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.

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

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.

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. You may wish to read aloud the introductory remarks which are included at the beginning each questionnaire.

Probes Remember that probes should be used only to clarify a particular question; they are not intended to suggest responses. If an interviewee seems to be having difficulty responding to a particular question, you may restate the question using simpler language. Be careful, however, not to insert any of the responses in such a probe; in other words, in an effort to clarify a question about knowledge of family planning, be very careful not to ask, “You know, have you heard of Norplant or IUDs?” This kind of probe will introduce significant bias into the survey. *Unless otherwise indicated on the questionnaire, do not read the choices aloud or ask the respondent about a particular response that he/she has yet to mention. To avoid bias, you may use probes such as, “Anything else?” or “Can you think of any other ways to prevent pregnancy?”

It is important to be tactful and to be aware of your tone of voice so that you will not come across as challenging the respondent. When using probes, do your best to let the respondent know that his/her opinions are extremely valuable, and that you therefore want to be sure that you understand and include them all. In a few instances, probes have already been directly inserted into the questionnaire; these should always be read aloud.

Recording Responses It is very important that all responses be recorded clearly in the spaces provided. When responses are coded by number (example: YES……1/ NO…….2) on the questionnaire form, neatly circle the number that best corresponds to the interviewee’s response. Be sure that the circle is clear and complete (). In the case of responses coded by number, only one number should be circled. Alternatively, when boxes are provided, mark a check () in the box/boxes as appropriate. Please pay careful attention to the specific instructions accompanying each question. In general, questions providing a single column of boxes require spontaneous responses; in other words, response choices should not be read aloud. In such cases, please check only those boxes corresponding to responses which are spontaneously mentioned by the interviewee. Other questions may require you to circle either ‘1’ (YES), ‘2’(NO), or ‘3’ (DON’T KNOW) for each item. Unless otherwise indicated, questions coded with ‘YES/NO/DK’ columns require that you read all response choices aloud, circling the number corresponding to the interviewee’s response for each item. Finally, when a response of ‘OTHER’ is indicated, please be sure to specify the

6 response stated in the space provided. In this case, always remember to double check that your classification is correct; an interviewee’s response should only be categorized as ‘OTHER’ if it does not fit into any of the already listed response choices.

Editing Interviewers should submit all completed household and individual questionnaires to their respective field team supervisors for editing. Team members should agree upon a central meeting place in each cluster where they can reconvene at mid-day; this will be an ideal time to discuss any problems encountered during the course of the morning, as well as to submit the questionnaires already administered. Every evening, prior to leaving the field, supervisors should complete editing of all questionnaires to ensure that recording errors, unclear or confusing responses, and omissions are corrected whenever possible. It is critical that editing take place before the team leaves the E.A.; this will not only increase the likelihood that interviewers will be able to recall missing or ambiguous information, but it will also make it possible for interviewers to re-visit respondents for clarification of particular items if necessary. Finally, interviewers must submit labeled cluster maps at the end of each day for thorough review by their team supervisor. Before leaving the field each day, each supervisor will be required to complete, sign and date a copy of the Supervisor’s End- of-Day Checklist (which should be copied from page 26 of the toolkit and distributed prior to data collection each morning).

End of Day Procedures Upon returning to DHMT headquarters each evening, supervisors should submit all completed questionnaires to the CHPS Evaluation Coordinator. The Coordinator will be responsible for stamping the upper right hand corner of all cover pages with a unique ‘Form ID Number’; each evening, the Coordinator will record the last number stamped into a log book. After being stamped, questionnaires should be immediately sorted into the appropriate box for safe storage until data entry (these boxes should be clearly labeled “Completed Household Questionnaires” and “Completed Individual Questionnaires” and “Refused”). In addition to the questionnaires, supervisors must submit 3 labeled cluster maps and a signed and dated copy of the Supervisor’s End-of-Day Checklist to the CHPS Evaluation Coordinator. At this time, supervisors should also report any problems or concerns to the CHPS Evaluation Coordinator. *For each team, the CHPS Evaluation Coordinator will then transfer the household location sketches and identifying information provided by each of the 3 interviewers onto one common cluster map; in subsequent years, survey teams will use these labeled E.A. maps to guide them in revisiting the 15 selected households.

Field Materials Before leaving DHMT headquarters, team members should be sure to pack the following materials:

Supervisors: . 3 household questionnaires and 6 individual questionnaires . 1 pencil sharpener per team . gifts for 10 interviewees

3 Team Members: . 7 household questionnaires and 15 individual questionnaires . gifts for 18 interviewees

All: . 2 sharpened pencils . 1 eraser . clipboard . plastic folder with snap closure . small plastic bag containing numbers 1-10 for random selection of households . large plastic bag to protect materials from dust and rain . snack food (recommended)

Please note that supervisors and team members are being asked to carry several additional questionnaire forms in the event of recording errors or damage to the materials, etc. Each morning, the CHPS Evaluation Coordinator will replenish both the questionnaires and gifts based on the exact number of completed questionnaires that were submitted by each team on the previous day. This system will help to ensure both that team members are not overburdened with unnecessary materials and that paper wastage is kept to a minimum.

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Household Questionnaire

***Before completing this questionnaire, ask the head of household (or a senior member of household): “Are there any women between the ages of 15-49 currently living in this household?” If yes, proceed with interview. If no, thank respondent and randomly select another household using the methodology described in detail above. In order to be included in the sample, a household must have a minimum of 1 woman between the ages of 15-49.

Form ID Number Each evening, the Coordinator will stamp the upper right hand corner of all cover pages with a unique ‘Form ID Number’; interviewers are not responsible for this information.

Household Identification Carefully record the 10-digit E.A. number, as well as the corresponding E.A. base and locality name, which can be found in the table on pages 31-34 at the back of this manual.

Household Number Record the household number as you have labeled it on the map of the E.A. If, for example, you have identified the household in question as ‘8’, record ‘08’ in the boxes provided. Please be sure that you have sketched the location of each household for which you administer a questionnaire (indicating the number of households along the directional line from the starting point.) If you learn that there are no women living in the household between the ages of 15 and 49 years, discard the questionnaire and randomly select an alternate household ‘08’. For a list of starting point and household identification assignments, please refer to page 30 at the back of this manual.

Additional House Number/Identifying Information 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 should be noted by interviewers both in the space provided on the cover page of the household questionnaire and on the photocopied maps of each cluster.

Name of Household Head Upon arrival, ask to speak with the head of household. In the event that this individual is not at home or is unavailable, this information can be obtained from another senior member of the household. In the space provided, be sure to record the name of the head of household (regardless of whether or not she/he is present).

Name of Respondent If the respondent is the head of household, enter this individual’s name again in the space provided. The head of household should be the first name listed in the household composition table on the following page; the code corresponding to head of household is therefore ‘01’ and should be entered in the appropriate boxes. If, however, the head of household is unavailable, another senior member of the household may be selected for the interview. In this case, record his/her full name in the blank following ‘Name of Respondent’ and be sure to enter the corresponding code for this individual (refer to line numbers from the household composition table in Section 1).

Name of Interviewer Enter your name and corresponding code on the questionnaire at the beginning of each interview that you conduct; each interviewer will be pre-assigned a 2-digit identity code. Please refer to the list of identity codes included on page 36 of this manual.

Interview Date/Number of Calls/Result Be sure to enter the appropriate date in the boxes provided. As indicated on the questionnaire, the interview date should be entered as DAY/MONTH/YEAR. For single digit dates or months, enter ‘0’, followed by the appropriate digit. For example, July 6, 2002 would be entered as follows: 06/07/02. In the box labeled ‘Number of Interviewer Calls’, record the total number of attempts that were required to interview this respondent. In addition, enter the code corresponding to the result of each interviewer call. *If ‘refused/4’, be sure to write ‘REFUSED’ in large print at the top of the cover page of that questionnaire.

Edited By The supervisor for each team should edit all questionnaires at the end of each day to assert that responses have been recorded properly and that all sections have been completed. If this is not possible, interview team members may exchange questionnaires with one another. In the event that a blank, incomplete, or unclear response is noted by the editor, he/she should consult the interviewer. It is critical that editing of all questionnaires take place before leaving the field; this will increase the likelihood that errors will be corrected and that interviewers will be able to recall missing information. When editing a questionnaire, please be sure to record your name and corresponding 2-digit identity code in the boxes provided.

Keyed By The data will be entered into the database by one of the data entry personnel. Ideally, this will be limited to three individuals, so as to ensure consistency. Each member of the data entry team will be assigned a 2-digit identity code and should be instructed to record both his/her full name and code in the spaces provided. Please refer to the list of identity codes included on page 36 of this manual.

. SECTION 1: HOUSEHOLD COMPOSITION Be sure to introduce yourself to the respondent and to briefly explain the purpose of the survey. You may wish to read aloud the introduction which is included at the beginning of this section of the questionnaire.

101 List the names of all individuals who are usual members of this household. Begin with the head of household. Temporary visitors should be excluded. However, all non-relatives who reside permanently in the household should be included. ‘Usual members’ are defined as those individuals for whom the head of household is ultimately responsible (those who usually eat meals and sleep in the household) and who have lived in the household for at least 9 months of the past year. If there are more than 10 usual members of the household, please tick the box at the bottom of page 2, indicating that the continuation sheet has been used. After completing a listing of the names of all usual members, begin with the first individual (line 01/column101 of the table) and proceed horizontally across the table before moving on to line 02. In other words, you will repeat the series of 3 questions (Questions 102-104) for each individual listed in column 101. Finally, remember to record the line number of the respondent for this interview (usually the head of household) in the boxes provided on the cover page of the questionnaire.

102 For each individual listed in column 101, record the corresponding code in the space provided on the appropriate line.

103 For each individual listed in column 101, record the corresponding code in the space provided on the appropriate line.

104 For each individual listed in column 101, record his/her age in completed years. Do not use decimals or fractions, and always round down to the nearest whole number; for example, if the interviewee reports that his son is 8 and a half years-old, this should be recorded as ‘08’. For infants younger than one year of age, please enter ‘00’ on the appropriate line; for example, in the case of a 9 month-old child, ‘00’ should be recorded on the corresponding line to indicate age in completed years. The accuracy with which this question is answered and recorded is critical, as it will determine the eligibility of household members for the individual interviews. *The Calendar of Historical Events and the Age/Year Born Conversion Table found on pages 37-45 of this manual can be used as a guide in verifying the age of each individual.

