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PMA2014/Uganda-R1 SOI

SNAPSHOT OF INDICATORS

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

PMA2014/Uganda, the first round of data collection in Uganda, used a two-­stage cluster design with urban/rural regions as strata. The first stage of sampling was at the sub-regional level using probability proportional to size procedures. Within the ten sub-regions, clusters were selected proportional to the urban/rural distribution. The sample was powered to generate national estimates of all woman mCPR with less than 5% margin of error. National, urban/rural, and sub-regional (10) estimates of mCPR are generated from PMA2014/Uganda. To read more details on our survey methodology including the survey tools, training, data processing and response rates, please scroll to the end of the below table.

The table below provides a summary of key family planning indicators and their breakdown by background characteristics. Estimates for all indicators are representative for ten sub-regions, but were collapsed by administrative region (Central, Western, Eastern, Northern) due to small sample sizes when disaggregated by background characteristics. To view the breakdown by background characteristics of the respondents (including education level, wealth quintile, region etc.), please click on the respective indicator link.

PMA2020 Standard
Family Planning Indicators

Round One
All Women Married Women
Utilization Indicators:
Contraceptive Use (click to see background characteristics)    
Contraceptive Prevalence Rate (CPR) 22.2 27.3
Modern Contraceptive Prevalence (mCPR) 21.0 25.7
Traditional Contraceptive Prevalence 1.2 1.6
Contraceptive Method Mix (by background characteristics)    
Contraceptive method mix (pie charts for married and all women)    
Number of modern contraceptive users (count of users in the sample) 816 655
Demand Indicators:
Unmet need for family planning (for spacing, limiting, and in total) 25.3 34.6
Total Contraceptive Demand (CPR & Unmet Need) 47.5 61.9
Percent of all/married women with demand satisfied by modern contraception 44.1 41.5
Percent of recent births unintended (wanted later/wanted no more)
Wanted Then 52.0 53.8
Wanted Later 29.4 29.1
Not At All 18.6 17.1
Indicators for Access, Equity, Quality & Choice :
Percent of users who chose their current method by themselves or jointly with a partner/provider 90.2 89.5
Percent of users who paid for family planning services 45.4 44.8
Method Information Index:    
Percent of recent/current users who were informed about other methods 59.5 61.2
Percent of recent/current users who were informed about side effects 50.9 52.7
Percent of recent/current users who were told what to do if they experienced side effects 85.2 88.6
Percent of recent/current users who would return and/or refer others to their provider 80.7 81.6
Percent of all/married women receiving family planning information in the past 12 months 16.9 19.2
Fertility Indicators:
Total Fertility Rate (TFR) 5.9  
Adolescent fertility rate (per 1,000 females age 15-19) 139  


The PMA2014/Uganda-R1 Survey in Detail

Sample design

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 (RE) 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 (PMA2014/Uganda), survey resources allowed targeting a sample size of 110 enumeration areas (EAs) to be selected from 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. A total of 110 EAs were sampled throughout all 10 sub-regions in Uganda. 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. The Uganda Bureau of Statistics provided the selection probabilities for the PMA2020 sampled clusters for constructing weights.

Before data collection, all households 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 the sampling process. The mapping and listing process and data collection took place between April 28 and June 20, 2014. Mapping and listing took an average of 5 days for each EA. Once listed, field supervisors systematically selected 44 households using a random number-generating mobile-phone application. All eligible women in selected households were approached and asked to provide informed consent (and assent if aged 15-17 years) to participate in the study.

Using this multistage sampling procedure and anticipated non-response rates, PMA2014/Uganda had a final sample size of 4,802 households and 3,975 females.

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

Questionnaires

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 seven local languages based on the UBOS sub-regions, and translations were reviewed for appropriateness.

The household and female 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 DHS.

All PMA2020 questionnaires are administered using Open Data Kit (ODK) software and Alcatel Android smartphones. The PMA2014/Uganda questionnaires were in English and could be switched into eight local languages (Luganda, Ngakarimojong, Runyankole, Runyoro-Rutooro, 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 REs in each 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. 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 water, sanitation, and hygiene (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.

Data processing

The PMA2014/Uganda fieldwork training started on January 14, 2014 with a training of 15 field supervisors and 3 central staff. PMA2020 staff led the training from the Bill & Melinda Gates Institute for Population and Reproductive Health, with support from UBOS and MakSPH project staff. These field supervisors then became the trainers for the two subsequent resident enumerator training sessions that took place between February 24-March 24 2014, in Kampala City, at the Global Grand Hotel on the outskirts of Makerere University. The first training had REs from 49 EAs from Kampala, Central 1, and Central, while REs from the remaining 61 EAs completed training a week later.

All participants received training in research ethics, comprehensive instruction on how to map and list households in 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 offered by a Professor of obstetrics and gynecology, and a senior nursing officer from the family planning clinic at Mulago National Referral Hospital.

Throughout the trainings, resident enumerators 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 and smartphone use in general. All trainings included three days of practical exercises, during which participants entered a practice enumeration area 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. Once the data were submitted to the cloud server, only the data manager and IT had access, and no data remained on the smartphones. The resident enumerator trainings were conducted primarily in English, whereas some small group sessions were conducted in all of the seven local languages.

