Maternal Health Survey 2007 - Ghana

Abstract
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The 2007 Ghana Maternal Health Survey (GMHS) is intended to serve as a source of data on maternal health and maternal death for policymakers and the research community involved in the R3M program. Specifically, the data collected in the GMHS is intended to help the GoG and the consortium of organizations participating in the R3M program to launch a series of collaborative efforts to significantly expand women’s access to modern family planning services and comprehensive abortion care (CAC), reduce unwanted fertility, and reduce severe complications and deaths resulting from unsafe abortion.

The GMHS collected data from a nationally representative sample of households and women of reproductive age (15-49). The data were collected in two phases. The primary objectives of the 2007 GMHS were:
• To collect data at the national level that will allow an assessment of the level of maternal mortality in Ghana for the country as a whole, for the R3M program regions (Greater Accra, Ashanti and Eastern Regions), and for the non-program regions;
• To identify specific causes of maternal and non-maternal deaths, and specifically to be able to identify deaths due to abortion-related causes, among adult women;
• To collect data on women’s perceptions and experience with antenatal, maternity, and emergency obstetrical care, especially with regard to care received before, during, and after the termination or abortion of a pregnancy;
• To measure indicators of the utilization of maternal health services and especially post-abortion care services in Ghana; and
• To provide baseline data for the R3M program and for follow-on studies and surveys that will be used to observe possible reductions in maternal mortality as well as reductions in abortion-related mortality.

Geographic coverage
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National

Analysis unit
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- Household
- Women age 15-49

Kind of data
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Sample survey data [ssd]

Sampling procedure
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Sample size: Phase I:240,000 households, Phase II: 4,203 verbal autopsies,10,858 households and 10,370 women age 15-49

Note: See detailed sample implementation tables is provided in APPENDIX B of the report which is presented in this documentation.

Mode of data collection
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Face-to-face [f2f]

Research instrument
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The GMHS involved four questionnaires:
(1) a Phase I short household questionnaire administered at the time of listing;
(2) a Phase II verbal autopsy questionnaire administered in households identified at listing as having experienced the death of a female household member age 12-49;
(3) a Phase II long-form household questionnaire administered in independently selected households chosen for the individual woman’s interview, and
(4) a Phase II questionnaire for individual women age 15-49 in the same phase two selected households.

The primary purpose of the short household questionnaire administered at the time of listing during Phase I was to identify deaths to women age 12-49, for administering the verbal autopsy questionnaire on the causes of female deaths, particularly maternal deaths and abortion-related deaths. Unique identifiers for households in phase one and households in phase two were not maintained; therefore households cannot be matched across both phases of the survey.

Response rate
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A total of 11,579 households were selected for the sample, of which 10,994 were occupied at the time of the survey and 10,858 (or 99 percent) were successfully interviewed. The difference is primarily due to dwellings being vacant or the inhabitants being gone for an extended period at the time of the survey. In the interviewed households, 10,627 women were identified as eligible for the individual interview (women age 15-49), and interviews were completed for 10,370, or 98 percent. The principal reason for nonresponse among eligible women was the failure to find them at home, despite repeated visits to the household. The refusal rate was low in both urban and rural areas.

Note: See summarized response rates in Table 1.2 of the report which is presented in this documentation.

Sampling error estimates
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See detailed sampling error tables in APPENDIX D of the report which is presented in this documentation.

Data appraisal
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Data Quality Tables
- Household age distribution
- Age distribution of eligible and interviewed women
- Completeness of reporting
- Births by calendar years
- Reporting of age at death in days
- Reporting of age at death in months
- Data on siblings
- Indicators of data quality
- Sibship size and sex ratio of siblings
- Additional data on siblings
- Imputation of data on living female siblings by age group

Note: See detailed tables in APPENDIX C of the report which is presented in this documentation.

摘要
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2007年加纳孕产妇健康调查（GMHS）旨在为政策制定者和参与R3M项目的科研人员提供孕产妇健康和孕产妇死亡数据来源。具体而言，GMHS收集的数据旨在帮助加纳政府以及参与R3M项目的组织联盟开展一系列协作努力，显著扩大妇女对现代计划生育服务和综合终止妊娠护理（CAC）的获取，降低不想要的生育率，以及降低因不安全终止妊娠导致的严重并发症和死亡。
GMHS从全国代表性的家庭和育龄妇女（15-49岁）中收集数据。数据收集分为两个阶段。2007年GMHS的主要目标是：
• 收集国家级数据，以评估加纳整体、R3M项目地区（阿克拉大区、阿散蒂区和东部地区）以及非项目地区的孕产妇死亡率水平；
• 确定孕产妇和非孕产妇死亡的具体原因，特别是能够识别成人妇女因与终止妊娠相关的死亡原因；
• 收集关于妇女对产前、分娩和紧急产科护理的认知和体验数据，特别是关于在终止或终止妊娠前后所接受的护理；
• 衡量加纳孕产妇健康服务，尤其是终止妊娠后护理服务的利用指标；
• 为R3M项目以及后续研究和调查提供基线数据，这些研究和调查将用于观察孕产妇死亡率的可能降低以及与终止妊娠相关的死亡率的降低。
地理覆盖范围
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全国
分析单位
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- 家庭
- 15-49岁妇女
数据类型
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样本调查数据 [ssd]
抽样程序
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样本量：第一阶段：240,000个家庭，第二阶段：4,203次口头尸检，10,858个家庭和10,370名15-49岁妇女
注：详见报告中附录B提供的详细样本实施表格。
数据收集方式
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面对面 [f2f]
研究工具
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GMHS涉及四个问卷：
(1) 第一阶段在登记时进行的简短家庭问卷；
(2) 第二阶段在登记时被确定为经历过12-49岁女性家庭成员死亡的家庭进行的口头尸检问卷；
(3) 第二阶段在独立选择的、用于对单个妇女进行访谈的家庭进行的长期家庭问卷；
(4) 第二阶段在相同第二阶段选择的家庭中对15-49岁单个妇女进行的问卷。
第一阶段在登记时进行的简短家庭问卷的主要目的是确定12-49岁妇女的死亡情况，以便对女性死亡原因进行口头尸检，特别是孕产妇死亡和与终止妊娠相关的死亡。第一阶段和第二阶段的家庭唯一标识符未保持；因此，家庭无法在调查的两个阶段之间进行匹配。
响应率
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共选择了11,579个家庭进行样本调查，其中10,994个家庭在调查时有人居住，10,858个（或99%）成功接受了访谈。差异主要是由于住房空置或居民在调查时长期不在。在受访的家庭中，有10,627名妇女被确定为符合个人访谈条件（15-49岁妇女），访谈完成了10,370次，或98%。合格妇女未响应的主要原因是在多次访问家庭后未能找到她们。城乡地区的拒绝率都很低。
注：详见报告中表格1.2的总结响应率。
抽样误差估计
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详见报告中附录D的详细抽样误差表格。
数据评估
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数据质量表格
- 家庭年龄分布
- 合格和受访妇女的年龄分布
- 报告的完整性
- 日历年度出生
- 死亡年龄以天为单位报告
- 死亡年龄以月为单位报告
- 兄弟姐妹数据
- 数据质量指标
- 兄弟姐妹的规模和性别比
- 兄弟姐妹的附加数据
- 按年龄组对存活女性兄弟姐妹数据的补充
注：详见报告中附录C的详细表格。