PMA2014/Kenya Round 1 Indicators

SNAPSHOT OF INDICATORS

PMA2020 Snapshot of Indicators (SOIs) are online tables that provide a summary of key family planning indicators and their breakdown by background characteristics (age, marital status, parity, education, residence, wealth, region). SOI tables include information on sample design, questionnaires, data processing, response rates and sample error estimates.

Summary of the sample design for PMA2014/Kenya-R1:

PMA2014/Kenya, the first round of data collection in Kenya, used a multi-stage cluster design with urban/rural regions as strata. The first stage of sampling was at the county level using probability proportional to size procedures to select 9 out of 47 counties: Nairobi, Kilifi, Nandi, Nyamira, Kiambu, Bungoma, Siaya, Kericho and Kitui. Within the nine selected counties, enumeration areas (EAs) were selected proportional to size with urban/rural stratification. The sample was powered to generate national estimates of all woman mCPR with less than 5% margin of error. The survey was also able to generate estimates on family planning services by including a random sample of up to three private service delivery points within each EA’s boundary. In addition, three public health service delivery points that serve the EA population were also selected—a dispensary, a health center and a referral hospital, either at the sub-county or county level. 

SOI Tables Detailed Indicator Report

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

For the first round of data collection (referred to as PMA2014/Kenya), the survey targeted a sample size of 120 enumeration areas to be selected from the Kenya National Bureau of Statistics’ master sampling frame and representative at the national and county levels for both urban and rural areas. Government interest in sub-national estimates made it possible to obtain county-level estimates in nine out of 47 counties. Thus at the first stage, the KNBS selected 9 counties using probability proportional to size: Nairobi, Kilifi, Nandi, Nyamira, Kiambu, Bungoma, Siaya, Kericho and Kitui. Thirteen EAs were sampled in each of 6 counties and 14 EAs were sampled in each of the remaining 3 counties (Kiambu, Bungoma and Nairobi). The primary sampling units for the survey were the EAs, created during the 2009 Kenya Population and Housing Census. The EAs were selected systematically with probability proportional to size with urban/rural stratification in the nine counties. The rationale was for PMA2020 estimates to be comparable to the most recent national survey and county-level estimates. The Kenya National Bureau of Statistics provided the selection probabilities for the PMA2020 sampled clusters for constructing weights.

Before data collection, all households, health service delivery points (SDPs) and key landmarks in each EA were listed and mapped by the REs to create a sampling frame for the second stage of the sampling process. The mapping and listing process took place between May and June 2014 with each EA taking an average of five days to be completed. Once listed, field supervisors systematically selected 42 households using a random number-generating mobile-phone application. All eligible women in selected households were approached and asked to provide informed consent to participate in the study.

A total of three private SDPs within each EA’s boundary were randomly selected from the EA listing. Three public health SDPs that serve the EA population were selected—a dispensary, health center and referral hospital, either at the sub-county or county level. Using this multistage sampling procedure and anticipated non-response rates, PMA2014/Kenya had a final sample size of 4,530 households, 3,807 females and 263 SDPs.

Weights were adjusted for non-response at the household and individual levels and applied to appropriate estimates in this report.

PMA2020 uses standardized questionnaires for households and SDPs to gather data 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. 

Household questionnaire, the female questionnaire and the service delivery point questionnaire. These questionnaires were based on model surveys designed by PMA2020 staff at the Bill & Melinda Gates Institute for Population and Reproductive Health, ICRHK, and fieldwork materials of the Kenya DHS.

All PMA2020 questionnaires are administered using Open Data Kit (ODK) software and Alcatel Android smartphones. The PMA2014/Kenya questionnaires were in English and could be switched into Swahili language on the phone. The questionnaires were translated using available translations from similar population surveys and experts in translation. The interviewers conducted the interviews in English or Swahili.

Female REs in each EA administered the household questionnaire and female questionnaire in selected households and administered the service delivery point questionnaire in private SDPs while the county field supervisors administered in the public SDPs questionnaire.

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 material, water sources, and sanitation facilities. This information is used to construct a wealth quintile index. Using PMA2020’s innovative mobile technology, the household questionnaire is linked with the female questionnaire, enabling disaggregation of the indicators generated by female data into household wealth quintiles.

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 WASH indicators, including regular sources and uses of water, sanitation facilities used and prevalence of open defecation by household members.

The female questionnaire is used to collect information from all women ages 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 collecting water on women.

