Ghana

Maternal
Health
Survey
2017
 Ghana

Maternal Health Survey

2017

Ghana Statistical Service

Accra, Ghana

Ministry of Health
Accra, Ghana

The DHS Program

ICF
Rockville, Maryland, USA

August 2018
The 2017 Ghana Maternal Health Survey (2017 GMHS) was implemented by the Ghana Statistical Service (GSS)
and the Ghana Health Service (GHS) from 15 June through 12 October 2017. The funding for the 2017 GMHS
was provided by the Government of Ghana, the United States Agency for International Development (USAID),
the European Union (EU) delegation to Ghana, and the United Nations Population Fund (UNFPA). ICF provided
technical assistance through The DHS Program, a USAID-funded project providing support and technical
assistance in the implementation of population and health surveys in countries worldwide.

Additional information about the 2017 GMHS may be obtained from the Ghana Statistical Service, Head Office,
P.O. Box GP 1098, Accra, Ghana; Telephone: +233-302-682-661/+233-302-663-578; Fax: +233-302-664-301;
Email: info@statsghana.gov.gh.

Information about The DHS Program may be obtained from ICF, 530 Gaither Road, Suite 500, Rockville, MD
20850, USA; Telephone: +1-301-407-6500; Fax: +1-301-407-6501; E-mail: info@DHSprogram.com; Internet:
www.DHSprogram.com.

Suggested citation:

Ghana Statistical Service (GSS), Ghana Health Service (GHS), and ICF. 2018. Ghana Maternal Health Survey
2017. Accra, Ghana: GSS, GHS, and ICF.
CONTENTS

TABLES AND FIGURES .................................................................................................................................. vii

FOREWORD ..................................................................................................................................................... xiii
ABBREVIATIONS ............................................................................................................................................. xv
READING AND UNDERSTANDING TABLES FROM THE 2017 GMHS .............................................. xvii
SUSTAINABLE DEVELOPMENT GOAL INDICATORS ......................................................................... xxv
MAP OF GHANA ............................................................................................................................................ xxvi

1 INTRODUCTION AND SURVEY METHODOLOGY ..................................................................... 1

1.1 Survey Objectives ...................................................................................................................... 1
1.2 Sample Design ........................................................................................................................... 1
1.3 Questionnaires ............................................................................................................................ 3
1.4 Listing and Pretest ...................................................................................................................... 4
1.5 Training of Field Staff................................................................................................................ 5
1.6 Fieldwork ................................................................................................................................... 5
1.7 Verbal Autopsy Cause of Death Training and Coding ............................................................... 5
1.8 Data Processing .......................................................................................................................... 6
1.9 Response Rates .......................................................................................................................... 6

2 CHARACTERISTICS OF HOUSEHOLDS, HOUSEHOLD POPULATION,

AND RESPONDENTS ........................................................................................................................... 7
2.1 Drinking Water Sources and Treatment ..................................................................................... 7
2.2 Sanitation ................................................................................................................................... 8
2.3 Other Household Characteristics ................................................................................................ 9
2.4 Household Wealth ...................................................................................................................... 9
2.5 Household Population and Composition .................................................................................. 10
2.6 Basic Characteristics of Survey Respondents .......................................................................... 10
2.7 Disability .................................................................................................................................. 11
2.8 Education and Literacy ............................................................................................................ 11
2.9 Mass Media Exposure .............................................................................................................. 13
2.10 Bank Accounts, Mobile Phones, and Internet Usage ............................................................... 13
2.11 Health Insurance Registration and Coverage ........................................................................... 14

3 MARRIAGE AND SEXUAL ACTIVITY .......................................................................................... 29

3.1 Marital Status ........................................................................................................................... 29
3.2 Polygyny .................................................................................................................................. 30
3.3 Age at First Marriage ............................................................................................................... 30
3.4 Age at First Sexual Intercourse ................................................................................................ 31
3.5 Recent Sexual Activity............................................................................................................. 32

4 FERTILITY AND FAMILY PLANNING ......................................................................................... 37

4.1 Current Fertility ....................................................................................................................... 38
4.2 Children Ever Born and Living ................................................................................................ 39
4.3 Birth Intervals .......................................................................................................................... 39
4.4 Age at First Birth ..................................................................................................................... 40
4.5 Teenage Childbearing .............................................................................................................. 40
4.6 Contraceptive Knowledge and Use .......................................................................................... 41

5 MATERNAL HEALTH CARE .......................................................................................................... 57

5.1 Antenatal Care Coverage and Content ..................................................................................... 58
5.1.1 Skilled Providers ........................................................................................................ 58
5.1.2 Timing and Number of ANC Visits ........................................................................... 59
5.2 Components of ANC Visits ..................................................................................................... 59
5.3 Protection against Neonatal Tetanus ........................................................................................ 60
5.4 Delivery Services ..................................................................................................................... 61
5.4.1 Institutional Deliveries ............................................................................................... 61

Contents • iii
 5.4.2 Skilled Assistance during Delivery ............................................................................ 62
5.4.3 Delivery by Caesarean and Other Interventions ........................................................ 62
5.4.4 Problems during Delivery .......................................................................................... 63
5.5 Postnatal Care .......................................................................................................................... 63
5.5.1 Postnatal Health Check for Mothers .......................................................................... 63
5.5.2 Postnatal Health Check for Newborns ....................................................................... 64
5.6 Combinations of Maternal Care ............................................................................................... 65
5.7 Problems in Accessing Health Care ......................................................................................... 65

6 INDUCED ABORTION AND MISCARRIAGE ............................................................................... 87

6.1 Pregnancy Outcomes................................................................................................................ 87
6.2 Induced Abortions .................................................................................................................... 88
6.2.1 Main Reason for Induced Abortion ........................................................................... 88
6.2.2 Methods to Induce Abortion ...................................................................................... 89
6.2.3 Assistance for and Location of Induced Abortion ..................................................... 90
6.2.4 Contraceptive Use and Induced Abortion .................................................................. 91
6.3 Induced Abortion Knowledge and Access ............................................................................... 91
6.4 Legality of Induced Abortion ................................................................................................... 92
6.5 Miscarriage .............................................................................................................................. 92
6.5.1 Help Seeking after Miscarriage ................................................................................. 92
6.5.2 Contraceptive Use and Miscarriage ........................................................................... 93

7 INFANT AND CHILD MORTALITY ............................................................................................. 109

7.1 Infant and Child Mortality ..................................................................................................... 110
7.2 Biodemographic and Sociodemographic Risk Factors........................................................... 110
7.3 Perinatal Mortality ................................................................................................................. 111
7.4 High-Risk Fertility Behaviour................................................................................................ 112

8 ADULT AND MATERNAL MORTALITY .................................................................................... 117

8.1 Data ........................................................................................................................................ 117
8.2 Direct Estimates of Adult Mortality ....................................................................................... 118
8.3 Trends in Adult Mortality ...................................................................................................... 119
8.4 Direct Estimates of Maternal Mortality ................................................................................. 119
8.5 Trends in Pregnancy-Related Mortality ................................................................................. 121

9 CAUSES OF DEATH ........................................................................................................................ 127

9.1 Verbal Autopsy Questionnaire ............................................................................................... 127
9.2 Verbal Autopsy Fieldwork ..................................................................................................... 127
9.3 Cause of Death Certification and ICD-10 Coding ................................................................. 128
9.4 Limitations ............................................................................................................................. 129
9.5 Characteristics of Deceased Women ...................................................................................... 130
9.6 Cause-Specific Mortality ....................................................................................................... 131
9.7 Maternal Causes of Death ...................................................................................................... 131
9.8 Deceased Women and Health Care ........................................................................................ 133
9.8.1 Treatment Seeking for Deceased Women ................................................................ 133
9.8.2 Sources of Care for Deceased Women .................................................................... 134
9.8.3 Visits to Health Facilities before Death ................................................................... 135
9.8.4 Logistical and Financial Issues ................................................................................ 135
9.9 Death Certificates and Burial Permits .................................................................................... 136

REFERENCES ................................................................................................................................................. 145

APPENDIX A SAMPLE DESIGN ............................................................................................................... 147

A.1 Introduction ............................................................................................................................ 147
A.2 Sampling Frame ..................................................................................................................... 147
A.3 Sample design and the Sampling Procedure .......................................................................... 148
A.4 Selection Probability and Sampling Weight .......................................................................... 150
A.5 Survey Implementation Results ............................................................................................. 152

APPENDIX B ESTIMATES OF SAMPLING ERRORS .......................................................................... 153

iv • Contents
APPENDIX C DATA QUALITY TABLES ................................................................................................ 173

APPENDIX D PARTICIPANTS IN THE 2017 GHANA MATERNAL HEALTH SURVEY ............... 177

APPENDIX E TABULATION OF INTERNATIONAL CLASSIFICATION OF DISEASE (ICD)

10 OBSTETRIC CODES ..................................................................................................... 183

APPENDIX F QUESTIONNAIRES ........................................................................................................... 187

Household Questionnaire ..................................................................................................................... 189
Woman’s Questionnaire ....................................................................................................................... 199
Verbal Autopsy Questionnaire ............................................................................................................. 249
Fieldworker Questionnaire ................................................................................................................... 289

Contents • v
TABLES AND FIGURES

1 INTRODUCTION AND SURVEY METHODOLOGY ..................................................................... 1

Table 1.1 Results of the household and individual interviews ..................................................... 6

2 CHARACTERISTICS OF HOUSEHOLDS, HOUSEHOLD POPULATION,

AND RESPONDENTS ........................................................................................................................... 7
Table 2.1 Household drinking water .......................................................................................... 16
Table 2.2 Household sanitation facilities ................................................................................... 17
Table 2.3 Household characteristics .......................................................................................... 18
Table 2.4 Household possessions .............................................................................................. 18
Table 2.5 Wealth quintiles ......................................................................................................... 19
Table 2.6 Household population by age, sex, and residence ..................................................... 19
Table 2.7 Household composition ............................................................................................. 20
Table 2.8 Background characteristics of respondents ................................................................ 20
Table 2.9 Disability by domain and age .................................................................................... 21
Table 2.10 Educational attainment .............................................................................................. 22
Table 2.11 Literacy ...................................................................................................................... 23
Table 2.12 Exposure to mass media ............................................................................................ 24
Table 2.13 Ownership and use of bank accounts and mobile phones .......................................... 25
Table 2.14 Internet usage ............................................................................................................. 26
Table 2.15 Health insurance registration and coverage ............................................................... 27
Table 2.16 Health insurance and maternity benefits .................................................................... 28

Figure 2.1 Household drinking water by residence ....................................................................... 8

Figure 2.2 Household toilet facilities by residence ....................................................................... 8
Figure 2.3 Household wealth by residence ................................................................................... 9
Figure 2.4 Population pyramid .................................................................................................... 10
Figure 2.5 Education of survey respondents ............................................................................... 12
Figure 2.6 No education by region .............................................................................................. 12
Figure 2.7 Secondary education by household wealth ................................................................ 12
Figure 2.8 Exposure to mass media ............................................................................................ 13
Figure 2.9 Internet access in past 12 months and mobile phone ownership ................................ 14
Figure 2.10 Health insurance coverage by region ......................................................................... 15

3 MARRIAGE AND SEXUAL ACTIVITY .......................................................................................... 29

Table 3.1 Current marital status ................................................................................................. 33
Table 3.2 Number of women’s co-wives ................................................................................... 33
Table 3.3 Age at first marriage .................................................................................................. 34
Table 3.4 Median age at first marriage by background characteristics ...................................... 34
Table 3.5 Age at first sexual intercourse ................................................................................... 35
Table 3.6 Median age at first sexual intercourse by background characteristics ....................... 35
Table 3.7 Recent sexual activity ................................................................................................ 36

Figure 3.1 Trends in polygyny .................................................................................................... 30

Figure 3.2 Women’s median age at first sex and first marriage .................................................. 31
Figure 3.3 Trends in early sexual intercourse among women ..................................................... 32

4 FERTILITY AND FAMILY PLANNING ......................................................................................... 37

Table 4.1 Current fertility .......................................................................................................... 44
Table 4.2 Fertility by background characteristics ...................................................................... 44
Table 4.3.1 Trends in age-specific fertility rates .......................................................................... 45

Tables and Figures • vii

 Table 4.3.2 Trends in age-specific and total fertility .................................................................... 45
Table 4.4 Children ever born and living .................................................................................... 45
Table 4.5 Birth intervals ............................................................................................................ 46
Table 4.6 Age at first birth ......................................................................................................... 47
Table 4.7 Median age at first birth ............................................................................................. 47
Table 4.8 Teenage pregnancy and motherhood ......................................................................... 48
Table 4.9 Sexual and reproductive health behaviours before age 15 ......................................... 48
Table 4.10 Knowledge of contraceptive methods ........................................................................ 49
Table 4.11 Knowledge of contraceptive methods according to background characteristics ........ 50
Table 4.12 Current use of contraception according to age ........................................................... 51
Table 4.13.1 Current use of contraception by background characteristics ..................................... 52
Table 4.13.2 Trends in current use of contraception ....................................................................... 54
Table 4.14 Knowledge of a source of family planning among nonusers ..................................... 54
Table 4.15 Knowledge of fertile period ....................................................................................... 55
Table 4.16 Knowledge of fertile period by age ........................................................................... 55

Figure 4.1 Trends in fertility by residence .................................................................................. 38

Figure 4.2 Trends in age-specific fertility ................................................................................... 38
Figure 4.3 Fertility by region ...................................................................................................... 39
Figure 4.4 Birth intervals ............................................................................................................ 39
Figure 4.5 Median age at first birth by residence ........................................................................ 40
Figure 4.6 Teenage pregnancy and motherhood by residence .................................................... 41
Figure 4.7 Teenage pregnancy and motherhood by region ......................................................... 41
Figure 4.8 Contraceptive use....................................................................................................... 42
Figure 4.9 Trends in contraceptive use ....................................................................................... 42
Figure 4.10 Use of modern methods by residence ........................................................................ 42
Figure 4.11 Modern contraceptive use by region .......................................................................... 43

5 MATERNAL HEALTH CARE .......................................................................................................... 57