Eligibility In this column, circle all line numbers corresponding to women who fall between the ages of 15- 49 years. *Be sure to include females who are currently 15 and 49 years old.

10 105 The total number of usual members in the household can be tallied by adding up the number of individuals (both male and female) listed in column 101, labeled ‘NAME OF USUAL MEMBER’. If the continuation sheet is used, be sure to include these individuals in your total number tally. *Please remember to make a tick mark if you have used the continuation sheet, as this will be critical during data entry. In the 2 boxes provided, record the total number of usual members in the household. If this total is a single digit, enter ‘0’ in the first box. For example, 9 members would be recorded as ‘09’.

106 The total number of females aged 15-49 years can be tallied by adding up the circled numbers in the last column of the table, which is labeled ‘ELIGIBILITY’. If the continuation sheet has been used, be sure to include these individuals in your total number tally. In the 2 boxes provided, enter the total number women residing in the household who fall into this age range. If the number of women is a single digit, enter ‘0’ in the first box. For example, 5 women meeting these criteria would be recorded as ‘05’.

107 The number of children less than 5 years of age can be tallied from column 104 (labeled ‘AGE’). If the continuation sheet is used, be sure to include these individuals in your total number tally. In the 2 boxes provided, record the total number children living in the household who fall into this age range. *This includes all children who are less than 5 years of age; in other words, you should include all entries of ‘0’, ‘1’, ‘2’, ‘3’, and ‘4’ from column 104 on pages 2 and 3 of the questionnaire.

. SECTION 2: COMMUNITY CHARACTERISTICS Before completing Section 2, check question 106. If ‘00’ women in age range, end the interview and thank respondent. In order to be included in the sample, a household must have a minimum of 1 woman between the ages of 15-49. If the response to question 106 is ‘00’, another household must be randomly selected; in such case, the household in question should not be counted as one of the households visited within the cluster.

201 Do not read response choices aloud. Circle the number that best corresponds to the type of transportation that would most likely be used in the event of an illness/injury requiring district hospital-level care. If the interviewee’s spontaneous reply does not fit into any of the categories listed, circle ‘9/OTHER’ and specify the type of transportation in the space provided.

202 If the approximate length of time it would take to reach the nearest district hospital by this means of transportation is reported as two and a half hours, enter ‘02’ in the boxes corresponding to hours and ‘30’ in the boxes corresponding to minutes. If the approximate length of time it would take to reach the nearest district hospital is less than one hour, enter ‘00’ for hours and specify minutes. If the number of minutes is a single digit, enter ‘0’ in the first box. For example, 5 minutes would be recorded as ‘00 hours’ and ‘05 minutes’.

203 Circle the number that corresponds to the response given. If the community cannot be reached by 4-wheel motor transport such as a car, truck, or bus (response = ‘NO/2), SKIP to question 206; questions 204 and 205 should be administered only to those interviewees who respond that the community can be reached by 4-wheel motor transport.

11 204 Circle the number that corresponds to the response given. A ‘regular basis’ is defined as the availability of public transportation in and out of the community at least once per week.

205 Circle the number that corresponds to the response given. If the road is cut off at any point during the year due to heavy rains or generally poor road conditions, circle ‘1/YES’.

206 Circle the number that corresponds to the response given. Circle ‘1/YES’ only if the community has access to a local FM radio station. If the community has access to national radio, but not to a local station, circle ‘2/NO’.

. SECTION 3: HOUSING CONDITIONS AND FACILITIES

301 Do not read choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response. ‘CONCRETE’ is a mixture of gravel and cement. ‘LANDCRETE’ is a mixture of cement and soil; it is less durable than cement. ‘BURNT BRICKS’ are characterized by their reddish-brown color; they are baked until hard unlike ‘MUD BRICKS’, which are much softer and brown in color. If the interviewee’s response regarding the main construction material used for the exterior of the dwelling is a not among the choices listed, circle ‘9/OTHER’ and specify the type of walls in the space provided.

302 Do not read choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response. If the interviewee responds that the main construction material used for the floor of the dwelling is not among the choices listed, circle ‘6/OTHER’ and specify the type of floor in the space provided.

303 Do not read choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response. If the interviewee responds that the main construction material used for the roof of the dwelling is not among the choices listed, circle ‘9/OTHER’ and specify the type of floor in the space provided.

304 Do not read response choices aloud. Circle the number that best corresponds to the major source of drinking water for the members of the respondent’s household. If the interviewee’s spontaneous reply does not fit into any of the categories listed, circle ‘7/OTHER’ and specify the source of drinking water in the space provided.

305 Do not read choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response. If the interviewee responds that the household uses a method to treat water that is not listed among the current choices, circle ‘5/OTHER’ and specify the source of type of treatment in the space provided. If the respondent states that members of the household do not do anything to treat their water before drinking, circle ‘1/NOTHING’. 12

306 Do not read choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response. ‘KVIP’ refers to the Kumasi Ventilated Improved Pit Latrine. If the respondent indicates that the household uses a latrine, be sure to probe in order to distinguish between a regular pit latrine and a KVIP. If the interviewee responds that the household uses a type of toilet facility other than those that are listed, circle ‘6/OTHER’ and specify the type of toilet facility in the space provided. If the household does not have any toilet facility (or the interviewee’s response is ‘bush’, ‘field’, ‘ocean’, ‘stream’, etc), circle ‘1/NO FACILITY/BUSH/RIVER/FIELD/OCEAN/STREAM’.

307 Do not read choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response. If the interviewee responds that the household’s main source of lighting is not among the choices listed, circle ‘6/OTHER’ and specify the source of lighting in the space provided. If the household does not have any source of light, circle ‘1/NO LIGHT’.

308 Do not read choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response. If the interviewee responds that the household’s main source of cooking fuel is not among the choices listed, circle ‘6/OTHER’ and specify the source of fuel in the space provided.

309 In the 2 boxes provided, enter the total number of rooms that the household occupies. If the number of rooms is a single digit, enter ‘0’ in the first box. For example, 4 rooms would be recorded as ‘04’. * Remember to read the probe aloud; your tally should include living rooms, dining rooms, and sleeping rooms, but NOT bathrooms or kitchens.

310 We would like to know of the total number of rooms tallied in 309, how many are currently used for sleeping; for example, these rooms may be used as living rooms during the day/sleeping rooms at nighttime. In the 2 boxes provided, record the total number of rooms that the household uses for sleeping. If the number of sleeping rooms is a single digit, enter ‘0’ in the first box. For example, 2 rooms would be recorded as ‘02’. This number should be less than or equal to the number of rooms tallied in Question 309.

311 Read aloud repeatedly, filling in the blank with each of the 7 items listed. Circle the number corresponding to interviewee’s response to each item listed. ‘YES/1’ should not be checked unless the item owned by the household member is currently functioning.

312 Do not read choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response. If the interviewee reports an alternative means of arranging emergency transportation, circle ‘5/OTHER’ and specify the type of arrangement in the space provided.

END OF HOUSEHOLD INTERVIEW

Look through the questionnaire thoroughly to verify that all questions have been answered. If so, end the household interview. Thank the respondent; you may read aloud the text provided at the end of the questionnaire.

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Individual Questionnaire

As indicated on the questionnaire, this interview is to be administered to all females between the ages of 15-49 years who are living in the household. The names of all eligible women who fall within this age range can be found in the Household Composition table on pages 2 and 3 of the Household Questionnaire. Refer to the last column of this table (labeled ‘ELIGIBILITY’), and interview those women whose line numbers have been circled. Separate interviews should be conducted with each woman.

Form ID Number Each evening, the Coordinator will stamp the upper right hand corner of all cover pages with a unique ‘Form ID Number’; interviewers are not responsible for this information.

Identification of Female Respondent (15-49 years) Carefully record the 10-digit E.A. number, as well as the corresponding E.A. base and locality name, which can be found in the table on pages 31-34 at the back of this manual.

House Number/Identifying Information 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 should be noted by interviewers both in the space provided on the cover page of the household questionnaire and on the photocopied maps of each cluster.

Name of Household Head Please record the full name of the head of household. This can be found on page 1 of the Household Questionnaire.

Name of Respondent Write the woman’s full name in the blank following ‘Name of Respondent’, and be sure to enter the corresponding code for this individual (refer to the corresponding line number from the household composition table in Section 1 of the Household Questionnaire.) 14

Edited By The supervisor for each team should edit all questionnaires at the end of each day to assert that responses have been recorded properly and that all sections have been completed. If this is not possible, team members may exchange questionnaires with one another. In the event that a blank, incomplete, or unclear response is noted by the editor, he/she should consult the interviewer. It is critical that editing of all questionnaires take place before leaving the field; this will increase the likelihood that errors will be corrected and that interviewers will be able to recall missing information. When editing a questionnaire, please be sure to record your name and corresponding 2-digit code in the boxes provided.

Keyed By The data will be entered into Epi Info by one of the data entry personnel. Ideally, this will be limited to three individuals, so as to ensure consistency. Each member of the data entry team will be assigned a 2-digit identity code and should be instructed to record both his/her full name and code in the spaces provided. Please refer to the list of individual identity codes included on page 36 of this manual.

. SECTION 1: BACKGROUND INFORMATION Interviewees may be more timid and less willing to respond frankly to some of the more sensitive questions when their husbands remain within close proximity. This may be most likely to occur when male interviewers administer the questionnaires. Consequently, prior to administering each individual questionnaire all interviewers should speak to the husband (if present at the time of the interview) and briefly explain the purpose of the survey. Be sure to introduce yourself to the female respondent and to briefly explain the purpose of the survey. You may read aloud the introduction which is included at the beginning of this section of the questionnaire.

101 Please enter the respondent’s age in the 2 boxes provided. All responses will be 2 digits, as all interviewees must fall between the ages of 15-49 years (this includes those who report being 15 or 49 on their last birthday.) Responses should be rounded down to the nearest whole number. If, for example, a woman responds that she will turn 41 in January, record ‘40’ in the boxes provided. *If a female respondent reports that she is younger than 15 or older than 49 years of age, be sure to confirm that this is indeed accurate. If so, thank the respondent and end the interview here. The Calendar of Historical Events and the Age/Year Born Conversion Table found on pages 37-45 of this manual can be used as a guide in verifying the age of each individual. 15

102 Do not read choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response. If the respondent has difficulty understanding the question, you may probe by asking, “Did you attend primary school? And what about junior secondary school?...”etc. If the respondent has not completed primary school, circle ‘NONE/1’. For respondents who reply that they have either completed SSS or have completed SSS plus a tertiary education (university, professional/technical institution, etc.), circle ‘4/SECONDARY +’.

