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Chps) District-Level Evaluation COMMUNITY-BASED HEALTH PLANNING AND SERVICES (CHPS) DISTRICT-LEVEL EVALUATION FIELD MANUAL Ghana Health Service Policy, Planning, Monitoring and Evaluation Division Nkwanta Health Development Centre February, 2004 TABLE OF CONTENTS . General Instructions Page 3 Schedule Household Selection and Enumeration Non-response Introductions /Confidentiality Probes Recording Responses Editing End of Day Procedures Field Materials . Household Questionnaire Page 8 . Individual Questionnaire Page 14 . Starting Point/Household Identification Assignments Page 30 . Field Work Schedule Page 31 . Individual Identity Codes Page 35 . Historical Calendar Page 36 . Age/Year Born Conversion Table Page 44 *Content that will require revision and adaptation to local circumstances has been highlighted in bright blue, and in some cases, a reminder has been inserted in yellow. 2 General Instructions . Upon entering a community, always introduce yourself and your fellow team members to the village chief and elders. Briefly explain the purpose of the survey, and be sure to gain permission before commencing data collection. Whenever possible, interview people alone; because some of the questions may address sensitive topics, the presence of another person may be distracting and may bias results. Always ask questions as they appear on the questionnaire, based on the translations agreed upon during the interviewer training. If questions are not asked in the same way, results will not be comparable. Unless otherwise indicated on the questionnaire, do not read response choices aloud; responses should be spontaneous. As a general rule, the response choices listed on the questionnaire should not be read aloud except for those questions containing 2 or more columns of check boxes (labeled ‘YES/NO/DK); items having either coded (numbered) response choices or a single column of check boxes should be posed as open-ended questions and responses should not be read aloud or prompted by the interviewer. It is critical that you do not suggest the correct response by your tone of voice or by your reaction to the interviewee’s responses. Be sure to pay close attention to the skip patterns that are indicated throughout the questionnaire. Before categorizing a response as ‘OTHER’, always check to be sure that the response given does not fit into one of the already existing response choices. For example, a question might ask “What kind of work are you paid to do?” If the response is recorded as ‘OTHER’ and then specified as “grow cassava” in the space provided, this would be an incorrect classification, as this response actually falls under ‘AGRICULTURAL LABOUR/FARMING’. Be patient and flexible. Although it is important to stay on schedule, some respondents may have trouble hearing you or understanding some of the questions. If this happens, slow down and repeat the question. Schedule The interviewer training, including a pretest of the questionnaires, will take place on Wednesday, 2 October, Thursday, 3 October, and Friday, 4 October (replace with appropriate dates). The training, which will begin promptly at 8:30 a.m. each morning, will be held in the conference room in the DHMT administration building. The field work has been scheduled for the following 15 days: 3 Monday, October 7 Tuesday, October 8 Wednesday, October 9 Thursday, October 10 Friday, October 11 Monday, October 14 Tuesday, October 15 Wednesday, October 16 Thursday, October 24 Friday, October 25 Saturday, October 26 Monday, October 28 Tuesday, October 29 Thursday, October 31 Friday, November 1 For the field work phase, please report to the conference room each morning no later than 5:15 a.m. If there are any changes to the schedule, interviewers will be notified either by the CHPS Evaluation Coordinator or by their team supervisor. Each field team will visit one cluster per day. While each of the 3 team members will be responsible for interviewing 5 heads of household, as well as administering individual-level questionnaires to all women between 15 and 49 years of age residing in these households, the team supervisor will be responsible for providing critical support, thoroughly editing all completed questionnaires, and overseeing the household mapping and enumeration process. Upon completion of the data collection phase of the evaluation, each team member will therefore have conducted exactly 75 household questionnaires and a minimum of 75 individual questionnaires. Household Selection and Enumeration For each team, the 3 interviewers have been assigned to unique starting points within the cluster; these have been labeled ‘A’, ‘B’ and ‘C’ on the E.A. maps that will be distributed to all interviewers before going to the field each morning. Interviewers should proceed to their respective starting points, where they will then randomly select the direction in which the first household will be located by spinning a bottle or pen on even ground. Wherever the bottle or pen is pointing when it stops will determine the direction of the first household to be visited. Each interviewer will select a random number n from 1-10 (drawn from folded pieces of paper), and he/she will proceed along the directional line until reaching the nth household. If the structure selected is a compound containing multiple households, the interviewer should proceed by randomly selecting one of these households. *After administering questionnaires in the first household, interviewers should return to their respective starting points for the random selection of each subsequent household. Once back at the starting point, he/she should repeat the sampling procedures outlined above. The district’s effectiveness in monitoring and evaluating health outcomes and health-related knowledge and behavior over time will depend largely on its capacity to revisit the original sample of households longitudinally. It is therefore essential that interviewers remember to sketch the location of each of the households for which they have administered questionnaires. For clarification of this process, refer to the sample diagram below and to the photocopied example of a labeled E.A. map that can be found in Appendix 3 of the toolkit. Please be sure to clearly label households by number 4 and to indicate the number of households along the directional line from the starting point to each of the 5 households that are selected. In addition to being assigned a cluster starting point, each team member has been assigned a range of numbers with which he/she should always label selected households. For example, Interviewer X might be assigned starting point ‘B’/ households 6-10; for every E.A. visited, this interviewer would therefore begin at starting point ‘B’ and would be expected to clearly label households ‘6’, ‘7’, ‘8’, ‘9’, and ‘10’ on the map. Please refer to the starting point and household identification assignments, included on page 30 at the back of this manual. 5 A 10 9 1 4 *Aside from labeling all households by number and distance from their respective starting points, field team members are encouraged to include any additional information that will assist in relocating the selected households for subsequent evaluations. Such identifying information might include, for example, physical characteristics of the house, a district assembly household number, or close proximity to some known landmark such as the market, a church, a particular store, a maternity home, etc. These details may be noted by interviewers on the photocopied maps of each cluster, as well as in the space provided on the cover pages of the household and individual questionnaires. Protocol for Non-response If neither the head of household nor some other senior member of a selected household are available at the time of your initial visit, do your best to locate one of these individuals during the course of the day. This may require moving on to the next selected household or households, and then returning to the initial household later in the morning and/or afternoon to make a second and third attempt to contact such individuals. In light of logistical constraints, field teams will visit each of the E.A.s/clusters only once; unfortunately, it will not be feasible to travel to clusters on subsequent days for follow-up in the event of nonresponse. Therefore, following the third unsuccessful attempt to reach a potential respondent, please proceed to your assigned starting point in the cluster and randomly select an alternative household. For the purposes of this evaluation, a household must have a minimum of 1 woman between the ages of 15-49 if it is to be included in the sample. If the head of household or senior household member indicates that there are no women in this age range currently residing in the household (or if attempts to locate and interview at least one such woman during the course of the day are unsuccessful), another household must be randomly selected; in such cases, the household in question should not be counted as one of the 5 households visited within the cluster, and an alternative household should be randomly selected. 5 Introductions/Confidentiality Upon arrival in each E.A./cluster, field team members should formally introduce themselves to village chiefs and elders. This initial contact with the chief and/or elders should include a briefing on the goals and objectives of the CHPS evaluation, as well as the criteria for selecting respondents (15 randomly selected households, heads of these households, and all women in eligible age range living in these households, etc.). At the beginning of each interview, always introduce yourself and briefly explain the purpose of conducting the survey. In addition, it is critical that you reassure interviewees that all responses will be kept strictly confidential. In other words, the names of individual respondents will not be used in analysis or dissemination of results; information that is obtained during the interviews will be used only in a form that cannot be identified with the respondent.
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