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PMA2014/Kinshasa, DRC Round 2 SOI

SNAPSHOT OF INDICATORS

Summary of the sample design for PMA2014/Kinshasa, DRC-R2:

PMA2020 is designed to create sentinel sites for data collection both at the population-level and among service delivery points (SDPs). Enumeration areas (EAs) selected in Round 1 are generally used for data collection in Rounds 2-4. Households within the EA are randomly sampled during each round; however the EA is consistent across rounds. For clarity, the original Round 1 sample design summary is provided below.

PMA2020 uses a two-­stage cluster design with residential area (urban and rural) as strata. The first stage of sampling was a selection of clusters within each sampling stratum using probability proportional to size procedures. The sample was designed to generate national estimates of all women modern contraceptive prevalence rate (mCPR) with a less than 3% margin of error and urban/rural estimates at less than 5% margin of error.

The table below provides a summary of key family planning indicators at the national level and their breakdown by background characteristics. Disaggregation by urban/rural distinction was done when possible.

To view the breakdown by background characteristics of the respondents, please click on the respective indicator link. Distribution of respondents by background characteristics is available here. Distribution of SDPs by background characteristics is available here.

Additional detail on sample design, data collection and processing, response rates, and standard errors are available below the indicator tables.

PMA2020 Standard
Family Planning Indicators

Round 2
All Women Married Women
Utilization:
Contraceptive Use    
Contraceptive Prevalence Rate (CPR) 30.3 35.6
Modern Contraceptive Prevalence (mCPR) 16.0 20.3
Traditional Contraceptive Prevalence 14.4 15.4
Contraceptive Method Mix    
Contraceptive method mix (stacked bar charts for all/married women)    
Demand for Family Planning and Fertility Preferences:
Unmet need for family planning 22.4 33.3
Demand for family planning 52.7 69.0
Percent of all/married women with demand satisfied by modern contraception 30.3 29.4
Percent of recent births, by intention
Wanted then 41.2 46.6
Wanted later 48.3 43.7
Wanted no more 10.6 9.7
Access, Equity, Quality and Choice
Percent of users who chose their current method by themselves or jointly with a partner/provider 84.5 82.9
Percent of users who paid for family planning services 60.1 62.6
Method Information Index Components:    
Percent of current users who were informed about other methods 35.9 41.2
Percent of current users who were informed about side effects 36.7 43.3
Percent of current users who were told what to do if they experienced side effects 81.6 85.7
Percent of current users who would return and/or refer others to their provider 49.2 51.3
Percent of women receiving family planning information in the past 12 months 6.6 9.0
Service Environment:
Charging fees for family planning    
Contraceptive choice: Availability of modern contraception, by method    
Contraceptive stock-outs, by method    
Number of new and continuing family planning visits, by method    


The PMA2014/Kinshasa, DRC-R2 Survey in Detail

Sample Design

Round 1 Sample Design

The PMA2020 survey collects data annually to allow for the estimation of key indicators to monitor progress in family planning. The resident enumerator (RE) model enables replication of the surveys twice a year for the first two years, and annually each year after that, to track progress.

Survey resources allowed targeting a sample size of 53 enumeration areas (EAs) and an anticipated sample size of 1,855 households. During Round 1, a total of 53 EAs were sampled throughout all regions in Burkina Faso, creating representative estimates at both the national and urban/rural level. The primary sampling units for the survey were the EAs, created during the 2006 Population and Housing Census. The EAs were selected systematically with probability proportional to size within urban/rural strata. Institut Supérieur des Sciences de la Population (ISSP) drew the sample and provided the selection probabilities with support from L'Institut national de la statistique et de la démographie (INSD).

In each selected EA, field supervisors randomly selected up to three private service delivery points (SDPs) to be interviewed by a resident enumerator using the SDP questionnaire. The field supervisors themselves administered the SDP questionnaires at an additional three public SDPs that serve each EA; the lowest, second-lowest, and third-lowest level public health SDPs designated to serve each EA.

Round 2 Sample Update

Data collection for Round 2 continued in the same 83 EAs as Round 3. Mapping and listing occurred in Round 3. As Round 2 was approximately six months after the Round 3 mapping and listing activity, mapping and listing was not repeated in Round 2. Rather, the Round 3 household list was used for selection into the sample.

Field supervisors randomly selected 35 households from the Round 3 household listing. A household roster was completed and all eligible women age 15-49 in selected households were approached and asked to provide informed consent to participate in the study.