103 This question is intended to serve as a proxy for female literacy. Circle the number that best corresponds to the interviewee’s response. Always probe to be sure that you have a clear understanding of the respondent’s literacy level. If, for example, the interviewee tentatively nods her head to suggest that she can indeed read a letter or newspaper, you must follow-up further by asking, “Can you read a letter easily, or is it difficult for you to read and understand certain words?”

104 Do not read choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response. If the interviewee’s ethnic group is not listed, circle ‘OTHER’ and specify the ethnic group in the space provided. (*The response choices for this question must be revised for each district; prior to printing questionnaires, the CHPS Evaluation Coordinator will need to insert a comprehensive list of the main ethnic groups represented by the district population.)

105 Do not read choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response. If the interviewee’s religion is not listed, circle ‘3/OTHER’, and specify in the space provided. In the event that the interviewee responds that she does not follow any religion/that she has no religious affiliation, please circle ‘4/NO RELIGION’.

106 Circle the number that corresponds to the response given.

107 Circle the number that corresponds to the interviewee’s current marital status. If the respondent reports that she has never been in either formal or informal union (that she has neither been married, nor has she ever lived with a partner), circle ‘NEVER MARRIED/NEVER IN UNION/1’. Circle ‘CURRENTLY MARRIED/2’ if the respondent reports that she is married at present, ‘CURRENTLY LIVING TOGETHER/3’ if she is presently living with a partner in informal union, ‘SEPARATED/4’ is she is not currently living with her husband or partner, ‘DIVORCED/5’ has been divorced and is not remarried, and ‘WIDOWED/6’ if her husband or partner has died and she is not remarried. If the interviewee has difficulty understanding the question, you may probe by reading the possible responses aloud.

108 Circle the number that corresponds to the response given. If the woman being interviewed does not perform work that earns money for her or the members of her household (response = ‘NO/2’), SKIP to Section 2; question 109 should be administered only to those women who respond that they are currently employed or earning money.

16 109 Do not read choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response. For example, ‘AGRICULTURAL LABOUR/FARMING/1’ includes work in the fields with any variety of crops; ‘NON-AGRICULTURAL LABOUR/2’ includes construction work, road paving and repair, etc.; ‘ARTISAN/TRADER/3’ includes sellers of beans, fish, grains, cooked food, fabric, etc., as well as weavers, stone carvers, fabric dyers, etc.; ‘PROFESSIONAL/TECHNICAL/4’ includes work as a doctor, nurse, teacher, mechanic, seamstress, etc.; ‘CLERICAL/ADMINISTRATIVE/5’ includes work as a receptionist, typist, secretary, etc.; and ‘SERVICE/6’ includes work at a restaurant, bar, or any retail establishment. If the interviewee’s type of work does not fit into any of the categories that are listed, circle ‘OTHER/7’, and indicate the type of work performed in the space provided.

. SECTION 2: FAMILY PLANNING It is particularly important for this section that female respondents are interviewed alone; because some of the questions address highly sensitive topics, the presence of another person may be distracting and may bias results.

201 Do not read response choices aloud. Check only those boxes corresponding to methods of FP that are spontaneously named by the respondent. If the woman names one or several methods of FP, you should prompt her to mention any additional known methods by asking, for example, “OK, aside from that, do you know of any other ways to prevent pregnancy?” However, it is critical that you do not ask her about specific methods (in other words, do not ask, “OK, you mentioned injections…are you also familiar with the pill?”). This kind of probe is inappropriate, and it is likely to bias the results of the survey. ‘ORAL PILLS’ are pills that a woman may swallow each day to prevent pregnancy. ‘IUD’ stands for intrauterine device. It is usually a small, flexible plastic frame with copper wire or sleeves on it, and it is inserted into a woman’s uterus through her vagina. ‘INJECTIONS’ – sometimes known as Depo-Provera – are contraceptive shots given in the arm or buttocks every few months as a way of preventing pregnancy. A ‘DIAPHRAGM’ is a soft rubber cup that covers the cervix and is placed in the vagina just before sexual intercourse. ‘FOAM/JELLY’ are contraceptives that a woman inserts into her vagina shortly before sex. A ‘CONDOM’ is a covering – usually made of latex rubber – that is made to fit over a man’s erect penis. ‘FEMALE STERILIZATION’ is a surgical procedure that provides permanent contraception by blocking off or cutting the woman’s fallopian tubes. ‘MALE STERILIZATION’ – also known as vasectomy – is a surgical procedure that provides permanent contraception by closing off the tubes than carry sperm from the man’s testicles to his penis. ‘NORPLANT’ is a set of 6 small, plastic capsules that are implanted under the skin of a woman’s upper arm. A woman using the ‘RHYTHM’ method determines the fertile time in her menstrual cycle through calendar calculations and then avoids unprotected sex between the first and last days of the estimated fertile time. ‘WITHDRAWAL’ – also known as pulling out - refers to sexual intercourse in which the man takes his penis out of the vagina before ejaculating. The ‘LACTATIONAL AMENORRHEA’ method is the use of breastfeeding as a temporary way of preventing pregnancy; a woman is naturally protected against pregnancy when she breastfeeds her baby often, her menstrual periods have not yet returned, and her baby is less than 6 months old. *If the respondent is unable to name any methods, check the box labeled ‘NONE MENTIONED’.

202 Circle the number that best corresponds to the interviewee’s spontaneous response.

203 Circle the number that corresponds to the response given. If the respondent and her partner are not currently doing anything to delay or prevent pregnancy (response = ‘NO/2’), SKIP to question 205; question 204 should be administered only to those women who respond that they are currently using a method of FP.

204 Do not read response choices aloud. Circle the number that corresponds to interviewee’s spontaneous response. If the method of FP that she and her husband/partner are currently using is not listed among the current choices, circle ‘12/OTHER’ and specify in the space provided. ‘ORAL PILLS’ are pills that a woman may swallow each day to prevent pregnancy. ‘IUD’ stands for intrauterine device. It is usually a small, flexible plastic frame with copper wire or sleeves on it, and it is inserted into a woman’s uterus through her vagina. ‘INJECTIONS’ – sometimes known as Depo-Provera – are contraceptive shots given in the arm or buttocks every few months as a way of preventing pregnancy. A ‘DIAPHRAGM’ is a soft rubber cup that covers the cervix and is placed in the vagina just before sexual intercourse. ‘FOAM/JELLY’ are contraceptives that a woman inserts into her vagina shortly before sex. A ‘CONDOM’ is a covering – usually made of latex rubber – that is made to fit over a man’s erect penis. ‘FEMALE STERILIZATION’ is a surgical procedure that provides permanent contraception by blocking off or cutting the woman’s fallopian tubes. ‘MALE STERILIZATION’ – also known as vasectomy – is a surgical procedure that provides permanent contraception by closing off the tubes than carry sperm from the man’s testicles to his penis. ‘NORPLANT’ is a set of 6 small, plastic capsules that are implanted under the skin of a woman’s upper arm. A woman using the ‘RHYTHM’ method determines the fertile time in her menstrual cycle through calendar calculations and then avoids unprotected sex between the first and last days of the estimated fertile time. ‘WITHDRAWAL’ – also known as pulling out - refers to sexual intercourse in which the man takes his penis out of the vagina before ejaculating. The ‘LACTATIONAL AMENORRHEA’ method is the use of breastfeeding as a temporary way of preventing pregnancy; a woman is naturally protected against pregnancy when she breastfeeds her baby often, her menstrual periods have not yet returned, and her baby is less than 6 months old. *After recording response to this question, always SKIP to question 206.

205 Do not read response choices aloud. Circle the number that corresponds to interviewee’s spontaneous response. If the respondent’s reason for no use of family planning is not listed among the current choices, circle ‘11/OTHER’ and specify in the space provided. If the interviewer shrugs when the question is posed or is unable to state a reason why she is not using a method of FP, circle ‘99/DON’T KNOW.’ *After recording response to this question, always SKIP to Section 3.

206 Do not read response choices aloud. Circle the number that best corresponds to interviewee’s spontaneous response. If the respondent’s primary source of FP is not listed among the current choices, circle ‘8/OTHER’ and specify in the space provided.

18 . SECTION 3: HIV/AIDS

301 Read each response choices aloud. Circle ‘YES/1’, ‘NO/2’, or ‘DK/3’ (DON’T KNOW) according to the interviewee’s response to each item listed. *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.

302 Circle the number that corresponds to the response given. *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.

303 Read all response choices aloud, filling in the blank with each method of prevention that is listed. Circle ‘YES/1’, ‘NO/2’, or ‘DK/3’ (DON’T KNOW) according to the interviewee’s response to each item listed. *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.

304 Circle the number that corresponds to the response given.

305 Circle the number that corresponds to the response given.

. SECTION 4: MATERNAL AND CHILD HEALTH

401 Do not read response choices aloud. Check all boxes corresponding to danger signs that are spontaneously mentioned by the respondent. You may probe to be sure that all known danger signs have been mentioned. For example, ask the respondent: “Can you think of any (or ‘any other’ if she already has named one) signs to look out for during pregnancy that would signal that something might be wrong and that would be reason to seek advice from a health provider?” If the woman cites a danger sign that is not listed among the current choices, check the box labeled ‘OTHER’ and specify in the space provided. If, after probing, the respondent is still unable to name any danger signs to look out for during pregnancy, check the box labeled ‘NONE MENTIONED’.

402 Do not read response choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response. *If the woman replies that breastmilk is the healthiest food for an infant between the ages of 0 and 6 months, use the following probe: “Breastmilk only or breastmilk and water and/or porridge?” Again, 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. If the interviewee’s response is not already listed, circle ‘5/OTHER’ and specify in the space provided.

