 22.1 21.6 1.9 5.1 40.9 4.4 0.3 100.0 1,072 Fourth 13.5 0.8 27.8 29.9 4.6 4.4 14.3 4.6 0.2 100.0 1,467 Highest 28.6 2.6 25.0 28.7 1.8 2.8 3.8 6.6 0.1 100.0 1,506 Total 15-49 11.7 0.9 23.5 26.9 2.7 3.9 25.0 4.9 0.3 100.0 5,913 50-54 16.9 0.1 19.4 29.5 2.0 2.6 27.2 2.4 0.0 100.0 315 Total 15-54 11.9 0.9 23.3 27.1 2.7 3.9 25.2 4.8 0.3 100.0 6,228 Note: Figures in parentheses are based on 25-49 unweighted cases. Characteristics of Respondents • 55 Table 3.8 Type of employment: Women Percent distribution of women age 15-49 employed in the 12 months preceding the survey by type of earnings, type of employer, and continuity of employment, according to type of employment (agricultural or nonagricultural), Zimbabwe 2015 Employment characteristic Agricultural work Nonagricultural work Total Type of earnings Cash only 63.6 81.5 78.1 Cash and in-kind 22.9 13.5 15.1 In-kind only 3.1 1.3 1.7 Not paid 10.4 3.8 5.1 Total 100.0 100.0 100.0 Type of employer Employed by family member 3.2 4.5 4.2 Employed by nonfamily member 21.5 43.4 39.7 Self-employed 75.2 52.1 56.1 Total 100.0 100.0 100.0 Continuity of employment All year 41.9 60.1 57.0 Seasonal 50.8 19.7 25.3 Occasional 7.3 20.2 17.7 Total 100.0 100.0 100.0 Number of women employed during the last 12 months 931 4,023 5,091 Note: Total includes women with missing information on type of employment who are not shown separately. 56 • Characteristics of Respondents Table 3.9.1 Health insurance coverage: Women Percentage of women age 15-49 with specific types of health insurance coverage, according to background characteristics, Zimbabwe 2015 Background characteristic Social security Health insurance through employer Mutual Health Organization/ community based insurance Privately purchased commercial insurance Other None Number of women Age 15-19 0.2 4.3 0.4 1.5 0.0 93.6 2,199 20-24 0.3 4.8 0.9 2.9 0.0 91.1 1,697 25-29 0.1 6.9 0.8 2.7 0.0 89.5 1,657 30-34 0.2 10.2 1.0 3.3 0.1 85.4 1,619 35-39 0.2 9.7 1.0 3.5 0.3 85.5 1,236 40-44 0.3 10.4 1.0 3.2 0.0 85.0 965 45-49 0.4 9.2 1.3 2.2 0.2 86.9 582 Residence Urban 0.5 14.3 1.6 6.1 0.2 77.5 3,829 Rural 0.0 3.0 0.3 0.6 0.0 96.1 6,126 Province Manicaland 0.0 3.1 0.7 1.4 0.0 94.7 1,266 Mashonaland Central 0.0 5.0 0.1 0.5 0.0 94.5 882 Mashonaland East 0.1 3.9 1.7 1.7 0.0 92.8 952 Mashonaland West 0.8 6.7 0.2 2.0 0.1 90.1 1,160 Matabeleland North 0.4 3.9 0.9 0.8 0.0 94.1 465 Matabeleland South 0.3 2.5 1.2 1.7 0.0 94.3 419 Midlands 0.0 5.0 0.2 2.8 0.0 91.9 1,263 Masvingo 0.4 9.1 1.4 0.4 0.0 88.7 1,187 Harare 0.1 14.7 0.5 7.6 0.4 77.2 1,783 Bulawayo 0.2 12.1 3.1 3.3 0.2 81.2 577 Education No education 0.0 1.7 0.0 0.0 0.0 98.3 126 Primary 0.0 0.6 0.0 0.1 0.0 99.3 2,571 Secondary 0.2 6.5 0.7 2.2 0.1 90.4 6,527 More than secondary 1.1 39.3 5.1 17.1 0.4 37.7 731 Wealth quintile Lowest 0.0 0.2 0.1 0.0 0.0 99.7 1,704 Second 0.0 0.4 0.1 0.0 0.0 99.5 1,693 Middle 0.0 1.7 0.2 0.1 0.0 98.0 1,748 Fourth 0.3 6.9 0.7 2.3 0.2 89.7 2,307 Highest 0.7 21.3 2.4 8.5 0.2 67.3 2,503 Total 0.2 7.3 0.8 2.7 0.1 88.9 9,955 Characteristics of Respondents • 57 Table 3.9.2 Health insurance coverage: Men Percentage of men age 15-49 with specific types of health insurance coverage, according to background characteristics, Zimbabwe 2015 Background characteristic Social security Health insurance through employer Mutual Health Organization/ community based insurance Privately purchased commercial insurance Other None Number of men Age 15-19 0.1 2.7 0.4 2.1 0.1 94.5 2,126 20-24 0.1 2.3 1.1 4.8 0.8 90.9 1,330 25-29 0.0 6.5 1.0 2.3 0.7 89.8 1,148 30-34 0.5 7.1 1.1 4.7 0.3 86.3 1,120 35-39 0.6 11.6 1.3 4.8 0.5 81.6 917 40-44 0.5 10.2 1.8 5.0 0.7 82.4 809 45-49 0.9 14.6 1.2 5.3 0.9 77.3 591 Residence Urban 0.6 13.5 2.1 8.5 1.2 74.5 2,900 Rural 0.1 2.5 0.4 1.1 0.1 95.8 5,140 Province Manicaland 0.5 3.2 0.8 0.8 0.1 94.6 1,072 Mashonaland Central 0.2 3.0 0.1 0.9 0.2 95.6 806 Mashonaland East 0.3 3.5 1.6 2.0 0.1 92.6 807 Mashonaland West 0.2 6.3 1.2 2.1 0.1 90.2 1,004 Matabeleland North 0.3 5.1 0.3 0.9 0.0 93.4 366 Matabeleland South 0.3 4.0 0.4 1.3 0.1 94.1 335 Midlands 0.3 5.2 0.2 4.8 0.0 89.6 986 Masvingo 0.3 7.5 2.7 2.7 1.2 85.8 843 Harare 0.2 11.8 1.1 10.1 1.9 75.5 1,412 Bulawayo 0.8 13.4 0.8 7.7 0.0 77.8 409 Education No education (0.0) (1.2) (0.0) (1.9) (0.0) (96.9) 38 Primary 0.0 0.5 0.0 0.1 0.0 99.4 1,803 Secondary 0.2 4.4 0.7 3.0 0.2 91.5 5,349 More than secondary 1.6 32.0 4.9 16.9 3.2 42.5 849 Wealth quintile Lowest 0.0 0.2 0.0 0.0 0.0 99.8 1,212 Second 0.0 0.2 0.1 0.3 0.0 99.4 1,448 Middle 0.2 1.0 0.1 0.5 0.0 98.2 1,558 Fourth 0.3 7.0 1.0 4.2 0.6 87.1 1,852 Highest 0.8 18.6 3.1 10.9 1.4 65.6 1,970 Total 15-49 0.3 6.4 1.0 3.8 0.5 88.1 8,041 50-54 0.3 9.2 3.7 6.9 0.3 79.6 355 Total 15-54 0.3 6.6 1.1 3.9 0.5 87.8 8,396 Note: Figures in parentheses are based on 25-49 unweighted cases. 