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

Data collection was conducted between April 28 and June 2014. Unlike traditional paper-and-pencil surveys, PMA2020 uses Open Data Kit 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 Open Data Kit questionnaire forms are programmed with automatic skip-patterns and built-in response constraints to prevent data entry errors.

The Open Data Kit Collect application enabled resident enumerators and supervisors to collect and transfer survey data, via the General Packet Radio Service network, to a central Open Data Kit Aggregate cloud server in real time. This instantaneous aggregation of data also allowed for real-time monitoring of data collection progress, concurrent data processing, and course corrections while PMA2020 was still active in the field. Throughout data collection, central staff at MakSPH in Uganda and the 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; therefore, data entry was completed when the last interview form was uploaded at the end of data collection in March.

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. Data analysis for the national dissemination of preliminary findings was conducted between August and September 2014. The national dissemination workshop of preliminary results was held on October 8th, 2014 at Imperial Royale Hotel, Kampala, Uganda.

Response Rates

The table below shows response rates at household and female respondents by residence (rural/urban) for both UDHS 2011 and PMA2014/Uganda. A total of 4,802 households were selected for the PMA2014 survey; 4,576 (95.3%) households were found to be occupied at the time of the fieldwork. Ninety three percent (4,257) of the occupied households consented to a household-level interview. However, the response rate for the household level was higher in the rural (96.3%) relative to the urban (84.7%) EAs.

In the occupied households that provided an interview, a total of 3,975 eligible women aged 15 to 49 years were identified. Overall, 94.4% of the eligible women were available and consented to the interview. The female response rate was higher in the rural (95.4%) relative to the urban (91.7%) EAs.

The PMA2014/Uganda response rates for the eligible women were comparable with those observed in the UDHS2011. Although the response rate at household level in the rural area was comparable between PMA2014/Uganda and UDHS 2011, the PMA2014 response rate at the household level was lower than the UDHS2011 (84.7% vs 91.3%).

  UDHS 2011   PMA2014/Uganda
Result Urban Rural Total   Urban Rural Total
Household interviews              
Households selected 2,977 7,109 10,086   1,362 3,440 4,802
Households occupied 2,794 6,686 9,480   1,281 3,295 4,576
Households interviewed 2,551 6,482 9,033   1,085 3,172 4,257
Household response rate* 91.3% 96.9% 95.3%   84.7% 96.3% 93.0%
             
Interviews with women ages 15 to 49
Number of eligible women** 2,805 6,442 9,247   1,027 2,948 3,975
Number of eligible women interviewed 2,562 6,112 8,674   942 2,812 3,754
Eligible women response rate 91.3% 94.9% 93.8%   91.7% 95.4% 94.4%
*Household response rate = households completed/households occupied

**Eligible women response rates include only women identified in completed household interviews

†Eligible response rate = eligible women interviewed/eligible women

Sources: Uganda Bureau of Statistics (UBOS) and ICF International Inc. 2012. Uganda Demographic and Health Survey 2011. Kampala, Uganda: UBOS and Calverton, Maryland: ICF International Inc.; and the Performance Monitoring and Accountability 2020 (PMA2020) survey PMA2014/Uganda Round 1.

Sample Error Estimates

The following table shows sample errors for the PMA2020 indicators described above. More information about PMA2020 indicators, including estimate type and base population, can be viewed here.

    Confidence Interval
Variable Value[R] Standard Error R-2SE R+2SE
ASFR for ages 15 to 19 0.139 0.014 0.119 0.161
All women ages 15 to 49
Currently using a modern method 0.210 0.013 0.185 0.235
Currently using a traditional method 0.012 0.002 0.007 0.017
Currently using any contraceptive method 0.222 0.013 0.196 0.248
Currently using injectables 0.122 0.009 0.103 0.141
Currently using condoms 0.213 0.003 0.015 0.027
Currently using implants 0.026 0.004 0.018 0.034
Chose method by self or jointly in past 12 months 0.902 0.022 0.859 0.945
Paid fees for family planning services in past 12 months 0.454 0.031 0.393 0.515
Informed by provider about other methods 0.595 0.027 0.541 0.648
Informed by provider about side effects 0.509 0.026 0.457 0.561
Satisfied with provider: Would return and refer friend/relative to provider 0.806 0.021 0.765 0.848
Visited by health worker who talked about family planning in past 12 months 0.169 0.017 0.135 0.203
Married women ages 15 to 49
Currently using a modern method 0.257 0.016 0.225 0.288
Currently using a traditional method 0.016 0.004 0.008 0.023
Currently using any contraceptive method 0.273 0.017 0.240 0.306
Currently using injectables 0.153 0.012 0.128 0.178
Currently using condoms 0.020 0.004 0.013 0.027
Currently using implants 0.033 0.005 0.023 0.043
Chose method by self or jointly in past 12 months 0.895 0.023 0.848 0.941
Paid fees for family planning services in past 12 months 0.448 0.031 0.386 0.510
Informed by provider about other methods 0.612 0.030 0.553 0.671
Informed by provider about side effects 0.527 0.032 0.463 0.591
Satisfied with provider: Would return and refer friend/relative to provider 0.816 0.023 0.770 0.863
Visited by health worker who talked about family planning in past 12 months 0.192 0.021 0.151 0.232
*Current or recent users = women currently using contraception, or have used in the last 12 months.