Table 5.1 Antenatal care ............................................................................................................ 66
Table 5.2 Reasons for not seeking antenatal care ...................................................................... 67
Table 5.3 Reasons for seeking antenatal care ............................................................................ 67
Table 5.4 Payments for antenatal care ....................................................................................... 68
Table 5.5 Number of antenatal care visits and timing of first visit ............................................ 69
Table 5.6 Components of antenatal care .................................................................................... 70
Table 5.7 Tetanus toxoid injections ........................................................................................... 71
Table 5.8 Place of delivery ........................................................................................................ 72
Table 5.9 Reasons for not delivering in a health facility ........................................................... 73
Table 5.10 Payments for delivery care ........................................................................................ 74
Table 5.11 Assistance during delivery ......................................................................................... 75
Table 5.12 Delivery interventions including Caesarean section .................................................. 76
Table 5.13 Duration of stay in health facility after birth.............................................................. 77
Table 5.14 Problems encountered during delivery ...................................................................... 77
Table 5.15 Timing of first postnatal check for the mother .......................................................... 78
Table 5.16 Type of provider of first postnatal check for the mother ........................................... 79
Table 5.17 Timing of first postnatal check for the newborn ........................................................ 80
Table 5.18 Type of provider of first postnatal check for the newborn ......................................... 81
Table 5.19 Content of postnatal care for newborns ..................................................................... 82
Table 5.20 Payments for postnatal checks ................................................................................... 83
Table 5.21 Combinations of antenatal care, assistance at delivery, and postnatal checks ........... 84
Table 5.22 Problems in accessing health care.............................................................................. 85

Figure 5.1 Trends in antenatal care coverage .............................................................................. 58

Figure 5.2 Components of antenatal care .................................................................................... 59
Figure 5.3 Trends in place of birth .............................................................................................. 61

viii • Tables and Figures

 Figure 5.4 Health facility births by education ............................................................................. 61
Figure 5.5 Trends in skilled assistance at delivery ...................................................................... 62
Figure 5.6 Postnatal checks on women ....................................................................................... 64

6 INDUCED ABORTION AND MISCARRIAGE ............................................................................... 87

Table 6.1 Pregnancy outcomes .................................................................................................. 94
Table 6.2 Lifetime experience with induced abortion ............................................................... 95
Table 6.3 Induced abortion and miscarriage in the past 5 years ................................................ 96
Table 6.4 Main reason for most recent induced abortion ........................................................... 97
Table 6.5 Partner’s attitude towards most recent induced abortion ........................................... 98
Table 6.6 Only/final method of most recent induced abortion .................................................. 99
Table 6.7 Assistance for and location of most recent induced abortion................................... 100
Table 6.8 Payment for, medications used during, and experience of health problems
after most recent induced abortion ........................................................................... 101
Table 6.9 Health problems and treatment after induced abortion ............................................ 101
Table 6.10 Contraception use before and discussions of contraception before and
after induced abortion .............................................................................................. 102
Table 6.11 Abortion knowledge and access............................................................................... 103
Table 6.12 Knowledge of places to get an abortion ................................................................... 104
Table 6.13 Miscarriage causes ................................................................................................... 105
Table 6.14 Seeking help after miscarriage ................................................................................. 106
Table 6.15 Treatment after miscarriage ..................................................................................... 107
Table 6.16 Health problems and treatment after miscarriage .................................................... 107
Table 6.17 Contraception use before and discussions of contraception before and after
miscarriage............................................................................................................... 108

Figure 6.1 Induced abortion methods .......................................................................................... 89

Figure 6.2 Non-medical methods by education........................................................................... 89
Figure 6.3 Problems within 1 month of most recent induced abortion ....................................... 91
Figure 6.4 Knowledge of legality of abortion by education ........................................................ 92
Figure 6.5 Problems within 1 month of most recent miscarriage ................................................ 93

7 INFANT AND CHILD MORTALITY ............................................................................................. 109

Table 7.1 Early childhood mortality rates ................................................................................ 113
Table 7.2 Five-year early childhood mortality rates according to background
characteristics .......................................................................................................... 113
Table 7.3 Ten-year early childhood mortality rates according to additional
characteristics .......................................................................................................... 114
Table 7.4 Perinatal mortality ................................................................................................... 115
Table 7.5 High-risk fertility behaviour .................................................................................... 116

Figure 7.1 Trends in early childhood mortality rates ................................................................ 110

Figure 7.2 Childhood mortality by previous birth interval ........................................................ 111
Figure 7.3 Under-5 mortality by region .................................................................................... 111

8 ADULT AND MATERNAL MORTALITY .................................................................................... 117

Table 8.1.1 Adult mortality rates: national ................................................................................. 123
Table 8.1.2 Adult mortality rates: zones ..................................................................................... 123
Table 8.2 Adult mortality probabilities .................................................................................... 124
Table 8.3.1 Maternal mortality: national .................................................................................... 124
Table 8.3.2 Maternal mortality: zones ........................................................................................ 124
Table 8.4 Maternal mortality ratio ........................................................................................... 125

Figure 8.1 Adult mortality rates by age ..................................................................................... 118

Figure 8.2 Zonal differences in Maternal Mortality Ratio (MMR) with confidence
intervals ................................................................................................................... 120

Tables and Figures • ix

 Figure 8.3 Trends in Pregnancy-Related Mortality Ratio (PRMR) with confidence
intervals ................................................................................................................... 122
Figure 8.4 Pregnancy-related mortality ratio in West Africa, 2010 2017 ................................. 122

9 CAUSES OF DEATH ........................................................................................................................ 127

Table 9.1 Background characteristics of deceased women ...................................................... 137
Table 9.2 Respondents to Verbal Autopsy Questionnaires ...................................................... 138
Table 9.3.1 All cause-specific mortality with provision for indirect maternal deaths ................ 138
Table 9.3.2 All cause-specific mortality ..................................................................................... 139
Table 9.4.1 Causes of maternal deaths following ICD-MM ....................................................... 139
Table 9.4.2 Causes of obstetric-coded deaths ............................................................................. 140
Table 9.5 Timing and onset period of causes of obstetric-coded deaths .................................. 140
Table 9.6 Treatment seeking for deceased women in the medical sector ................................ 141
Table 9.7 Treatment seeking for deceased women in the non-medical sector ......................... 141
Table 9.8 Source of care for deceased women ......................................................................... 142
Table 9.9 Visits to health facilities before death ...................................................................... 143
Table 9.10 Logistical and financial issues ................................................................................. 144
Table 9.11 Death certificates and burial permits ....................................................................... 144

Figure 9.1 All-cause mortality .................................................................................................. 131

Figure 9.2 Maternal causes of death.......................................................................................... 132
Figure 9.3 Causes of obstetric-coded deaths ............................................................................. 133
Figure 9.4 Use of medical care and traditional/herbal and/or spiritual medicine by cause
of death .................................................................................................................... 134
Figure 9.5 Logistical and financial issues by zone .................................................................... 135

APPENDIX A SAMPLE DESIGN ............................................................................................................... 147

Table A.1 Distribution of population by region and by type of residence ................................ 148
Table A.2 Distribution of residential households by region and by type of residence ............. 148
Table A.3 Distribution of enumeration areas and their average size in number of households 148
Table A.4 Sample allocation of clusters and households by region and by type of residence .. 149
Table A.5 Sample allocation of expected number of women interviews.................................. 150
Table A.6 Sample implementation: Women ............................................................................. 152

APPENDIX B ESTIMATES OF SAMPLING ERRORS .......................................................................... 153

Table B.1 List of selected variables for sampling errors, Ghana MHS 2017 ........................... 155
Table B.2 Sampling errors: Total sample, Ghana MHS 2017 .................................................. 156
Table B.3 Sampling errors: Urban sample, Ghana MHS 2017................................................. 157
Table B.4 Sampling errors: Rural sample, Ghana MHS 2017 .................................................. 158
Table B.5 Sampling errors: Coastal zone sample, Ghana MHS 2017 ...................................... 159
Table B.6 Sampling errors: Middle zone sample, Ghana MHS 2017....................................... 160
Table B.7 Sampling errors: Northern zone sample, Ghana MHS 2017 .................................... 161
Table B.8 Sampling errors: Western region sample, Ghana MHS 2017 .................................. 162
Table B.9 Sampling errors: Central region sample, Ghana MHS 2017 .................................... 163
Table B.10 Sampling errors: Greater Accra region sample, Ghana MHS 2017 ......................... 164
Table B.11 Sampling errors: Volta region sample, Ghana MHS 2017....................................... 165
Table B.12 Sampling errors: Eastern region sample, Ghana MHS 2017 ................................... 166
Table B.13 Sampling errors: Ashanti region sample, Ghana MHS 2017 ................................... 167
Table B.14 Sampling errors: Brong Ahafo region sample, Ghana MHS 2017 .......................... 168
Table B.15 Sampling errors: Northern region sample, Ghana MHS 2017 ................................. 169
Table B.16 Sampling errors: Upper East region sample, Ghana MHS 2017 .............................. 170
Table B.17 Sampling errors: Upper West region sample, Ghana MHS 2017 ............................ 171
Table B.18 Sampling errors for adult and maternal mortality rates, Ghana 2017 ...................... 172

APPENDIX C DATA QUALITY TABLES ................................................................................................ 173

Table C.1 Household age distribution ...................................................................................... 173

x • Tables and Figures

Table C.2 Age distribution of eligible and interviewed women ............................................... 174
Table C.3 Completeness of reporting ....................................................................................... 174
Table C.4 Births by calendar years ........................................................................................... 174
Table C.5 Reporting of age at death in days ............................................................................. 175
Table C.6 Reporting of age at death in months ........................................................................ 175
Table C.7 Completeness of information on siblings ................................................................ 176
Table C.8 Sibship size and sex ratio of siblings ....................................................................... 176
Table C.9 Pregnancy-related mortality trends .......................................................................... 176

Tables and Figures • xi

FOREWORD

T
his report presents the findings of the 2017 Ghana Maternal Health Survey (GMHS). The 2017
GMHS is the second nationally representative household survey to collect comprehensive
information on maternal health issues, maternal mortality, and specific causes of death among
women in the country, following the 2007 GMHS. The survey gathered information on maternal health in
two phases. In Phase 1, 900 enumeration areas (EAs) (466 in urban areas and 434 in rural areas) were
selected. All households in the selected clusters were listed, and households in which a woman age 12-49
had died since January 2012 were also identified for a verbal autopsy. In Phase 2, 26,324 households were
interviewed, and in these households 25,062 eligible women age 15-49 were asked questions about a wide
range of maternal health-related issues pertaining to pregnancies, live births, abortions and miscarriages,
and utilisation of health services in relation to these events. Interviews with women also included a sibling
history that allows for calculation of the maternal mortality rate in Ghana. The Verbal Autopsy
Questionnaire was used to collect information that allows for determination of cause(s) of death among
1,240 women age 12-49 who died in the 5 years before the survey identified in Phase 1.
The primary aim of the 2017 GMHS was 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 and for the Coastal, Middle, and
Northern zones. Another goal was to identify specific causes of maternal and non-maternal deaths. The
project also sought to collect data on women’s perceptions of and experiences with antenatal, maternity,
and emergency obstetrical care, especially with regard to care received before, during, and following the
termination or abortion of a pregnancy, and to measure indicators of the utilisation of maternal health
services, especially post-abortion care services. In addition, the project creates an avenue for follow-on
studies that can contribute to possible reductions in maternal mortality as well as abortion-related
mortality. The information collected is intended to help policymakers and programme managers evaluate
and design programmes and strategies for improving maternal health in Ghana.
The 2017 GMHS was implemented by the Ghana Statistical Service (GSS) with technical assistance from
ICF through The DHS Program, which is funded by the United States Agency for International
Development (USAID) and offers financial support and technical assistance for population and health
surveys in countries worldwide. Financial support for the 2017 GMHS was provided by the Government of
Ghana through the Ministry of Health (MOH) and by USAID, the European Union (EU) delegation to
Ghana, and the United Nations Population Fund (UNFPA).
The GMHS results show that 10% of deaths among women age 12-49 in Ghana are due to direct maternal
causes, with obstetric haemorrhage the largest single cause of direct maternal deaths. Almost all pregnant
women receive antenatal care from a skilled provider, 8 in 10 deliveries take place in a health facility and
are attended by a skilled provider, and slightly more than 8 in 10 women receive postnatal care within 2
days after delivery. While the country’s policy and programme emphasis on continuity of care has resulted
in nearly three quarters of women receiving all three maternity care components (antenatal care, delivery
care, and postnatal care), efforts to achieve Sustainable Development Goal (SDG) 3 must focus on the
quarter of women who still have incomplete access.
I would like to acknowledge the EU delegation to Ghana, USAID, UNFPA, and the MOH for their
financial support. The close cooperation between the GSS and the Ghana Health Service (GHS) was
critical to the successful completion of the survey, and special thanks go to the project implementation
team for tirelessly working hard up to the preparation of this valuable report. I am grateful to ICF for its
technical support in all phases of the survey. Last but not least, I am grateful to the field staff who

Foreword • xiii
 sincerely committed to collecting the data, the households and individuals who willingly provided
responses to all the questions and the medical doctors who coded causes of death, enabling us to identify
maternal causes of death in Ghana. I am most grateful to all for the successful completion of this survey.