403 Circle the number that corresponds to the response given. *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.

19 . SECTION 5: SAFE MOTHERHOOD

501 Circle the number that corresponds to the response given. *Probe to be sure the respondent understands that we are interested even in those pregnancies that may have ended in miscarriage or abortion. If the respondent says that she has not been pregnant at any time during the last 5 years (response = ‘NO/2’), SKIP to Section 6; question 502 should be administered only to those women who respond that they have been pregnant at least once during the last 5 years.

502 Circle the number that corresponds to the response given. If the respondent says that she did not receive antenatal care when she was pregnant with her last child (response = ‘NO/2’), SKIP to question 507; question 503 should be administered only to those women who respond that they did receive antenatal care during their last pregnancy.

503 Do not read response choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response. *If the interviewee reports that she received antenatal care from a nurse, always probe to distinguish between a CHO and any other nurse. Ask: “Does this health care provider wear a uniform? (If yes) What color uniform was he/she wearing? In order to verify the interviewee’s response, you may show the photographs of all community health nurses and CHOs in the district. Probing is very important, as it will minimize misclassification of responses. If the woman received antenatal care from a provider that is not listed among the current choices, circle ‘6/OTHER’ and specify the type of provider in the space provided.

504 Record the number of months at the time of the first antenatal visit (for the most recent pregnancy). If the woman reports that she was 5 months pregnant at her first visit, enter ‘05’ in the boxes provided. If the respondent is unsure as to the approximate timing of her first antenatal visit, record ‘99’ (‘DON’T KNOW’) in the boxes provided.

505 Record the number of times that the woman reports receiving antenatal care during her last pregnancy. If the woman had a total of 6 antenatal visits, enter ‘06’ in the boxes provided. If the respondent is unsure as to the number of antenatal visits, record ‘99’ (‘DON’T KNOW’) in the boxes provided.

506 Read all response choices aloud. Circle ‘YES/1’, ‘NO/2’, or ‘DK/3’ (DON’T KNOW) according to the interviewee’s response regarding each item listed.

507 Circle the number that corresponds to the interviewee’s response. If the respondent did not receive a tetanus toxoid injection during her last pregnancy, or if she is unsure as to whether or not she received one (responses = ‘NO/2’ or ‘DON’T KNOW/3’), SKIP to question 509; question 508 should be administered only to those women who respond that they did receive an injection in the arm to prevent the baby from getting tetanus.

20 508 Record the number of times that the woman reports receiving a tetanus toxoid injection during her last pregnancy. If the woman had a total of 3 TT injections, enter ‘03’ in the boxes provided. If the respondent is unsure as to the exact number of injections, record ‘99’ (‘DON’T KNOW’) in the boxes provided.

509 Circle the number that corresponds to the interviewee’s response. *It is extremely important that children who cried or showed signs of life at birth be counted as ‘BORN ALIVE’, even if they died within a few minutes or hours. If the respondent’s last pregnancy did not result in a live birth (responses = ‘BABY STILLBORN/2’ or ‘PREGNANCY TERMINATED BEFORE BIRTH/3’), SKIP to Section 6.

510 Do not read response choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response. If the woman delivered her last child in a place that is not listed among the current choices, circle ‘7/OTHER’ and specify the type of location in the space provided.

511 Do not read response choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response. *If the interviewee reports that a nurse assisted with the delivery of her last child, always probe to distinguish between a CHO and any other nurse. Ask: “Does this health care provider wear a uniform? (If yes) What color uniform was he/she wearing? In order to verify the interviewee’s response, you may show the photographs of all community health nurses and CHOs in the district. If the main person who assisted with the delivery is not listed among the current choices, circle ‘8/OTHER’ and specify the type of birth attendant in the space provided. If the woman delivered her baby by herself, with no help from anyone, circle ‘7/NO ONE.’

512 Do not read response choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response. *If the interviewee reports that a nurse performed a postnatal check on her, always probe to distinguish between a CHO and any other nurse. Ask: “Does this health care provider wear a uniform? (If yes) What color uniform was he/she wearing? In order to verify the interviewee’s response, you may show the photographs of all community health nurses and CHOs in the district. If the woman replies that no one performed a postnatal check on her in the 6 weeks following the birth of her last child, circle ‘6/NO ONE’. If the person who performed a postnatal check on the woman is not listed among the current choices, circle ‘7/OTHER’ and specify the type of provider in the space provided. *If more than 1 type of provider was seen, circle the number corresponding to the most qualified.

513 Do not read response choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response. *If the interviewee reports that a nurse performed a postnatal check on the baby, always probe to distinguish between a CHO and any other nurse. Ask: “Does this health care provider wear a uniform? (If yes) What color uniform was he/she wearing? In order to verify the interviewee’s response, you may show the photographs of all community health nurses and CHOs in the district. If the woman replies that no one performed a postnatal check on the baby in the 6 weeks after birth, circle ‘6/NO ONE’. If the person who performed a postnatal check on the baby is not listed among the current choices, circle ‘7/OTHER’ and specify the type of provider in the space provided. *If more than 1 type of provider was seen, circle the number corresponding to the most qualified.

. SECTION 6: COMMUNITY-BASED HEALTH SERVICES Please be sure to read aloud the introduction which is included at the beginning of this section of the questionnaire. This text provides an overview of the main components of the CHPS program. Some women may live in CHPS zones, but may be unaware that the nurse living in their community is called a ‘CHO’ or that the program is formally known as ‘CHPS’; by briefly explaining the program, however, you will ensure more accurate responses and a more valid assessment of the initiative. In order to optimize the accuracy of responses to this section, you may show the photographs of all community health nurses and CHOs in the district.

601 Circle the number that corresponds to the interviewee’s response. If the respondent states that neither she nor any members of her household have gone to a CHO for health information/services or that she does not know if any members have gone to a CHO (responses = ‘2/NO’ or ‘3/DON’T KNOW’), SKIP to question 604; questions 602 and 603 should be administered only to those women who respond that they have sought health information or services from a CHO. In order to verify the interviewee’s response, you may show the photographs of all CHOs currently working in the district.

602 Do not read response choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response.

603 Do not read response choices aloud. Check all boxes corresponding to CHO services that are spontaneously named by the respondent. If the woman names one or several types of services offered by the CHO, probe to be sure that she has named all known services. Ask, for example, “OK, aside from that, does the CHO offer any other services, information, or supplies?” It is, however, critical that you do not ask her about specific services (in other words, do not ask, “OK, you mentioned FP…does the CHO also provide childhood delivery or referral services?”). This kind of probe is inappropriate, and it is likely to bias the results of the survey.

604 Circle the number that corresponds to the interviewee’s response. If the respondent states that neither she nor any members of her household have gone to a Community Health Volunteer for health information or services or that she does not know if any members have gone to a Volunteer (responses = ‘2/NO’ or ‘3/DON’T KNOW’), SKIP to question 607; questions 605 and 606 should only be administered to those women who respond that they have sought health information or services from a Community Health Volunteer.

605 Do not read response choices aloud. Check all boxes corresponding to volunteer services that are spontaneously named by the respondent. If the woman names one or several types of services offered by the Community Health Volunteer(s), probe to be sure that she has named all known services by asking, for example, “OK, aside from that, do volunteers offer any other services, information, or supplies?” However, it is critical that you do not ask her about specific services (in other words, do not ask, “OK, you mentioned FP…do the volunteers also provide first aid services?”). This kind of probe is inappropriate, and it is likely to bias the results of the survey. Note that ‘health education’ may include immunization, nutrition, STIs, HIV/AIDS, antenatal care, sanitation, etc.

22 606 Do not read response choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response.

607 Do not read response choices aloud. Circle the number that best corresponds to the interviewee’s spontaneous response.

. SECTION 7A: BIRTH HISTORY Read aloud the introduction which is included at the beginning of this section of the questionnaire.

701 Circle the number that corresponds to the response given. If the interviewee has never had a live birth (response = ‘NO/2’), SKIP to question 901; question 702 should be administered only to those women who respond that they have had at least one live birth. *Read aloud the probe that has been included on the questionnaire to be sure that the respondent understands the question. The probe is intended to clarify that a ‘live birth’ is defined as the delivery of a child who cried or showed any sign of life at birth, even if he/she died within a few minutes, hours, or days.

702 In the column labeled ‘CHILD’S NAME’, record the full names of all children to whom the respondent has given birth, beginning with the most recent birth (the youngest child). After completing a listing of all children, begin with the first child (line 1/column 702 of the table) and proceed horizontally across all questions on the table before moving on to line 2. In other words, you will administer questions 703-709) for Child Number 1 before moving on to Child Number 2.

703 For each child listed in column 702, circle the code corresponding to the child’s sex on the appropriate line; circle ‘1’ for a boy and ‘2’ for a girl.

704 For each child listed in column 702, circle the code corresponding to single (‘1’) or multiple (‘2’) birth on the appropriate line. A ‘multiple birth’ refers to a child who is a twin or a triplet. Twin or triplet siblings should be listed on adjacent lines.

705 For each child listed in column 702, record the month and year of birth in the boxes provided on the appropriate line. All birth dates should be recorded as MM/YYYY (month/year). For single months, enter ‘0’, followed by the appropriate digit. For example, May, 1999 would be entered as follows: ‘05/1999’. February, 2001 would be recorded as: ‘02/2001’. If the respondent knows the year of the child’s birth, but does not know the exact month, enter ‘99’ in the boxes labeled ‘MM’. For example, if a mother reports that her son was born in 1991 but that she does not recall the exact month of his birth, you would enter ‘99/1991’ in the boxes provided. If the respondent cannot recall either the year or the month of the child’s birth, enter ‘99’ in the boxes labeled ‘MM’ and ‘9999’ in the boxes labeled ‘YYYY’. *The Calendar of Historical Events and the Age/Year Born Conversion Table found on pages 37-45 of this manual can be used as a guide in verifying the age of each individual.

23 706 For each child listed in column 702, circle the code corresponding to the mother’s response on the appropriate line. If the child in question has died (response = ‘NO/2’), SKIP to question 709; question 707 should be administered only if the mother responds that the child in question is still alive (response = ‘YES/1’).

707 *It is extremely important that this question be answered as accurately as possible for every child listed. This question has been inserted as a means to cross-check responses to question 705. For each child listed in column 702, record the age in years in the boxes provided on the appropriate line. Because we are interested in the age of the child on his/her last birthday, the response should always be a whole number; a response of ‘my daughter is 5 and a half years old’ would be rounded down to 5 years of age. The following chart can be used to guide you in converting age in months to age in years. If, for example, a woman responds that the child in question is 18 months old, you would record ‘01’ in the boxes labeled ‘AGE IN YEARS’.

