Ghana - Demographic and Health Survey 2008

Start	End	Cycle
2008-09-08	2008-11-25	N/A

Face-to-face [f2f]
PRE-TEST

Pre-test training and practice fieldwork were conducted from 23 June to 12 July 2008 for 14 participants: seven women and seven men. Training entailed classroom discussions and practice focusing on the three questionnaires: Household Questionnaire, Women’s Questionnaire, and Men’s questionnaire. Two trainers assigned by the GSS conducted the training with support from ICF Macro. Guest speakers from the MOH were invited to make short presentations on family planning, child health, and nutrition programmes in place in Ghana. The participants, most of whom had been involved in the previous DHS survey, actively discussed the questionnaires and made suggestions for modifications. Based on these suggestions, all versions of the questionnaires (English, Akan, Ewe, and Ga) were updated for the pre-test fieldwork.

Pre-test fieldwork was done in several stages. Interviewers were divided into four teams and during the period July 7-11 all teams worked in three urban areas and two rural areas. A total of 68 women’s interviews, 66 men’s interviews, and 79 household interviews were completed. Interviews were conducted in English, Akan, Ewe, and Ga. By the end of the pre-test, a few errors in skip patterns and translation were identified and corrected.

TRAINING AND FIELDWORK

Fieldwork training began on 11 August 2008 at Winneba Sports College, located about 35 miles west of Accra. Three weeks of training on the GDHS were followed by three days of training on the Verbal Autopsy Questionnaire for deaths of children under five years. A total of 160 persons were trained on the GDHS at one training location. The first week of training also included 10 data entry personnel. Most of the trainees had prior experience as interviewers in previous GDHS surveys. The trainees were also recruited on the basis of language skills. Interviewer training was conducted mostly in English by senior staff from GSS, with technical input from ICF Macro. In addition, resource persons from other agencies made presentations on family planning, Ghana’s programme on Integrated Management of Childhood Illnesses (IMCI), nutrition and anthropometric measurements, and malaria. All participants were trained on interviewing techniques and the contents of the GDHS questionnaires. The training was conducted following the standard DHS training procedures, including class presentations, mock interviews, and written tests. All of the participants were trained on how to complete the Household Questionnaire, the Women’s Questionnaire and the Men’s Questionnaire, and how to collect anthropometric measurements. In addition to interviewer training, all female interviewers were trained in anaemia testing and in informed consent procedures. Training included four days of field practice, three days implementing the Household and Individual Questionnaires, and one day implementing the Verbal Autopsy Questionnaires. Trainees also practiced interviewing (mock interviews) in English as well as in the local languages. During training, it was emphasised that only female interviewers interview respondents for the Women’s Questionnaire and only male interviewers interview respondents for the Men’s Questionnaire. Trainees selected as supervisors and field editors were given an additional two days of training on how to supervise fieldwork and edit questionnaires, followed by three days of training on the Verbal Autopsy Questionnaire for deaths of children under five years.

At the end of the main training 23 teams were designated to carry out the fieldwork. Each team was composed of one supervisor, one editor, two female interviewers, two male interviewers, and a driver. A standby list of 22 people was kept for replacement in cases of interviewer attrition. Interviewers were selected on the basis of in-class participation, field practice, fluency in the Ghanaian languages, and an assessment test. The most experienced trainees, those who had participated in the pre-test and those who did extremely well during the training were selected to be supervisors and editors.

Senior staff from GSS coordinated and supervised the fieldwork activities. ICF Macro participated in field supervision of interviews, weight and height measurements, and blood sample collection. Data collection took place over a two and half-month period, from early September to late November 2008.

Three questionnaires were used for the 2008 GDHS: the Household Questionnaire, the Women’s Questionnaire and the Men’s Questionnaire. The content of these questionnaires was based on model questionnaires developed by the MEASURE DHS programme and the 2003 GDHS Questionnaires.

A questionnaire design workshop organised by GSS was held in Accra to obtain input from the Ministry of Health and other stakeholders on the design of the 2008 GDHS Questionnaires. Based on the questionnaires used for the 2003 GDHS, the workshop and several other informal meetings with various local and international organisations, the DHS model questionnaires were modified to reflect relevant issues in population, family planning, domestic violence, HIV/AIDS, malaria and other health issues in Ghana. These questionnaires were translated from English into three major local languages, namely Akan, Ga, and Ewe. The questionnaires were pre-tested in July 2008. The lessons learnt from the pre-test were used to finalise the survey instruments and logistical arrangements.

The Household Questionnaire was used to list all the usual members and visitors in the selected households. Some basic information was collected on the characteristics of each person listed, including age, sex, education, and relationship to the head of the household. The main purpose of the Household Questionnaire was to identify women and men who were eligible for the individual interview. The Household Questionnaire collected information on characteristics of the household’s dwelling unit, such as the source of water, type of toilet facilities, materials used for the floor and roof of the house, ownership of various durable goods, and ownership and use of mosquito nets. The Household Questionnaire was also used to record height and weight measurements, consent for, and the results of, haemoglobin measurements for women age 15-49 and children under five years. The haemoglobin testing procedure is described in detail in the next section.

The Household Questionnaire was also used to record all deaths of household members that occurred since January 2003. Based on this information, in each household that reported the death of a child under age five years since January 2005,3 field editors administered a Verbal Autopsy Questionnaire. Data on child mortality based on the verbal autopsy will be presented in a separate publication.

The Women’s Questionnaire was used to collect information from all women age 15-49 in half of selected households. These women were asked questions about themselves and their children born in the five years since 2003 on the following topics: education, residential history, media exposure, reproductive history, knowledge and use of family planning methods, fertility preferences, antenatal and delivery care, breastfeeding and infant and young child feeding practices, vaccinations and childhood illnesses, marriage and sexual activity, woman’s work and husband’s background characteristics, childhood mortality, awareness and behaviour about AIDS and other sexually transmitted infections (STIs), awareness of TB and other health issues, and domestic violence.

The Women’s Questionnaire included a series of questions to obtain information on women’s exposure to malaria during their most recent pregnancy in the five years preceding the survey and the treatment for malaria. In addition, women were asked if any of their children born in the five years preceding the survey had fever, whether these children were treated for malaria and the type of treatment they received.

The Men’s Questionnaire was administered to all men age 15-59 living in half of the selected households in the GDHS sample. The Men’s Questionnaire collected much of the same information found in the Women’s Questionnaire, but was shorter because it did not contain a reproductive history or questions on maternal and child health or nutrition.