Baah Wadieh
Acting Government Statistician
Ghana Statistical Service

xiv • Foreword
ABBREVIATIONS

ANC antenatal care

CAPI computer-assisted personal interviewing

CARMMA Campaign for Accelerated Reduction of Maternal Mortality in Africa
CBR crude birth rate
CPR contraceptive prevalence rate
C-section Caesarean section
CSPro Censuses and Surveys Processing

D&C dilation and curettage

D&E dilation and evacuation
DHS Demographic and Health Surveys

EA enumeration area
EU European Union

GDHS Ghana Demographic and Health Survey

GFR general fertility rate
GHS Ghana Health Service
GMHS Ghana Maternal Health Survey
GSS Ghana Statistical Service

ICD-10 International Statistical Classification of Diseases and Related Health Problems,

10th revision
ICF ICF (originally, Inner City Fund)
IFSS internet file streaming system
IUD intrauterine contraceptive device

JHS junior high school

JSS junior secondary school

LAM lactational amenorrhoea method

MAF Millennium Development Goal 5 Accelerated Framework

MDG Millennium Development Goal
MICS Multiple Indicator Cluster Survey
MMR maternal mortality ratio
MOH Ministry of Health

NGO nongovernmental organization

NHIS National Health Insurance Scheme

PHC Population and Housing Census

PNC postnatal care
PRMR pregnancy-related mortality ratio

Abbreviations • xv
 SD standard deviations
SDG Sustainable Development Goal
SDM standard days method
SHS senior high school
SSS senior secondary school

TFR total fertility rate

UNFPA United Nations Population Fund

USAID United States Agency for International Development

VIP ventilated improved pit (latrine)

WHO World Health Organization

xvi • Abbreviations
READING AND UNDERSTANDING TABLES
FROM THE 2017 GHANA MATERNAL
HEALTH SURVEY (GMHS)

T
he 2017 GMHS final report is based on
approximately 138 tables of data. They are
located for quick reference through links in
the text (electronic version) and at the end of each
chapter. Additionally, this report features about 47
figures that clearly highlight trends, subnational
patterns, and background characteristics. Large
colourful maps display breakdowns for regions in
Ghana. The text highlights key points in bullets and
clearly identifies indicator definitions in boxes.

While the text and figures featured in each chapter

highlight some of the most important findings from
the tables, not every finding can be discussed or
displayed graphically. For this reason, GMHS data
users should be comfortable reading and interpreting
tables.

The following pages provide an introduction to the

organization of GMHS tables, the presentation of
background characteristics, and a brief summary of
sampling and understanding denominators. In
addition, this section provides some exercises for
users as they practice their new skills in interpreting
GMHS tables.

Reading and Understanding Tables from the 2017 GMHS • xvii

 Example 1: Exposure to Mass Media
A Question Asked of All Survey Respondents
Table 2.12 Exposure to mass media

Percentage of women age 15-49 who are exposed to specific media on a weekly basis, according to background characteristics, Ghana
1
MHS 2017

2
Reads a Accesses all Accesses none

3
newspaper at Watches Listens to the three media at of the three
Background
least once a television at least radio at least least once a media at least Number of
characteristic
week once a week once a week week once a week women
Age
15-19 9.4 57.1 38.6 4.4 30.8 4,785
20-24 8.4 63.9 47.8 5.1 23.4 4,208
25-29 9.0 64.2 52.7 6.4 23.0 4,229
30-34 7.3 61.7 56.2 5.2 23.4 3,709
35-39 4.8 56.1 53.7 3.5 27.2 3,313
40-44 3.6 55.2 55.3 2.7 27.7 2,481
45-49 3.2 49.4 54.3 2.6 30.5 2,337
Residence
Urban 10.5 72.0 54.9 6.9 17.5 13,752
Rural 3.0 43.4 44.6 1.6 37.1 11,310
Zone
Coastal 9.1 65.6 55.2 5.9 20.0 12,121
Middle 6.2 59.5 48.7 4.0 27.2 9,674
Northern 2.2 33.8 36.3 0.9 47.2 3,267
Zone
Coastal 9.1 65.6 55.2 5.9 20.0 12,121
Middle 6.2 59.5 48.7 4.0 27.2 9,674
Northern 2.2 33.8 36.3 0.9 47.2 3,267
Region
Western 4.2 61.7 50.5 2.0 22.0 3,230
Central 4.8 58.2 42.3 2.1 27.2 2,218
Greater Accra 16.2 76.7 63.0 11.2 12.0 4,673
Volta 5.1 54.0 59.1 3.7 27.2 2,000
Eastern 5.5 47.4 41.9 3.3 38.1 2,517
Ashanti 7.4 68.9 55.7 5.2 19.1 4,790
Brong Ahafo 4.4 53.3 41.7 2.4 32.2 2,367
Northern 1.3 34.2 34.8 0.6 49.6 1,786
Upper East 4.2 32.8 41.3 1.5 41.6 854
Upper West 2.1 34.1 34.1 0.9 48.1 628
Education
No education 0.1 35.3 39.3 0.1 44.9 4,585
Primary 0.7 50.8 45.3 0.3 32.1 3,934

5
Middle/JSS/JHS 4.2 61.8 50.3 2.1 24.3 10,081
Secondary/SSS/SHS 14.1 74.4 57.3 8.7 15.0 4,550
More than secondary 35.8 82.3 69.4 26.2 7.2 1,912
Wealth quintile
Lowest 1.0 16.0 34.7 0.3 57.5 4,064
Second 2.4 43.4 44.8 1.1 35.6 4,721
Middle 4.0 64.2 47.7 2.2 23.1 5,111
Fourth 6.6 76.0 54.5 3.8 14.7 5,443
Highest 18.6 82.0 64.1 13.0 10.4 5,723
Total
4 7.1 59.1 50.2 4.5 26.3 25,062

Step 1: Read the title and subtitle—highlighted in orange in Example 1. They tell you the topic and the
specific population group being described. In this case, the table is about women’s exposure to mass
media. All eligible female respondents age 15-49 were asked these questions.

Step 2: Scan the column headings—highlighted in green. They describe how the information is
categorized. In this table, the first three columns of data show different types of media that women access
at least once a week. The fourth column shows women who access all three types of media, while the fifth
column shows women who do not access any of the three types of media at least once a week. The last
column lists the number of women who were asked these questions.

Step 3: Scan the row headings—the first vertical column highlighted in blue. These show the different
ways the data are divided into categories based on population characteristics. In this case, the table presents
women’s exposure to mass media by age, urban-rural residence, zone, region, educational level, and
wealth quintile. Most of the tables in the GMHS report will be divided into these same categories.

xviii • Reading and Understanding Tables from the 2017 GMHS

Step 4: Look at the row at the bottom of the table highlighted in pink. These percentages represent the
totals of all women age 15-49 and their access to different types of media. In this case, 7.1%* of women
age 15-49 read a newspaper at least once a week, 59.1% watch television at least once a week, and 50.2%
listen to the radio at least once a week.

Step 5: To find out what percentage of women with more than secondary education access all three media
at least once a week, draw two imaginary lines, as shown on the table. This shows that 26.2% of women
age 15-49 with more than secondary education access all three media at least once a week.

By looking at patterns by background characteristics, we can see how exposure to mass media varies
across Ghana. Mass media are often used to communicate health messages. Knowing how mass media
exposure varies among different groups can help program planners and policy makers determine how to
most effectively reach their target populations.

*For the purpose of this tutorial, data are presented exactly as they appear in the table including decimal places. However,
the text in the remainder of this report rounds data to the nearest whole percentage point.

Practice: Use the table in Example 1 to answer the following questions:

a) What percentage of women in Ghana do not access any of the three media at least once a week?
b) Which age group of women is most likely to listen to the radio at least once a week?
c) Compare women in urban areas to women in rural areas – which group is more likely to read a newspaper at
least once a week?
d) What are the lowest and highest percentages (range) of women who do not access any of the three types of media
at least once a week by region?
e) Is there a clear pattern in exposure to television at least once a week by education level?
f) Is there a clear pattern in exposure to newspapers at least once a week by wealth quintile?
quintile.
lowest wealth quintile read a newspaper at least once a week, compared to 18.6% of women in the highest wealth
f) Yes, exposure to newspapers at least once a week increases as household wealth increases; 1.0% of women in the
watch television at least once a week, compared to 82.3% of women with more than secondary education.
e) Yes, exposure to television increases as a woman’s level of education increases; 35.3% of women with no education
Northern region.
d) Women with no exposure at least once a week ranges from a low of 12.0% in Greater Accra to a high of 49.6% in
c) Women in urban areas, 10.5% read a newspaper at least once a week, compared to 3.0% of women in rural areas.
b) Women age 30-34: 56.2% of women in this age group listen to the radio at least once a week.
a) 26.3%
Answers:

Reading and Understanding Tables from the 2017 GMHS • xix

 Example 2: Teenage Pregnancy and Motherhood
Minimum Number of Cases Necessary for Reliable Results

Table 4.8 Teenage pregnancy and motherhood

1
Percentage of women age 15-19 who have had a live birth or who are pregnant with their first child, and percentage
who have begun childbearing, according to background characteristics, Ghana MHS 2017
Percentage of women age 15-19 who:

3 2
Percentage who
Background Have had Are pregnant with have begun Number
characteristic a live birth first child childbearing of women

Age
15-17 5.7 1.8 7.5 3,080
15 2.7 0.7 3.4 1,046
16 4.3 2.3 6.6 936
17 9.7 2.5 12.3 1,098
18 17.7 4.8 22.5 974
19 29.9 2.5 32.3 731
Residence
Urban 9.2 1.8 11.0 2,411
Rural 14.5 3.3 17.8 2,374
Zone
Coastal 11.9 2.2 14.1 2,206
Middle 12.2 2.4 14.6 1,916
Northern 10.5 4.0 14.5 663
Region
Western 15.6 3.3 18.9 650
Central 13.6 2.2 15.8 413
Greater Accra 6.8 0.2 7.0 748
Volta 13.7 4.3 17.9 396
Eastern 11.1 1.9 13.0 490
Ashanti 12.2 2.6 14.8 936
Brong Ahafo 13.3 2.7 16.0 490
Northern 11.6 4.2 15.8 351
Upper East 12.7 4.6 17.3 176
Upper West 4.7 2.8 7.5 136
Education
No education 27.1 7.7 34.7 164
Primary 19.9 3.2 23.1 835
Middle/JSS/JHS 12.3 2.7 15.0 2,595

4
Secondary/SSS/SHS 3.1 1.0 4.2 1,152
More than secondary * * * 39
Wealth quintile
Lowest 16.8 4.4 21.1 869
Second 18.5 2.9 21.4 1,027
Middle 13.2 3.2 16.3 1,051
Fourth 7.4 1.9 9.3 953
Highest 2.5 0.2 2.7 886
Total 11.8 2.5 14.4 4,785
4
Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed.

Step 1: Read the title and subtitle. In this case, the table is about women age 15-19 and whether they have
had a live birth or were pregnant at the time of the survey.

Step 2: Scan the column headings. The first column of data shows women age 15-19 who have had a live
birth. The second column of data shows women age 15-19 who were pregnant at the time of the survey.
The third column of data shows women who have begun childbearing, which includes both women who
have had a live birth and women who were pregnant at the time of the survey. The final column lists the
number of women age 15-19 interviewed in the survey.

Step 3: Scan the row headings. This table presents teenage pregnancy and motherhood by age, urban-rural
residence, region, educational level, and wealth quintile.

Step 4: How many women age 15-19 were interviewed in the 2017 GMHS? It’s 4,785. Once these women
are further divided into the background characteristic categories, there may be too few cases for the
percentages to be reliable.

xx • Reading and Understanding Tables from the 2017 GMHS

  What percentage of women age 15-19 with more than secondary education have had a live
birth? There is no number in this cell—only an asterisk. This is because fewer than 25 women
age 15-19 with more than secondary education were interviewed. Results for this group are not
reported. The subgroup is too small, and therefore the data are not reliable.

Note: When asterisks (or parentheses, although this table does not have any) are used in a table, the
explanation will be noted under the table. If there are no parentheses or asterisks in a table, you can
proceed with confidence that enough cases were included in all categories that the data are reliable.

Reading and Understanding Tables from the 2017 GMHS • xxi

 Example 3: Understanding Sampling Weights in GMHS Tables

A sample is a group of people who have Table 2.8 Background characteristics of respondents
been selected for a survey. In the 2017 Percent distribution of women age 15-49 by selected background characteristics,
GMHS, the sample is designed to Ghana MHS 2017
represent the national population age 15- Number of women
49. In addition to national data, most Background Weighted Weighted Unweighted
characteristic percent number number
countries want to collect and report data
on smaller geographical or administrative
Region
Western 3 12.9 2 3,230 1 2,334
areas. However, doing so requires a Central
Greater Accra
8.9
18.6
2,218
4,673
1,603
2,535
minimum sample size per area. For the Volta 8.0 2,000 1,466
Eastern 10.0 2,517 2,172
2017 GMHS, the survey sample is Ashanti 19.1 4,790 3,136
representative at the national and regional Brong Ahafo
Northern
9.4
7.1
2,367
1,786
2,302
4,202
levels, across 3 zones, and for urban and Upper East 3.4 854 2,709
Upper West 2.5 628 2,603
rural areas.
Total 15-49 100.0 25,062 25,062

To generate statistics that are

representative of the country as a whole and the 10 regions, the number of women surveyed in each region
should contribute to the size of the total (national) sample in proportion to size of the region. However, if
some regions have small populations, then a sample allocated in proportion to each region’s population
may not include sufficient women from each region for analysis. To solve this problem, regions with small
populations are oversampled. For example, let’s say that you have enough money to interview 25,062
women and want to produce results that are representative of Ghana as a whole and its regions (as in Table
2.8). However, the total population of Ghana is not evenly distributed among the regions: some regions,
such as Ashanti, are heavily populated while others, such as Upper West, are not. Thus, Upper West must
be oversampled.

A sampling statistician determines how many women should be interviewed in each region in order to get
reliable statistics. The blue column (1) in the table at the top of this page shows the actual number of
women interviewed in each region. Within the regions, the number of women interviewed ranges from
1,466 in Volta region to 4,202 in Northern region. The number of interviews is sufficient to get reliable
results in each region.

With this distribution of interviews, some regions are overrepresented and some regions are
underrepresented. For example, the population in Ashanti is 19% of the population in Ghana, while Upper
West’s population contributes only about 3% of the population in Ghana. But as the blue column shows,
the number of women interviewed in Ashanti accounts for only about 13% of the total sample of women
interviewed (3,136/25,602) and the number of women interviewed in Upper West accounts for about 10%
of women interviewed (2,603/25,062). This unweighted distribution of women does not accurately
represent the population.