Age in Years Age in Months 0 0-11 1 12-23 2 24-35 3 36-47 4 48-59 5 60-72 etc………. etc………..

708 For each child listed in column 702, circle the code corresponding to the mother’s response on the appropriate line. A child who is ‘living in the household’ is defined as one who has resided there for the past month or longer. After recording the response to this question, SKIP to question 710; question 709 should be administered only for those children who have reportedly died.

709 For each deceased child (all responses of ‘NO/2’ listed in column 706), record the date of death in the boxes provided on the appropriate line. *Record age in years if the child was older than 1 year of age at the time of death OR age in months if the child was younger than 1 year of age at time of death. Always round down to the nearest whole number; for example, a child who was ‘2 and a half’ at the time of death would be recorded as ‘02’ in ‘years of age’. For children less than 1 month of age at the time of death, record ‘00’ in ‘months of age’. For single months, enter ‘0’, followed by the appropriate digit. For example, for a child who died at 6 months of age, you would record ‘06’ in the boxes labeled ‘months of age’ ; years of age would be left blank. If the respondent cannot recall the exact age at death, record the best estimate. *The Calendar of Historical Events and the Age/Year Conversion Table found on pages 37-45 of this manual can be used as a guide in verifying the age at death for each child in question.

**Before proceeding to Section 7B, circle the line numbers of all children born in the last 5 years (both those who are still alive and those who have since died), as indicated in column 705. This will be helpful in identifying all children eligible for Sections 7B and 7C.

. SECTION 7B: CHILD MORBIDITY AND HEALTH SEEKING BEHAVIOUR IN THE PAST MONTH *REFER TO COLUMN 702 ON THE PREVIOUS PAGE AND TRANSFER THE NAME(S) AND LINE NUMBER(S) OF ALL CHILDREN THAT WERE BORN IN THE LAST FIVE YEARS. When transferring this information, be sure that the line numbers correspond exactly to those in the table in Section 7A. For all children who were born over 5 years ago, indicate by drawing a line through the tables in Sections 7B and 7C (questions 710-724) on the line corresponding to the child/children.

Read aloud the introduction which is included at the beginning of this section of the questionnaire. Remember that for the purposes of this section of the survey, we are only interested in children who were born within the last five years (60 months). In other words, we are seeking information about all children to whom the respondent has given birth since today’s date minus 5 yrs. This includes her children who have since died, those who currently live in her household, and those who live away in another household.

710 For each child listed in Table 7B, circle the code corresponding to the mother’s response. Illness of any type during the past month – whether mild or severe – should be recorded as a ‘YES’ response and coded as ‘1’ on the appropriate line. If the woman responds that the child in question has not been sick in the past month (response = ‘NO/2’), SKIP to SECTION 7C/IMMUNIZATION (question 715); the remainder of SECTION 7B should be administered only for those children who have reportedly been sick at some point during the past month. *If the child in question has not been sick in the past month, or if the child is reportedly deceased, indicate by crossing out the corresponding line of the table in Section 7B (questions 711-714).

711 Do not read response choices aloud. For each child who has been sick during the past month, record the code corresponding to the mother’s spontaneous response. *To be sure there is a clear distinction between CHO vs. regular nurse, you may show the photographs of all community health nurses and CHOs in the district; you may also probe. Ask, for example: “Does this health care provider wear a uniform? (If yes) What color uniform was he/she wearing? At which facility did he/she work? Was she riding a motorbike?” etc. Probing is very important, as it will minimize misclassification of responses. If the first person who was consulted is not listed among the current choices, record ‘8’ (the code for ‘OTHER’) and specify in the space provided on the appropriate line. If no one was consulted about the child’s illness record ‘9’ (the code for ‘NO ONE’) on the appropriate line and SKIP to question 714; question 712 should be administered only if the respondent did seek advice or treatment for the child in question.

712 For each child in question, record the code corresponding to the response given. If the mother responds that she did not seek help from anyone else (‘NO/2’), SKIP to question 715.

713 Do not read response choices aloud. For each child who has been sick during the past month, record the code corresponding to the mother’s spontaneous response. *To be sure there is a clear distinction between CHO vs. regular nurse, you may show the photographs of all community health nurses and CHOs in the district; you may also probe. Ask, for example: “Does this health care provider wear a uniform? (If yes) What color uniform was he/she wearing? At which facility did he/she work? Was she riding a motorbike?” etc. Probing is very important, as it will minimize misclassification of responses. If the last person who was consulted is not listed among the current choices, record 25 ‘8’ (‘OTHER’) and specify in the space provided on the appropriate line. After asking this question, always SKIP to question 715; question 714 should be administered only to those women who replied in question 711 that they did not seek advice or treatment from anyone (response = ‘NO ONE/9’).

714 Do not read response choices aloud. For each child in question, record the code corresponding to the mother’s spontaneous response. If the reason why no one was consulted is not listed among the current choices, record ‘7’ (the code for ‘OTHER’) and specify in the space provided on the appropriate line.

. SECTION 7C: IMMUNIZATION *TRANSFER THE NAME AND LINE NUMBER OF EVERY CHILD LISTED IN TABLE 7B ON THE PREVIOUS PAGE. THIS INCLUDES ALL CHILDREN BORN IN THE LAST 5 YEARS(BOTH LIVING AND DECEASED). When transferring this information, be sure that the line #s correspond exactly to those in the birth history in Section 7A.

Ask the respondent for the ROAD TO HEALTH CARD OR YELLOW CARD FOR EACH CHILD BORN IN THE LAST 5 YEARS (including those who are still living and those who are now deceased); in other words, you will request a health card for each child listed in Table 7B. Record exact dates (DD/MM/YY) of specific vaccinations only if indicated in the table only if confirmed by card. If the child has no card, or if the card is not available, ask the mother whether or not the child has received the immunization. If she reports that the immunization was given (but this is not confirmed by card), or if the card shows that a vaccination was given, but no date is specified, record 88/88/88 on the appropriate line. If the mother reports that the immunization was not given or that she does not recall whether it was given, record a dash ( ------) on the appropriate line.

715 For each child listed in Table 7C, record the code corresponding to the response given on the appropriate line. The number ‘1’ (the code for ‘YES’) should be recorded only if the child’s Road to Health card or yellow immunization card is actually seen by the interviewer.

716 For each child listed in Table 7C, record the exact date (DD/MM/YY) of BCG vaccination if available and verified by card. If the date cannot be verified by card but this vaccination can be verified by history (mother’s verbal confirmation), record ‘88/88/88’ on the appropriate line. If the respondent reports that the immunization was not given or if she replies that she is not sure, record a dash (-----) on the appropriate line. *Even if you see the child’s BCG scar during your visit, you may only record a specific date of vaccination if confirmed by card; if the card is not available, record ‘88/88/88’.

717 For each child listed in Table 7C, record the exact date (DD/MM/YY) of the yellow fever vaccination if available and verified by card. If the date cannot be verified by card but this vaccination can be verified by history (mother’s verbal confirmation), record ‘88/88/88’ on the appropriate line. If the respondent reports that the immunization was not given or if she replies that she is not sure, record a dash (-----) on the appropriate line.

26 718 For each child listed in Table 7C, record the exact date (DD/MM/YY) of the first DPT/PENTA vaccination if available and verified by card. If the date cannot be verified by card but this vaccination can be verified by history (mother’s verbal confirmation), record ‘88/88/88’ on the appropriate line. If the respondent reports that the immunization was not given or if she replies that she is not sure, record a dash (----) on the appropriate line. In February, 2002, the Ministry of Health of Ghana made the transition from the DPT 1,2,3 series to the PENTA 1,2,3 series. Children no longer receive DPT; instead, they are given PENTA, which is a combination of DPT, HepB, and HiB. Like the DPT series, the PENTA series should be administered to children at 6 weeks, 10 weeks, and 14 weeks of age. This recent transition to PENTA means that many children may have received, for example, DPT1 and DPT2, followed by PENTA; because PENTA contains DPT, this child would be fully immunized with the series of 3 vaccinations, assuming that the appropriate vaccination schedule was followed. *In assessing a child’s immunization status, it is therefore critical that any combination of 3 shots of DPT and/or PENTA be recorded in the table (along with the dates of these vaccinations when confirmed by card).

719 For each child listed in Table 7C, record the exact date (DD/MM/YY) of the second DPT/PENTA vaccination if available and verified by card. If the date cannot be verified by card but this vaccination can be verified by history (mother’s verbal confirmation), record ‘88/88/88’ on the appropriate line. If the respondent reports that the immunization was not given or if she replies that she is not sure, record a dash (----) on the appropriate line. In February, 2002, the Ministry of Health of Ghana made the transition from the DPT 1,2,3 series to the PENTA 1,2,3 series. Children no longer receive DPT; instead, they are given PENTA, which is a combination of DPT, HepB, and HiB. Like the DPT series, the PENTA series should be administered to children at 6 weeks, 10 weeks, and 14 weeks of age. This recent transition to PENTA means that many children may have received, for example, DPT1 and DPT2, followed by PENTA; because PENTA contains DPT, this child would be fully immunized with the series of 3 vaccinations, assuming that the appropriate vaccination schedule was followed. *In assessing a child’s immunization status, it is therefore critical that any combination of 3 shots of DPT and/or PENTA be recorded in the table (along with the dates of these vaccinations when confirmed by card).

720 For each child listed in Table 7C, record the exact date (DD/MM/YY) of the third DPT/PENTA vaccination if available and verified by card. If the date cannot be verified by card but this vaccination can be verified by history (mother’s verbal confirmation), record ‘88/88/88’ on the appropriate line. If the respondent reports that the immunization was not given or if she replies that she is not sure, record a dash (----) on the appropriate line. In February, 2002, the Ministry of Health of Ghana made the transition from the DPT 1,2,3 series to the PENTA 1,2,3 series. Children no longer receive DPT; instead, they are given PENTA, which is a combination of DPT, HepB, and HiB. Like the DPT series, the PENTA series should be administered to children at 6 weeks, 10 weeks, and 14 weeks of age. This recent transition to PENTA means that many children may have received, for example, DPT1 and DPT2, followed by PENTA; because PENTA contains DPT, this child would be fully immunized with the series of 3 vaccinations, assuming that the appropriate vaccination schedule was followed. *In assessing a child’s immunization status, it is therefore critical that any combination of 3 shots of DPT and/or PENTA be recorded in the table (along with the dates of these vaccinations when confirmed by card).

