PMA2018/Côte d'Ivoire Round 2 Indicators

Round 2 Sample Design

The PMA2020 survey collects annual data 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 of family planning indicators.

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 2,425 households (98.1% response rate), and 2,738 females (98.1% response rate), were interviewed, along with 135 SDPs. Data collection for this second round in Cote d’Ivoire was conducted between July and August 2018.

Weights were adjusted for non-response, and applied to all estimations at the household and individual level in the presented tables.

PMA2020 uses standardized questionnaires to gather data about households, individual females, and service delivery points 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 female questionnaires were translated into the local languages, and translations were reviewed for appropriateness.

Three questionnaires were used to collect data from the PMA2018/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

The PMA2018/Cote d’Ivoire fieldwork training started with a training of supervisors in the summer of 2018. PMA2020 staff from the Bill & Melinda Gates Institute for Population and Reproductive Health led the training. Field supervisors and central staff, supported by the PMA2020 Gates Institute team, then became the trainers for the subsequent resident enumerator (RE) trainings that took place in the summer of 2018, following a supervisor refresher training and ahead of the first round of data collection.

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 & Processing

Data collection was conducted between July and August 2018. 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.

This table shows response rates for household and female respondents by for PMA2018/Cote d’Ivoire. A total of 2,552 households were selected for the PMA2018 survey; 2,473 households were found to be occupied at the time of the fieldwork. Of the occupied households, 2,425 (98.1%) consented to a household-level interview. The response rate at the household level was lower in urban (97.3%) relative to the rural (99.2%) enumeration areas (EAs).

In the occupied households that provided an interview, a total of 2,790 eligible women aged 15 to 49 years were identified. Overall, 98.1% of the eligible women were available and consented to the interview. The female response rate was higher in the rural (98.8%) and the urban (97.7%) 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 139 facility interviews, of which 135 were completed for a response rate of 97.1%.

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.

To view the sample errors for the PMA2020 indicators described above, download the full SOI report here. For more information about PMA2020 indicators, including estimate type and base population, click here.