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PMA2015/Kinshasa-R3 (EN)

SNAPSHOT OF INDICATORS

Summary of the sample design for PMA2015/Kinshasa, DRC:

PMA2015/Kinshasa Round 3 used a two-stage cluster design to draw a representative urban sample. A sample of 58 enumeration areas (EAs) was drawn (probability proportional to size) from the total of approximately 350 in Kinshasa. For each EA, 30 households were selected, and a random start method was used to systematically select households. All women of reproductive age (15-49) within each selected household were contacted and consented for interviews. Up to six health service delivery points (SDP) were selected in each EA.

The table below provides a summary of key family planning indicators and their breakdown 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.

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PMA2020 Standard
Family Planning Indicators

Round 3
All Women Women in Union
Utilization Indicators
Contraceptive Use (click to see background characteristics)    
Contraceptive Prevalence Rate (CPR) 34.3 42.3
Modern Contraceptive Prevalence (mCPR) 17.0 20.4
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) 937 512
Demand Indicators:
Unmet need for family planning (for spacing, limiting, and in total) 20.1 31.3
Total Contraceptive Demand (CPR & Unmet Need) 54.4 73.7
Percent of all/married women with demand satisfied by modern contraception 31.2 27.6
Percent of recent births unintended (wanted later/wanted no more)
Wanted Then 42.3 49.1
Wanted Later 45.2 40.5
Not At All 12.5 10.4
Indicators for Access, Equity, Quality & Choice:
Percent of users who chose their current method by themselves or jointly with a partner/provider 87.6 89.5
Percent of users who paid for family planning services 49.0 47.1
Method Information Index:    
Percent of recent/current users who were informed about other methods 36.2 48.1
Percent of recent/current users who were informed about side effects 37.7 45.5
Percent of recent/current users who were told what to do if they experienced side effects 78.0 83.7
Percent of recent/current users who would return and/or refer others to their provider 59.3 65.2
Percent of all/married women receiving family planning information in the past 12 months 6.9 7.7
Fertility Indicators:
Total Fertility Rate (TFR) 4.4  
Adolescent fertility rate (per 1,000 females age 15-19) 74.2  
Service Delivery Point Indicators:
Percentage of service delivery points that offer different contraceptive methods, by type of contraceptive method  
Percentage of service delivery points stocked out of modern contraceptives in the past 3 months, by method  
Number of family planning visits (new and continuing) in last month, by method  
Percent of service delivery points charging fees for family planning services  
Percent of service delivery points offering 3 or 5 methods of contraception  


The PMA2015/Kinshasa-R3 Survey in Detail

Sample Design

The PMA2020 survey collects annual data at the national level 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.

The first three rounds of data collection occurred exclusively in Kinshasa. For the third round of data collection (PMA2015/Kinshasa-R3), the project sampled 58 enumeration areas (EAs) to achieve a representative urban sample in Kinshasa. The EAs were selected systematically using probability proportional to size within urban/rural strata.

Before 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 30 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 (and assent if aged 15-17 years) 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.

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

Questionnaires

PMA2020 uses standardized questionnaires for households, females and SDPs 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.

Three questionnaires were used to collect data from the PMA2015/Kinshasa survey: the household questionnaire, the female questionnaire and the service delivery point (SDP) 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, University of Kinshasa's 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 installed on mobile phones (smartphones) using the Android operating system. In addition to French, key words from the PMA2015/Kinshasa questions appeared on the phones in the main local languages.

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 to construct a wealth quintile index, such as ownership of livestock and durable goods, characteristics of the dwelling unit, including wall, floor and roof materials, water sources, and sanitation facilities. Using PMA2020’s innovative mobile technology, the household questionnaire is linked with the female questionnaire, enabling analysis of female data by her household’s socioeconomic status.

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 household members 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.

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. It 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 time to collect water by women.

In each selected EA, field supervisors randomly select up to three private SDPs to be interviewed by the RE using the SDP questionnaire. All private SDPs were interviewed if there were less than three SDPs in an EA. Field supervisors administered the survey to the three public SDPs serving each EA.

The SDP 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.

Data Processing

The PMA2015/Kinshasa fieldwork training started with a training of five central staff and five field supervisors in April 2015. PMA2020 staff from the Bill & Melinda Gates Institute for Population and Reproductive Health led the training. Field supervisors, supported by the central team and PMA2020 team, then became the trainers for the subsequent resident enumerator (RE) training sessions that took place in April of 2015 in Kinshasa before the start of the third round of data collection. A total of 58 REs have been trained in Kinshasa.