In order to get statistics that are representative of Ghana, the distribution of the women in the sample needs
to be weighted (or mathematically adjusted) such that it resembles the true distribution in the country.
Women from a less populous region, like Upper West, should only contribute a small proportion to the
national total. Women from a more populous region, like Ashanti, should contribute much more.
Therefore, DHS statisticians mathematically calculate a “weight” which is used to adjust the number of
women from each region so that each region’s contribution to the total is proportional to the actual
population of the region. The numbers in the purple column (2) represent the “weighted” values. The
weighted values can be smaller or larger than the unweighted values at region level. The total national
sample size of 25,062 women has not changed after weighting, but the distribution of the women in the
regions has been changed to represent their contribution to the total population size.

xxii • Reading and Understanding Tables from the 2017 GMHS

How do statisticians weight each category? They take into account the probability that a woman was
selected in the sample. If you were to compare the green column (3) to the actual population distribution
of Ghana, you would see that women in each region are contributing to the total sample with the same
weight that they contribute to the population of the country. The weighted number of women in the survey
now accurately represents the proportion of women who live in Upper West region and the proportion of
women who live in Ashanti region.

With sampling and weighting, it is possible to interview enough women to provide reliable statistics at
national and region levels. In general, only the weighted numbers are shown in each of the GMHS tables,
so don’t be surprised if these numbers seem low: they may actually represent a larger number of women
interviewed.

Reading and Understanding Tables from the 2017 GMHS • xxiii

SUSTAINABLE DEVELOPMENT GOAL
INDICATORS

Sustainable Development Goal Indicators

Ghana MHS 2017

Sex Table
Indicator Male Female Total number
3. Good health and well-being
3.1.1 Maternal mortality ratio1 na na 310 8.4
3.1.2 Proportion of births attended by skilled health personnel2 na na 79.4 5.11
3.2.1 Under-five mortality rate3 57 47 52 7.2
3.2.2 Neonatal mortality rate3 28 21 25 7.2
3.7.2 Adolescent birth rates per 1,000 women
a) Girls aged 10-14 years4 na 2 na 4.1
b) Women aged 15-19 years5 na 75 na 4.1
5. Gender equality
5.3.1 Proportion of women aged 20-24 years who were married or in a union before age
15 and before age 18
a) before age 15 na 4.9 na 3.3
b) before age 18 na 20.5 na 3.3
5.b.1 Proportion of individuals who own a mobile telephone6 na 70.2 na 2.13

Residence
Table
Urban Rural Total number

7. Affordable clean energy

7.1.1 Proportion of population with access to electricity 90.5 63.3 77.0 2.3
7.1.2 Proportion of population with primary reliance on clean fuels and technology7 35.6 7.1 21.5 2.3

Sex Table
Male Female Total number

8. Decent work and economic growth

8.7.2 Proportion of adults (15 years and older) with an account at a bank or other
financial institution or with a mobile-money-service provider8 na 29.5 na 2.13
17. Partnerships for the goals
17.8.1 Proportion of individuals using the Internet9 na 22.5 na 2.14

na = Not applicable
1
Expressed in terms of maternal deaths per 100,000 live births in the 7-year period preceding the survey.
2
Most recent live births and still births in the 5-year period preceding the survey.
3
Expressed in terms of deaths per 1,000 live births for the 5-year period preceding the survey.
4
Equivalent to the age-specific fertility rate for girls age 10-14 for the 3-year period preceding the survey, expressed in terms of births per 1,000
girls age 10-14.
5
Equivalent to the age-specific fertility rate for women age 15-19 for the 3-year period preceding the survey, expressed in terms of births per 1,000
women age 15-19.
6
Data are available for women age 15-49 only.
7
Measured as the percentage of the population using clean fuel for cooking.
8
Data are available for women age 15-49 who have and use and account at bank or other financial institution; information on use of a mobile-
money-service provider is not available.
9
Data are available for women age 15-49 who have used the internet in the past 12 months.

Sustainable Development Goal Indicators • xxv

xxvi • Map of Ghana
INTRODUCTION AND SURVEY METHODOLOGY 1
T
he 2017 Ghana Maternal Health Survey (GMHS) was implemented by the Ghana Statistical
Service (GSS). Data collection took place from 15 June to 12 October 2017. ICF provided
technical assistance through The DHS Program, which is funded by the United States Agency for
International Development (USAID) and offers financial support and technical assistance for population
and health surveys in countries worldwide. Financial support for the 2017 GMHS was provided by the
Government of Ghana through the Ministry of Health (MOH) and by USAID, the European Union (EU)
delegation to Ghana, and the United Nations Population Fund (UNFPA).

1.1 SURVEY OBJECTIVES

The primary objectives of the 2017 GMHS were as follows:

 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 and for three zones: Coastal (Western, Central, Greater Accra, and
Volta regions), Middle (Eastern, Ashanti, and Brong Ahafo regions), and Northern (Northern, Upper
East, and Upper West regions)

 To identify specific causes of maternal and non-maternal deaths, in particular deaths due to abortion-
related causes, among adult women

 To collect data on women’s perceptions of and experiences with antenatal, maternity, and emergency
obstetrical care, especially with regard to care received before, during, and following the termination
or abortion of a pregnancy

 To measure indicators of the utilisation of maternal health services, especially post-abortion care
services

 To allow follow-on studies and surveys that will be used to observe possible reductions in maternal
mortality as well as abortion-related mortality

The information collected through the 2017 GMHS is intended to assist policymakers and programme
managers in evaluating and designing programmes and strategies for improving the health of the country’s
population.

1.2 SAMPLE DESIGN

The sample for the 2017 GMHS was designed to provide estimates of key reproductive health indicators
for the country as a whole, for urban and rural areas separately, for three zonal levels (Coastal, Middle, and
Northern), and for each of the 10 administrative regions in Ghana (Western, Central, Greater Accra, Volta,
Eastern, Ashanti, Brong Ahafo, Northern, Upper East, and Upper West).

The sampling frame used for the 2017 GMHS is the frame of the 2010 Population and Housing Census
(PHC) conducted in Ghana. The 2010 PHC frame is maintained by GSS and updated periodically as new
information is received from various surveys. The frame is a complete list of all census enumeration areas
(EAs) created for the PHC. An EA is a geographic area that covers an average of 161 households (per
updates to the PHC frame from the 2014 Ghana Demographic and Health Survey [GDHS]). Individual EA
size is the number of residential households in the EA according to the 2010 PHC. The average size of
urban EAs (185 households) is slightly larger than the average size of rural EAs (114 households). The

Introduction and Survey Methodology • 1

 sampling frame contains information about the EA’s location, type of residence (urban or rural), and
estimated number of residential households.

The 2017 GMHS sample was stratified and selected from the sampling frame in two stages. Each region
was separated into urban and rural areas; this yielded 20 sampling strata. Samples of EAs were selected
independently in each stratum in two stages. Implicit stratification and proportional allocation were
achieved at each of the lower administrative levels by sorting the sampling frame within each sampling
stratum before the sample selection, according to administrative units at different levels, and by using a
probability proportional to size selection at the first stage of sampling.

In the first stage, 900 EAs (466 EAs in urban areas and 434 EAs in rural areas) were selected with
probability proportional to EA size and with independent selection in each sampling stratum. A household
listing operation was implemented from 25 January to 9 April 2017 in all of the selected EAs. The
resulting lists of households then served as a sampling frame for the selection of households in the second
stage. The household listing operation included inquiring of each household if there had been any deaths in
that household since January 2012 and, if so, the name, sex, and age at time of death of the deceased
person(s).

Some of the selected EAs were very large. To minimise the task of household listing, each large EA
selected for the 2017 GMHS was segmented. Only one segment was selected for the survey with
probability proportional to segment size. Household listing was conducted only in the selected segment.
Thus, in the GMHS, a cluster is either an EA or a segment of an EA. As part of the listing, the field teams
updated the necessary maps and recorded the geographic coordinates of each cluster. The listing was
conducted by 20 teams that included a supervisor, three listers/mappers, and a driver.

The second stage of selection provided two outputs: the list of households selected for the main survey
(Household Questionnaire and Woman’s Questionnaire) and the list of households selected for the verbal
autopsy survey (Verbal Autopsy Questionnaire).

Selection for Main Survey

In the second stage of selection for the main survey, a fixed number of 30 households were selected from
each cluster, resulting in a total sample size of 27,000 households. Replacement of nonresponding
households was not allowed. Due to the non-proportional allocation of the sample to the different regions
and the possible differences in response rates, sampling weights are required for any analysis that uses the
2017 GMHS data. This ensures the representativeness of the survey results at the national and regional
levels. Results shown in this report have been weighted to account for the complex sample design.

All women age 15-49 who were either permanent residents of the selected households or visitors who
stayed in the household the night before the survey were eligible to be interviewed.

Selection for Verbal Autopsy Survey

In the second stage of selection for the verbal autopsy survey, all households in which a female resident
age 10-54 died in 2012 or later were selected to be visited by an interviewer. However, only the deaths of
female residents who were age 12-49 at the time of death were eligible to be included in the survey. A
wider age range was used for the initial selection in case of minor inaccuracies on the part of the person
who provided information during the household listing operation; the first questions in the Verbal Autopsy
Questionnaire established true eligibility, and interviews ended if the deceased woman was discovered to
have died before age 12, after age 49, or before 2012.

There is a chance that some households were both purposively selected for the verbal autopsy survey and
randomly selected for the main survey.

2 • Introduction and Survey Methodology

1.3 QUESTIONNAIRES
Three questionnaires were used in the 2017 GMHS: the Household Questionnaire, the Woman’s
Questionnaire, and the Verbal Autopsy Questionnaire. The survey protocol was reviewed and approved by
the ICF Institutional Review Board.

The Household Questionnaire and the Woman’s Questionnaire were adapted from The DHS Program’s
standard Demographic and Health Survey questionnaires and the questionnaires used in the 2007 GMHS
to reflect the specific interests and data needs of this survey. The Verbal Autopsy Questionnaire was
adapted from the recent 2016 World Health Organization (WHO) verbal autopsy instrument.

For all questionnaires, input was solicited from stakeholders representing government ministries and
development partners. After the finalization of the questionnaires in English, they were translated into
three major languages: Akan, Ga, and Ewe. The Household and Woman’s Questionnaires were
programmed into tablet computers to facilitate computer-assisted personal interviewing (CAPI) for data
collection purposes, with the capability to choose any of the four languages for either of the questionnaires.
The Verbal Autopsy Questionnaire was filled out on paper during data collection and entered into the
CAPI system afterwards. The tablet computers were equipped with Bluetooth® technology to enable
remote electronic transfer of files, such as assignments from the team supervisor to the interviewers,
individual questionnaires among survey team members, and completed questionnaires from interviewers to
team supervisors. The CAPI data collection system employed in the 2017 GMHS was developed by The
DHS Program using the mobile version of CSPro. The CSPro software was developed jointly by the U.S.
Census Bureau, The DHS Program, and Serpro S.A.

Household Questionnaire

The Household Questionnaire was used to list all members of and visitors to selected households. Basic
demographic information was collected on the characteristics of each person listed, including his or her
age, sex, marital status, education, and relationship to the head of the household. The data on age and sex
of household members obtained in the Household Questionnaire were used to identify women who were
eligible for individual interviews. The Household Questionnaire also collected information on
characteristics of the household’s dwelling unit, such as source of water, type of toilet facilities, materials
used for the floor of the dwelling unit, and ownership of various durable goods.

Woman’s Questionnaire

The Woman’s Questionnaire was used to collect information from women age 15-49. These women were
asked questions on the following topics:

 Background characteristics

 Pregnancy history: number, outcome (live birth, stillbirth, miscarriage, abortion), and timing of all
pregnancies

 Family planning: knowledge of contraception, current use and current source of contraception

 Pregnancy and postnatal care for most recent live birth or stillbirth: antenatal, delivery, and
postnatal care; complications experienced and treatment sought during any of these stages

 Abortion: method used, complications experienced, and care sought for abortion; knowledge of
abortion

 Miscarriage: perceived cause, complications experienced, and care sought for miscarriage

Introduction and Survey Methodology • 3

  Marriage and sexual activity: marital status, age at first marriage, number of unions, and age at first
sexual intercourse

 Adult and maternal mortality

 Health care access, insurance, and disability

Verbal Autopsy Questionnaire

The Verbal Autopsy Questionnaire was used to collect information on the deaths of women who died on or
after 1 January 2012 while age 12-49. Questions were asked on the following topics:

 Background characteristics

 Narrative of illness/events leading to death

 History of injuries/accidents: details of any injury/accident sustained by the deceased

 History of diagnoses: whether the deceased had been diagnosed with any of a list of specific
illnesses/conditions

 General signs/symptoms: whether the deceased exhibited particular signs/symptoms (coughing, night
sweats, fever, rash, etc.)

 Signs/symptoms associated with pregnancy: detailed questions on signs/symptoms associated with

maternal causes of death

 Risk factors: consumption of alcohol and tobacco

 Treatment received: treatment/medical details of the deceased’s contact with health services before
death

 Access to and quality of services: contextual information about the deceased’s contact with health
services before death

 Death certificate and burial permit: information on timing and cause of death from the death
certificate and burial permit (if available)

Fieldworkers for the 2017 GMHS also completed the Fieldworker Questionnaire, adapted from The DHS
Program’s standard questionnaire. The purpose of the Fieldworker Questionnaire is to collect basic
background information on the people who are collecting data in the field, both supervisors and
interviewers.

1.4 LISTING AND PRETEST

The listing training took place from 16-22 January 2017 in Winneba (Central region). GSS recruited and
trained 89 people (78 men, 11 women) to serve as supervisors and listers/mappers. The listing for the 2017
GMHS was unusual among DHS Program surveys because it incorporated screening of households for
deaths that would be eligible for inclusion in the verbal autopsy sample.

The pretest training took place from 8 March to 4 April 2017 in Winneba. GSS and ICF trained 15 female
participants on survey procedures and how to administer the Household, Woman’s, and Verbal Autopsy
Questionnaires. The trainees had a mix of backgrounds and spoke a variety of languages, including Akan,
Ga, and Ewe. A few had never participated in any survey, and the remainder had various degrees of
experience with previous GSS and DHS surveys, including one individual who had participated in the
2007 GMHS. One had completed medical school. The pretest fieldwork was conducted on 1 and 3 March

4 • Introduction and Survey Methodology

2017 in clusters near the training venue that were not included in the 2017 GMHS survey sample area.
GSS, the Ghana Health Service (GHS), and ICF held a debriefing on the field practice on 4 April 2017,
and the questionnaires were modified based on lessons learned from the exercise.