The majority of SDPs are repeated in each round, forming a panel survey. If an EA had more than three private SDPs identified during the listing process, then three private SDPs are randomly selected in each round.

Questionnaires

PMA2020 uses standardized questionnaires to gather data about households, individual females and health service delivery points (SDPs) that are comparable across program countries and consistent with existing national surveys. Prior to launching the survey in each country, local experts review and modify these questionnaires to ensure all questions are appropriate to each setting. All questionnaires were previously translated into French, the national language of Burkina Faso and translations were reviewed for appropriateness.

The household questionnaire, the female questionnaire and the SDP questionnaire were based on model surveys designed by PMA2020 staff at the Bill & Melinda Gates Institute for Population and Reproductive Health of the Johns Hopkins Bloomberg School of Public Health, the Institut Supérieur des Sciences de la Population (ISSP) of the University of Ouagadougou and fieldwork materials of the Burkina Faso Demographic and Health Survey (DHS).

All PMA2020 questionnaires are administered using Open Data Kit (ODK) software and Android smartphones. Given that PMA2020 questionnaires are typically administered in local languages (French not included), supervisors and REs worked in small teams during training prior to data collection to determine standard translations orally in all local languages spoken by the REs. The interviews were conducted in the local language, or French in a few cases when the respondent was not comfortable with the local language, the RE did not speak the maternal language of the respondent, or the respondent was more comfortable in French . Female resident enumerators in each EA administered the household and female questionnaires in the selected households.

The household questionnaire gathers basic information about the household, such as ownership of durable goods, as well as characteristics of the dwelling unit, including wall, floor, and roof material, water sources and sanitation facilities. This information is used to construct a wealth quintile.

The first section of the household questionnaire, the household roster, lists basic demographic information about all usual members of the household and visitors who stayed with the household the night before the interview. This roster is used to identify eligible respondents for the female questionnaire. In addition to the roster, the household questionnaire also gathers data that are used to measure key water, sanitation and hygiene (WASH) indicators, including regular sources and uses of WASH facilities and prevalence of open defecation by household members.

The female questionnaire is used to collect information from all women age 15 to 49 who were listed on the household roster at selected households. The female questionnaire gathers specific information on education; fertility and fertility preferences; family planning access, choice and use; quality of family planning services; exposure to family planning messaging in the media; and the burden of collection water on women.

The SDP questionnaire is used to collect information about the provision and quality of reproductive health services and products, integration of health services, and water and sanitation within the SDP.

Training, Data Collection & Processing

Training

The PMA2020/Kinshasa, DRC Round 2 fieldwork training started on November 8, 2016 with a five-day training for the new resident enumerators (REs) followed by a five-day refresher training of all continuing staff on the project -- eight field supervisors, three central staff and 83 REs. Institut Supérieur des Sciences de la Population (ISSP) PMA2020 project staff led both the new and refresher trainings, with in-person and remote support from the PMA2020 team from the Bill & Melinda Gates Institute for Population and Reproductive Health of the Johns Hopkins Bloomberg School of Public Health. The training was held in Ouagadougou, at ISSP, housed within the University of Ouagadougou.

As this was a refresher training for continuing staff, the training focused on a handful of newly added questions an annual questionnaire review process, as well as a new section developed in collaboration with FHI 360 exploring acceptability of new contraceptive devices among women of reproductive age in Burkina Faso. The training also focused on a review of the service delivery point (SDP) questionnaire and review of survey content and protocol.

Throughout the training, REs and supervisors were evaluated based on their performance on phone-based assessments, practical field exercises for the SDP survey and class participation. The training included a half-day of practical exercises, during which participants entered a practice enumeration area (EA) to conduct SDP interviews. The training was conducted primarily in French, but some small group sessions were conducted in all of the local languages spoken by the REs and their supervisors.

Data Collection & Processing

Data collection was conducted between November 2016 and January 2017. Unlike traditional paper-and-pencil surveys, PMA2020 uses Open Data Kit (ODK) Collect, an open-source software application, to collect data on mobile phones. All the questionnaires were programmed using this software and installed onto all project smartphones. The ODK questionnaire forms are programmed with automatic skip-patterns and built-in response constraints to reduce data entry errors.

