Eligible females of reproductive age (15-49 years) living in selected households were contacted and consented for interviews. The final sample included 3,992 households (98.7% response rate), 3,663 females (97.4% response rate) and 154 SDPs (90.6% response rate). Data collection was conducted between August and November 2016.
The sample was powered to generate national-level estimates of all women modern contraceptive prevalence with less than 2% margin of error at the national level and less than 3% for the urban and rural estimates. For more details on our survey methodology including the survey tools, training, data processing and response rates, please scroll to the end of the table below.
The table below provides a summary of key family planning indicators and their breakdown by respondent background characteristics.
|All Women||Married Women|
|Contraceptive Prevalence Rate (CPR)||26.0||31.2|
|Modern Contraceptive Prevalence (mCPR)||21.7||25.9|
|Traditional Contraceptive Prevalence||4.3||5.3|
|Demand for Family Planning and Fertility Preferences:|
|Unmet need for family planning||23.5||32.1|
|Demand for family planning||49.5||63.3|
|Percent of all/married women with demand satisfied by modern contraception||43.8||40.9|
|Percent of recent births, by intention:|
|Wanted no more||14.5||12.7|
|Access, Equity, Quality and Choice|
|Percent of users who chose their current method by themselves or jointly with a partner/provider||92.0||93.6|
|Percent of users who paid for family planning services||67.0||67.6|
|Method Information Index:|
|Percent of current users who were informed about other methods||59.0||61.4|
|Percent of current users who were informed about side effects||55.2||57.7|
|Percent of current users who were told what to do if they experienced side effects||80.2||80.5|
|Percent of current users who would return and/or refer others to their provider||74.6||75.8|
|Percent of women receiving family planning information in the past 12 months||16.6||20.8|
The PMA2016 Ghana Round 5 Survey in Detail
Round 1 Sample Design
In each selected EA cluster, households and private health facilities were listed and mapped. Field supervisors randomly selected 42 households from the household listing using a random start method. A household roster was completed and all eligible women age 15-49 in selected households were approached and asked to provide informed consent (and assent if aged 15-17 years) to participate in the study.
For the SDP survey, up to three private SDPs, including pharmacies, within each sampled EA cluster boundary were randomly selected from the listing. In addition, three public health SDPs (lowest, second-lowest and third-lowest level) designated to serve each EA population were selected.
Round 5 Sample Design
PMA2016/Ghana-R5, the fifth round of data collection in Ghana, used a two-stage cluster design with urban-rural, major ecological zones as the strata. A new sample of 100 enumeration areas (EA) was drawn by the Ghana Statistical Service from its master sampling frame. The same EAs were used for founds 1-4 of data collection. For each new EA, 42 households were selected. A random start method was used to systematically select households within the EA.
All households, health service delivery points and key landmarks in each EA were listed and mapped by the REs to create a frame for the second stage of the sampling process. Field supervisors randomly selected 42 households and up to 3 private SDPs using a phone-based random number-generating application.
All occupants in selected households were enumerated and from this list, all eligible women age 15-49 were approached and asked to give informed consent to participate in the study.
The final sample included 3,992 households (98.7% response rate), 3,663 females (97.4% response rate) and 154 SDPs (90.6% response rate). Data collection was conducted between August and November 2016.
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 a new, random sample of three private SDPs is selected during each round. With the newly selected EAs this round, the sample of private SDPs during this fifth survey round was a new, random sample that had not been selected in previous rounds.
The household, female and service delivery point questionnaires 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 Kwame Nkrumah University of Science & Technology (KNUST) School of Public Health in collaboration with University of Development Studies (UDS), and fieldwork materials of the Ghana Demographic and Health Survey (GDHS).
All PMA2020 questionnaires are administered using Open Data Kit (ODK) software and Android smartphones. The PMA2016/Ghana-R5 questionnaires were in English on the phone. The interviews were conducted in the local language or in English in a few cases when the respondent was not comfortable with the local language. Female resident enumerators (data collectors) in each enumeration area (EA) administered the household and female questionnaires in the selected households and the SDP questionnaire for sampled private SDPs. Field supervisors administered the SDP questionnaire in public SDPs.
The household questionnaire gathers basic information about the household, such as ownership of livestock and durable goods, as well as characteristics of the dwelling unit, including wall, floor and roof materials, water sources, and sanitation facilities. This information is used to construct a wealth index.
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 used 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; and exposure to family planning messaging in the media.
The SDP questionnaire collected 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
Throughout the two-week training, REs and supervisors were evaluated based on their performance on several written and phone-based assessments, mock field exercises and class participation. The RE training sessions were conducted primarily in English, whereas small group sessions were all conducted in the local languages predominantly spoken in the selected EAs.
Supervisors received additional training prior to and after the RE training to further strengthen their supervisory skills, including instruction on conducting re-interviews, carrying out random spot checks, and engaging communities through local leaders.
Data Collection & ProcessingData collection was conducted between August and November 2016. Unlike traditional paper-and-pencil surveys, PMA2020 uses 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, the central staff at KNUST in Kumasi, Ghana and the data manager at Bill & Melinda Gates Institute at Johns Hopkins School of Public Health 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 November 2016.
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® version 14 software.
In the occupied households that provided an interview, a total of 3,860 eligible women aged 15 to 49 years were identified. Overall, 97.0% of the eligible women were available and consented to the interview. The female response rate was similar in the rural (96.8%) relative to the urban (98.0%) EAs. Only de facto females are included in the PMA analyses; the final completed de facto female sample size was 3,663 (unweighted).
During the survey, 171 SDPs were identified of which 156 SDPs completed the survey (91.2% response rate).
Weights were adjusted for non-response at the household and individual levels and applied to all household and individual estimates in this report. SDP estimates are not weighted.
|PMA2016/Ghana Round 5|
|Household response rate* (%)||98.4||99.0||98.6|
|Interviews with women age 15-49|
|Number of eligible women**||2,096||1,689||3,785|
|Number of eligible women interviewed||2,028||1,655||3,683|
|Eligible women response rate† (%)||96.8||97.3||97.3|
**Eligible women response rates include only women identified in completed household interviews
†Eligible women response rate = eligible women interviewed/eligible women
Sample Error Estimates
Kwame Nkrumah University of Science & Technology School of Medicine and The Bill & Melinda Gates Institute for Population and Reproductive Health at The Johns Hopkins Bloomberg School of Public Health. Performance Monitoring and Accountability 2020 (PMA2020) Survey Round 5, PMA2016/Ghana-R5 Snapshot of Indicators. 2016. Ghana and Baltimore, Maryland, USA.