1.5 TRAINING OF FIELD STAFF

The main training took place from 8 May to 8 June 2017 in Winneba (Central region). GSS recruited 106
interviewer trainees (all women) and 27 supervisor trainees (19 men, 8 women). The trainees had a mix of
backgrounds and spoke a variety of languages, including Akan, Ga, and Ewe. Some had never participated
in any survey, while the remainder had varied degrees of experience with previous GSS and DHS surveys.
In addition, some had trained as nurses or midwives. Prospective supervisors had all worked on many GSS
surveys. The training course consisted of instruction regarding interviewing techniques and field
procedures, a detailed review of questionnaire content, instruction on how to administer the paper and
electronic questionnaires, mock interviews between participants in the classroom, quizzes and homework,
and practice interviews with real respondents in locations outside the 2017 GMHS survey sample area. To
help put the importance of the 2017 GMHS into context for the trainees, the training also included a
presentation by a representative of GHS on maternal health and Ghana-specific maternal health policies.

Practice fieldwork was conducted on 27 May and from 5-6 June 2017 in clusters near the training venue
that were not included in the 2017 GMHS survey sample area. GSS, GHS, and ICF held a debriefing after
each field practice session and provided clarifications to trainees in addition to making modifications to the
questionnaires based on lessons learned in the field.

Training participants were evaluated through classwork, in-class exercises, quizzes, and observations made
during field practice. Ultimately, 100 of them were selected to serve as interviewers and 25 as supervisors.
Selection of supervisors was based on their experience leading survey teams and their performance during
the pretest (if applicable) and main training. Supervisors received additional instructions and practice using
the CAPI system to perform supervisory activities. These activities included assigning households and
receiving completed interviews from interviewers, recognising and dealing with error messages, receiving
system updates and distributing updates to interviewers, dealing with duplicated cases, closing clusters,
and transferring interviews to the central office via a secure internet file streaming system (IFSS). In
addition to the CAPI material, supervisors received training on their roles and responsibilities and how to
fulfil them.

1.6 FIELDWORK
Data collection was carried out by 25 field teams, each consisting of one supervisor (male or female), four
interviewers (all female), and one driver. Electronic data files were transferred from each interviewer’s
tablet computer to the team supervisor’s tablet computer every day. Field supervisors transferred data to
the central data processing office via the IFSS. Senior staff from GSS coordinated and monitored
fieldwork activities. Data collection took place over a 4-month period, from 15 June through 12 October
2017.

1.7 VERBAL AUTOPSY CAUSE OF DEATH TRAINING AND CODING

For the verbal autopsy process to be complete, each questionnaire must be reviewed (ideally by a
physician), and the reviewer must complete a death certificate with the immediate and underlying cause(s)
of death. Coding the cause(s) of death recorded in the death certificate according to the International
Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10), is a further step
that produces internationally comparable data on the underlying cause of death.

The cause of death certification and ICD-10 coding training took place 15-25 January 2018 in Mankessim
(Central region). GSS recruited six physicians (five men, one woman) who were trained on both cause of
death certification and ICD-10 coding; two GSS staff (both men) were also trained on ICD-10 coding.

Introduction and Survey Methodology • 5

 The cause of death certification and coding exercise took place over a 4-month period, from 26 January
through 21 May 2018. As part of quality assurance, each Verbal Autopsy Questionnaire was independently
reviewed and assigned a cause (or causes) of death by two different physicians to validate one another.
When the two physicians had discordant results for a questionnaire, that questionnaire was re-reviewed by
two physicians (not necessarily the original reviewers); for more details, see Chapter 9. In all, there were
1,367 Verbal Autopsy Questionnaires completed for women who died after 1 January 2012; 1,240 died in
the 5 years preceding the survey (time between date of death and date of interview).

1.8 DATA PROCESSING

All electronic data files for the 2017 GMHS were transferred via the IFSS to the GSS central office in
Accra, where they were stored on a password-protected computer. The data processing operation included
registering and checking for any inconsistencies and outliers. Data editing and cleaning included structure
and consistency checks to ensure completeness of work in the field. The central office also conducted
secondary editing, which required resolution of computer-identified inconsistencies and coding of open-
ended questions. The data were processed by five GSS staff members. Data editing was accomplished
using CSPro software. Secondary editing and data processing were initiated in June and completed in
November 2017.

1.9 RESPONSE RATES

A total of 27,001 households were selected for the sample, of which 26,500 were occupied at the time of
fieldwork (Table 1.1). Of the occupied households, 26,324 were successfully interviewed, yielding a
response rate of 99%. In the interviewed households, 25,304 eligible women were identified for individual
interviews; interviews were completed with 25,062 women, yielding a response rate of 99%.

Table 1.1 Results of the household and individual interviews

Number of households, number of interviews, and response rates, according

to residence (unweighted), Ghana MHS 2017
Residence
Result Urban Rural Total
Household interviews
Households selected 13,980 13,021 27,001
Households occupied 13,720 12,780 26,500
Households interviewed 13,590 12,734 26,324
Household response rate1 99.1 99.6 99.3
Interviews with women age 15-49
Number of eligible women 12,681 12,623 25,304
Number of eligible women interviewed 12,544 12,518 25,062
Eligible women response rate2 98.9 99.2 99.0

1
Households interviewed/households occupied
2
Respondents interviewed/eligible respondents

6 • Introduction and Survey Methodology

CHARACTERISTICS OF HOUSEHOLDS,
HOUSEHOLD POPULATION, AND RESPONDENTS 2
Key Findings

 Drinking water: Nearly 9 in 10 households (89%) have

access to an improved source of drinking water.
 Sanitation: Eight in 10 households (82%) have
unimproved toilet facilities.
 Literacy: More than half of Ghanaian women age 15-49
are literate (54%).
 Education: Women in urban areas are four times as
likely as women in rural areas to have more than
secondary education (12% versus 3%).
 Media access: Twenty-six percent of women age 15-49
does not access newspaper, television or radio at least
once a week.
 Health insurance: Twenty-one percent of women age
15-49 are neither registered nor covered under any
health insurance scheme in Ghana.

I
nformation on the socioeconomic characteristics of the household population in the 2017 GMHS
provides context to interpret demographic and health indicators and can furnish an approximate
indication of the representativeness of the survey. In addition, this information sheds light on the living
conditions of the population.

This chapter presents information on source of drinking water, sanitation, wealth, and household
population composition. This chapter also presents information on the demographic and socioeconomic
characteristics of the survey respondents such as age, disability, education, place of residence, marital
status, and wealth status. This information is useful for understanding the factors that affect use of
reproductive health services, contraceptive use, and other health behaviours.

2.1 DRINKING WATER SOURCES AND TREATMENT

Improved sources of drinking water

Include piped water, public taps, standpipes, tube wells, boreholes, protected
dug wells and springs, and rainwater. Households that use bottled or sachet
water for drinking are classified as using an improved source only if their water
source for cooking and handwashing comes from an improved source.
Sample: Households

Characteristics of Households, Household Population, and Respondents • 7

 As seen in Table 2.1 and Figure Figure 2.1 Household drinking water by residence
2.1, 89% of households in Ghana Percent distribution of households by source
get their drinking water from an of drinking water
improved source. One in three Unimproved source
5
households uses bottled/sachet 11 3
6 19
water for drinking and has an 4 Protected well or
improved source of water used for 5 spring, rainwater
20 15
other purposes (34% of Tube well or borehole
households). Tube wells/boreholes
are the second most common source 18 37 Public tap/standpipe
for drinking water (20%), followed
by public taps (18%). In urban 51
Bottled/sachet water
households, half of households use
bottled/sachet water for drinking 34 20 Piped water into
and have an improved source for dwelling/yard/plot/
other uses (51%), 15% use a public neighbour
12
20
tap, and 12% use piped water. For 14
7
rural areas, the most common
source of drinking water is tube Total Urban Rural
wells/boreholes (37%), followed by
public taps (20%). Nineteen percent of rural households use unimproved sources for drinking water. For 1
in 10 households (12%), it takes 30 or more minutes (round trip) to obtain drinking water.

Trends: The percentage of households using an improved source of drinking water increased from 61% in
1993 to 68% in 2007 to 90% in 2014 and remained stable at 89% in 2017.

2.2 SANITATION

Improved toilet facilities

Include any non-shared toilet of the following types: flush/pour flush toilets to
piped sewer systems, septic tanks, and pit latrines; ventilated improved pit (VIP)
latrines; pit latrines with slabs; and composting toilets.
Sample: Households

Only 18% of households in Ghana have an improved Figure 2.2 Household toilet facilities
toilet facility (Table 2.2 and Figure 2.2). Fifty-two by residence
percent use facilities that would be considered Percent distribution of households
improved if not shared by two or more households, by type of toilet facilities
15% use unimproved facilities, and 15% have no 8
15
facility at all and use open defecation. Nearly half of 8 25 No facility/
rural households use either unimproved facilities 15 bush/field
(23%) or open defecation (25%). 23 Unimproved
facility
62
Trends: The percentage of households that have an 52 Shared facility
improved toilet facility increased from 10% in 2007 39
to 18% in 2017. Improved
22 facility
18 13

Total Urban Rural

8 • Characteristics of Households, Household Population, and Respondents

2.3 OTHER HOUSEHOLD CHARACTERISTICS
Seventy-nine percent of Ghanaian households have electricity - 91% of households in urban areas and 65%
in rural areas (Table 2.3). The percentage of households with electricity increased from 52% in 2007 to
79% in 2017. Cement is the most common flooring material used in Ghana (54% of all households, 46% of
urban households, and 63% of rural households). The type of fuel used for cooking by a household can
affect indoor air quality and household health. Seven in 10 households use either charcoal or wood (35%
each), and one-quarter use liquefied petroleum gas/natural gas/biogas. Only about one-quarter of Ghanaian
households (27%) use clean fuel for cooking.

2.4 HOUSEHOLD WEALTH

Household Durable Goods

The possession of household durable goods is a useful indicator of household socioeconomic status (Table
2.4). Nine in ten households in urban areas (95%) and eight in ten households in rural areas (85%) possess
mobile phones. Sixty-four percent of households in Ghana have a radio, and an equal percentage own a
television. A refrigerator is available in 36% of households, with urban households being more than twice
as likely as rural households to own a refrigerator (50% compared with 18%). Bicycles are the most
commonly owned means of transport, with 21% of households in Ghana owning a bicycle. Twelve percent
of the households own motorcycle/scooter, while 10% own a car/truck. One-third of households own
agricultural land, with rural households more likely to own land (50%) than urban households (18%).
Thirty-six percent of households in the country possess farm animals; 56% in rural areas and 21% in
urban areas.

Wealth Index

Wealth index
Households are given scores based on the number and kinds of consumer
goods they own, ranging from a television to a bicycle or car, and housing
characteristics such as source of drinking water, toilet facilities, and flooring
materials. These scores are derived using principal component analysis.
National wealth quintiles are compiled by assigning the household score to each
usual (de jure) household member, ranking each person in the household
population by their score, and then dividing the distribution into five equal
categories, each with 20% of the population.
Sample: Households

Table 2.5 shows the distribution of the de jure Figure 2.3 Household wealth
household population by wealth quintile, according by residence
to place of residence and region. Eighty-six percent Percent distribution of de jure population
of urban residents are distributed among the top three by wealth quintiles
quintiles, compared with just 34% of rural residents
5
(Figure 2.3). At the regional level, Greater Accra 10
region has the greatest percentage of the population 35
19 Wealthiest
in the highest wealth quintile (52%), compared with
only 2% of the population in Upper East region, 3% Fourth
in Northern region and 4% in Upper West region. 30 29 Middle
More than half of the population in Northern, Upper Second
East and Upper West regions is in the lowest wealth Poorest
21
quintile (58%, 72% and 61% respectively). 38
12
3
Urban Rural

Characteristics of Households, Household Population, and Respondents • 9

 2.5 HOUSEHOLD POPULATION AND COMPOSITION

Household
A person or group of related or unrelated persons who live together in the same
dwelling unit(s), who acknowledge one adult male or female as the head of the
household, who share the same housekeeping arrangements, and who are
considered a single unit.

De facto population
All persons who stayed in the selected households the night before the interview
(whether usual residents or visitors).

De jure population
All persons who are usual residents of the selected households, whether or not
they stayed in the household the night before the interview.

How data are calculated

All tables are based on the de facto population, unless specified otherwise.

Table 2.6 and Figure 2.4 present Figure 2.4 Population pyramid
the distribution of the de facto Percent distribution of the household population
household population by age and Age
sex according to urban and rural 80+
residence. The 2017 GMHS 75-79
enumerated 98,564 persons, of 70-74
65-69
which 52% are females, yielding a 60-64
sex ratio (the number of males for 55-59
every 100 females) of 92 (Table 50-54 Male Female
2.6). The population is equally 45-49
40-44
divided among the urban and rural 35-39
areas. Forty percent of the 30-34
population in Ghana is under age 25-29
15, and 5% is age 65 or older. 20-24
15-19
Together, these two age groups
10-14
constitute the dependent age group. 5-9
The percentage of the population in <5
the dependent age group is greater 16 12
12 8 4 0 4 8 12 16
in rural than urban areas (46% and
41%, respectively). Further, 14% of the population is under age 5 and 22% are adolescents (age 10-19).

Table 2.7 shows that almost twice as many households are headed by men as by women (67% versus
34%), a pattern observed both in urban and in rural areas. The household size is larger in rural areas (mean
size of 4.2 persons) than in urban areas (mean size of 3.4 persons). Single-member households are more
common in urban areas (24%) than in rural areas (18%).

Trends: The percentage of households headed by females in 2017 (34%) is almost the same as in 2007
(32%). Within the same period, there was a decrease in the average size of households in Ghana from 4.2
to 3.8 persons.

