SNAPSHOT OF INDICATORS
Summary of the sample design for PMA2016/Uganda-R4:
PMA2020 is designed to create sentinel sites for data collection both at the population-level and among service delivery points (SDPs). Enumeration areas (EAs) selected in Round 1 are generally used for data collection in Rounds 2-4. Households within the EA are randomly sampled during each round; however the EA is consistent across rounds. For clarity, the original Round 1 sample design summary is provided below.
PMA2020 uses a two-stage cluster design with residential area (urban and rural) and sub-regions as strata. The first stage of sampling was a selection of clusters within each sampling stratum using probability proportional to size procedures. The sample was designed to generate national estimates of all women modern contraceptive prevalence rate (mCPR) with less than 2% margin of error and urban/rural estimates at less than 3% margin of error.
Disaggregation by administrative unit was done at the region level (Central, Western, Eastern, and Northern) due to small sample sizes when disaggregated by sub-region.
Round 1 Sample Design
The PMA2020 survey collects data annually 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 (RE) model enables replication of the surveys twice a year for the first two years, and annually each year after that, to track progress.
Survey resources allowed targeting a sample size of 110 enumeration areas (EAs) and a final sample size of 4,840 households. A total of 110 EAs were sampled throughout all 10 sub-regions in Uganda selected by the Uganda Bureau of Statistics (UBOS) master sampling frame, which was representative at the national and sub-regional levels for both urban and rural areas. The primary sampling units for the survey were the EAs, created during the 2002 National Population and Housing Census. The EAs were selected systematically with probability proportional to size with urban/rural stratification in the 10 sub-regions. The rationale was for PMA2020 estimates to be comparable to the most recent national survey estimates. UBOS provided the selection probabilities for the PMA2020 sampled clusters for constructing weights.
In each selected EA, field supervisors randomly selected up to three private service delivery points (SDPs) to be interviewed by a resident enumerator using the SDP questionnaire. The field supervisors themselves administered the SDP questionnaires at an additional three public SDPs that serve each EA; the lowest, second-lowest, and third-lowest level public health SDPs designated to serve each EA.
Round 4 Sample Update
Data collection for Round 4 continued in the same EAs as all previous rounds. Mapping and listing occurred in Round 3. As Round 4 was approximately six months after the Round 3 mapping and listing activity, mapping and listing was not repeated in Round 4. Rather, the Round 3 household list was used for selection into the sample.
Field supervisors randomly selected 44 households from the original household listing. 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.
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 sample of the private SDPs is selected during each round.
PMA2020 uses standardized questionnaires to gather data about households and individual females 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 based on the Uganda Bureau of Statistics (UBOS) sub-regions, and translations were reviewed for appropriateness.
The household, the female and the service delivery point (SDP) questionnaires were based on model surveys designed by PMA2020 staff at the Bill & Melinda Gates Institute for Population and Reproductive Health, the Makerere University School of Public Health, and fieldwork materials of the Uganda Demographic and Health Survey (DHS).
All PMA2020 questionnaires are administered using Open Data Kit (ODK) software and Android smartphones. The PMA2016/Uganda-R4 questionnaires were in English and could be switched into eight local languages (Luganda, Ngakarimojong, Runyankole, Runyoro-Rutoro, Luo, Lugbara, Ateso, and Lusoga) on the phone. The questionnaires were translated using available translations from similar population surveys and experts in translation. The interviews were conducted in the local language, or English in a few cases when the respondent was not comfortable with the local language. Female resident enumerators in each enumeration area (EA) administered the household and female questionnaires in the selected households.
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 quintile 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; exposure to family planning messaging in the media; and the burden of collecting water on women.
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.
The PMA2016/Uganda-R4 fieldwork refresher training of all the continuing staff on the project – 15 field supervisors, three central staff and 110 resident enumerators (REs) – was held from March 21 to March 25, 2016. PMA2020 staff from the Bill & Melinda Gates Institute for Population and Reproductive Health of the Johns Hopkins Bloomberg School of Public Health led the training, with support from the Uganda Bureau of Statistics (UBOS) and Makerere University School of Public Health (MakSPH) project staff. The training was held in Kampala City, at the Global Grand Hotel on the outskirts of Makerere University.
As this was a refresher training for continuing staff, the training focused on a handful of newly added questions to the household, female and service delivery point (SDP) questionnaires and review of survey content and protocol.
Data Collection and Processing
Data collection was conducted between April and May 2016. 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 MakSPH in Kampala, Uganda and the data manager at the Gates Institute at Johns Hopkins 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 May.
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. The national dissemination workshop of preliminary results was held on August 24, 2016 at Serena Hotel, Kampala, Uganda.
This table shows response rates for household and female respondents by residence (rural/urban) for PMA2016/Uganda-R4. A total of 4,839 households were selected for the survey; 4,433 households were found to be occupied at the time of the fieldwork. Of the occupied households 4,191 (94.5%) consented to a household-level interview. The response rate for the household level was higher in the rural (96.2%) relative to the urban (90.1%) enumeration areas (EAs).
In the occupied households that provided an interview, a total of 3,992 eligible women aged 15 to 49 years were identified. Overall, 95.0% of the eligible women were available and consented to the interview. The female response rate was higher in the rural (96.7%) relative to the urban (90.3%) EAs. Only de facto females are included in the PMA analyses; the final completed de facto female sample size was 3,793 (unweighted).
The final service delivery point (SDP) sample include 378 interviews, of which 350 were completed for a response rate of 92.6%.
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.
Makerere University, School of Public Health at the College of Health Sciences 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 4, PMA2016/Uganda-R4 Snapshot of Indicators. 2016. Uganda and Baltimore, Maryland, USA.