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 was conducted between May and June 2015. Unlike traditional paper-and-pencil surveys, PMA2020 uses ODK Collect, an open-source software application, to collect data on mobile phones. All the questionnaires were programmed using this software and installed onto project smartphones. The ODK 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 REs and supervisors to collect and transfer survey data, via the General Packet Radio Service (GPRS) network, a central cloud server that aggregates data 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, the central staff in Kinshasa and data managers 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 combines 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.

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® version 14 software. A preliminary analysis in the first two months following each round of data collection allows tracking of key indicators in real time.

Response Rates

The table below shows response rates of household and female respondents for PMA2015/Kinshasa-Round 3 and the 2013-14 DRC Demographic and Health Survey (DHS). Of the 1,844 households selected 1,828 (99.1%) households were occupied at the time of the fieldwork. Among the 1,828 potential respondents, 1,768 consented to the household interview (96.7% response rate).

In the selected households 2,815 eligible women aged 15 to 49 years were identified and 2,683 of them were interviewed (response rate of 95.3%).

The PMA2015/Kinshasa-R3 response rates were lower than those observed in the DRC DHS 2013-14 for both households and eligible women. The relatively low response rate for PMA2020 could be related to the smaller sample size that is more sensitive to higher response rates.

  DHS 2013-14/DRC   PMA2015/Kinshasa-R3
Result Urban Rural Total   Urban Rural Total
Household interviews              
Households selected 18,224 -- 18,224   1,828 -- 1,828
Households occupied 18,190 -- 18,190   1,828 -- 1,828
Households interviewed 18,171 -- 18,171   1,768 -- 1,768
Household response rate* 99.1% -- 99.1%   96.7% -- 96.7%
             
Interviews with women ages 15 to 49
Number of eligible women** 23,748 -- 23,748   2,815 -- 2,815
Number of eligible women interviewed 23,020 -- 23,020   2,683 -- 2,683
Eligible women response rate 96.9% -- 96.9%   95.3% -- 95.3%
*Household response rate=number of household interviews/households occupied

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

†Eligible women response rate = eligible women interviewed/eligible women

Sources: Ministry of Planning and Monitoring Implementation of the Revolution of Modernity (MPSMRM), Ministry of Public Health (MSP) and ICF International, 2014. Democratic Republic of the Congo Demographic and Health Survey 2013-2014. Rockville, Maryland, USA : MPSMRM, MSP and ICF International; and the Performance Monitoring and Accountability 2020 (PMA2020) survey PMA2015/Kinshasa, DRC Round 3.

The tables in this report are weighted and adjusted for non-response households and women interviewed.

Sample Error Estimates

The following table shows sample errors for the PMA2020 indicators described above. For more information about PMA2020 indicators, including estimate type and base population, click here.

    Confidence Intervals
Variable Value [R] Standard Error (SE) R-2SE R+2SE
Age-specific fertility rate for women ages 15-19 0.074 0.007 0.058 0.089
All women ages 15-49
Currently using a modern method 0.170 0.008 0.154 0.186
Currently using a traditional method 0.173 0.008 0.158 0.190
Currently using any contraceptive method 0.343 0.010 0.323 0.364
Currently using injectables 0.021 0.003 0.016 0.028
Currently using male condoms 0.087 0.006 0.075 0.100
Currently using implants 0.024 0.003 0.018 0.031
Chose method by self or jointly in past 12 months 0.865 0.012 0.841 0.887
Paid fees for family planning services in past 12 months 0.348 0.017 0.316 0.381
Informed by provider about other methods 0.351 0.017 0.319 0.386
Informed by provider about side effects 0.361 0.023 0.318 0.407
Satisfied with provider: Would return and refer friend/relative to provider 0.512 0.026 0.461 0.563
Visited by health worker who talked about family planning in past 12 months 0.200 0.019 0.166 0.239
Women in union ages 15-49
Currently using a modern method 0.204 0.013 0.179 0.230
Currently using a traditional method 0.220 0.013 0.195 0.247
Currently using any contraceptive modern method 0.423 0.016 0.392 0.455
Currently using injectables 0.033 0.006 0.023 0.046
Currently using male condoms 0.074 0.009 0.059 0.093
Currently using implants 0.039 0.006 0.028 0.052
Chose method by self or jointly in past 12 months 0.888 0.014 0.856 0.913
Paid fees for family planning services in past 12 months 0.336 0.022 0.294 0.380
Informed by provider about other methods 0.418 0.023 0.373 0.464
Informed by provider about side effects 0.442 0.032 0.380 0.507
Satisfied with provider: Would return and refer friend/relative to provider 0.567 0.035 0.497 0.634
Visited by health worker who talked about family planning in past 12 months 0.281 0.029 0.229 0.341
*Current or recent users = women currently using contraception, or have used in the last 12 months.