27 721 For each child listed in Table 7C, record the exact date (DD/MM/YY) of the first polio vaccination if available and verified by card. If the date cannot be verified by card but this vaccination can be verified by history (mother’s verbal confirmation), record ‘88/88/88’ on the appropriate line. If the respondent reports that the immunization was not given or if she replies that she is not sure, record a dash (----) on the appropriate line.

722 For each child listed in Table 7C, record the exact date (DD/MM/YY) of the second polio vaccination if available and verified by card. If the date cannot be verified by card but this vaccination can be verified by history (mother’s verbal confirmation), record ‘88/88/88’ on the appropriate line. If the respondent reports that the immunization was not given or if she replies that she is not sure, record a dash (----) on the appropriate line.

723 For each child listed in Table 7C, record the exact date (DD/MM/YY) of the third polio vaccination if available and verified by card. If the date cannot be verified by card but this vaccination can be verified by history (mother’s verbal confirmation), record ‘88/88/88’ on the appropriate line. If the respondent reports that the immunization was not given or if she replies that she is not sure, record a dash (----) on the appropriate line.

724 For each child listed in Table 7C, record the exact date (DD/MM/YY) of measles vaccination if available and verified by card. If the date cannot be verified by card but this vaccination can be verified by history (mother’s verbal confirmation), record ‘88/88/88’ on the appropriate line. If the respondent reports that the immunization was not given or if she replies that she is not sure, record a dash (----) on the appropriate line.

. SECTION 8: VERIFICATION OF TOTAL BIRTHS

801 In the 2 boxes provided, record the total number of the respondent’s children who are still living. If the number of living children is a single digit, enter ‘0’ in the first box. For example, 4 children would be recorded as ‘04’. If none of the children to whom the woman has given birth are still living, enter ‘00’ in the boxes provided.

802 In the 2 boxes provided, enter the total number of the respondent’s children who were born alive but have since died. If the number of children who have died is a single digit, enter ‘0’ in the first box. For example, 2 deceased children would be recorded as ‘02’. *Again, please remember to read the probe aloud; count any children who cried or showed signs of life at birth, even if they died within a few minutes, hours or days. If none of her children have died, enter ‘00’ in the boxes provided.

803 This question is intended to verify the responses to the 2 previous questions. In the 2 boxes provided, record the total number of live births; this number should equal the sum of questions 801 and 802 (in other words, this number should equal the sum of biological children who are still alive and those who have died); if the woman’s response to this question is not equal to the sum of

28 questions 801 and 802, you should return to both of the previous questions in an attempt to identify the inaccurate information. If the total number of children born alive is a single digit, enter ‘0’ in the first box. For example, 6 children would be recorded as ‘06’.

SUPERVISOR CHECK I This question serves as a cross-check with the birth history in section 7A.. Compare the response to 803 with total number of births listed in table on page 11 (section 7a) and check the appropriate box.

SUPERVISOR CHECK II This question is intended to verify that the birth history (Table 7A) has been fully completed and that essential information pertaining to each child listed has been recorded in the appropriate spaces.

END OF INDIVIDUAL INTERVIEW

Look through the questionnaire thoroughly to verify that all questions have been answered. If so, end the interview. Thank the respondent; you may read aloud the text provided.

* Question 901 should be completed immediately following the interview. Check all boxes corresponding to the presence of another person/persons during this interview. This information will be useful during the data analysis phase of evaluation.

______

Cluster Starting Point & Household Identification Assignments

*The information provided below is specific to Nkwanta District and is intended to serve only as a guide; the CHPS Evaluation Coordinator should personalize this list by replacing the names below with the names of members and supervisors of their own district research team.

. Field Team 1 Pamela Quaye, Supervisor Haibor Comfort (Starting point A / households 1-5) Wayen George (Starting point B / households 6-10) Eric Akpabli (Starting point C / households 11-15)

. Field Team 2 Egblewogbe Lambert, Supervisor Rosena Danso (Starting point A / households 1-5) Michael Agdo (Starting point B / households 6-10) Getor Emmanuel (Starting point C / households 11-15)

. Field Team 3 Constant Dedo, Supervisor Eunice Kwakofi (Starting point A / households 1-5) Edmund Tsogbey (Starting point B / households 6-10) Mr. Donkor (Starting point C / households 11-15)

. Field Team 4 Dina Yakobu, Supervisor Dorwu Elorm (Starting point A / households 1-5) Maxwell Agbolosu (Starting point B / households 6-10) Hamid Safiano (Starting point C / households 11-15)

CHPS EVALUATION FIELD WORK SCHEDULE Nkwanta District

*Note that the cluster, sub-district, E.A. and locality information provided below is intended only as an example; the CHPS Evaluation Coordinator will need to personalize the field work schedule by replacing these details with information specific to their own district sample.

DAY 1 Monday, October 7, 2002 CLUSTER SUB-DISTRICT E.A. CODEE.A. BASE LOCALITY TRANSPORT TEAM 25 KPASSA 411002015 Elf Filling Station KPASSA Vehicle A 1 26 KPASSA 411002018 Kpassa J.S.S. 'A' KPASSA Vehicle A 2 27 KPASSA 411002022 Deeper Life Church KPASSA Vehicle B 3 28 KPASSA 411002024 Nlen's House KPASSA Vehicle B 4

DAY 2 Tuesday, October 8, 2002 CLUSTER SUB-DISTRICT E.A. CODEE.A. BASE LOCALITY TRANSPORT TEAM 49 TUTUKPENE 411021424 Church of Pentecost, Alokpatsa (single locality E.A.) ALOKPATSA Vehicle A 1 47 TUTUKPENE 411001724 Kotorkro Baku (Binya Akura) (single locality E.A.) KOTORKRO BAKU Vehicle A 2 44 TUTUKPENE 411001711 Ofosu Battor Akura (single locality E.A.) OFOSU BATTOR AKURA Vehicle B 3 50 TUTUKPENE 411024416 Tamaklo's Kiosk (single locality E.A.) TUTUKPENE Vehicle B 4

DAY 3 Wednesday, October 9, 2002 CLUSTER SUB-DISTRICT E.A. CODEE.A. BASE LOCALITY TRANSPORT TEAM 48 TUTUKPENE 411012420 Evangelical Church of Ghana (single locality E.A.) KECHEIBI Vehicle A 1 46 TUTUKPENE 411001721 Mamfi Kope MAMFI KOPE Vehicle A 2 9 NKWANTA 411001748 Sei-Akura (single locality E.A.) SEI-AKURA 2 motorbikes 3 24 KPASSA 411001772 Aswar (single locality E.A.) ASWAR Vehicle B 4

DAY 4 Thursday, October 10, 2002 CLUSTER SUB-DISTRICT E.A. CODEE.A. BASE LOCALITY TRANSPORT TEAM 29 KPASSA 411002027 Agyapaye's House KPASSA Vehicle A 1 30 KPASSA 411002029 Kpassa Senior Secondary School (single locality E.A.) KPASSA Vehicle A 2 31 KPASSA 411006439 Togbe's Store (single locality E.A.) BONAKYE Vehicle B 3 36 KPASSA 411023445 Kofi Agou's House (single locality E.A.) NEW AGOU Vehicle B 4

DAY 5 Friday, October 11, 2002 CLUSTER SUB-DISTRICT E.A. CODEE.A. BASE LOCALITY TRANSPORT TEAM 19 KPASSA 411001754 Mama Akura MAMA AKURA Vehicle A 1 20 KPASSA 411001756 Nyamebua NYAMEBUA Vehicle A 2 21 KPASSA 411001759 Jombo No. 2 (Okpari Akura) JOMBO NO.2 Vehicle B 3 16 KPASSA 411001742 Old Potripo (Jabal Akura) OLD POTRIPO Vehicle B 4

DAY 6 Monday, October 14, 2002 CLUSTER SUB-DISTRICT E.A. CODEE.A. BASE LOCALITY TRANSPORT TEAM 40 BREWANIASE 411004401 Ntruboman Senior Sec. School (single locality E.A.) BREWANIASE Vehicle A 1 41 BREWANIASE 411004405 Brewaniase Market (single locality E.A.) BREWANIASE Vehicle A 2 42 BREWANIASE 411007409 L.A. Primary 'B' PUSUPU Vehicle B 3 43 BREWANIASE 411016415 R.C. Chapel (single locality E.A.) BONTIBOR Vehicle B 4

DAY 7 Tuesday, October 15, 2002 CLUSTER SUB-DISTRICT E.A. CODEE.A. BASE LOCALITY TRANSPORT TEAM 55 DAMANKO 411003031 L.A. Primary School, Damanko (single locality E.A.) DAMANKO Vehicle A 1 56 DAMANKO 411003034 Damanko Market (single locality E.A.) DAMANKO Vehicle A 2 57 DAMANKO 411003036 Try Again Store (single locality E.A.) DAMANKO Vehicle B 3 52 DAMANKO 411001775 Pibilla No. 2 (single locality E.A.) PIBILLA NO.2 Vehicle B 4

DAY 8 Wednesday October 16, 2002 CLUSTER SUB-DISTRICT E.A. CODEE.A. BASE LOCALITY TRANSPORT TEAM 1 NKWANTA 411001003 Mosque Nkwanta NKWANTA Vehicle A 1 2 NKWANTA 411001005 District Assembly Administration NKWANTA Vehicle A 2 3 NKWANTA 411001008 A.Y. Benchi Fashion (NKO 83) NKWANTA Vehicle B 3 4 NKWANTA 411001011 Nkwanta Senior Secondary School NKWANTA Vehicle B 4

DAY 9 Thursday, October 24, 2002 CLUSTER SUB-DISTRICT E.A. CODEE.A. BASE LOCALITY TRANSPORT TEAM 22 KPASSA 411001763 Winn WINN Vehicle A 1 23 KPASSA 411001766 Nantwi Akura (Nye Kope) NANTWI AKURA Vehicle A 2 53 DAMANKO 411001778 Jato Krom JATO KROM Vehicle B 3 54 DAMANKO 411001781 Badule (single locality E.A.) BADULE Vehicle B 4