58 • Characteristics of Respondents Table 3.10.1 Tobacco smoking: Women Percentage of women age 15-49 who smoke cigarettes, according to background characteristics, Zimbabwe 2015 Background characteristic Percentage who smoke cigarettes1,2 Number of women Age 15-19 0.2 2,199 20-24 0.3 1,697 25-29 0.2 1,657 30-34 0.5 1,619 35-39 0.1 1,236 40-44 0.4 965 45-49 0.7 582 Residence Urban 0.6 3,829 Rural 0.1 6,126 Province Manicaland 0.3 1,266 Mashonaland Central 0.0 882 Mashonaland East 0.1 952 Mashonaland West 0.3 1,160 Matabeleland North 0.2 465 Matabeleland South 0.5 419 Midlands 0.0 1,263 Masvingo 0.2 1,187 Harare 0.6 1,783 Bulawayo 0.9 577 Education No education 0.8 126 Primary 0.1 2,571 Secondary 0.4 6,527 More than secondary 0.5 731 Wealth quintile Lowest 0.2 1,704 Second 0.0 1,693 Middle 0.1 1,748 Fourth 0.3 2,307 Highest 0.7 2,503 Total 0.3 9,955 1 Includes daily and occasional (less than daily) use 2 Includes manufactured cigarettes and hand-rolled cigarettes Characteristics of Respondents • 59 Table 3.10.2 Tobacco smoking: Men Percentage of men age 15-49 who smoke various tobacco products, and percent distribution of men by smoking frequency, according to background characteristics, Zimbabwe 2015 Percentage who smoke:1 Smoking frequency Number of men Background characteristic Cigarettes2 Other type of tobacco3 Any type of tobacco Daily smoker Occasional smoker4 Non- smoker Total Age 15-19 1.9 0.4 2.1 0.8 1.5 97.7 100.0 2,126 20-24 14.0 1.9 14.5 8.8 6.7 84.5 100.0 1,330 25-29 26.4 2.3 27.0 18.8 9.0 72.2 100.0 1,148 30-34 29.1 2.2 29.4 23.0 7.3 69.7 100.0 1,120 35-39 23.9 1.3 23.9 17.2 7.2 75.6 100.0 917 40-44 20.8 0.6 21.0 16.9 5.5 77.6 100.0 809 45-49 18.7 0.5 18.9 14.3 5.5 80.2 100.0 591 Residence Urban 15.4 1.6 15.8 10.9 5.2 83.9 100.0 2,900 Rural 17.6 1.1 17.9 13.0 5.8 81.2 100.0 5,140 Province Manicaland 15.7 1.2 16.1 11.6 5.3 83.1 100.0 1,072 Mashonaland Central 24.3 1.5 24.4 16.8 8.3 75.0 100.0 806 Mashonaland East 17.2 1.1 17.5 14.5 3.9 81.6 100.0 807 Mashonaland West 16.6 1.7 17.3 12.6 4.8 82.6 100.0 1,004 Matabeleland North 17.9 2.8 18.3 12.2 7.8 80.0 100.0 366 Matabeleland South 19.7 0.8 19.8 15.5 6.9 77.7 100.0 335 Midlands 12.9 0.3 12.9 8.4 5.8 85.9 100.0 986 Masvingo 14.2 0.9 14.5 10.6 4.8 84.7 100.0 843 Harare 16.7 1.2 16.9 11.7 5.2 83.1 100.0 1,412 Bulawayo 16.5 2.7 17.2 12.1 5.9 81.9 100.0 409 Education No education (27.0) (1.8) (27.0) (27.1) (3.1) (69.8) (100.0) 38 Primary 22.0 1.5 22.5 16.7 6.9 76.4 100.0 1,803 Secondary 16.0 1.4 16.3 11.3 5.6 83.1 100.0 5,349 More than secondary 10.4 0.5 10.4 8.0 2.9 89.1 100.0 849 Wealth quintile Lowest 23.5 1.4 23.8 17.9 6.8 75.3 100.0 1,212 Second 19.5 1.6 19.8 14.0 6.9 79.0 100.0 1,448 Middle 14.8 1.0 15.1 11.0 5.0 84.0 100.0 1,558 Fourth 18.0 1.6 18.4 13.3 5.5 81.2 100.0 1,852 Highest 11.3 1.0 11.4 7.5 4.5 88.1 100.0 1,970 Total 15-49 16.8 1.3 17.1 12.3 5.6 82.1 100.0 8,041 50-54 29.5 0.8 29.9 22.6 8.7 68.7 100.0 355 Total 15-54 17.4 1.3 17.7 12.7 5.7 81.6 100.0 8,396 Note: Figures in parentheses are based on 25-49 unweighted cases. 1 Includes daily and occasional (less than daily) use 2 Includes manufactured cigarettes and hand-rolled cigarettes 3 Includes pipes and other types of tobacco 4 Occasional refers to less often than daily use 60 • Characteristics of Respondents Table 3.11 Average number of cigarettes smoked daily: Men Among men age 15-49 who smoke cigarettes daily, percent distribution by average number of cigarettes smoked per day, according to background characteristics, Zimbabwe 2015 Average number of cigarettes smoked per day1 Number of respondents who smoke cigarettes daily1 Background characteristic <5 5-9 10-14 15-24 ≥25 Don’t know Total Age 15-19 * * * * * * * 15 20-24 40.3 34.3 8.8 12.0 4.6 0.0 100.0 114 25-29 43.9 26.1 15.7 11.6 2.6 0.0 100.0 211 30-34 34.5 23.4 20.4 16.1 5.0 0.7 100.0 256 35-39 32.8 24.2 20.4 17.8 4.9 0.0 100.0 155 40-44 36.0 24.1 20.8 12.8 6.4 0.0 100.0 130 45-49 35.4 29.8 16.8 9.5 8.5 0.0 100.0 83 Residence Urban 31.1 30.3 21.3 14.0 2.8 0.6 100.0 312 Rural 40.8 23.7 15.9 13.8 5.8 0.0 100.0 652 Province Manicaland 29.8 35.3 11.4 20.4 3.2 0.0 100.0 122 Mashonaland Central 49.9 20.8 12.4 13.1 3.8 0.0 100.0 131 Mashonaland East 32.1 27.8 22.4 13.5 4.2 0.0 100.0 113 Mashonaland West 53.6 15.3 19.5 4.1 7.5 0.0 100.0 126 Matabeleland North 49.8 17.8 21.5 8.1 2.8 0.0 100.0 44 Matabeleland South 30.8 25.2 14.9 15.8 13.4 0.0 100.0 50 Midlands 41.2 18.5 24.3 10.5 5.4 0.0 100.0 80 Masvingo 37.9 23.8 11.5 19.8 7.0 0.0 100.0 84 Harare 27.7 31.5 20.7 16.8 2.2 1.0 100.0 165 Bulawayo 19.1 42.8 20.1 15.1 3.0 