2.6 BASIC CHARACTERISTICS OF SURVEY RESPONDENTS

Table 2.8 shows the weighted and unweighted numbers and the weighted percent distributions of women
age 15-49 who were interviewed in the 2017 GMHS, by background characteristics. More than half of the

10 • Characteristics of Households, Household Population, and Respondents

respondents age 15-49 are under age 30 (53%). The vast majority of respondents are Christians. More than
4 in 10 women (44%) are Pentecostal/Charismatic. Ten percent, 13%, and 14% are Catholic, Anglican/
Methodist/Presbyterian, and other Christian respectively. Fifteen percent of women are Muslim.

The Akans form the largest ethnic group, with about half of respondents (49%), followed by the Mole-
Dagbanis (15%), and the Ewes (14%). One-third of women (34%) have never been married, and over half
of women (57%) are married or living together with a partner (i.e., in union). Only 7% of women are
divorced/separated, while 2% are widowed (2%). More than half of women age 15-49 live in urban areas
(55%). The percentage of women in each of the 10 sub-national regions ranges from 3% in the Upper West
region to 19% in the Ashanti and Greater Accra regions.

2.7 DISABILITY
The 2017 GMHS included The DHS Program disability module, a series of questions based on the
Washington Group on Disability Statistics Short Set that are based on the framework of the World Health
Organization’s International Classification of Functioning, Disability, and Health. The questions address
six core functional domains—seeing, hearing, communication, cognition, walking, and self-care. Each
respondent was asked if she had no difficulty, some difficulty, a lot of difficulty, or did not have the ability
at all in each domain.

Functional domains
Seeing, hearing, communicating, remembering or concentrating, walking or
climbing steps, and washing all over or dressing.
Sample: Women age 15-49

Fifty-two percent of women age 15-49 had no difficulty in functioning in any of the domains studied.
However, 10% had a lot of difficulty performing the functions of at least one domain, and 0.2% cannot
function at all in at least one domain. The percentage of women who have a lot of difficulty or cannot
function at all in a given domain ranges from 0.6% for communicating to 4% in remembering or
concentrating. The percentage of women who have a lot of difficulty or cannot function at all in at least
one of the six domains increases with age from 8% or less among women under age 30 to 18% among
women age 40-49 (Table 2.9).

2.8 EDUCATION AND LITERACY

Literacy
Respondents who have attended higher than secondary school are assumed to
be literate. All other respondents, shown a typed sentence to read aloud, are
considered literate if they could read all or part of the sentence.
Sample: Women age 15-49

Characteristics of Households, Household Population, and Respondents • 11

 Nearly one-fifth (18%) of the women interviewed Figure 2.5 Education of survey
had no education, 12% had incomplete primary respondents
education, had 4% complete primary education, 47% Percent distribution of women age 15-49
had incomplete secondary education, and 12% by highest level of schooling attended
completed secondary education, with only 8% or completed
attaining more than secondary education. More than More than
secondary
half of women age 15-49 (54%) are literate (Table 8%
2.10, Table 2.11, and Figure 2.5).
Completed No
secondary education Primary
Trends: Women’s educational attainment has 12% 18% incomplete
improved since 2007. The percentage of women with 12%
no education decreased from 26% in 2007 to 18% in
2017. While the percentage of women with complete
Some
secondary education increased from 7% to 12%, secondary Primary
those with more than secondary education increased 47% complete
from 3% to 8%. 4%

Patterns by background characteristics

 Women age 20-24 (28%) are more likely than women in other age groups to have complete secondary
education (28%), while those age 25-29 are most likely to have attended more than secondary
education, and women age 45-49 are the most likely to have never attended school.

 Among the regions, the percentage of women age 15-49 with no education is highest in the Northern
region (58%) and lowest in Greater Accra (7%) (Figure 2.6).

 Women in urban areas (12%) are four times as likely to complete more than secondary education as
women in the rural areas (3%).

 Whereas 46% of women in the highest wealth quintile have completed secondary education or more,
only 3% of women in the lowest quintile have done so (Figure 2.7).

Figure 2.6 No education Figure 2.7 Secondary education

by region by household wealth
Percentage of women age 15-49 with no education Percentage of women age 15-49 with
complete secondary education or higher

46

23
12
3 6

Lowest Second Middle Fourth Highest

Poorest Wealthiest

12 • Characteristics of Households, Household Population, and Respondents

2.9 MASS MEDIA EXPOSURE

Exposure to mass media

Respondents were asked how often they read a newspaper, listened to the
radio, or watched television. Those who responded at least once a week are
considered regularly exposed to that form of media.
Sample: Women age 15-49

Women age 15-49 were asked how often they listen Figure 2.8 Exposure to mass media
to the radio, watch television, or read the newspaper.
Percentage of women age 15-49 who are
Only 7% of women age 15-49 read a newspaper at exposed to media on a weekly basis
least once a week whereas 59% watch television at
least once a week, and 50% listen to the radio at least
once a week. Only 5% of women access all three
media at least once a week, while 26% access none 59
50
of the three media at least once a week (Table 2.12
and Figure 2.8).
26
Trends: The survey results show a decline in the 7 5
percentage of women 15-49 who read a newspaper at
least once a week from 12% in the 2007 GHMS, to Reads Watches Listens to All three None of
7% in the 2017 GMHS. Likewise, those who listen to news- television radio media these
the radio at least once a week decreased from 74% in paper media
2007 to 50% in 2017. However, the percentage who
watch television increased from 48% in the 2007
GMHS to 59% in 2017.

Patterns by background characteristics

 Seven percent of urban women accesses all three media at least once a week, compared with 2% of
their counterparts in the rural areas.

 There is a wide variation in access to media by region. More than three in four women in Greater
Accra region who watch television at least once a week (77%), compared with 33% of women in the
Upper East region.

 Only 7% of women 15-49 with more than secondary education access none of the three media at least
once a week, compared with 45% of those with no education.

2.10 BANK ACCOUNTS, MOBILE PHONES, AND INTERNET USAGE

Has and uses a bank account

Respondents who have an account in a bank or other financial institution that
they themselves use
Sample: Women age 15-49

The 2017 GMHS asked women whether they have and use a bank account and whether they own a mobile
phone. Women who own mobile phones were asked if they use their mobile phone for any financial
transactions. Thirty percent of women age 15-49 have a bank account that they themselves use. Seventy
percent of women own a mobile phone, and among these, 63% use their mobile phone for financial
transactions (Table 2.13).

Characteristics of Households, Household Population, and Respondents • 13

 Respondents were also asked if they have ever used the internet and if they have used it in the last 12
months. Women who used the internet in the past 12 months were asked how often they used the internet
in the past month. One in four women have ever used the internet (25%), and 23% used the internet in the
past year. Among women who used the internet in the past 12 months, the majority of women (64%) said
that during the past month, they used the internet almost every day (Table 2.14).

Patterns by background characteristics

 By age, women age 30-34 (39%) are most likely to have a bank account, while those age 25-29 are
most likely to own a mobile phone (80%). Among those who own a mobile phone, those age 25-29 are
also most likely to use it for financial transactions (70%).

 Women in the Northern zone are much less likely than those in the Middle and Coastal zones to have a
bank account (11% vs. 32%), own a mobile phone (48% vs. 72% or higher), to use a mobile phone for
financial transactions (46% of mobile phone owners vs. 64% or higher), and to have ever used the
internet (10% vs. 24% or higher).

 Women in urban areas are more Figure 2.9 Internet access in past 12 months and
likely than those in rural areas mobile phone ownership
to have and use a bank account, Percentage of women age 15-49 who have
own a mobile phone, and, if used the internet in the past 12 months
they own a mobile phone, to and who own a mobile phone
use it for financial transaction Internet in past 12 months Mobile phone ownership
compared with their rural 99
counterparts. Urban women are 87 90
also more likely to have ever
used the internet (37% vs. 70
10%). 59
52 54

 Ownership of a bank account

and mobile phone, use of a
mobile phone for financial 13
transactions, and use of the 4
1
internet all increase markedly
with education and wealth. For No education Primary Middle/ Secondary/ More than
JSS/JHS SSS/SHS secondary
example, ownership of a mobile
phone increases from 52% among women with no education to 99% among those with more than
secondary education (Figure 2.9).

2.11 HEALTH INSURANCE REGISTRATION AND COVERAGE

The National Health Insurance Scheme (NHIS) was established as one of the key pillars of the Poverty
Reduction Programme of the Government of Ghana. It was introduced in 2003 by the National Health
Insurance Act (Act 650) with the view of improving financial access of Ghanaians, especially the poor and
the vulnerable, to quality basic health care services. The NHIS is a contributory scheme, renewable on an
annual basis, and valid card holders can access both public and private healthcare facilities accredited by
the National Health Insurance Authority. The contribution is structured in a way that people contribute
according to their ability, and each person receives according to his/her need. In this way, the health
insurance subsidises the health cost for the sick, and the economically active pay for children, the aged,
and the indigent.

In Ghana, it is possible to be registered for health insurance without being covered, i.e. in possession of a
valid insurance card and therefore able to access the benefits of health insurance. Being registered without
being covered may happen if an individual has not fully paid their premium, or if an individual is in the

14 • Characteristics of Households, Household Population, and Respondents

waiting period between completion of registration paperwork and receiving a card, or an individual’s card
has expired and has not been renewed. Seventy-nine percent of women age 15-49 have registered with any
health insurance scheme in the country. However, only 46% are actually covered by any insurance scheme.
One-fifth (21%) of women age 15-49 are neither registered nor covered under any scheme. The
national/district health insurance schemes are the most common type of health insurance coverage,
covering 46% of women age 15-49 (Table 2.15).

Patterns by background characteristics

 Urban and rural women are roughly equally Figure 2.10 Health insurance coverage
likely to be registered with any insurance (80% by region
vs. 78%). By region, being registered with any Percentage of women age 15-49 with health
insurance ranges from 69% in Volta to 92% in insurance coverage
the Upper East region (Figure 2.10).

 One-quarter of women with no education are

neither registered nor covered under any
insurance scheme compared with 12% of those
with more than secondary education.

 Women in the poorest quintile (26%) are more

likely to lack coverage compared with those in
the richest quintile (17%).

Health Insurance and Maternity Benefits

Respondents were also asked about the maternity

benefits associated with health insurance. Among
women age 15-49 with health insurance, 83%
indicated that their insurance covers antenatal care,
79% said their insurance covers childbirth health care
in a facility, 78% said their insurance covers
postnatal care health care for themselves, and 77% said their insurance covers postnatal health care for the
child. Only 3% said they receive cash benefits during maternity leave, and 15% said they receive no
benefits for any maternity-related services. (Table 2.16)

Sixty-eight percent of respondents said they sometimes have to pay out of their pockets for drugs and
services, 16% said they always have to pay for drugs, and 15% said they never had to pay out of their
pockets for drugs and services.

LIST OF TABLES

For more information on housing characteristics, household population, and survey respondents, see the
following tables:

 Table 2.1 Household drinking water

 Table 2.2 Household sanitation facilities
 Table 2.3 Household characteristics
 Table 2.4 Household possessions
 Table 2.5 Wealth quintiles
 Table 2.6 Household population by age, sex, and residence
 Table 2.7 Household composition
 Table 2.8 Background characteristics of respondents
 Table 2.9 Disability by domain and age

Characteristics of Households, Household Population, and Respondents • 15

  Table 2.10 Educational attainment
 Table 2.11 Literacy
 Table 2.12 Exposure to mass media
 Table 2.13 Ownership and use of bank accounts and mobile phones
 Table 2.14 Internet usage
 Table 2.15 Health insurance registration and coverage
 Table 2.16 Health insurance and maternity benefits

Table 2.1 Household drinking water

Percent distribution of households and de jure population by source of drinking water, and by time to obtain drinking water according to residence, Ghana
MHS 2017
Households Population
Characteristic Urban Rural Total Urban Rural Total
Source of drinking water
Improved source 95.3 80.7 88.8 94.9 79.6 87.3
Piped into dwelling/yard/plot 12.1 3.7 8.3 12.9 3.4 8.2
Piped to neighbour 7.4 3.4 5.6 8.2 3.4 5.9
Public tap/standpipe 15.3 20.1 17.5 16.6 19.4 18.0
Tube well/borehole 6.4 37.0 19.9 7.4 40.3 23.7
Protected dug well 2.8 3.7 3.2 3.4 3.8 3.6
Protected spring 0.1 0.3 0.2 0.2 0.4 0.3
Rain water 0.3 0.7 0.5 0.4 0.5 0.4
Bottled/sachet water, improved source
for cooking/handwashing1 51.0 11.8 33.7 45.8 8.4 27.3
Unimproved source 4.7 19.3 11.2 5.1 20.4 12.7
Unprotected dug well 1.0 3.5 2.1 1.3 4.1 2.7
Unprotected spring 0.1 0.6 0.3 0.1 0.6 0.3
Tanker truck/cart with small tank 0.1 0.0 0.1 0.1 0.0 0.1
Surface water 0.8 13.6 6.5 1.1 14.6 7.8
Bottled/sachet water, unimproved
source for cooking/handwashing1 2.6 1.5 2.2 2.5 1.0 1.8
Other source 0.0 0.0 0.0 0.0 0.0 0.0
Total 100.0 100.0 100.0 100.0 100.0 100.0
Time to obtain drinking water
(round trip)
Water on premises2 62.9 15.8 42.1 61.8 14.4 38.4
Less than 30 minutes 32.7 63.1 46.1 32.9 61.2 46.9
30 minutes or longer 4.1 20.8 11.5 4.9 24.0 14.4
Don’t know/missing 0.3 0.4 0.3 0.3 0.4 0.3
Total 100.0 100.0 100.0 100.0 100.0 100.0
Number 14,678 11,646 26,324 50,094 49,077 99,171

1
Households using bottled water for drinking are classified as using an improved or unimproved source according to their water source for cooking and
handwashing.
2
Includes water piped to a neighbour