DAY 10 Friday, October 25, 2002 CLUSTER SUB-DISTRICT E.A. CODEE.A. BASE LOCALITY TRANSPORT TEAM 33 KPASSA 411011452 Church of Pentecost, Abunyanya (single locality E.A.) ABUNYANYA Vehicle A 1 34 KPASSA 411011454 Yaki's House (single locality E.A.) ABUNYANYA Vehicle A 2 32 KPASSA 411010465 Masuren's House (single locality E.A.) NABU Vehicle B 3 35 KPASSA 411019450 Tinjase Market (single locality E.A.) TINJASE Vehicle B 4

DAY 11 Saturday, October 26, 2002 CLUSTER SUB-DISTRICT E.A. CODEE.A. BASE LOCALITY TRANSPORT TEAM 11 NKWANTA 411014433 Keri J.S.S. KERI Vehicle A 1 13 NKWANTA 411020449 Kue Primary and J.S.S. KUE Vehicle A 2 10 NKWANTA 411013427 Nana Okpora's House (single locality E.A.) SHIARE Vehicle B 3 12 NKWANTA 411017426 Mbey's House ODUMASE ADELE Vehicle B 4

DAY 12 Monday, October 28, 2002 CLUSTER SUB-DISTRICT E.A. CODEE.A. BASE LOCALITY TRANSPORT TEAM 5 NKWANTA 411001715 Kpeve (single locality E.A.) KPEVE Vehicle A 1 6 NKWANTA 411001729 Dadiase (single locality E.A.) DADIASE Vehicle A 2 7 NKWANTA 411001732 Nyambong Junction NYAMBONG JUNCTION Vehicle B 3 ABREWANKOR 8 NKWANTA 411001735 Abrewankor Junction JUNCTION Vehicle B 4

DAY 13 Tuesday, October 29, 2002 CLUSTER SUB-DISTRICT E.A. CODEE.A. BASE LOCALITY TRANSPORT TEAM 58 DAMANKO 411005457 E.P. Church of Ghana (single locality E.A.) SIBI HILL TOP Vehicle A 1 59 DAMANKO 411009460 Sibi Central Market (single locality E.A.) SIBI CENTRAL Vehicle A 2 60 DAMANKO 411026463 Jato Kwaku's House (single locality E.A.) JATO KPRAKPRA 2 motorbikes 3 51 DAMANKO 411001769 Obunja (single locality E.A.) OBUNJA Vehicle B 4

DAY 14 Thursday, October 31, 2002 CLUSTER SUB-DISTRICT E.A. CODEE.A. BASE LOCALITY TRANSPORT TEAM 38 BREWANIASE 411001705 Laboano LABOANO Vehicle A 1 39 BREWANIASE 411001714 New Ahodwo NEW AHODWO Vehicle A 2 45 TUTUKPENE 411001718 Adam Akura ADAM AKURA 2 motorbikes 3 37 BREWANIASE 411001702 Abubruwa (single locality E.A.) ABUBRUWA Vehicle B 4

DAY 15 Friday, November 1, 2002 CLUSTER SUB-DISTRICT E.A. CODEE.A.BASE LOCALITY TRANSPORT TEAM 14 KPASSA 411001736 Kunji (single locality E.A.) KUNJI Vehicle A 1 15 KPASSA 411001738 Dawa (single locality E.A.) DAWA Vehicle A 2 17 KPASSA 411001744 Nyakoma NYAKOMA Vehicle B 3 18 KPASSA 411001751 Obitiyie OBITIYIE Vehicle B 4

Individual Identity Codes

. Field Team 1 Pamela Quaye, Supervisor 10 Haibor Comfort 11 Wayen George 12 Eric Akpabli 13

. Field Team 2 E. Lambert, Supervisor 20 Rosena Danso 21 Michael Agdo 22 Getor Emmanuel 23

. Field Team 3 Constant Dedo, Supervisor 30 Eunice Kwakofi 31 Edmund Tsogbey 32 Paul Donkor 33

. Field Team 4 Dina Yakobu, Supervisor 40 Dorwu Elorm 41 Maxwell Agbolosu 42 Hamid Safiano 43

. Data Management Ellie Feinglass, Project Coordinator 01 Diana Ideidgo 02 Enos Amado 03

Calendar Of Historical Events (to be used as a guide for estimating age)

* The district CHPS Evaluation Coordinator should be sure to update this conversion table each year.

. NATIONAL EVENTS

# OF NATIONAL EVENT YEAR YEARS UP TO 2004

Overhead telegraph opened in the Gold Coast 1887 117 Rev. T.B. Freeman died in Accra 1890 114 Commotion over proposed Crown Land Ordinance 1895 109 Gold Coast aborigines Rights Protection Society organized 1896 108 Invasion of Kumasi; King Prempeh taken prisoner 1896 108 King Prempeh removed from Sierra Leone to the Seychelles Islands 1900 104 Yaa Asantewaa war 1900 104 Capture of Yaa Asantewaa 1901 103 First World War 1914 90 West African currency notes introduced 1918 86 Armistice Day (End of First World War) 1918 86 Prince of Wales visited Gold Coast 1925 79 First Aeroplane arrived in Accra 1926 78 Dr. Kwegyir Aggrey died 1927 77 Takoradi Harbour opened 1928 76 Introduction of Basic Rate 1936 68 Cocoa hold–up 1938 66 Earthquake (30th June) 1939 65 Second World War started 1939 65 Eclipse of the sun 1947 57 Looting in various parts of the country following the shooting of Sergeant Adjetey and others 1948 56 Arrest of six leaders of the United Gold Coast Convention 1948 56 Founding of CPP by Kwame Nkrumah 1949 55 Positive Action declared 1950 54 Kwame Nkrumah made Leader of Government Business 1951 53 Kwame Nkrumah made first Prime Minister of the Gold Coast 1952 52 Ghana’s Independence 1957 47

36 # OF NATIONAL EVENT YEAR YEARS UP TO 2004

R.R. Amponsah and M.K. Apaloo (both opposition members arrested) 1958 46 Preventive Detention Act came into force 1958 46 French Togoland became an Independent State 1960 44 Ghana became a Republic 1960 44 Queen Elizabeth II visited Ghana 1961 43 Murder of former Congo Premier Patrice Lumumba 1961 43 Railway employees at Takoradi went on strike 1961 43 Kulungugu bomb explosion 1962 42 Tema Harbour opened 1962 42 Detention of Ako Adjei, Tawiah Adamafio and H. Coffie Crabbe 1962 42 President Nkrumah dismissed Sir Arku Korsah from his post as Chief Justice 1963 41 Flagstaff House shooting incident involving Ametewee 1964 40 Death of Dr. J. B. Danquah 1965 39 Formal opening of Akosombo Dam 1965 39 O.A.U. Summit Conference in Accra 1965 39 Introduction of decimal currency in Ghana (the Old Cedi and Old Pesewa) 1965 39 Military coup d’état in Nigeria 1966 38 Overthrow of President Nkrumah by the Army and the Police 1966 38 Introduction of the New Cedis and New Pesewas 1967 37 Death of Lieutenant –General E. K. Kotoka 1967 37 Lifting of ban on political activity in Ghana after the 1966 Coup 1969 35 Dr. K. A. Busia made Prime Minister of Ghana 1969 36 Death of Asantehene Nana Sir Osei Agyemang Prempeh II 1970 34 Formation of “Justice Party” by a merger of National alliance of Liberals and three other Opposition Parties 1970 34 Overthrow of Dr. K.A. Busia’s Progress Party Government by Colonel I.K. Acheampong 1972 32 Students harvest Sugar cane at Asutuare and Komenda 1972 32 Operation Feed Yourself Programme Launched 1972 32 Death of Dr. Kwame Nkrumah in Romania 1972 32 Arrival of Dr. Kwame Nkrumah’s corpse in Ghana from Guinea 1972 32 Ghana broke off diplomatic relations with Israel 1973 31 Introduction of right-hand traffic 1974 30 J.H. Mensah and two others arrested on sedition charges 1975 29 Creation of Supreme Military Council (SMC1) 1975 29

Appointment of Dr.Koranteng Addo’s Committee to gather 1977 27 information on how to implement the Union Government of Ghana 37 # OF NATIONAL EVENT YEAR YEARS UP TO 2004

1977 27 Closure of three Universities following student demonstrations against high food prices Strike action by members of Ghana Medical Association 1977 27 demanding the re-opening of the closed Universities 1977 27 The Ghana Bar Association called on the SMC1 Government to handover power to a Presidential Commission pending a return to civilian rule 1978 26 Discovery of oil in commercial quantities off-shore saltpond by Agri-Pecto Ghana Incorporated 1978 26 Referendum on Union Government 1978 26 Strike action by the Ghana Bar Association 1978 26 Demonstration by university students against the Union Government concept 1978 26 Invasion of Legon Campus by armoured police cars

Formation of People’s Movement for Freedom and Justice (PMFJ) 1978 26 by K.A.Gbedema, A.A. Afrifa and William Ofori-Atta

Banning of PMFJ, the Front for the Prevention of Dictatorship and 1978 26 the Third Force by General Acheampong

1978 26 General Acheampong removed from Office/Lt.-General F.W.K Akuffo became

Chairman of the reconstituted Supreme Military Council (SMC II) 1979 25 Dr.K.A.Busia died in London 1979 25 Appointment of Mr. Justice Amissah and Mrs. Gloria Amon-Nikoi as Attorney-General and Commissioner for Foreign Affairs, respectively 1979 25 Currency change exercise (¢50 notes added) 1979 25 An abortive uprising in which Flt. Lt. J.J. Rawlings was arrested

The revolution that overthrew SMC II, led by J.J. Rawlings as Chairman 1979 25

of the Armed Forces Revolutionary Council (AFRC)

