Knowledge Practice & Coverage Survey (KPC) Overview & resources Moving from research objectives, questions, hypothesis to questionnaire design Day 3: Session 10:30-11:30am – Jennifer Luna Operations Research Workshop February 16, 2011

Agenda  Brief overview of the KPC tool and resources  Description of analysis needed to move from research objectives, questions and hypothesis to questionnaire design  Small group exercise of applying this analysis to PVO studies

KPC  Developed by JHU / CSSP 1990  Based on 30x7 cluster methodology used by EPI program Developed 25+ years ago Rapid, lower cost methodology by visiting only 30 sites EPI methodology validated by computer simulation  Used by PVOs for CSHGP grants since 1991  Collected at baseline, mid-term and final  Same questions, indicators at baseline, MTE, FE

KPC Consists of:  12 modules (technical areas) Grantees select modules relevant to technical areas of project Within each module, grantees select questions and indicators relevant to interventions  Rapid CATCH questions and indicators All grantees collect this information regardless of technical interventions Currently 18 indicators  Key indicators Highly recommended for each technical area, included in modules

KPC  Targets mothers of children 0-23 months  Two standard sampling methodologies  30x10 cluster sample of 300 (coverage for entire project area)  LQAS sample of 95 (coverage for entire project area) or 19/supervision area to determine if target reached  Updated to be compatible with:  DHS; USAID priority indicators; LiST Tool; Common Evaluation Framework; MEASURE Evaluation; Malaria MERG; findings from SNL; future MCHIP findings

KPC 30x10 - Cluster  PPS used to select 30 clusters  In each cluster, 10 interviews conducted with mothers of children 0-23 months  Total of 300 interviews  One questionnaire with all indicators used  Sub-sets of these interviews analyzed for indicators with different denominators  ORT use for children w/diarrhea last 2 weeks, Denominator children w/diarrhea last two weeks  Births attended by skilled personnel, Denominator, all children 0-23 months  (May be too small to answer OR questions about sub-sets)  Information at the project area level, but not for sub-areas

Resources: MCHIP NGO/PVO support website (  Rapid CATCH (questionnaire, tabulation plan)  Key indicators  12 Modules (questionnaires, tabulation plans)  Documents useful for implementation:  Rapid Catch Requirements by Cycle  How to Write a Survey Report  Methodology and Sampling Appendix  Procedures for anthropometric measurement  KPC Field Guide

Resources: MCHIP NGO/PVO support website  Rapid Health Surveys Handbook (Public Health Institute) CORE website: (  KPC Trainer of Survey Trainers (TOAST)  LQAS trainers guides  LQAS protocol for parallel sampling  LQAS FAQs

Moving from objectives, research questions and hypotheses to questionnaire design

 List each piece of information separately for objectives, questions and hypotheses  ANC, skilled attendance at birth, appropriate response to newborn complications,  Find out if there is consistency of information needed for objectives, research questions and hypotheses.  If not re-write so that there is consistency

 What questions should you consider to determine if this piece of information should be in a survey?

Questions to ask about each piece of information 1.Is this appropriate to be collected through a household survey? 1. If not what is an alternative method for obtaining this information? 2.Is it well enough defined to be collected through a survey? 3.What is the target population to be interviewed for the information? 4.Is the event for which you want to collect information rare or common? 1. If it is rare, how large a sample size would you need to collect this information? 5.Will the project actually have an effect on the event you are measuring? 6.How complicated is it to collect the information through a survey?

 Check to see if an appropriate indicator is in KPC tool; if so use it  If the event is rare, try to develop an indicator that closely measures the same thing but is not so rare  Re-write indicators to avoid needing many sampling groups

 Consistency between information needed for objectives, research questions and hypothesis  Use language that directly links to information that is not complicated to measure  Use language that describes events, conditions, or outcomes on which the the project will have an effect

Moving from objectives, research questions and hypotheses to questionnaire design

Hypothesis CRS Nicaragua: Increasing awareness among men in regards to recognizing danger signs during pregnancy and newborn periods, and by motivating them to make joint decisions with their wives will result in boosting seeking care during obstetric and newborn emergencies in a timely manner and an increase in ANC, institutional deliveries; therefore improving maternal and newborn health.

Information needed for hypothesis 1.Men recognize danger signs during pregnancy 2.Men recognize danger signs during newborn period 3.Men make joint decisions with their wives 4.Care seeking during obstetrical emergencies 5.Care seeking during newborn emergencies 6.ANC 7.Skilled attendance at birth

Men make joint decision with their wives 1.Is this appropriate to be collected through a household survey?  If not what is an alternative method for obtaining this information? 2.Is it well enough defined to be collected through a survey? 3.What is the target population to be interviewed for the information?

Men make joint decision with their wives 4.Is the event for which you want to collect information rare or common?  If it is rare, how large a sample size would you need to collect this information? 5.Will the project actually have an effect on the event you are measuring? 6.How complicated is it to collect the information through a survey?

Care seeking during obstetrical emergencies 1.Is it well enough defined to be collected through a survey? 2.What is the target population to be interviewed for the information? 3.Is the event for which you want to collect information rare or common?  If it is rare, how large a sample size would you need to collect this information?

KPC indicators available for:  ANC:  % of mothers of children age 0-23 months who had four or more antenatal visits when they were pregnant with the youngest child  Skilled attendance at birth:  % of children 0-23 months whose births were attended by skilled personnel

Project defined indicator for:  Men make joint decisions with their wives  % of men that responded that the decision to seeking care during pregnancy was made with their wives.

Once ready to develop questionnaire  Write the questionnaire  If appropriate use KPC questions  Translate  Back translate  Adjust translation  Pre-test  Adjust questionnaire

Small group work WV CHS-URC AKF CFI CORE Mercy Corp CARE CRS Concern Worldwide IRD Africare HKI

Exercise: Evaluative phase  Starting point for is revised hypothesis  Objectives and research questions from evaluative phase they are included in the concept paper  Group helps each new grantee to complete questionnaire preparation process  Worksheet (4 steps)  Reference from Rapid Household Survey Handbook  Very short plenary discussion about the process