16 • Characteristics of Households, Household Population, and Respondents

Table 2.2 Household sanitation facilities

Percent distribution of households and de jure population by type of toilet/latrine facilities according to residence, Ghana MHS 2017
Households Population
Type of toilet/latrine facility Urban Rural Total Urban Rural Total
Improved sanitation 22.4 13.4 18.4 24.7 13.9 19.4
Flush/pour flush to piped sewer system 0.5 0.1 0.3 0.6 0.1 0.3
Flush/pour flush to septic tank 16.8 3.1 10.7 18.0 2.7 10.4
Flush/pour flush to pit latrine 0.2 0.2 0.2 0.2 0.2 0.2
Ventilated improved pit (VIP) latrine 2.6 3.5 3.0 3.1 3.7 3.4
Pit latrine with a slab 2.2 6.5 4.1 2.7 7.2 4.9
Composting toilet 0.0 0.0 0.0 0.1 0.0 0.1
Unimproved sanitation 77.6 86.6 81.6 75.3 86.1 80.6
Shared facility1 62.1 39.0 51.9 58.7 33.1 46.0
Flush/pour flush to piped sewer system 0.6 0.0 0.4 0.5 0.0 0.2
Flush/pour flush to septic tank 21.6 3.0 13.4 19.1 2.0 10.6
Flush/pour flush to pit latrine 1.8 0.6 1.3 1.8 0.5 1.2
Ventilated improved pit (VIP) latrine 28.9 17.9 24.0 28.5 15.2 21.9
Pit latrine with a slab 9.0 17.4 12.7 8.8 15.2 12.0
Composting toilet 0.1 0.1 0.1 0.1 0.1 0.1
Unimproved facility 8.0 22.6 14.5 8.2 23.6 15.8
Flush/pour flush not to sewer/septic
tank/pit latrine 0.3 0.1 0.2 0.3 0.1 0.2
Pit latrine without slab/open pit 6.8 22.1 13.5 7.0 23.3 15.1
Bucket 0.2 0.2 0.2 0.2 0.1 0.2
Hanging toilet/hanging latrine 0.0 0.1 0.0 0.0 0.0 0.0
Other 0.7 0.1 0.5 0.7 0.1 0.4
Open defecation (No facility/bush/field) 7.5 25.0 15.2 8.4 29.4 18.8
Total 100.0 100.0 100.0 100.0 100.0 100.0
Number of households/population 14,678 11,646 26,324 50,094 49,077 99,171

1
Facilities that would be considered improved if they were not shared by two or more households.

Characteristics of Households, Household Population, and Respondents • 17

 Table 2.3 Household characteristics
Percent distribution of households and de jure population by housing characteristics, percentage using solid fuel for cooking and percentage using clean fuel
for cooking, according to residence, Ghana MHS 2017
Households Population
Housing characteristic Urban Rural Total Urban Rural Total
Electricity
Yes 90.5 65.0 79.2 90.5 63.3 77.0
No 9.5 35.0 20.8 9.5 36.7 23.0
Total 100.0 100.0 100.0 100.0 100.0 100.0
Flooring material
Earth/sand 3.3 14.5 8.2 3.7 15.5 9.6
Dung 0.1 0.6 0.3 0.1 0.8 0.4
Wood planks 0.5 0.1 0.3 0.3 0.0 0.2
Palm/bamboo 0.0 0.0 0.0 0.0 0.0 0.0
Parquet or polished wood 0.2 0.3 0.3 0.2 0.3 0.3
Vinyl or asphalt strips 0.0 0.0 0.0 0.0 0.0 0.0
Ceramic or porcelain tiles/ marble/terrazzo 16.6 3.2 10.7 17.1 3.1 10.1
Cement 45.8 63.4 53.6 48.9 65.7 57.2
Woolen carpet/synthetic carpet 19.4 9.0 14.8 17.4 7.0 12.3
Linoleum/rubber carpet 14.1 8.8 11.7 12.3 7.4 9.9
Other 0.0 0.0 0.0 0.0 0.0 0.0
Total 100.0 100.0 100.0 100.0 100.0 100.0
Rooms used for sleeping
One 61.3 51.7 57.0 47.3 35.5 41.4
Two 25.2 28.1 26.5 30.8 31.6 31.2
Three or more 13.5 20.2 16.5 21.9 32.9 27.3
Total 100.0 100.0 100.0 100.0 100.0 100.0
Cooking fuel
Electricity 1.2 0.9 1.1 1.0 0.8 0.9
LPG/natural gas/biogas 38.7 9.6 25.8 34.6 6.3 20.6
Kerosene 0.1 0.0 0.1 0.1 0.0 0.0
Coal/lignite 0.1 0.0 0.0 0.1 0.0 0.0
Charcoal 44.4 22.1 34.6 47.5 18.0 32.9
Wood 11.8 64.5 35.1 15.5 73.0 44.0
Straw/shrubs/grass 0.0 0.9 0.4 0.1 1.1 0.6
Agricultural crops 0.0 0.2 0.1 0.0 0.3 0.2
No food cooked in household 3.6 1.7 2.8 1.2 0.5 0.9
Total 100.0 100.0 100.0 100.0 100.0 100.0
Percentage using solid fuel for cooking1 56.3 87.8 70.2 63.1 92.5 77.6
Percentage using clean fuel for cooking2 39.9 10.5 26.9 35.6 7.1 21.5
Number of households/population 14,678 11,646 26,324 50,094 49,077 99,171

LPG = Liquefied petroleum gas

1
Includes coal/lignite, charcoal, wood, straw/shrubs/grass, and agricultural crops
2
Includes electricity and LPG/natural gas/biogas

Table 2.4 Household possessions

Percentage of households possessing various household effects, means of transportation,
agricultural land and livestock/farm animals, according to residence, Ghana MHS 2017
Residence
Possession Urban Rural Total
Household effects
Radio 67.8 59.4 64.1
Television 78.6 44.6 63.6
Mobile phone 94.7 85.0 90.4
Computer 24.9 7.3 17.1
Non-mobile telephone 1.6 0.3 1.0
Refrigerator 50.1 18.2 36.0
Means of transport
Bicycle 16.5 26.8 21.1
Animal drawn cart 0.4 1.4 0.9
Motorcycle/scooter 9.3 14.7 11.7
Car/truck 13.8 4.8 9.8
Boat with a motor 0.5 0.4 0.5
Ownership of agricultural land 18.4 50.3 32.5
Ownership of farm animals1 20.9 55.9 36.4
Number 14,678 11,646 26,324

1
Milk cows, other cattle, horses, donkeys, mules, goats, sheep, chickens, other poultry,
pigs, rabbits and/or grasscutters

18 • Characteristics of Households, Household Population, and Respondents

Table 2.5 Wealth quintiles

Percent distribution of the de jure population by wealth quintiles and the Gini Coefficient, according to residence and region, Ghana MHS 2017
Wealth quintile Number of Gini
Residence/region Lowest Second Middle Fourth Highest Total persons coefficient
Residence
Urban 2.8 11.6 21.1 29.7 34.7 100.0 50,094 0.16
Rural 37.5 28.5 18.8 10.1 5.0 100.0 49,077 0.30
Region
Western 14.7 24.4 24.1 20.8 16.0 100.0 10,765 0.30
Central 9.8 27.3 25.9 23.1 13.9 100.0 9,091 0.24
Greater Accra 0.7 5.9 13.9 26.9 52.5 100.0 16,457 0.16
Volta 31.2 29.0 19.5 13.5 6.7 100.0 8,980 0.36
Eastern 15.7 23.1 21.6 23.4 16.1 100.0 10,441 0.25
Ashanti 6.6 17.4 25.2 25.6 25.3 100.0 18,677 0.22
Brong Ahafo 21.7 28.3 25.5 17.2 7.3 100.0 9,468 0.31
Northern 58.0 19.7 11.2 7.7 3.4 100.0 8,481 0.40
Upper East 72.1 13.9 7.2 4.5 2.3 100.0 4,074 0.38
Upper West 60.6 21.2 7.9 6.4 3.9 100.0 2,738 0.35
Total 20.0 20.0 20.0 20.0 20.0 100.0 99,171 0.28

Table 2.6 Household population by age, sex, and residence

Percent distribution of the de facto household population by various age groups and percentage of the de facto household population age 10-19,
according to sex and residence, Ghana MHS 2017
Urban Rural
Age Male Female Total Male Female Total Male Female Total
<5 13.9 12.1 12.9 15.2 13.8 14.5 14.6 12.9 13.7
5-9 13.3 11.2 12.2 16.1 14.0 15.1 14.8 12.6 13.6
10-14 11.6 11.3 11.4 14.3 12.2 13.2 13.0 11.7 12.3
15-19 9.4 8.9 9.1 10.6 9.4 10.0 10.0 9.1 9.6
20-24 8.1 8.6 8.4 6.9 7.2 7.0 7.4 7.9 7.7
25-29 7.8 9.1 8.5 5.8 7.0 6.4 6.8 8.0 7.4
30-34 7.2 7.7 7.4 5.3 6.2 5.7 6.2 7.0 6.6
35-39 6.0 6.6 6.3 4.7 5.9 5.3 5.3 6.2 5.8
40-44 5.4 4.9 5.1 4.4 4.5 4.5 4.9 4.7 4.8
45-49 4.3 4.4 4.4 3.9 4.2 4.1 4.1 4.3 4.2
50-54 3.5 4.3 4.0 3.1 3.5 3.3 3.3 4.0 3.6
55-59 2.9 3.2 3.1 2.3 3.3 2.8 2.6 3.2 2.9
60-64 2.3 2.6 2.5 2.4 2.6 2.5 2.4 2.6 2.5
65-69 1.7 1.6 1.6 1.5 1.8 1.7 1.6 1.7 1.6
70-74 1.0 1.3 1.2 1.4 1.5 1.4 1.2 1.4 1.3
75-79 0.7 0.9 0.8 0.9 1.1 1.0 0.8 1.0 0.9
80 + 0.8 1.4 1.2 1.1 1.8 1.5 1.0 1.6 1.3
Don’t know/missing 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Dependency age groups
0-14 38.8 34.5 36.5 45.7 40.0 42.8 42.3 37.2 39.6
15-64 57.0 60.2 58.7 49.3 53.7 51.6 53.1 57.1 55.2
65+ 4.2 5.2 4.7 4.9 6.3 5.6 4.6 5.7 5.2
Don’t know/missing 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Child and adult populations
0-17 44.7 40.1 42.2 52.6 46.2 49.3 48.7 43.0 45.8
18+ 55.2 59.9 57.7 47.4 53.8 50.6 51.2 57.0 54.2
Don’t know/missing 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Adolescents 10-19 21.1 20.1 20.6 24.9 21.6 23.2 23.0 20.8 21.9
Number of persons 23,079 26,634 49,714 24,093 24,757 48,850 47,173 51,391 98,564

Characteristics of Households, Household Population, and Respondents • 19

 Table 2.7 Household composition

Percent distribution of households by sex of head of household and by

household size; and mean size of households, according to residence,
Ghana MHS 2017
Residence
Characteristic Urban Rural Total
Household headship
Male 63.3 70.5 66.5
Female 36.7 29.5 33.5
Total 100.0 100.0 100.0
Number of usual members
0 0.0 0.1 0.0
1 24.0 17.7 21.2
2 16.2 12.4 14.5
3 16.3 14.5 15.5
4 15.3 14.8 15.0
5 12.2 12.7 12.4
6 7.6 10.1 8.7
7 3.9 7.4 5.5
8 2.2 4.4 3.1
9+ 2.2 6.0 3.9
Total 100.0 100.0 100.0
Mean size of households 3.4 4.2 3.8
Number of households 14,678 11,646 26,324

Note: Table is based on de jure household members, i.e., usual residents.

Table 2.8 Background characteristics of respondents

Percent distribution of women age 15-49 by selected background characteristics, Ghana MHS 2017
Number of women
Background Weighted Weighted Unweighted
characteristic percent number number
Age
15-19 19.1 4,785 4,888
20-24 16.8 4,208 4,259
25-29 16.9 4,229 4,179
30-34 14.8 3,709 3,628
35-39 13.2 3,313 3,262
40-44 9.9 2,481 2,448
45-49 9.3 2,337 2,398
Disability status1
A lot of difficulty or unable to function in at
least one domain 10.2 2,554 2,582
Some or no difficulty in all domains 89.8 22,508 22,480
Religion
Catholic 9.6 2,411 3,322
Anglican/Methodist/Presbyterian 12.7 3,193 2,441
Pentecostal/Charismatic 44.2 11,076 9,013
Other Christian 13.9 3,479 2,975
Muslim 15.4 3,860 6,080
Traditional/Spiritualist 1.8 462 617
No religion 2.3 578 611
Other 0.0 4 3
Ethnic group
Akan 48.6 12,191 8,837
Ga/Dangme 8.1 2,038 1,279
Ewe 13.9 3,471 2,474
Guan 3.3 824 905
Mole-Dagbani 15.1 3,790 7,651
Grusi 2.8 703 1,284
Gurma 5.1 1,287 1,799
Mande 0.9 222 293
Other 2.1 535 540
Marital status
Never married 33.5 8,397 7,936
Married 36.3 9,098 10,869
Living together 21.0 5,262 4,183
Divorced/separated 6.9 1,736 1,430
Widowed 2.3 568 644

Continued

20 • Characteristics of Households, Household Population, and Respondents

 Table 2.8—Continued
Number of women
Background Weighted Weighted Unweighted
characteristic percent number number
Residence
Urban 54.9 13,752 12,544
Rural 45.1 11,310 12,518
Zone
Coastal 48.4 12,121 7,938
Middle 38.6 9,674 7,610
Northern 13.0 3,267 9,514
Region
Western 12.9 3,230 2,334
Central 8.9 2,218 1,603
Greater Accra 18.6 4,673 2,535
Volta 8.0 2,000 1,466
Eastern 10.0 2,517 2,172
Ashanti 19.1 4,790 3,136
Brong Ahafo 9.4 2,367 2,302
Northern 7.1 1,786 4,202
Upper East 3.4 854 2,709
Upper West 2.5 628 2,603
Education
No education 18.3 4,585 6,508
Primary 15.7 3,934 3,897
Middle/JSS/JHS 40.2 10,081 8,695
Secondary/SSS/SHS 18.2 4,550 4,180
More than secondary 7.6 1,912 1,782
Wealth quintile
Lowest 16.2 4,064 6,925
Second 18.8 4,721 4,714
Middle 20.4 5,111 4,447
Fourth 21.7 5,443 4,631
Highest 22.8 5,723 4,345
Total 15-49 100.0 25,062 25,062

Note: Education categories refer to the highest level of education attended, whether or not that level
was completed.
na = Not applicable
1
If a woman reported having difficulty in more than one domain, only the highest level of difficulty is
shown. Domains are seeing, hearing, communicating, remembering or concentrating, walking or
climbing steps, and washing all over or dressing.