1979 25 Execution of General Acheampong, General Akuffo, Lt. General A.A. Afrifa, 1979 25 Major General Utuka and four other Senior Military Officers 1979 25 General elections 1979 25 Major General Odartey Wellington given a state burial 1979 25 Demolition of Makola No. 1 market 1979 25 Mr. Justice Akuffo-Addo died and was buried at Akropong 1979 25 Second Round of Presidential Elections 1980 24 Handing Over of Power to the People’s National Party (PNP) Administration by the AFRC 1980 24 Usher Fort Jail Break by Captain Koda, Captain Okaikoi and three

other military personnel

38 # OF NATIONAL EVENT YEAR YEARS UP TO 2004

Pope John Paul II visited Ghana 1980 24 Head of Ahmadiyya Muslim visited Ghana 1981 23 Visit to Ghana by the Archbishop of Canterbury (Head of the Anglican 1981 23 Church) 1983 21 Commissioning of Ghana’s first satellite earth station at Nkuntunse 1984 20 Overthrow of PNP Administration by J.J. Rawlings as Chairman of the 1987 17 PNDC

Drought, bush fires, caterpillars and hunger (Rawlings chain) 1987 17 Cancellation of all A and O level results throughout West Africa 1989 15 Voters Registration Exercise 1991 13 Introduction of Second Phase of Junior Secondary Schools 1992 12 District Level Elections 1993 11 Constitution for the 4th Republic 1996 8 Election of JJ Rawlings as President of Ghana 1997 7 An elephant wandered into Navrongo 1998 6 Third round of Presidential elections (JJ Rawlings re-elected) 1998 6 Low water level at the Akosombo Dam 2000 4 Visit of the American President (President Clinton) 2000 4 Death of Dr. Hilla Limann (February) 2001 3 Election of President Kuffour (Fourth Republic) 2001 3

. REGIONAL EVENTS # OF REGIONAL EVENT YEAR YEARS UP TO 2004

CENTRAL AND WESTERN REGIONS

Opening of Aboso Mines 1878 126 Ten Winneba Rioters executed in Accra 1885 119 Cape Coast District visited by Locusts 1894 110 Deputation of Chiefs and Dignitaries embarked for England in Connection with proposed Land Bill 1897 107 Rev. William Stephen died in Shama 1899 105 First Train from Sekondi arrived in Kumasi 1903 101 Rev. Attoh-Ahuma died 1921 83 39 # OF REGIONAL EVENT YEAR YEARS UP TO 2004

Nana Attafua, Omanhene of Akim Kotoku died 1927 77 Governor Guggisberg died 1930 74 Nana Mbra Ansa died 1933 71 First section of Sese Oil Palm Plantation started 1934 70 Secondary schools in Cape Coast went on strike 1948 56 Ahanta/Dixcove Local Council was established 1952 52 Opening of St. Mary’s Training College at Apowa 1954 50 Nana Baidoo Bonsoe VIII died 1954 50 Tarkwa and Aboso Mines closed 1956 48 Opening of Busua Pleasure Beach 1963 41 Aboso Glass Factory started operations 1963 41 Nana Hima Dekyi XII (KC), Omanhene of Upper Dixcove died 1963 41 Visit of Queen Elizabeth II to Cape Coast Victoria Park with Osagyefo Dr. 1963 41 Kwame Nkrumah to unveil Queen Victoria (her mother)’s bust

Nana Aboayisa II, Chief of Ewusiajoe died 1964 40

Enstoolment of Nana Hima Dekyi XIII of Upper Dixcove 1964 40 Plane crash at Phillip Quarcoo Boy’s School (18th February) 1966 38 Death of Rev. John Kodwo Amissah, Catholic Archbishop of Cape Coast (11th September) 1992 12

Death of Nana Osabarima Kojo Mmrah V, Omanhene of Oguaa traditional area 1997 7

# OF REGIONAL EVENT YEAR YEARS UP TO 2004

GREATER ACCRA, EASTERN AND VOLTA REGIONS

Glover (Anwuma) War 1873 131 Sir Garnet Wolseley (Sagrante) War 1874 130 Anlo and Danish War, bombardment of Keta by the French (Arbeille) 1874 130 Alata and Havito set ablaze 1879 125 Anum township rebuilt after the Ashanti invasion 1882 122 Location of the Juabens in Koforidua 1884 120 Agreement with Chiefs of Pe and Fetish Chiefs of Togo 1884 120 Ho Civil War: Ashantis invaded Ho and Eweland 1884 120 Togoland was proclaimed a German protectorate 1886 118 Treaty between Mr. Riby-Williams and Chiefs of Aggravie, Battor, Mepe and Blappa 1888 116 Agreement by Chiefs of Krepi to keep road open 1892 112 Krobos driven from the Shai Hills by Governor Griffiths 1902 102 Execution of Sotordugbe of Aflao Viefe at Viefe 1906 98 Rev. A.W.Clerk of Basel Mission Church died at Aburi 1907 97 Dedication of Larteh Basel Mission Church 1908 96 Bubonic Plague (Akpornabu) 1913 91 Rev. Theopilus Opoku died at Akropong 1913 91 Major Agricultural Show took place at Krobo Odumase 1913 91 Motor Car first climbed Aburi Hill 1920 84 Anum-Peki political unrest 1921 83 Korle-Bu Hospital foundation laid 1925 79 Death of Odikro Anakwa of Mamfe 1925 79 Achimota School opened 1927 77 Opening of the joint Provincial Council at Dodowa 1941 63 Bishop Dr. John Ofreur Anglionby of the Anglican Missio visited Anum 1941 63 Governor Allen Burns visited Anum 1946 58 Anum and Boso Lands Boundary Commission inquiry by

Justice John Jackson 1953 51 Adomi Bridge (Volta) opened 1957 47 The Golden Jubilee of Nana Kumi VII 1960 44 Cutting of “Aryee Canal” at Kedzi near Keta 1963 41 Accra Floods 1995 9 Area Canal Commisoned at Kezi near Keta 41 2001 3 # OF REGIONAL EVENT YEAR YEARS UP TO 2004

ASHANTI AND BRONG AHAFO REGIONS

Golden Axe sent to Queen Victoria 1881 123 Kumasi defeated Adansi 1886 118 Invasion of Kumasi: King Prempeh taken prisoner 1896 108 Capt. R. Osborne Fraser died at Sampa 1899 105 First Train arrived in Kumasi 1903 101 Lt. Lionel Henry Trafford Martin of the 1st Gold Coast Regiment Died at Sampa 1905 99 Basel Missionaries arrived at Sampa 1919 85 King Prempeh I returned from exile 1925 79 Ashanti Techiman killed their Omanhene Yao Kramo 1927 77 Muslims led by Malam Halidu left Atebubu and settled at Prang 1927 77 Installation of King Prempeh II 1931 73 Kumasi Fort destroyed accidentally by fire 1932 72 Restoration of Ashanti Confederacy 1935 69 Suma became a member of the Ashanti Confederacy 1935 69 Telephone extension to Berekum 1946 58 Telephone service extended to Dormaa-Ahenkro 1948 56 Telephone service extended to Nsoatre 1954 50 Kwame Nkrumah visited Yeji 1955 49 Creation of the Brong Ahafo Region 1959 45 Foundation of Atebubu Training College laid 1965 39

42 # OF REGIONAL EVENT YEAR YEARS UP TO 2004

NORTHERN, UPPER EAST AND UPPER WEST REGIONS

Treaty concluded with Tongu, Bole, Daboya, Dagomba, Bimbilla for friendship and trade 1892 112

A Foreign army led by Samori to Bole destroyed small towns and villages around Bole 1892 112

Treaty with Dagarti, Mamprusi, Moshie, Banda, Chokosi, Salaa, Debre, Buipe, Busumsu for friendship and trade 1894 110

Treaty for Friendship and Protection – Dagarti, Mamprusi, Lakhama (Dasima), Gbelu (Bolugu), Achilon (Leo), Tumu, Kpan (Yela), Lobi, 1897 107 Bona, Moshie, Yeji and Salaga

Treaty for Friendship and Protection – Duruman, Issa, Buse, Wagu, 1898 106 Nadewe, Gindi and Debre

First Chiefs meeting at Yapei 923 81 First Aeroplane to Northern Territories 1934 70 Construction of Wa-Tamale Road 1940 64 The initial operation of the Gonja Development Company in Damongo (GDC) 1948 56

Gonja Development Company established 1950 54 Chiefs from the Northern Region visited Accra 1956 48 Epidemic known as “Accra Zukogli” 1957 47 Opening of Notre Dam Seminary and Navrongo Secondary School 1960 44 Death of Monsignor Alexis Abatey 1968 36 Construction of Tono Irrigation Dam started 1975 29 Shooting of Felli and others by firing Squad 1979 25 Fighting between Saboro and Wusungu 1985 19 Start of Mamprusi/Kusasi War in Bawku 1985 19 Major dust storm 1985 19 Start of army worm invasion 1988 16 Establishment of the University for Development Studies 1992 12 Opening of a University Campus in Navrongo 1995 9 Reconstruction (asphalting) of the Tamale-Paga Road 1997 7 Death of Yaa Naa, Chief of Dagbon (26th March) 2002 2

Age/Year Born Conversion Table

* The district CHPS Evaluation Coordinator should be sure to update this conversion table each year.

YEAR AGE IN YEAR AGE IN YEAR AGE IN BORN 2004 BORN 2004 BORN 2004

1900 104 1938 66 1976 28 1901 103 1939 65 1977 27 1902 102 1940 64 1978 26 1903 101 1941 63 1979 25 1904 100 1942 62 1980 24 1905 99 1943 61 1981 23 1906 98 1944 60 1982 22 1907 97 1945 59 1983 21 1908 96 1946 58 1984 20 1909 95 1947 57 1985 19 1910 94 1948 56 1986 18 1911 93 1949 55 1987 17 1912 92 1950 54 1988 16 1913 91 1951 53 1989 15 1914 90 1952 52 1990 14 1915 89 1953 51 1991 13 1916 88 1954 50 1992 12 1917 87 1955 49 1993 11 1918 86 1956 48 1994 10 1919 85 1957 47 1995 9 1920 84 1958 46 1996 8 1921 83 1959 45 1997 7 1922 82 1960 44 1998 6 1923 81 1961 43 1999 5 1924 80 1962 42 2000 4 1925 79 1963 41 2001 3 1926 78 1964 40 2002 2 1927 77 1965 39 2003 1 1928 76 1966 38 2004 0 1929 75 1967 37 1930 74 1968 36 1931 73 1969 35 1932 72 1970 34 1933 71 1971 33 1934 70 1972 32 1935 69 1973 31 1936 68 1974 30 1937 67 1975 29