0.0 100.0 48 Education No education * * * * * * * 9 Primary 43.1 25.5 15.1 10.8 5.6 0.0 100.0 293 Secondary 36.0 26.5 17.4 15.3 4.5 0.3 100.0 597 More than secondary 29.7 23.2 30.4 12.8 3.9 0.0 100.0 65 Wealth quintile Lowest 50.0 19.9 16.9 8.4 4.9 0.0 100.0 212 Second 34.2 23.2 16.3 20.8 5.5 0.0 100.0 199 Middle 37.8 26.9 14.7 15.1 5.5 0.0 100.0 165 Fourth 33.3 28.0 21.2 12.7 4.1 0.7 100.0 246 Highest 31.5 33.3 17.9 13.2 4.2 0.0 100.0 142 Total 15-49 37.7 25.8 17.6 13.9 4.8 0.2 100.0 964 50-54 37.9 20.1 24.4 12.1 3.8 1.7 100.0 78 Total 15-54 37.7 25.4 18.1 13.8 4.7 0.3 100.0 1,042 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 1 Includes manufactured cigarettes and hand-rolled cigarettes Marriage and Sexual Activity • 61 MARRIAGE AND SEXUAL ACTIVITY 4 Key Findings  Age at first marriage: Marriage is almost universal in Zimbabwe. The median age at marriage among women age 25-49 is 19.8 years and among men age 30-54 is 25.6 years.  Polygyny: Eleven percent of married women reported that their husband has more than one wife.  Sexual initiation: The median age at first sexual intercourse for women age 25-49 is about 1 year younger than the median age at first marriage, indicating that women engage in sex before marriage.  Widowhood: More than one in five (23 percent) of women age 45-49 are widowed. arriage and sexual activity help determine the extent to which women are exposed to the risk of pregnancy. Thus, they are important determinants of fertility levels. However, the timing and circumstances of marriage and sexual activity also have profound consequences for women’s and men’s lives. This chapter also presents information on marital status, polygyny, age at first marriage, and age at first sexual intercourse for both women and men. 4.1 MARITAL STATUS Currently married Women and men who report being married or living together with a partner as if married at the time of the survey Sample: Women and men age 15-49 Marriage is nearly universal in Zimbabwe. By age 45-49, only 4 percent and 2 percent of women and men, respectively, have never been married (Table 4.1). Sixty-two percent of women and 50 percent of men age 15-49 are currently married or living together with a partner as though married (Figure 4.1). Although nearly all men eventually marry, they tend to marry later than women; thus, a higher percentage of men than women age 15-49 have never married (45 percent compared with 25 percent). Women are more likely than men to be widowed (4 percent compared with 1 percent), while the proportion of women who are divorced or separated is more than twice that of men (9 percent and 4 percent, respectively). The percentage widowed increases with increasing age, especially among women (Table 4.1). M 62 • Marriage and Sexual Activity Figure 4.1 Marital status Percent distribution of women and men age 15-49 by current marital status Trends: The percentage of women age 15-49 who are married or living together has remained at 62 percent since 2010-11. The proportion of men married or living together is also similar, 50 percent in 2010-11 and 49 percent in 2015. Over this same time period, the proportion of men who were widowed has remained constant at less than 1 percent. 4.2 POLYGYNY Polygyny Women who report that their husband or partner has other wives are considered to be in a polygynous marriage. Sample: Currently married women and men age 15-49 Polygyny has implications for the frequency of exposure to sexual activity and therefore fertility. The extent of polygyny in Zimbabwe was measured by asking all women currently married or living with a man the question: “Does your husband/partner have other wives, does he live with other women as if married, or does he maintain a small house?” In Zimbabwe, the term “small house” is used to refer to a woman having an extramarital relationship with a married man. The majority of married women report their husband or partner has no other wives (88 percent). Eleven percent of women report their husbands have more than one wife, while 1 percent don’t know if their husbands have other wives (Table 4.2.1). Interestingly, a higher percentage of men age 15-49 report that they have only one wife compared with women (95 percent versus 88 percent), and only 5 percent report that they have multiple wives (Table 4.2.2). Trends: The percentage of women and men who report polygyny has remained consistent over the past decade, at 11 percent among currently married women and 5 percent among currently married men. Patterns by background characteristics  The percentage of women who report that their husbands or partners have multiple wives increases with an increase in age, from 8 percent for women age 15-24 to 16-18 percent for women age 40-49.  