TY - JOUR
T1 - Assessing the reliability of phone surveys to measure reproductive, maternal and child health knowledge among pregnant women in rural India
T2 - A feasibility study
AU - Ng, Angela
AU - Mohan, Diwakar
AU - Shah, Neha
AU - Scott, Kerry
AU - Ummer, Osama
AU - Chamberlain, Sara
AU - Bhatnagar, Aarushi
AU - Dhar, Diva
AU - Agarwal, Smisha
AU - Ved, Rajani
AU - Lefevre, Amnesty Elizabeth
N1 - Funding Information:
Competing interests All authors have completed the Unified Competing Interest form (available on request from the corresponding author) and declare that the research reported was funded by the Bill and Melinda Gates Foundation. AG, SC, PD are employed by BBC Media Action, one of the entities supporting programme implementation. The authors do not have other relationships and are not engaged in activities that could appear to have influenced the submitted work.
Funding Information:
Twitter Kerry Scott @kerfully, Osama Ummer @ OsamaUmmer?t=ac8vollkoRHLSuYvW_n5mQ&s=08 and Amnesty Elizabeth LeFevre @Amnesty_LeFevre Acknowledgements We thank the women and families of Madhya Pradesh who generously gave their time to support this work. We are humbled by the opportunity to convey their perspectives and experiences. We additionally are grateful to Neha Dumke and the team at the National Health Systems Resource Centre (NHSRC) for their support. This work was made possible by the Bill and Melinda Gates Foundation. We thank Diva Dhar, Suhel Bidani, Rahul Mullick, Dr Suneeta Krishnan, Dr Neeta Goel and Dr Priya Nanda for believing in us and giving us this opportunity. We additionally wish to thank the larger team of enumerators from OPM-India and NHSRC who worked tirelessly over many months to implement the surveys that form the backbone of our analyses. We additionally thank Vinit Pattnaik at OPM and Erica Crawford at Johns Hopkins University for the financial management support of our work.
Publisher Copyright:
© Authors 2022
PY - 2022/3/10
Y1 - 2022/3/10
N2 - Objectives Efforts to understand the factors influencing the uptake of reproductive, maternal, newborn, child health and nutrition (RMNCH&N) services in high disease burden low-resource settings have often focused on face-to-face surveys or direct observations of service delivery. Increasing access to mobile phones has led to growing interest in phone surveys as a rapid, low-cost alternatives to face-to-face surveys. We assess determinants of RMNCH&N knowledge among pregnant women with access to phones and examine the reliability of alternative modalities of survey delivery. Participants Women 5-7 months pregnant with access to a phone. Setting Four districts of Madhya Pradesh, India. Design Cross-sectional surveys administered face-to-face and within 2 weeks, the same surveys were repeated among two random subsamples of the original sample: face-to-face (n=205) and caller-attended telephone interviews (n=375). Bivariate analyses, multivariable linear regression, and prevalence and bias-adjusted kappa scores are presented. Results Knowledge scores were low across domains: 52% for maternal nutrition and pregnancy danger signs, 58% for family planning, 47% for essential newborn care, 56% infant and young child feeding, and 58% for infant and young child care. Higher knowledge (≥1 composite score) was associated with older age; higher levels of education and literacy; living in a nuclear family; primary health decision-making; greater attendance in antenatal care and satisfaction with accredited social health activist services. Survey questions had low inter-rater and intermodal reliability (kappa<0.70) with a few exceptions. Questions with the lowest reliability included true/false questions and those with unprompted, multiple response options. Reliability may have been hampered by the sensitivity of the content, lack of privacy, enumerators' and respondents' profile differences, rapport, social desirability bias, and/or enumerator's ability to adequately convey concepts or probe. Conclusions Phone surveys are a reliable modality for generating population-level estimates data about pregnant women's knowledge, however, should not be used for individual-level tracking. Trial registration number NCT03576157.
AB - Objectives Efforts to understand the factors influencing the uptake of reproductive, maternal, newborn, child health and nutrition (RMNCH&N) services in high disease burden low-resource settings have often focused on face-to-face surveys or direct observations of service delivery. Increasing access to mobile phones has led to growing interest in phone surveys as a rapid, low-cost alternatives to face-to-face surveys. We assess determinants of RMNCH&N knowledge among pregnant women with access to phones and examine the reliability of alternative modalities of survey delivery. Participants Women 5-7 months pregnant with access to a phone. Setting Four districts of Madhya Pradesh, India. Design Cross-sectional surveys administered face-to-face and within 2 weeks, the same surveys were repeated among two random subsamples of the original sample: face-to-face (n=205) and caller-attended telephone interviews (n=375). Bivariate analyses, multivariable linear regression, and prevalence and bias-adjusted kappa scores are presented. Results Knowledge scores were low across domains: 52% for maternal nutrition and pregnancy danger signs, 58% for family planning, 47% for essential newborn care, 56% infant and young child feeding, and 58% for infant and young child care. Higher knowledge (≥1 composite score) was associated with older age; higher levels of education and literacy; living in a nuclear family; primary health decision-making; greater attendance in antenatal care and satisfaction with accredited social health activist services. Survey questions had low inter-rater and intermodal reliability (kappa<0.70) with a few exceptions. Questions with the lowest reliability included true/false questions and those with unprompted, multiple response options. Reliability may have been hampered by the sensitivity of the content, lack of privacy, enumerators' and respondents' profile differences, rapport, social desirability bias, and/or enumerator's ability to adequately convey concepts or probe. Conclusions Phone surveys are a reliable modality for generating population-level estimates data about pregnant women's knowledge, however, should not be used for individual-level tracking. Trial registration number NCT03576157.
KW - community child health
KW - maternal medicine
KW - neonatal intensive & critical care
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UR - http://www.scopus.com/inward/citedby.url?scp=85126399801&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2021-056076
DO - 10.1136/bmjopen-2021-056076
M3 - Article
C2 - 35273055
AN - SCOPUS:85126399801
SN - 2044-6055
VL - 12
JO - BMJ open
JF - BMJ open
IS - 3
M1 - e056076
ER -