PMA2015-16/Kongo Central Round 1 Indicators

Kongo Central Sample Design

The PMA2020 survey collects annual data to allow for the estimation of key indicators to monitor progress in family planning. The project uses local, female resident enumerators (RE) to collect data. The 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.

As in PMA2020/Kinshasa, PMA2020/Kongo Central is led by the University of Kinshasa’s School of Public Health, in collaboration with Tulane University School of Public Health and Tropical Medicine. The first three rounds of data collection occurred exclusively in Kinshasa. In 2015-16 (fourth round in Kinshasa, first round in Kongo central), the PMA2020 DRC team expanded to cover Kongo Central, the province adjacent to Kinshasa. The project sampled 52 enumeration areas (EAs) to achieve a representative sample in Kongo Central. The EAs were selected systematically using probability proportional to size.

For the first round of data collection in Kongo Central, the project drew a sample of 52 enumeration areas (EAs) were sampled using probability proportional to size. EAs were obtained from the National Statistical Institute. In each selected EA cluster, households and private health facilities were listed and mapped. Field supervisors randomly selected 33 households from the household listing using a random start method. A household roster was completed and all eligible women age 15-49 in selected households were approached and asked to provide informed consent to participate in the study.

For the SDP survey, up to three private SDPs, including pharmacies, within each sampled EA cluster boundary were randomly selected from the listing. In addition, three public health SDPs (lowest, second-lowest and third-lowest level) designated to serve each EA population were selected.

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, and translations were reviewed for appropriateness.

Three questionnaires were used to collect data: the household questionnaire, the female questionnaire and the service delivery point questionnaire. The household, female and service delivery point questionnaires were based on model surveys designed by PMA2020 staff at the Bill & Melinda Gates Institute for Population and Reproductive Health of the Johns Hopkins Bloomberg School of Public Health, in collaboration with Tulane University School of Public Health and Tropical Medicine, and fieldwork materials of the DRC Demographic and Health Survey (DHS).

All PMA2020 questionnaires are administered using Open Data Kit (ODK) software and Android smartphones in French. 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 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; 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 PMA2015-16/Kongo Central fieldwork training started with a training of supervisors in the fall of 2015. Central staff from the Kinshasa School of Public Health led this training, which was followed by an RE training in Matadi, Kongo Central, that was further supported by PMA2020 staff from the Bill & Melinda Gates Institute for Population and Reproductive Health in collaboration with Tulane University School of Public Health and Tropical Medicine.

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-based server. The RE trainings were conducted primarily in French, with discussions in small groups to standardize translations orally in local languages.

Supervisors received additional training prior to and after the RE training to further strengthen their supervisory skills, including instruction on conducting re-interviews, carrying out random spot checks, and engaging communities through local leaders.

Data Collection & Processing

Data collection was conducted between November 2015 and January 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 the Kinshasa School of Public Health and the data managers at Tulane University School of Public Health and Tropical Medicine and the Gates Institute 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 January 2016.

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.

This table shows response rates for household and female respondents by for PMA2015-16/Kongo Central. A total of 1,720 households were selected for the survey; 1,688 households were found to be occupied at the time of the fieldwork. Of the occupied households, 1,625 (96.3%) consented to and completed a household-level interview.

In the occupied households that provided an interview, a total of 1,634 eligible women aged 15 to 49 years were identified. Overall, 95.8% of the eligible women were available and consented to and completed the interview. Only de facto females are included in the PMA analyses; the final completed de facto female sample size was 1,565 (unweighted).

The final SDP sample included 76 facility interviews.

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.