Women in rural areas are more than twice as likely as their urban counterparts to report that their husband or partner has multiple wives (14 percent and 6 percent, respectively).  The proportion of women who report having co-wives is highest in Manicaland (16 percent). Never married 25% Married 59% Living together 3% Divorced 5% Separated 4% Widowed 4% Women Never married 45% Married 49%Living together 1% Divorced 2% Separated 3% Widowed 1% Men Marriage and Sexual Activity • 63  There is an inverse relationship between education and wealth, and polygyny; women who have no education are the most likely to report having co-wives (20 percent) and those with more than a secondary education are the least likely (3 percent). Similarly, 15 percent of women in the lowest wealth quintile report that their husbands or partners have multiple wives compared with 4 percent of women in the highest wealth quintile. 4.3 AGE AT FIRST MARRIAGE Median age at first marriage Age by which half of respondents have been married Sample: Women age 20-49 and age 25-29, and men age 30-54 For most societies, marriage marks the point in a woman’s life when childbearing first becomes socially acceptable. On average, women who marry early will have longer exposure to pregnancy and a greater number of lifetime births. The median age at marriage among women 25-49 is 19.8 years and the majority of women are married by age 25 (83 percent) (Table 4.3). Men get married later than women; median age at marriage among men 30-54 is 25.6 years and 46 percent of men age 30-54 get married by the age of 25. Trends: During the 16-year period between 1999 and 2015, the median age at marriage among women has increased slowly but steadily, from 19.3 years in 1999 and 2005 to 19.8 years in 2015. A similar trend is observed among men over the same period. Patterns by background characteristics  Urban women marry later than rural women. The median age at first marriage is about 2 years older among urban than among rural women age 25-49 (21.2 years compared with 19.1 years) (Table 4.4).  By province, the median age at first marriage for women ranges from 18.4 years in Mashonaland Central to 22.4 years in Bulawayo.  Educated women marry much later. There is a 6.3-year difference in the median age at first marriage between women with no education and those with more than a secondary education (17.2 years compared with 23.6 years).  The median age at first marriage for women increases steadily with household wealth, from18.5 years in the lowest wealth quintile to 21.6 years in the highest wealth quintile. 4.4 AGE AT FIRST SEXUAL INTERCOURSE Median age at first sexual intercourse Age by which half of respondents have had sexual intercourse Sample: Women age 20-49 and age 25-29, and men age 25-49 and 25-54 Age at first marriage can be used as a proxy for the beginning of exposure to the risk of pregnancy. However, because some women are sexually active before marriage, the age at which women initiate sexual intercourse more precisely marks the beginning of their exposure to reproductive risks. The median age at first intercourse for women age 25-49 in Zimbabwe is 18.7 years (Table 4.5). Six percent of women age 25-49 have had sexual intercourse before age 15 and 40 percent before age 18. By age 20, 66 percent of Zimbabwean women have had sexual intercourse. 64 • Marriage and Sexual Activity Zimbabwean men have an older median age at first intercourse compared with women. Among men age 25-49, the median age at first intercourse is 20.5 years, compared with 18.7 years among women the same age. Four percent of men age 25-49 have had sexual intercourse before age 15 and 24 percent before age 18. By age 20, more than four in ten men have initiated sexual intercourse (44 percent). A comparison of the median age at first intercourse with the median age at first marriage can be used as a measure of whether respondents engage in sex before marriage. The median age at first intercourse for women age 25-49 in Zimbabwe is about 1 year younger than the median age at first marriage of women the same age (18.7 years versus 19.8 years). This indicates that many women engage in sex before marriage. Thus, women in Zimbabwe may be exposed to the risk of pregnancy and begin childbearing at an earlier age than indicated by the median age at first marriage. Trends: Since 1999, the median age at first sexual intercourse among women age 25-49 has remained constant at 18.7 years. Among men age 25-49 it has increased from 19.7 years in 1999 to 20.5 years in 2015. Over the same 16-year period, women age 25-49 engaging in sex by age 18 has remained steady at about 4 in 10 women. However, among men age 25-49, the proportion that has initiated sexual intercourse by age 18 has decreased from 29 percent in 1999 to 24 percent in 2015. Patterns by background characteristics  The median age at first sex for women age 25-49 is 1.8 years younger among rural than among urban women (18.1 years versus 19.9 years) (Table 4.6).  