Ghana - Ghana Maternal Health Survey 2007

Start	End	Cycle
2007-10-01	2007-12-31	-

Face-to-face [f2f]
Ten days training was organized for field staff comprising of 19 supervisor trainees, 58 editor/interviewer trainees for women questionnaires (WQ) and 25 editor/interviewer trainees (nurses) for verbal autopsy questionnaires (VAQ).
The training took place between 16th and 27th September 2007, 15 teams were constituted for data collection. In all 15 teams were formed, 10 for WQ and 5 for VAQ of which a team is made up of a supervisor, an editor and four interviewers.
Interviews were conducted in both english and local languages (Akan, Ga & Ewe)
Effective field monitoring was planned and executed.
There was a pre-test of the questionnaire to fine-tune the questionnaires before the main survey.

The GMHS used four questionnaires: (1) a Phase I short household questionnaire administered at
the time of listing; (2) a Phase II verbal autopsy questionnaire administered in households identified at listing as
having experienced the death of a female household member age 12-49; (3) a Phase II long-form household
questionnaire administered in independently selected households chosen for the individual woman’s interview,
and (4) a Phase II questionnaire for individual women age 15-49 in the same phase two selected households. The
primary purpose of the short household questionnaire administered at the time of listing during Phase I was to
identify deaths to women age 12-49, for administering the verbal autopsy questionnaire on the causes of female
deaths, particularly maternal deaths and abortion-related deaths. Unique identifiers for households in phase one
and households in phase two were not maintained; therefore households cannot be matched across both phases
of the survey.
During the first phase of the survey, all households in each selected cluster were listed and administered
the short household questionnaire. This questionnaire was administered to identify households that experienced
the death of a female [regular] household member in the five years preceding the survey. The verbal autopsy
questionnaire (VAQ) was administered during the second phase of fieldwork in those households in which thefemale who died was age 12-49. The VAQ was designed to collect as much information as possible on the causes
of all female deaths, to inform the subsequent categorization of maternal deaths, and facilitate specific
identification of abortion-related deaths. During the second phase of fieldwork, a longer household
questionnaire was administered in the independent subsample of households, to identify eligible women age 15-
49 for the individual woman’s questionnaire and to obtain some background information on the socioeconomic
status of these women. The individual questionnaire included the maternal mortality module, which allows for
the calculation of direct estimates of pregnancy-related mortality rates and ratios based on the sibling history.
The individual questionnaire also gathered information on abortions and miscarriages, the utilization of
maternal health services and post-abortion care, women’s knowledge of the legality of abortion in Ghana, the
services they have utilized for abortion and if not, the reasons they have not been able to access professional
health care for abortions, the places that offer abortion-related care, the persons offering such services, and other
related questions.
During the design of these questionnaires, input was sought from a variety of organizations that are
expected to use the resulting data. After preparation of the questionnaires in English, they were translated into
three languages: Akan, Ga, and Ewe. Back translations into English were carried out by people other than the
initial translators to verify the accuracy of the translations in the three languages to be used. All problems arising
during the translations were resolved before the pretest.
The translated questionnaires were pretested to detect any problems in the translations or the flow of
the questionnaire, as well as to gauge the length of time required for interviews. GSS and GHS engaged 20
interviewers for approximately two weeks for the pretest (with proficiency in each of the local languages used in
the survey). All the pretest interviewers were trained for two weeks. The pretest interviewing took about one
week to complete, during which approximately 30 women were interviewed in each of the local languages. The
pretest results were used to modify the survey instruments as necessary. All changes in the questionnaire after the
pretest were agreed to by GSS, GHS, and Macro. GSS and GHS were responsible for producing a sufficient
number of the various questionnaires for the main fieldwork.
During the pretest and main survey training, experts in the areas of health and family planning were
identified by GSS and GHS to provide guidance in the presentation of topics in their fields, as they relate to the
GMHS questionnaires.
Other technical documents that were finalized include:
• Household listing manual, listing forms and cartographic materials;
• Interviewer’s manual;
• Supervisor’s manual;
• Interviewer and Supervisor’s assignment sheets.

Name	Abbreviation	Affiliation
Ghana Statistical Service	GSS	Autonomous
Ghana Health Service	GHS	MOH

Quality control was assured through supervision and monitoring of teams during fieldwork. Team
supervisors and editors were responsible for the performance of their teams. Work sessions were held frequently
within each team (on a daily basis during fieldwork), with the goal of reinforcing the training received and
correcting data collection errors. In addition to the internal supervision of each field team (by the team
supervisor and editor), the GSS and GHS Field Coordinators maintained close contact with the teams under
their responsibility. Several Macro staff also travelled to Ghana over the course of the fieldwork to observe the
progress and to monitor the quality of data collection. In addition, a set of field control tables (data quality
tables) were run at GSS every two weeks on the questionnaires that had been captured into the computers as of
that time. These tables were specially designed to detect systematic errors made by individual interviewers and
specific interviewing teams. Data collection errors detected during fieldwork were discussed with the appropriate
interviewers and interviewing teams to ensure that the problems did not persist.