Interviewer effects on abortion reporting: a multilevel analysis of household survey responses in Côte d’Ivoire, Nigeria and Rajasthan, India

ObjectivesThe analysis aimed to assess the scale of interviewer effects on abortion survey responses, to compare interviewer effects between different question wordings and between direct and indirect approaches, and to identify interviewer and interview characteristics that explain interviewer effects on abortion reporting.Setting2018 Performance Monitoring for Action nationally representative household surveys from Côte d’Ivoire, Nigeria and Rajasthan, India.ParticipantsSurvey data from 20 016 interviews with reproductive age (15–49) women, selected using multistage stratified cluster sampling. Data from self-administered interviewer surveys and from a sample of health service delivery points that serve the female survey participants were also included.Primary outcome measuresOutcomes were the respondent’s own experience of ever ‘removing a pregnancy’, their closest confidante’s experience of pregnancy removal and the respondent’s own experience of period regulation.ResultsSubstantial interviewer effects were observed, ranging from 7% in Côte d’Ivoire to 24% in Nigeria for pregnancy removal. Interviewer effects for survey questions that were designed to ask about abortion in a less stigmatising way were either similar to (9%–26% for confidante-reporting) or higher than (17%–32% for a question about period regulation) the pregnancy removal question. Interviewer and interview characteristics associated with abortion reporting included respondent–interviewer familiarity, the language of interview and the interviewer’s comfort asking questions about abortion.ConclusionThis study highlights that questions designed to be less stigmatising may increase interviewer effects due to lower comprehension among respondents. Further work is needed to assess question wordings for different contexts. Selecting and training interviewers to ensure comfort asking questions about abortion is important for reproductive health surveys. Challenges for the use of ‘insider’ interviewers and the management of surveys in countries with high linguistic diversity are also identified.

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The Potential of Food Fortification to Add Micronutrients in Young Children and Women of Reproductive Age – Findings from a Cross-Sectional Survey in Abidjan, Côte d’Ivoire

PLoS ONE ◽

10.1371/journal.pone.0158552 ◽

2016 ◽

Vol 11 (7) ◽

pp. e0158552 ◽

Cited By ~ 4

Author(s):

Fabian Rohner ◽

Magali Leyvraz ◽

Amoin G. Konan ◽

Lasme J. C. E. Esso ◽

James P. Wirth ◽

...

Keyword(s):

Young Children ◽

Cote D'ivoire ◽

Côte D’Ivoire ◽

Reproductive Age ◽

Food Fortification ◽

Women Of Reproductive Age ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Cote D’Ivoire ◽

Côte D'ivoire

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The Effects of an Oil and Wheat Flour Fortification Program on Pre-School Children and Women of Reproductive Age Living in Côte d’Ivoire, a Malaria-Endemic Area

Nutrients ◽

10.3390/nu8030148 ◽

2016 ◽

Vol 8 (3) ◽

pp. 148 ◽

Cited By ~ 8

Author(s):

Fabian Rohner ◽

Giovanna Raso ◽

Sassor Aké-Tano ◽

Andreas Tschannen ◽

Christopher Mascie-Taylor ◽

...

Keyword(s):

Wheat Flour ◽

School Children ◽

Cote D'ivoire ◽

Endemic Area ◽

Côte D’Ivoire ◽

Reproductive Age ◽

Malaria Endemic Area ◽

Women Of Reproductive Age ◽

Cote D’Ivoire ◽

Côte D'ivoire

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Social network-based measurement of abortion incidence: promising findings from population-based surveys in Nigeria, Cote d’Ivoire, and Rajasthan, India

Population Health Metrics ◽

10.1186/s12963-020-00235-y ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Suzanne O. Bell ◽

Mridula Shankar ◽

Elizabeth Omoluabi ◽

Anoop Khanna ◽

Hyacinthe Kouakou Andoh ◽

...

Keyword(s):

Social Network ◽

Cote D'ivoire ◽

Côte D’Ivoire ◽

Removal Rate ◽

Population Based ◽

Incidence Rates ◽

Reproductive Age ◽

Cote D’Ivoire ◽

Côte D'ivoire ◽

Abortion Incidence

Abstract Background Monitoring abortion rates is highly relevant for demographic and public health considerations, yet its reliable estimation is fraught with uncertainty due to lack of complete national health facility service statistics and bias in self-reported survey data. In this study, we aim to test the confidante methodology for estimating abortion incidence rates in Nigeria, Cote d’Ivoire, and Rajasthan, India, and develop methods to adjust for violations of assumptions. Methods In population-based surveys in each setting, female respondents of reproductive age reported separately on their two closest confidantes’ experience with abortion, in addition to reporting about their own experiences. We used descriptive analyses and design-based F tests to test for violations of method assumptions. Using post hoc analytical techniques, we corrected for biases in the confidante sample to improve the validity and precision of the abortion incidence estimates produced from these data. Results Results indicate incomplete transmission of confidante abortion knowledge, a biased confidante sample, but reduced social desirability bias when reporting on confidantes' abortion incidences once adjust for assumption violations. The extent to which the assumptions were met differed across the three contexts. The respondent 1-year pregnancy removal rate was 18.7 (95% confidence interval (CI) 14.9–22.5) abortions per 1000 women of reproductive age in Nigeria, 18.8 (95% CI 11.8–25.8) in Cote d’Ivoire, and 7.0 (95% CI 4.6–9.5) in India. The 1-year adjusted abortion incidence rates for the first confidantes were 35.1 (95% CI 31.1–39.1) in Nigeria, 31.5 (95% CI 24.8–38.1) in Cote d’Ivoire, and 15.2 (95% CI 6.1–24.4) in Rajasthan, India. Confidante two’s rates were closer to confidante one incidences than respondent incidences. The adjusted confidante one and two incidence estimates were significantly higher than respondent incidences in all three countries. Conclusions Findings suggest that the confidante approach may present an opportunity to address some abortion-related data deficiencies but require modeling approaches to correct for biases due to violations of social network-based method assumptions. The performance of these methodologies varied based on geographical and social context, indicating that performance may be better in settings where abortion is legally and socially restricted.