The median age at first sexual intercourse for women age 25-49 ranges from 17.7 years in Matabeleland North to 20.0 years in Harare.  More educated women wait longer before having sex. Among women age 25-49, there is an almost 6- year difference in the median age at first sex between women with no education and those with more than a secondary education (16.4 years compared with 22.1 years).  Age at first sexual intercourse increases steadily with household wealth. The median age at first sex for women in the lowest quintile is about 3 years younger than for women in the highest wealth quintile (17.6 years versus 20.3 years). 4.5 RECENT SEXUAL ACTIVITY In the absence of effective contraception, the probability of becoming pregnant is highly dependent upon the frequency of intercourse. Therefore, information on sexual activity can be used to refine measures of exposure to pregnancy. Men and women who have ever had sex were asked how long ago they most recently had sexual intercourse. More than half of respondents age 15-49 (54 percent of women and 52 percent of men) reported having sexual intercourse within the four weeks before the survey (Tables 4.7.1 and 4.7.2). Nine percent of women age 15-49 have not had sexual intercourse for one or more years, and 19 percent have never had sexual intercourse. Among men age 15-49, 7 percent have not been sexually active for one or more years and 24 percent have never had sexual intercourse. For more information on recent sexual activity, see Tables 4.7.1 and 4.7.2. Trends: Since 2010-11, there was a slight increase in the percentage of women and men age 15-49 who reported having had sexual intercourse within the four weeks preceding the interview from 50 percent to 54 percent for women and from 51 percent to 52 percent for men. Marriage and Sexual Activity • 65 LIST OF TABLES For more information on marriage and sexual activity, see the following tables:  Table 4.1 Current marital status  Table 4.2.1 Number of women’s co-wives  Table 4.2.2 Number of men’s wives  Table 4.3 Age at first marriage  Table 4.4 Median age at first marriage by background characteristics  Table 4.5 Age at first sexual intercourse  Table 4.6 Median age at first sexual intercourse by background characteristics  Table 4.7.1 Recent sexual activity: Women  Table 4.7.2 Recent sexual activity: Men 66 • Marriage and Sexual Activity Table 4.1 Current marital status Percent distribution of women and men age 15-49 by current marital status, according to age, Zimbabwe 2015 Marital status Total Percentage of respondents currently in union Number of respondents Age Never married Married Living together Divorced Separated Widowed WOMEN 15-19 77.2 17.0 2.6 1.2 1.8 0.1 100.0 19.6 2,199 20-24 29.1 57.4 4.2 4.3 4.7 0.2 100.0 61.6 1,697 25-29 9.5 73.8 3.3 6.4 5.3 1.7 100.0 77.1 1,657 30-34 5.0 78.9 3.5 6.4 2.9 3.4 100.0 82.3 1,619 35-39 2.7 76.1 2.8 6.4 4.7 7.4 100.0 78.9 1,236 40-44 2.4 71.1 2.2 8.0 3.3 13.0 100.0 73.3 965 45-49 4.3 63.1 2.4 6.2 1.4 22.6 100.0 65.5 582 Total 15-49 25.2 58.7 3.1 5.0 3.6 4.4 100.0 61.8 9,955 MEN 15-19 99.0 0.8 0.0 0.0 0.2 0.0 100.0 0.9 2,126 20-24 73.7 21.0 1.0 1.0 3.2 0.0 100.0 22.0 1,330 25-29 30.9 60.2 1.8 2.9 3.9 0.3 100.0 62.1 1,148 30-34 10.9 81.4 1.3 2.1 3.8 0.5 100.0 82.7 1,120 35-39 3.8 88.2 0.7 3.5 3.0 0.8 100.0 88.9 917 40-44 2.1 88.7 0.7 3.4 2.7 2.4 100.0 89.4 809 45-49 1.7 88.1 0.3 4.4 2.6 3.0 100.0 88.4 591 Total 15-49 45.1 49.1 0.8 1.9 2.5 0.7 100.0 49.9 8,041 50-54 0.4 88.4 1.0 4.4 2.0 3.7 100.0 89.4 355 Total 15-54 43.2 50.8 0.8 2.0 2.5 0.8 100.0 51.5 8,396 Marriage and Sexual Activity • 67 Table 4.2.1 Number of women’s co-wives Percent distribution of currently married women age 15-49 by number of co-wives, according to background characteristics, Zimbabwe 2015 Background characteristic Number of co-wives Total Number of women 0 1 2+ Don’t know Age 15-19 91.5 4.0 3.8 0.8 100.0 432 20-24 91.0 6.1 1.7 1.3 100.0 1,045 25-29 89.7 6.7 2.7 0.9 100.0 1,278 30-34 88.9 7.9 2.1 1.0 100.0 1,333 35-39 85.4 8.9 4.0 1.7 100.0 975 40-44 80.1 12.2 5.7 2.0 100.0 707 45-49 81.7 11.9 4.2 2.2 100.0 381 Residence Urban 91.7 5.4 1.0 1.9 100.0 2,100 Rural 85.4 9.3 4.2 1.0 100.0 4,051 Province Manicaland 82.7 7.4 8.4 1.5 100.0 857 Mashonaland Central 86.9 10.9 2.0 0.2 100.0 638 Mashonaland