All eligible women, aged 15 to 49, in the sampled households were contacted and consented for interviews. The SDP sample included three public SDPs that serve an EA and up to three private SDPs within the EA. Data collection occurred from September-October 2017. The final database included 2,402 households (96.0% response rate), 2,738 de facto women (97.1% response rate) and 141 SDPs (95.9% response rate), of which 106 are public. The sample was powered to generate Cote d’Ivoire specific estimates of all women mCPR with a 3% margin of error.
The table below provides a summary of key family planning indicators and their breakdown by background characteristics.
|All Women||Married Women|
|Contraceptive Prevalence Rate (CPR)||26.0||23.5|
|Modern Contraceptive Prevalence (mCPR)||21.8||18.9|
|Traditional Contraceptive Prevalence||4.1||4.6|
|Demand for Family Planning and Fertility Preferences:|
|Unmet need for family planning||25.1||32.7|
|Demand for family planning||51.1||56.2|
|Percent of all/married women with demand satisfied by modern contraception||42.7||33.7|
|Percent of recent births, by intention:|
|Wanted no more||5.1||4.3|
|Access, Equity, Quality and Choice|
|Percent of users who chose their current method by themselves or jointly with a partner/provider||82.7||84.1|
|Percent of users who paid for family planning services||75.8||83.6|
|Method Information Index:|
|Percent of current users who were informed about other methods||42.9||51.9|
|Percent of current users who were informed about side effects||34.3||43.6|
|Percent of current users who were told what to do if they experienced side effects||84.8||88.5|
|Percent of current users who would return and/or refer others to their provider||76.5||76.4|
|Percent of women receiving family planning information in the past 12 months||4.6||5.1|
The PMA2017 Côte d’Ivoire Round 1 Survey in Detail
Round 1 Sample Design
PMA2020/Côte d’Ivoire is led by the Institut National de la Statistique de la Côte d’Ivoire (INS-Côte d’Ivoire) and the Direction de Coordination du Programme National de Santé de la Mère et de l’Enfant (DC-PNSME) within the Ministry of Health. The project sampled 73 enumeration areas (EAs) using a two-stage cluster design with urban-rural strata to achieve a representative sample in Cote d’Ivoire. The EAs were selected systematically using probability proportional to size.
Before the first round of data collection, all households, private service delivery points (SDPs) and key landmarks in each EA were listed and mapped by trained resident enumerators (REs) to create a sampling frame for the second stage of sampling for households and private SDPs. The mapping and listing process took place the first week of data collection in each EA with the help of cartographers and supervisors. Once households had been listed, field supervisors systematically selected 35 households per EA using a random number-generating mobile-phone application. All members of the selected households were enumerated by the interviewers when completing household questionnaires, and from this household roster, all eligible women (aged 15-49) were approached and asked to provide informed consent to participate in the study.
Up to three private SDPs located within each EA were selected from the list of SDPs available in the EA. In addition, three public SDPs, primary health centers, secondary medical centers with or without a surgery units and tertiary regional or national/teaching hospitals serving the selected EA populations were selected.
A total of 2,402 households (96.0% response rate), and 2,785 females (96.5% response rate), were interviewed, along with 141 SDPs. Data collection for this first round in Cote d’Ivoire was conducted between September and October 2017.
Weights were adjusted for non-response, and applied to all estimations at the household and individual level in the presented tables.
Three questionnaires were used to collect data from the PMA2017/Cote d’Ivoire survey: the household questionnaire, the female questionnaire and the service delivery point questionnaire. These questionnaires are based on model surveys designed by PMA2020 staff at the Bill & Melinda Gates Institute for Population and Reproductive Health in Baltimore, in collaboration with the Institut National de la Statistique de la Côte d’Ivoire (INS-Côte d’Ivoire) and the Direction de Coordination du Programme National de Santé de la Mère et de l’Enfant (DC-PNSME) within the Ministry of Health.
All PMA2020 questionnaires are administered using Open Data Kit (ODK) software installed on mobile phones (smartphones) using the Android operating system in French. REs administered the questionnaires using standardized oral transltions of the preferred local language of the respondent if the respondent was not able to complete the interview in French or was more comfortable in a mutually-spoken local language between RE and respondent. REs in each EA administered the household and female questionnaires in the selected households and the private SDP questionnaires. Field supervisors administered questionnaires at 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
All participants received training in research ethics, comprehensive instruction on how to map and list households in enumeration areas (EAs), and instruction on how to complete the household and female questionnaires using appropriate and ethical interview skills. In addition to PMA2020 survey training, all participants received training on contraceptive methods by a physician specializing in reproductive health.
Throughout the trainings, REs and supervisors were evaluated based on their performance on several written and phone-based assessments, practical field exercises and class participation. As all questionnaires were completed on project smartphones, the training also familiarized participants with Open Data Kit (ODK) and smartphone use in general. All trainings included three days of practical exercises, during which participants entered a practice EA to conduct mapping and listing, and household, female and SDP interviews. All responses were captured on project smartphones, and submitted to a practice cloud server—a centralized data storage system. The RE trainings were conducted primarily in French, with discussions about translation to local languages.
Supervisors received training on procedures for supervision of field work including instruction on conducting re-interviews, carrying out random spot checks in 10% of the households surveyed by the REs.
Data Collection & ProcessingData collection was conducted between September and October 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 the central staff at the Institut National de la Statistique de la Côte d’Ivoire (INS-Côte d’Ivoire) 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 October.
Once all data were on the server, data analysts cleaned and de-identified the data, applied survey weights, and prepared the final dataset for analysis using Stata.
In the occupied households that provided an interview, a total of 2,885 eligible women aged 15 to 49 years were identified. Overall, 96.5% of the eligible women were available and consented to the interview. The female response rate was higher in the rural (99.0%) and the urban (95.6%) EAs. Only de facto females are included in the PMA analyses; the final completed de facto female sample size was 2,738 (unweighted).
The final SDP sample included 147 facility interviews, of which 141 were completed for a response rate of 95.9%.
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.
|PMA2017/Côte d’Ivoire Round 1|
|Household response rate* (%)||93.9||99.3||96.0|
|Interviews with women age 15-49|
|Number of eligible women**||1,799||1,022||2,821|
|Number of eligible women interviewed||1,723||1,015||2,738|
|Eligible women response rate† (%)||95.8||99.3||97.1|
**Eligible women response rates include only women identified in completed household interviews
†Eligible women response rate = eligible women interviewed/eligible women