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Prevalence and public health relevance of micronutrient deficiencies and undernutrition in pre-school children and women of reproductive age in Côte d'Ivoire, West Africa

Public Health Nutrition ◽

10.1017/s136898001300222x ◽

2013 ◽

Vol 17 (9) ◽

pp. 2016-2028 ◽

Cited By ~ 16

Author(s):

Fabian Rohner ◽

Christine Northrop-Clewes ◽

Andres B Tschannen ◽

Patrice E Bosso ◽

Valérie Kouassi-Gohou ◽

...

Keyword(s):

Public Health ◽

Vitamin A ◽

Cote D'ivoire ◽

Côte D’Ivoire ◽

Vitamin A Deficiency ◽

Public Health Problem ◽

Reproductive Age ◽

Vitamin B ◽

Cote D’Ivoire ◽

Côte D'ivoire

AbstractObjectiveTo provide nationally representative data on the prevalence of anaemia, vitamin A and Fe deficiencies among pre-school age children (pre-SAC) and non-pregnant women of reproductive age (WRA), and on vitamin B12and folate deficiencies in WRA, and the influence of inflammation on their interpretation.DesignA cross-sectional survey to measure anthropometry, malaria parasitaemia and micronutrient status. Specifically, blood samples were analysed for Hb, plasma ferritin, soluble transferrin receptors, C-reactive protein, α1-acid glycoprotein, retinol-binding protein, vitamin B12and folate.SettingCôte d'Ivoire in 2007.SubjectsNine hundred and twenty-eight WRA and 879 pre-SAC.ResultsIn WRA, prevalence ofPlasmodiumparasitaemia (5 %) was low, but inflammation (34 %) was higher. Anaemia was a severe public health problem and prevalence differed by residency and eco-region. Inflammation-adjusted Fe deficiency was highest in urban areas (20 %). Nationally, folate deficiency was 86 %, higher in urban areas and varied by eco-region. Prevalence of vitamin B12deficiency was low but higher in the rural areas and the north. Inflammation-adjusted vitamin A deficiency was very low (1 %). In pre-SAC, prevalence of inflammation (67 %) andPlasmodiumparasites (25 %) was high; the latter was associated with poverty, rural residency and higher ferritin concentrations. Anaemia was classified as a severe public health problem (72 %), and was higher in rural areas (76 %) and the north (87 %). A quarter of pre-SAC suffered from vitamin A deficiency (inflammation-adjusted) and prevalence of undernutrition was high.ConclusionsPrevalence of inflammation,Plasmodiumparasitaemia and micronutrient deficiencies were high in Côte d'Ivoire, particularly in pre-SAC. Nutritional interventions should be accompanied by strategies to reduce exposure to infections.

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Comparison of a possession score and a poverty index in predicting anaemia and undernutrition in pre-school children and women of reproductive age in rural and urban Côte d'Ivoire

Public Health Nutrition ◽

10.1017/s1368980012002819 ◽

2012 ◽

Vol 15 (9) ◽

pp. 1620-1629 ◽

Cited By ~ 8

Author(s):

Fabian Rohner ◽

Andres B Tschannen ◽

Christine Northrop-Clewes ◽

Valérie Kouassi-Gohou ◽

Patrice E Bosso ◽

...

Keyword(s):

School Children ◽

Cote D'ivoire ◽

Rural Areas ◽

Côte D’Ivoire ◽

Venous Blood ◽

Reproductive Age ◽

Poverty Index ◽

Women Of Reproductive Age ◽

Cote D’Ivoire ◽

Côte D'ivoire

AbstractObjectiveTo determine whether a possession score or a poverty index best predicts undernutrition and anaemia in women of reproductive age (15–49 years; WRA) and children aged 6–59 months living in Côte d'Ivoire.DesignAnthropometric measurements were converted to Z-scores to assess stunting, wasting and underweight in children, and converted to BMI in WRA. A venous blood sample was drawn, and Hb concentration and Plasmodium spp. infection were determined. A possession score was generated with categories of zero to four possessions. A five-point (quintile) poverty index using household assets was created using principal component analysis. These socio-economic measures were compared for their ability to predict anaemia and malnutrition.SettingData were from a nationally representative survey conducted in Côte d'Ivoire in 2007.SubjectsA sample of 768 WRA and 717 children aged 6–59 months was analysed.ResultsOverall, 74·9 % of children and 50·2 % of WRA were anaemic; 39·5 % of the children were stunted, 28·1 % underweight and 12·8 % wasted, while 7·4 % of WRA had BMI < 18·5 kg/m2. In general, there were more stunted and underweight children and thin WRA in rural areas. The poverty index showed a stronger relationship with nutritional status than the possession score; mean Hb difference between the poorest and wealthiest quintiles in children and WRA was 8·2 g/l and 6·5 g/l, respectively (13·9 % and 19·8 % difference in anaemia, respectively; P < 0·001), and Z-scores and BMI were significantly better in the wealthiest quintile (P < 0·001).ConclusionsThe poverty index was generally a better predictor of undernutrition in WRA and pre-school children than the possession score.

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