East 86.9 8.8 3.3 1.1 100.0 622 Mashonaland West 86.2 9.6 3.9 0.3 100.0 774 Matabeleland North 86.9 8.2 1.4 3.5 100.0 279 Matabeleland South 94.4 4.1 1.0 0.4 100.0 214 Midlands 87.5 8.5 3.3 0.7 100.0 794 Masvingo 87.5 8.3 2.2 2.0 100.0 740 Harare 90.5 6.1 0.8 2.6 100.0 976 Bulawayo 96.2 3.2 0.3 0.4 100.0 258 Education No education 79.6 11.5 8.9 0.0 100.0 88 Primary 81.4 11.6 6.0 1.1 100.0 1,826 Secondary 89.9 6.8 1.9 1.4 100.0 3,813 More than secondary 95.2 2.4 0.4 2.0 100.0 424 Wealth quintile Lowest 83.6 9.7 5.6 1.1 100.0 1,193 Second 86.4 9.0 3.8 0.8 100.0 1,191 Middle 85.6 9.4 4.5 0.5 100.0 1,073 Fourth 87.7 8.3 2.0 1.9 100.0 1,402 Highest 93.9 3.8 0.3 2.0 100.0 1,292 Total 87.6 8.0 3.1 1.3 100.0 6,151 68 • Marriage and Sexual Activity Table 4.2.2 Number of men’s wives Percent distribution of currently married men age 15-49 by number of wives, according to background characteristics, Zimbabwe 2015 Background characteristic Number of wives Total Number of men 1 2+ Age 15-19 * * 100.0 18 20-24 98.3 1.7 100.0 293 25-29 97.6 2.4 100.0 713 30-34 96.1 3.9 100.0 926 35-39 94.7 5.3 100.0 815 40-44 92.0 8.0 100.0 723 45-49 89.6 10.4 100.0 523 Residence Urban 97.6 2.4 100.0 1,485 Rural 93.0 7.0 100.0 2,525 Province Manicaland 92.9 7.1 100.0 493 Mashonaland Central 90.8 9.2 100.0 462 Mashonaland East 95.1 4.9 100.0 418 Mashonaland West 93.5 6.5 100.0 533 Matabeleland North 95.5 4.5 100.0 169 Matabeleland South 97.2 2.8 100.0 128 Midlands 93.0 7.0 100.0 519 Masvingo 95.7 4.3 100.0 410 Harare 98.1 1.9 100.0 712 Bulawayo 98.3 1.7 100.0 168 Education No education * * 100.0 19 Primary 92.7 7.3 100.0 887 Secondary 94.4 5.6 100.0 2,545 More than secondary 98.9 1.1 100.0 560 Wealth quintile Lowest 91.6 8.4 100.0 715 Second 93.1 6.9 100.0 715 Middle 93.2 6.8 100.0 674 Fourth 96.1 3.9 100.0 943 Highest 97.9 2.1 100.0 964 Total 15-49 94.7 5.3 100.0 4,010 50-54 90.7 9.3 100.0 318 Total 15-54 94.4 5.6 100.0 4,328 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. Marriage and Sexual Activity • 69 Table 4.3 Age at first marriage Percentage of women and men age 15-49 who were first married by exact ages and median age at first marriage, according to current age, Zimbabwe 2015 Percentage first married by exact age: Percentage never married Number of respondents Median age at first marriage Current age 15 18 20 22 25 WOMEN 15-19 2.7 na na na na 77.2 2,199 a 20-24 3.7 32.4 55.3 na na 29.1 1,697 19.5 25-29 4.5 30.5 54.8 71.4 85.6 9.5 1,657 19.6 30-34 3.1 28.7 51.3 66.9 81.8 5.0 1,619 19.9 35-39 4.1 27.6 52.1 69.1 83.2 2.7 1,236 19.8 40-44 6.4 28.0 51.1 68.4 82.8 2.4 965 19.9 45-49 8.0 31.8 49.4 67.7 81.9 4.3 582 20.1 20-49 4.5 29.9 52.9 na na 10.5 7,756 19.7 25-49 4.7 29.1 52.2 68.9 83.3 5.3 6,060 19.8 MEN 15-19 0.0 na na na na 99.0 2,126 a 20-24 0.1 1.2 8.6 na na 73.7 1,330 a 25-29 0.9 2.5 9.7 23.4 49.9 30.9 1,148 a 30-34 0.4 3.3 10.6 22.7 50.1 10.9 1,120 25.0 35-39 1.0 2.4 8.2 19.9 47.2 3.8 917 25.4 40-44 0.9 2.7 7.3 19.0 45.4 2.1 809 25.6 45-49 0.8 3.6 9.4 21.8 41.8 1.7 591 26.3 20-49 0.6 2.5 9.0 na na 25.7 5,914 a 25-49 0.8 2.8 9.2 21.5 47.6 11.7 4,584 a 20-54 0.6 2.5 9.0 na na 24.3 6,270 a 30-54 0.7 2.9 8.9 20.3 45.7 4.9 3,792 25.6 Note: The age at first marriage is defined as the age at which the respondent began living with her/his first spouse/partner. na = Not applicable due to censoring a = Omitted because less than 50 percent of the women or men began living with their spouse or partner for the first time before reaching the beginning of the age group 70 • Marriage and Sexual Activity Table 4.4 Median age at first marriage by background characteristics Median age at first marriage among women age 20-49 and age 25-49, and median age at first marriage among men age 20-54 and 30-54, according to background characteristics, Zimbabwe 2015 Background characteristic Women age Men age 20-49 25-49 25-54 30-54 Residence Urban a 21.2 a 26.2 Rural 18.9 19.1 24.8 25.1 Province Manicaland 19.2 19.4 24.9 25.0 Mashonaland Central 18.3 18.4 24.4 24.6 Mashonaland East 19.3 19.4 a 25.4 Mashonaland West 18.6 18.7 a 25.8 Matabeleland North 19.8 19.9 a 26.1 Matabeleland South a 21.2 a 26.9 Midlands 19.5 19.7 a 25.5 Masvingo 19.8 19.9 a 25.7 Harare a 21.2 a 25.6 Bulawayo a 22.4 a 27.5 Education No education 17.0 17.2 a a Primary 17.9 18.0 24.5 24.8 Secondary a 20.1 a 25.3 More than secondary a 23.6 a 27.1 Wealth quintile Lowest 18.3 18.5 24.4 24.8 Second 18.6 18.7 24.6 24.8 Middle 19.3 19.4 25.0 25.1 Fourth a 20.2 a 25.6 Highest a 21.6 a 26.6 Total 19.7 19.8 a 25.6 Note: The age at first marriage is defined as the age at which the respondent began living with her/his first spouse/partner. a = Omitted because less than 50 percent of the