The service delivery point questionnaire collects information about the provision and quality of reproductive health services and products, integration of health services, and water and sanitation within the health facility.

Training

The PMA2014/Kenya fieldwork trainings started on March 3, 2014. In preparation for data collection, project staff conducted a two-week training for the field supervisors and the rapid response team, who subsequently conducted three two-week training sessions for REs. A total of nine field supervisors and three members of the rapid response team were trained in this first training. The training took place between March 3 and March 13, 2014, in Mombasa, Kenya, and was led by PMA2020 staff from the Bill & Melinda Gates Institute for Population and Reproductive Health and ICRHK central staff who were trained in Kampala, Uganda. The field supervisors and members of the rapid response team then became the trainers for three subsequent RE trainings.

The RE training sessions began on March 24 and ended on May 1, 2014. The first RE training was held in Bungoma and included REs from Bungoma, Siaya and Nyamira counties. This training ended on April 3, 2014. The next training was held in Kericho with REs from Kericho, Nandi and Kiambu counties. This training occurred from April 7 to 17, 2014. The final RE training was conducted in Mombasa and included REs from Kilifi, Kitui and Nairobi counties. This training started on April 21 and ended on May 1, 2014.

All training participants received comprehensive instructions on how to complete the household, female and service delivery point questionnaires. In addition to PMA2020 survey training, all participants received training on contraceptive methods by Dr. Peter Gichangi, the principal investigator for PMA2020/Kenya who is also a practicing obstetrician/gynecologist.

Throughout the trainings, REs and supervisors were evaluated based on their performance on several written and phone-based assessments, mock field exercises and class participation. As all questionnaires were completed on project smartphones, the training also familiarized participants with Open Data Kit and smartphone use in general. All trainings included three days of field exercises, during which participants entered a mock EA to practice listing, mapping and conducting household, female and SDP interviews; recording all responses on their project phones; and submitting to a practice cloud server—a centralized data storage system. The RE trainings were conducted primarily in English, whereas some small group sessions were conducted in Swahili.

Supervisors received additional training on how to oversee fieldwork and complete household reinterviews used to carry out random spot checks in 10 percent of the households interviewed by REs.

Data Collection & Processing

Data collection was conducted between May 27 and July 23, 2014.

Unlike traditional paper-and-pencil surveys, PMA2020 collects data on smartphones using Open Data Kit (ODK) Collect, an open-source software application. All questionnaires were programmed using this software and installed onto project smartphones. The ODK questionnaire forms were programmed with automatic skip-patterns and built-in response constraints to prevent data entry errors.

The ODK Collect application enabled REs and supervisors to collect and transfer survey data, via the General Packet Radio Service (GPRS) network, to a central ODK Aggregate cloud server in real time. This instantaneous aggregation of data also allowed for real-time monitoring of data collection progress and concurrent data processing while PMA2020 was still active in the field and course corrections could be made. Throughout data collection, a local data manager and a central data manager in Baltimore 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. Data entry was therefore completed when the last interview form was uploaded at the end of data collection in July 2014.

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 12 Software. Final data analysis was conducted between August and November 2014 and the national dissemination workshop of preliminary results was held on October 7, 2014 in Nairobi, Kenya.

This table shows response rates at the household and female respondent levels  for PMA2014/Kenya and the 2008–2009 Kenya DHS. A total of 5,040 households were selected to be contacted. Of these, 4,859 households were successfully identified, and from these a total of 4,530 consented to the household interview. This translated to a total response rate of 93.2 percent. Comparing the urban and rural response rate for the household questionnaire, there was a higher response rate in the rural regions (96.4 percent) as compared to the urban areas (88.8 percent). This finding is consistent with the KDHS 2008– 2009.

In all households that completed the interview, all eligible women ages 15 to 49 were contacted for interviews. A total of 3,969 eligible women were identified from the completed household interviews. Out of the 3,969 eligible women, 3,807 were consented. The female interviews achieved a total response rate of 95.9 percent. The response rate among the eligible women was higher in the rural regions at 96.5% compared to the urban response rate of 95.1%. Comparing the total response rates, the female questionnaire had a higher response rate than the household questionnaire.

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

International Centre for Reproductive Health Kenya (ICRHK) 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 1, PMA2014/Kenya-R1 Snapshot of Indicators. 2014. Kenya and Baltimore, Maryland, USA.

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