The ODK application enabled REs and supervisors to collect and transfer survey data to a central ODK Aggregate cloud server. This instantaneous aggregation of data also allowed for concurrent data processing and course corrections while PMA2020 was still active in the field. Throughout data collection, central staff at ISSP in Ouagadougou, Burkina Faso and the data manager at the Gates Institute at Johns Hopkins in Baltimore, Maryland routinely monitored the incoming data and notified field staff of any potential errors, missing data or problems found with form submissions on the central server. The use of mobile phones combined data collection and data entry into one step; therefore, data entry was completed when the last interview form was uploaded at the end of data collection in February.

Once all data were on the server, data analysts cleaned and de-identified the data, applied survey weights, and prepared the final data set for analysis using Stata software. Data analysis for the national dissemination of preliminary findings was conducted between February and June 2017. There was a small dissemination event with the Technical Working Group for Reproductive Health (GT/SR) for Round 2 results at ISSP in Ougadougou, Burkina Faso in early June 2017.

Response Rates

The table below shows response rates for household and female respondents by residence (rural/urban) for PMA2014/Kinshasa Round 2. A total of 1,900 households were selected for the PMA2014 survey; 2,807 households were found to be occupied at the time of the fieldwork. 2,751 of the occupied households (98.0%) consented to a household-level interview. The response rate for the household level was higher in the rural (99.2%) relative to the urban (96.8%) enumeration areas (EAs).

In the occupied households that provided an interview, a total of 3,352 eligible women aged 15 to 49 years were identified. Overall, 95.6% of the eligible women were available and consented to the interview. The female response rate was higher in the rural (97.3%) relative to the urban (93.8%) EAs. Only de facto females are included in the analyses; the final completed de facto female sample size was 3,203 (unweighted).

    PMA2014/Kinshasa-R2
Result   Urban Rural Total
Household interviews              
Households selected   -- -- --
Households occupied   -- -- --
Households interviewed   1,900 -- 1,900
Household response rate* (%)   *** -- ***
             
Interviews with women age 15-49
Number of eligible women**   2,989 -- 2,989
Number of eligible women interviewed   2,860 -- 2,860
Eligible women response rate (%)   95.7 -- 95.7
*Household response rate = number of household interviews/households occupied

**Eligible women response rates include only women identified in completed household interviews

Eligible women response rate = eligible women interviewed/eligible women

***In DRC Rounds 1 and 2, only household forms that were completed were uploaded and saved. It is thus not possible to calculate % of households occupied or non-response rates for these two rounds.

Sample Error Estimates

The following table shows sample errors for the PMA2020 indicators described above. For more information about PMA2020 indicators, including estimate type and base population, click here.

   
Variable Value[R] Standard Error Confidence Interval
R-2SE R+2SE
All women age 15-49
Currently using a modern method 0.160 0.013 0.134 0.186
Currently using a traditional method 0.144 0.015 0.113 0.174
Currently using any contraceptive method 0.303 0.021 0.261 0.346
Currently using injectables 0.023 0.004 0.015 0.031
Currently using male condoms 0.068 0.007 0.054 0.082
Currently using implants 0.030 0.004 0.022 0.038
Chose method by self or jointly in past 12 months 0.870 0.028 0.815 0.926
Paid fees for family planning services in past 12 months 0.330 0.026 0.278 0.382
Informed by provider about other methods 0.280 0.029 0.223 0.337
Informed by provider about side effects 0.357 0.027 0.304 0.410
Satisfied with provider: Would return and refer friend/relative to provider 0.483 0.041 0.401 0.565
Visited by health worker who talked about family planning in past 12 months 0.066 0.010 0.045 0.086
Married women age 15 to 49
Currently using a modern method 0.203 0.018 0.167 0.238
Currently using a traditional method 0.154 0.019 0.116 0.192
Currently using any contraceptive method 0.356 0.025 0.306 0.407
Currently using injectables 0.037 0.006 0.024 0.049
Currently using condoms 0.063 0.009 0.045 0.080
Currently using implants 0.050 0.007 0.036 0.064
Chose method by self or jointly in past 12 months 0.860 0.027 0.806 0.913
Paid fees for family planning services in past 12 months 0.372 0.033 0.306 0.437
Informed by provider about other methods 0.324 0.031 0.262 0.385
Informed by provider about side effects 0.419 0.032 0.354 0.484
Satisfied with provider: Would return and refer friend/relative to provider 0.503 0.044 0.415 0.592
Visited by health worker who talked about family planning in past 12 months 0.090 0.015 0.061 0.120