respondents began living with their spouse/partners for the first time before reaching the beginning of the age group Marriage and Sexual Activity • 71 Table 4.5 Age at first sexual intercourse Percentage of women and men age 15-49 who had first sexual intercourse by exact ages, percentage who never had sexual intercourse, and median age at first sexual intercourse, according to current age, Zimbabwe 2015 Current age Percentage who had first sexual intercourse by exact age: Percentage who never had intercourse Number of respondents Median age at first intercourse 15 18 20 22 25 WOMEN 15-19 4.7 na na na na 66.9 2,199 a 20-24 4.4 40.9 68.7 na na 16.0 1,697 18.6 25-29 5.7 41.1 67.8 82.7 93.8 2.9 1,657 18.6 30-34 4.9 39.0 64.2 80.4 91.2 1.3 1,619 18.8 35-39 4.4 39.9 66.5 83.2 93.8 1.2 1,236 18.7 40-44 8.1 38.9 65.1 81.8 93.4 0.9 965 18.8 45-49 7.0 42.7 66.3 81.6 92.0 1.3 582 18.6 20-49 5.4 40.3 66.6 na na 4.8 7,756 18.7 25-49 5.7 40.1 66.0 81.9 92.9 1.6 6,060 18.7 15-24 4.6 na na na na 44.7 3,895 a MEN 15-19 5.8 na na na na 72.9 2,126 a 20-24 5.0 26.4 55.5 na na 22.6 1,330 19.6 25-29 4.0 27.3 47.4 67.2 86.5 4.9 1,148 20.2 30-34 4.4 24.6 45.6 66.2 84.6 1.9 1,120 20.3 35-39 4.9 25.1 46.7 63.8 79.8 0.9 917 20.3 40-44 4.7 21.9 37.8 59.7 76.6 0.6 809 20.9 45-49 3.8 20.3 39.7 59.0 75.8 0.5 591 20.8 20-49 4.5 24.8 46.7 na na 6.7 5,914 a 25-49 4.4 24.4 44.1 63.9 81.6 2.0 4,584 20.5 15-24 5.5 na na na na 53.5 3,456 a 20-54 4.4 24.6 46.5 na na 6.3 6,270 a 25-54 4.2 24.2 44.1 63.7 81.3 1.9 4,940 20.5 na = Not applicable due to censoring a = Omitted because less than 50 percent of the respondents had sexual intercourse for the first time before reaching the beginning of the age group 72 • Marriage and Sexual Activity Table 4.6 Median age at first sexual intercourse by background characteristics Median age at first sexual intercourse among women age 20-49 and age 25-49, and median age at first sexual intercourse among men age 20-54 and age 25-54, according to background characteristics, Zimbabwe 2015 Background characteristic Women age Men age 20-49 25-49 20-54 25-54 Residence Urban 19.8 19.9 a 20.5 Rural 18.1 18.1 a 20.5 Province Manicaland 18.5 18.5 a 20.7 Mashonaland Central 17.9 17.9 a 20.7 Mashonaland East 18.6 18.6 a 20.7 Mashonaland West 18.1 18.1 a 20.7 Matabeleland North 17.7 17.7 19.1 19.4 Matabeleland South 18.1 18.2 18.9 19.1 Midlands 18.5 18.6 a 20.6 Masvingo 18.9 18.9 a 20.3 Harare a 20.0 a 20.4 Bulawayo 19.8 19.9 19.8 20.0 Education No education 16.3 16.4 a (20.3) Primary 17.1 17.2 a 20.2 Secondary 19.1 19.1 a 20.4 More than secondary a 22.1 a 21.5 Wealth quintile Lowest 17.5 17.6 a 20.4 Second 17.8 17.8 a 20.5 Middle 18.4 18.4 a 20.4 Fourth 19.0 19.1 a 20.3 Highest a 20.3 a 20.7 Total 18.7 18.7 a 20.5 Note: Figures in parentheses are based on 25-49 unweighted cases. a = Omitted because less than 50 percent of the respondents had intercourse for the first time before reaching the beginning of the age group Marriage and Sexual Activity • 73 Table 4.7.1 Recent sexual activity: Women Percent distribution of women age 15-49 by timing of last sexual intercourse, according to background characteristics, Zimbabwe 2015 Timing of last sexual intercourse Never had sexual intercourse Total Number of women Background characteristic Within the past 4 weeks Within 1 year1 One or more years Missing Age 15-19 17.7 11.5 3.8 0.1 66.9 100.0 2,199 20-24 55.7 20.2 7.8 0.3 16.0 100.0 1,697 25-29 67.7 20.6 8.2 0.6 2.9 100.0 1,657 30-34 71.8 19.8 6.3 0.8 1.3 100.0 1,619 35-39 69.7 18.5 10.0 0.6 1.2 100.0 1,236 40-44 61.7 18.1 18.7 0.7 0.9 100.0 965 45-49 57.3 14.0 26.0 1.5 1.3 100.0 582 Marital status Never married 5.3 12.6 8.4 0.4 73.3 100.0 2,511 Married or living together 82.4 15.4 1.9 0.3 0.0 100.0 6,151 Divorced/separated/ widowed 16.0 37.1 45.0 1.9 0.0 100.0 1,292 Marital duration2 0-4 years 79.6 18.9 1.3 0.2 0.0 100.0 1,292 5-9 years 85.4 12.8 1.4 0.4 0.0 100.0 1,264 10-14 years 81.6 16.3 1.8 0.2 0.0 100.0 1,002 15-19 years 82.9 14.0 2.6 0.5 0.0 100.0 788 20-24 years 80.9 15.4 3.3 0.5 0.0 100.0 503 25+ years 81.5 15.1 3.3 0.1 0.0 100.0 339 Married more than once 83.8 14.3 1.8 0.1 0.0 100.0 963 Residence Urban 52.6 15.4 9.4 0.9 21.8 100.0 3,829 Rural 55.5 18.8 9.0 0.3 16.4 100.0 6,126 Province Manicaland 53.3 18.3 11.7 0.8 15.9 100.0 1,266 Mashonaland Central 64.9 13.5 6.8 0.1 14.8 100.0 882 Mashonaland East 57.3 16.4 9.0 0.4 16.9 100.0 952 Mashonaland West 62.0 13.0 7.2 0.0 17.8 100.0 1,160 Matabeleland North 51.2 24.5 9.2 0.4 14.9 100.0 465 Matabeleland South 42.7 33.4 9.4 0.2 14.3 100.0 419 Midlands 56.4 17.0 7.8 0.1 18.7 100.0 1,263 Masvingo 48.2 20.1 10.2 0.5 21.0 100.0 1,187 Harare 52.5 13.7 9.7 1.6 22.6 100.0 1,783 Bulawayo 