Background

 

In October 2013, USAID /Bangladesh awarded a four-year contract for the Mayer Hashi (MH) II Family Planning Project. This project was built upon the previous experiences of the Mayer Hashi I 2009-2013 Project, which aimed to increase the use of long acting and permanent methods (LAPMs) in low-performing areas. The current MH II Project focuses on a national scale up of successful models, tools and approaches for promoting long acting and reversible contraceptive (LARC) and permanent method (PM) use and tests new innovations. MEASURE Evaluation, with the support of USAID, will examine changes in key outcome indicators related to MH II objectives and will evaluate the impact of MH II interventions at the population level. Mitra and Associates is conducted the Endline Survey of Mayer Hashi II project. The evaluation was based on baseline and endline individual level data collected through household surveys in Phase I districts and Phase III districts, with Phase III districts treated as the comparison area. Data on intermediate outcomes was collected from facilities and providers. The survey was carried out from March 16, 2017 and July 31, 2017.

 

Survey objectives

 

The principal objectives of the endline survey were the same as those of the baseline survey – to collect data on key outcome indicators from women in the Phase I and Phase III districts, with Phase I districts serving as the intervention area and Phase III districts serving as the comparison area. These data was used:

 

1. To assess changes in the indicators specified in the MH II   Project and 
2. To evaluate the contribution of the MH II project to any of these changes.

 

In addition, this study covered an assessment of the skills and practices of service providers in the provision of LARCs and PMs and a health facility assessment in the MH ll Phase I and Phase III districts.  The facilities included in the facility survey were those serving the communities in which the household interviews take place.

 

Survey method

 

Sample

 

The endline survey was conducted in the same 400 clusters in 46 districts that were selected for the baseline survey.  A new sample of households was selected in each of these clusters. The facilities included in the facility survey were the same facilities covered in the baseline survey, serving the communities in which the household interviews take place. Providers included FWV or paramedic, MO-MCH or MO (physician), and obstetrician/gynecologist from the sample facilities. The survey covered (a) currently married women of reproductive age (CMWRA) from 12,004 households, (b) 824 facilities, and (c) 1,648 providers.

 

Tool

 

Three different questionnaires for different group of participants were used in this survey. The questionnaires were short and focused on LARC/PM, and each of the questionnaires took approximately 30 minutes to complete:

 

1. Currently married women of reproductive ages (15-49) (CMWRA) questionnaire, including a short household section.
2. Service provider questionnaire – providers include: Ob/Gyn, MO-MCH, and RMO, FWV (DGFP and DGHS), medical officer (physician) and paramedic (NGO and private sector).
3. Health facility questionnaire – facilities include FWC/NGOclinics, UHC, and district hospitals/medical college hospitals.

 

Tasks to be carried out by Mitra and Associates

 

Preparatory works

 

The specific tasks for the preparation of the survey include:

 

1. To prepare  and submit the survey protocol to the local IRB;
2. Development of household listing form & translation, back translation, and modification of survey questionnaires
3. Develop technical manuals and forms e.g. Interviewers’, supervisors’ and editors’ manuals; Household listers’ manual and listing forms; and Interviewers’ and supervisor’s assignment sheets for control of fieldwork
4. To recruit  the field work team

 

Pre-testing

 

The pretest of the questionnaires was done in three areas outside the selected sample to check the translation, consistency and integrity of the questionnaire and made further modifications in tools. Pretest training took place for 4 days. In addition, 2 days was spent for field work and 1 day was spent for review.

 

Training

 

Training on household listing operation was conducted for 4 working days and an 11 days training program on data collection operation was organized for the field personnel including interviewers, supervisors and quality control officers and Doctors. The training covered the following:

 

1. To provide  required  ethics/human   subject protection  training  to all staff involved in survey activities;
2. To provide full-fledged listing operation training;
3. To provide full-fledged questionnaire training;

 

Data collection & quality control

 

Fourteen teams was deployed for listing fieldwork and the fieldwork was carried out for 2 months. 12 teams for HH and 12 teams for facility, provider & client were deployed for data collection for a period of 3 months. GPS coordinates for both the clusters and health facilities were collected along with the data collection. Quality control checking was undertaken both in presence and absence of the interviewing team in a sample cluster. It was designed to physically verify the right respondents in the right households by asking the right questions. Also was generated field check tables during the fieldwork to monitor and check the quality of fieldwork. 

 

Data processing & reporting

 

Data entry and cleaning was performed by using Cs-pro and SPSS software. Cleaning included checking of range, structure and a selected set of checks for internal consistency, frequency distribution to see the accuracy of data and prepared the preliminary data set and a final data set. Overall, the data processing & reporting covered the following:

 

1. To conduct  data entry and management;
2. To conduct appropriate quality checks at different stages of field work, data entry and data management  process;
3. To produce frequency distributions for the data sets;
4. To prepare preliminary and final datasets with appropriate documentation;
5. To draft a report describing all data collection and data management procedures, supervisor observations/comments, and limitations/problems encountered;

 

Client Reference & Contact Person

 

Measure Evaluation, University of North Carolina, Chapel Hill, USA.Dr. James C. Thomas, Principal Investigator, MEASURE Evaluation Carolina Population Center, University of North Carolina, Chapel Hill,400 Meadowmont Village Circle, 3rd Floor, Chapel Hill, NC 27517, USA. Telephone: 919-445-9350 Fax: 919-445-9353, E-mail: measure_subs@unc.edu; jim_thomas@unc.edu; web site: www.cpc.unc.edu/measure and represented by Mizanur Rahman, PhD, Senior Research Advisor MEASURE Evaluation as local Principal Investigator, Cell : 01732-678853, Email: mizanur@icddrb.org and mizanur20wood@gmail.com