PMA’s core survey collects data across selected geographies to track indicators of family planning demand, access, and use on an annual basis at both household and health facility levels to inform policies and programs. Its data collection design introduced an innovative approach by recruiting women from their communities who are trained to collect data using smartphone technology.
Building upon this innovative design, PMA has continued innovating in numerous ways with modifications to design and content that advance our understanding of contraceptive use dynamics, as well other areas of public health. Listed below are examples of these innovations with links to publications that provide more detail.
PMA has undertaken several data collection activities that capture COVID-19 information. PMA administered a COVID-19 survey with women via telephone who participated in a baseline survey of a new phase of longitudinal data collection in the Democratic Republic of Congo (DRC), Kenya, Burkina Faso and Nigeria (described here). In this survey we measure media exposure to COVID-19 messages, perceived risk of infection, behavior change, the economic impact, and the impact of COVID-19 on family planning-related outcomes. We then combined information from the baseline survey (e.g., sociodemographic information like marital status, household size and age structure, household economic status) with COVID-19 measures for further analysis. The PMA COVID-19 survey results have been provided to local governments to produce actionable information and guide the public health response to COVID-19.
Additionally, PMA has added questions on COVID-19 to the baseline survey instruments (both female and service delivery point surveys) in four countries that implemented the baseline survey in the summer/fall of 2020 (Niger, Cote d’Ivoire, Uganda, India). PMA also added questions on COVID-19 to the first follow up longitudinal survey that will take place one year after the baseline in the original four countries (DRC, Kenya, Burkina Faso, and Nigeria).
PMA Ethiopia is incorporating COVID-19 specific questions into all ongoing data collection activities to evaluate the impact of COVID-19 on maternal and newborn health service utilization, including fertility intentions, skilled birth attendance, postnatal care, and vaccination coverage.
Maternal and newborn health (MNH)
Maternal and newborn health (MNH) was evaluated through two survey projects in Ethiopia to generate new information on key maternal and newborn health indicators. The PMA Maternal and Newborn Health (MNH) Survey launched in 2016 in Southern Nations, Nationalities and Peoples’ region (SNNPR), and was designed to collect information on knowledge, practice and coverage of MNH services. Its successor, PMA-Ethiopia, launched in 2019, implementing cross-sectional, longitudinal, and facility-based surveys with a focus on measuring the comprehensiveness of RMNH care services and the barriers and facilitators to such care. Read more here.
Nutrition data was collected in Burkina Faso and Kenya over two rounds, covering interventions received during antenatal care visits, breastfeeding and complementary feeding practices, receipt of under-5 interventions, dietary practices among key sub-populations, and food security. Read more about nutrition findings in Burkina Faso and Kenya. A report on technical innovations was also produced that included questions about coverage of nutrition-specific interventions and diet that are not commonly measured in nationally representative household surveys.
Primary Health Care
Primary Health Care information was collected in Ghana and more recently in Uganda under a collaboration with Harvard University, Ariadne Labs. The Uganda survey revealed that most people report significant financial barriers to access care, that most lack continuous relationships with a care provider, while providers lack access to patient information. Read more here.
Water and Sanitation/Schistosomiasis
Water and Sanitation/Schistosomiasis monitoring was supported in Uganda over two rounds of nation-level data collection that revealed higher levels of prevalence than expected among all educational levels and wealth quintiles. Children ages 2-4 are the most at-risk age group for schistosomiasis. Read more here.
Menstrual Hygiene Management (MHM)
Menstrual Hygiene Management (MHM) modules were included in 12 PMA survey rounds and encompassed questions on the type of MHM materials used, location for changing materials and the safety, cleanliness and privacy of these locations. Read more MHM findings for Niger, Ethiopia, and Kongo Central DRC.
Quarterly facility surveys
Quarterly facility surveys provide information, via our recently concluded PMA Agile project, on contraceptive method availability, stock-outs, and volumes of clients served, shared with public and private program managers through rapidly posted dashboards, such as this one from Kenya. Data are also shared through briefs, such as these from Nigeria Ogun State, Kericho Kenya, and Kinshasa DRC.
Client-exit interviews (CEIs)
Client-exit interviews (CEIs) with phone follow-up, via our recently concluded PMA Agile project, assess quality of care, method use, four-month method continuation, discontinuation, new adoption, and switching and reasons for change in method status. These data are also provided quickly for use by data managers through dashboards, such as this one from Kenya. Results from these interviews are summarized in briefs, such as these from Nigeria Ogun State, Kericho Kenya, and Kinshasa DRC.
Women & girls’ empowerment
Women & girls’ empowerment is studied across three countries (Ethiopia, Uganda, Nigeria). The qualitative design led to the development of measurements, including contraceptive autonomy and efficacy, that are incorporated into PMA baseline and panel rounds. Read the executive summary of this study here and the complete study here.
Uganda panels, re-interviewing women from rounds 1 and 6, demonstrate the value of measuring background/demand information at baseline as leading indicators for contraception adoption/continuation -- and incorporating questions in areas that will be used in future surveys, including women’s agency and community norms.
Abortion modules introduced in three countries (Cote d’Ivoire, India, Nigeria) demonstrate the value of encompassing a “confidante” measure that better estimates true abortion rates. Components have also been incorporated to better understand factors underlying decisions and methods used and to better understand medical abortion availability. Briefs are available from Cote d’Ivoire, India, and Nigeria.
Youth Respondent Driven Sampling (YRDS)
Youth Respondent Driven Sampling (YRDS) approach was implemented in Abidjan and Nairobi with sexually-active, unmarried female and male youth to better capture contraceptive access, norms and “hidden” use dynamics, including coercion, in a population that is often under-and misrepresented with traditional survey designs. Read more about YRDS in Abidjan and Nairobi.
Exposure to Communication Interventions
Exposure to family planning communication interventions was evaluated in DRC from 2016-2018, through a collaboration with the Johns Hopkins Center for Communication Programs. PMA data are cited in CCP’s Family Planning and the ‘Voice of Youth’ in Democratic Republic of Congo.
Implant Use and Removal
Implant Use and Removal questions are added to survey rounds in countries with high implant use. The questions encompass background characteristics of implant users, service readiness to remove implants, counseling on removal, and implant removal experience among women who have sought but not received a removal. Read the results from Ethiopia here.