45.2 22.8 10.2 0.2 21.6 100.0 577 Education No education 59.5 19.0 18.1 2.9 0.5 100.0 126 Primary 61.6 18.1 10.6 0.0 9.6 100.0 2,571 Secondary 51.0 17.3 8.3 0.6 22.7 100.0 6,527 More than secondary 57.2 16.4 10.4 1.0 15.0 100.0 731 Wealth quintile Lowest 57.0 20.2 10.3 0.2 12.3 100.0 1,704 Second 56.3 20.1 7.8 0.3 15.6 100.0 1,693 Middle 53.0 18.5 9.7 0.2 18.6 100.0 1,748 Fourth 57.4 16.7 8.2 0.7 17.0 100.0 2,307 Highest 49.3 13.9 9.7 1.0 26.0 100.0 2,503 Total 54.3 17.5 9.1 0.5 18.5 100.0 9,955 1 Excludes women who had sexual intercourse within the last 4 weeks 2 Excludes women who are not currently married 74 • Marriage and Sexual Activity Table 4.7.2 Recent sexual activity: Men Percent distribution of men age 15-49 by timing of last sexual intercourse, according to background characteristics, Zimbabwe 2015 Timing of last sexual intercourse Never had sexual intercourse Total Number of men Background characteristic Within the past 4 weeks Within 1 year1 One or more years Missing Age 15-19 5.4 14.2 7.6 0.0 72.9 100.0 2,126 20-24 32.8 32.7 11.9 0.0 22.6 100.0 1,330 25-29 64.8 23.1 7.2 0.0 4.9 100.0 1,148 30-34 82.5 11.8 3.9 0.0 1.9 100.0 1,120 35-39 84.7 10.5 3.9 0.0 0.9 100.0 917 40-44 83.1 9.7 6.4 0.2 0.6 100.0 809 45-49 81.0 12.0 6.5 0.0 0.5 100.0 591 Marital status Never married 10.4 24.5 11.5 0.0 53.6 100.0 3,624 Married or living together 91.2 8.1 0.6 0.0 0.0 100.0 4,010 Divorced/separated/ widowed 27.2 40.6 32.1 0.0 0.0 100.0 407 Marital duration2 0-4 years 92.1 7.9 0.0 0.0 0.0 100.0 254 5-9 years 90.9 8.9 0.3 0.0 0.0 100.0 220 10-14 years 93.3 5.6 1.1 0.0 0.0 100.0 160 15-19 years 87.3 11.0 1.7 0.0 0.0 100.0 149 20-24 years 97.0 3.0 0.0 0.0 0.0 100.0 92 25+ years (90.7) (9.3) (0.0) (0.0) (0.0) 100.0 32 Married more than once 91.1 8.2 0.6 0.0 0.0 100.0 3,104 Residence Urban 54.2 19.5 6.0 0.1 20.2 100.0 2,900 Rural 50.1 15.8 7.7 0.0 26.4 100.0 5,140 Province Manicaland 46.2 16.5 8.9 0.0 28.5 100.0 1,072 Mashonaland Central 57.6 11.1 9.4 0.0 21.9 100.0 806 Mashonaland East 52.9 15.3 7.3 0.0 24.4 100.0 807 Mashonaland West 53.8 14.7 7.1 0.0 24.4 100.0 1,004 Matabeleland North 51.5 21.4 6.6 0.0 20.4 100.0 366 Matabeleland South 50.2 24.3 5.2 0.0 20.4 100.0 335 Midlands 52.6 16.2 5.9 0.0 25.2 100.0 986 Masvingo 46.7 16.2 6.7 0.0 30.4 100.0 843 Harare 52.9 21.0 6.0 0.1 20.1 100.0 1,412 Bulawayo 49.2 22.1 7.2 0.0 21.4 100.0 409 Education No education (44.2) (22.3) (14.0) (0.0) (19.5) 100.0 38 Primary 50.5 16.5 7.8 0.0 25.2 100.0 1,803 Secondary 49.5 17.2 7.0 0.0 26.4 100.0 5,349 More than secondary 67.2 18.4 6.0 0.2 8.3 100.0 849 Wealth quintile Lowest 58.5 13.0 6.9 0.0 21.7 100.0 1,212 Second 49.0 16.9 8.2 0.0 25.9 100.0 1,448 Middle 45.5 16.5 8.0 0.0 30.0 100.0 1,558 Fourth 53.0 19.0 6.7 0.0 21.3 100.0 1,852 Highest 52.5 18.7 6.2 0.1 22.5 100.0 1,970 Total 15-49 51.5 17.2 7.1 0.0 24.2 100.0 8,041 50-54 81.4 11.6 6.6 0.1 0.4 100.0 355 Total 15-54 52.8 16.9 7.1 0.0 23.2 100.0 8,396 Note: Figures in parentheses are based on 25-49 unweighted cases. 1 Excludes men who had sexual intercourse within the last 4 weeks 2 Excludes men who are not currently married Fertility • 75 FERTILITY 5 Key Findings  Total fertility rate: The current total fertility rate in Zimbabwe is 4.0 children per woman, a slight decline from 4.1 children per woman in the 2010-11 ZDHS (4.1 children).  Patterns of fertility: Fertility levels are markedly lower among urban women, highly educated women, and women in wealthy households compared with other women.  Birth intervals: The median birth interval in Zimbabwe has decreased in Zimbabwe from 47.1 months in 2010- 11 to 43.5 months in 2015.  Age at first birth: The median age at first birth among women age 25-49 is 20.3. n the 2015 ZDHS, data were collected on current and completed fertility. The birth histories of women interviewed in the survey contribute to a description of level and differentials in current fertility. The number of children that a woman bears depends on many factors, including the age she begins childbearing, how long she waits between births, and her fecundity. Postponing first births and extending the interval between births have played a role in reducing fertility levels in many countries. These factors also have positive health consequences. In contrast, short birth intervals (of less than 24 months) can lead to harmful outcomes for both newborns and their mothers, such as preterm birth, low birth weight, and death. Childbearing at a very young age is associated with an increased risk of complications during pregnancy and childbirth and higher rates of neonatal mortality. This chapter describes the current lev

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