Table 2.9 Disability by domain and age

Percent distribution of women age 15-49 by degree of difficulty in functioning according to domain, and percent distribution by the highest degree
of difficulty in functioning in at least one domain by age, Ghana MHS 2017
Degree of difficulty A lot of
difficulty or
Some A lot of Cannot Don’t know/ cannot Number of
Domain and age No difficulty difficulty difficulty do at all missing Total do at all women
Domain
Difficulty seeing 77.8 19.4 2.8 0.0 0.0 100.0 2.8 25,062
Difficulty hearing 93.8 5.5 0.7 0.0 0.0 100.0 0.7 25,062
Difficulty communicating 95.8 3.6 0.5 0.1 0.0 100.0 0.6 25,062
Difficulty remembering or
concentrating 73.7 21.9 4.4 0.0 0.0 100.0 4.4 25,062
Difficulty walking or climbing
steps 81.7 15.0 3.3 0.1 0.0 100.0 3.3 25,062
Difficulty washing all over or
dressing 95.3 4.0 0.6 0.0 0.0 100.0 0.7 25,062
Difficulty in at least one
domain1
15-19 55.6 36.9 7.4 0.1 0.0 100.0 7.5 4,785
20-29 58.4 34.2 7.2 0.3 0.0 100.0 7.4 8,437
30-39 52.6 37.2 10.1 0.1 0.0 100.0 10.2 7,022
40-49 34.3 48.1 17.3 0.3 0.0 100.0 17.6 4,818
Total1 51.6 38.2 10.0 0.2 0.0 100.0 10.2 25,062

1
If a woman reported having difficulty in more than one domain, only the highest level of difficulty is shown.

Characteristics of Households, Household Population, and Respondents • 21

 Table 2.10 Educational attainment

Percent distribution of women age 15-49 by highest level of schooling attended or completed, and median years completed, according to background
characteristics, Ghana MHS 2017
Highest level of schooling Median
Background No Some Completed Some Completed More than years Number of
characteristic education primary primary1 secondary secondary2 secondary Total completed women
Age
15-24 5.9 10.5 4.0 57.0 17.7 4.9 100.0 8.2 8,993
15-19 3.4 13.0 4.4 69.7 8.6 0.8 100.0 7.8 4,785
20-24 8.7 7.7 3.5 42.6 28.1 9.5 100.0 8.6 4,208
25-29 16.0 9.6 4.5 39.3 16.8 13.8 100.0 8.4 4,229
30-34 22.3 12.4 3.7 39.7 9.0 12.8 100.0 8.1 3,709
35-39 27.5 13.6 3.9 41.4 6.7 6.8 100.0 7.0 3,313
40-44 31.3 13.6 4.4 43.2 3.1 4.4 100.0 5.7 2,481
45-49 36.7 13.2 4.2 41.3 1.3 3.3 100.0 5.0 2,337
Disability status3
A lot of difficulty or unable to
function in at least one
domain 26.3 14.9 4.6 43.8 6.9 3.5 100.0 6.2 2,554
Some or no difficulty in all
domains 17.4 11.2 4.0 46.9 12.4 8.1 100.0 8.1 22,508
Residence
Urban 11.2 9.3 3.6 48.1 16.2 11.7 100.0 8.5 13,752
Rural 27.0 14.5 4.7 44.7 6.5 2.7 100.0 6.1 11,310
Zone
Coastal 13.6 11.1 4.5 48.7 13.0 9.0 100.0 8.2 12,121
Middle 13.5 12.0 3.9 51.8 11.9 6.9 100.0 8.2 9,674
Northern 49.9 12.2 2.9 23.0 7.1 4.8 100.0 0.0 3,267
Region
Western 17.6 10.1 3.8 51.5 11.5 5.5 100.0 8.0 3,230
Central 13.2 14.7 2.6 53.6 10.8 5.1 100.0 8.1 2,218
Greater Accra 7.3 8.9 4.7 46.1 17.8 15.2 100.0 8.7 4,673
Volta 22.2 13.9 7.4 45.0 6.9 4.5 100.0 6.3 2,000
Eastern 11.0 13.6 5.7 52.6 11.4 5.7 100.0 8.1 2,517
Ashanti 10.8 10.9 3.2 53.6 13.2 8.4 100.0 8.4 4,790
Brong Ahafo 21.8 12.8 3.5 47.1 9.9 5.0 100.0 7.1 2,367
Northern 58.3 9.3 2.6 18.4 6.7 4.6 100.0 0.0 1,786
Upper East 38.2 15.7 3.6 29.9 8.1 4.6 100.0 4.2 854
Upper West 41.8 16.0 3.1 26.8 6.6 5.7 100.0 3.4 628
Wealth quintile
Lowest 47.8 17.3 4.5 27.7 2.5 0.2 100.0 1.0 4,064
Second 22.7 16.5 5.4 49.4 5.4 0.7 100.0 6.1 4,721
Middle 15.8 12.7 4.3 55.5 9.7 2.0 100.0 7.8 5,111
Fourth 10.5 9.5 4.0 53.2 16.7 6.1 100.0 8.4 5,443
Highest 3.3 4.6 2.6 43.3 21.1 25.1 100.0 9.8 5,723
Total 18.3 11.6 4.1 46.6 11.8 7.6 100.0 8.1 25,062

1
Completed 6th grade at the primary level
2
Completed 6th grade at the secondary level
3
If a woman reported having difficulty in more than one domain, only the highest level of difficulty is shown. Domains are seeing, hearing,
communicating, remembering or concentrating, walking or climbing steps, and washing all over or dressing.

22 • Characteristics of Households, Household Population, and Respondents

Table 2.11 Literacy

Percent distribution of women age 15-49 by level of schooling attended and level of literacy, and percentage literate, according to background characteristics,
Ghana MHS 2017
No schooling or primary or secondary school
Higher than Can read a Can read No card with
Background secondary whole part of a Cannot read required Blind/visually Percentage Number of
characteristic schooling sentence sentence at all language impaired Total literate1 women
Age
15-24 4.9 54.8 14.3 25.8 0.2 0.0 100.0 74.0 8,993
15-19 0.8 62.0 15.9 21.0 0.2 0.0 100.0 78.7 4,785
20-24 9.5 46.6 12.5 31.2 0.2 0.1 100.0 68.6 4,208
25-29 13.8 32.3 11.5 42.3 0.1 0.0 100.0 57.6 4,229
30-34 12.8 24.6 10.1 52.4 0.1 0.0 100.0 47.6 3,709
35-39 6.8 18.3 11.8 62.9 0.1 0.1 100.0 37.0 3,313
40-44 4.4 16.1 10.6 68.7 0.1 0.1 100.0 31.1 2,481
45-49 3.3 15.4 8.9 71.9 0.1 0.4 100.0 27.6 2,337
Residence
Urban 11.7 40.9 12.2 35.0 0.1 0.1 100.0 64.8 13,752
Rural 2.7 26.0 11.8 59.3 0.2 0.0 100.0 40.5 11,310
Zone
Coastal 9.0 37.9 13.6 39.3 0.2 0.1 100.0 60.5 12,121
Middle 6.9 34.7 11.1 47.2 0.1 0.1 100.0 52.6 9,674
Northern 4.8 19.0 8.9 66.9 0.2 0.0 100.0 32.8 3,267
Region
Western 5.5 34.1 12.8 47.3 0.2 0.2 100.0 52.4 3,230
Central 5.1 33.6 14.0 47.1 0.1 0.1 100.0 52.7 2,218
Greater Accra 15.2 44.5 14.0 26.2 0.0 0.0 100.0 73.7 4,673
Volta 4.5 33.5 13.3 48.2 0.5 0.0 100.0 51.3 2,000
Eastern 5.7 40.1 14.8 39.4 0.0 0.0 100.0 60.5 2,517
Ashanti 8.4 35.7 9.9 45.9 0.0 0.2 100.0 54.0 4,790
Brong Ahafo 5.0 26.9 9.5 58.3 0.3 0.0 100.0 41.4 2,367
Northern 4.6 15.8 8.6 70.8 0.1 0.0 100.0 29.1 1,786
Upper East 4.6 24.2 9.9 60.9 0.5 0.1 100.0 38.6 854
Upper West 5.7 21.2 8.6 64.2 0.3 0.0 100.0 35.5 628
Wealth quintile
Lowest 0.2 15.6 9.1 74.8 0.2 0.1 100.0 24.9 4,064
Second 0.7 26.5 12.5 60.1 0.2 0.0 100.0 39.7 4,721
Middle 2.0 35.3 13.1 49.4 0.1 0.1 100.0 50.3 5,111
Fourth 6.1 42.1 13.7 37.9 0.1 0.1 100.0 61.9 5,443
Highest 25.1 45.2 11.1 18.4 0.0 0.1 100.0 81.5 5,723
Total 7.6 34.2 12.0 46.0 0.1 0.1 100.0 53.8 25,062

1
Refers to women who attended schooling higher than the secondary level and women who can read a whole sentence or part of a sentence

Characteristics of Households, Household Population, and Respondents • 23

 Table 2.12 Exposure to mass media

Percentage of women age 15-49 who are exposed to specific media on a weekly basis, according to background characteristics, Ghana
MHS 2017
Reads a Accesses all Accesses none
newspaper at Watches Listens to the three media at of the three
Background least once a television at least radio at least least once a media at least Number of
characteristic week once a week once a week week once a week women
Age
15-19 9.4 57.1 38.6 4.4 30.8 4,785
20-24 8.4 63.9 47.8 5.1 23.4 4,208
25-29 9.0 64.2 52.7 6.4 23.0 4,229
30-34 7.3 61.7 56.2 5.2 23.4 3,709
35-39 4.8 56.1 53.7 3.5 27.2 3,313
40-44 3.6 55.2 55.3 2.7 27.7 2,481
45-49 3.2 49.4 54.3 2.6 30.5 2,337
Residence
Urban 10.5 72.0 54.9 6.9 17.5 13,752
Rural 3.0 43.4 44.6 1.6 37.1 11,310
Zone
Coastal 9.1 65.6 55.2 5.9 20.0 12,121
Middle 6.2 59.5 48.7 4.0 27.2 9,674
Northern 2.2 33.8 36.3 0.9 47.2 3,267
Zone
Coastal 9.1 65.6 55.2 5.9 20.0 12,121
Middle 6.2 59.5 48.7 4.0 27.2 9,674
Northern 2.2 33.8 36.3 0.9 47.2 3,267
Region
Western 4.2 61.7 50.5 2.0 22.0 3,230
Central 4.8 58.2 42.3 2.1 27.2 2,218
Greater Accra 16.2 76.7 63.0 11.2 12.0 4,673
Volta 5.1 54.0 59.1 3.7 27.2 2,000
Eastern 5.5 47.4 41.9 3.3 38.1 2,517
Ashanti 7.4 68.9 55.7 5.2 19.1 4,790
Brong Ahafo 4.4 53.3 41.7 2.4 32.2 2,367
Northern 1.3 34.2 34.8 0.6 49.6 1,786
Upper East 4.2 32.8 41.3 1.5 41.6 854
Upper West 2.1 34.1 34.1 0.9 48.1 628
Education
No education 0.1 35.3 39.3 0.1 44.9 4,585
Primary 0.7 50.8 45.3 0.3 32.1 3,934
Middle/JSS/JHS 4.2 61.8 50.3 2.1 24.3 10,081
Secondary/SSS/SHS 14.1 74.4 57.3 8.7 15.0 4,550
More than secondary 35.8 82.3 69.4 26.2 7.2 1,912
Wealth quintile
Lowest 1.0 16.0 34.7 0.3 57.5 4,064
Second 2.4 43.4 44.8 1.1 35.6 4,721
Middle 4.0 64.2 47.7 2.2 23.1 5,111
Fourth 6.6 76.0 54.5 3.8 14.7 5,443
Highest 18.6 82.0 64.1 13.0 10.4 5,723
Total 7.1 59.1 50.2 4.5 26.3 25,062

24 • Characteristics of Households, Household Population, and Respondents

Table 2.13 Ownership and use of bank accounts and mobile phones
Percentage of women age 15-49 who have and use an account in a bank or other financial institution and percentage who own a mobile
phone; among women who own a mobile phone, percentage who use it for financial transactions, according to background characteristics,
Ghana MHS 2017
Use mobile phone Number of women
Background Have and use a Own a mobile Number of for financial who own a mobile
characteristic bank account phone women transactions phone
Age
15-19 5.5 39.9 4,785 46.1 1,909
20-24 28.3 78.2 4,208 69.0 3,290
25-29 37.6 80.0 4,229 69.6 3,383
30-34 39.4 77.5 3,709 66.0 2,874
35-39 37.3 76.8 3,313 61.0 2,545
40-44 34.8 76.7 2,481 58.2 1,903
45-49 33.4 72.0 2,337 61.8 1,683
Residence
Urban 40.9 81.5 13,752 67.8 11,206
Rural 15.6 56.4 11,310 54.9 6,380
Zone
Coastal 32.0 75.1 12,121 65.7 9,102
Middle 32.3 71.7 9,674 63.5 6,933
Northern 11.4 47.5 3,267 46.0 1,552
Region
Western 25.6 70.8 3,230 61.6 2,287
Central 23.7 70.6 2,218 65.1 1,566
Greater Accra 48.2 85.4 4,673 69.3 3,989
Volta 13.7 63.0 2,000 63.0 1,259
Eastern 27.7 72.8 2,517 69.5 1,832
Ashanti 36.2 74.9 4,790 65.2 3,589
Brong Ahafo 29.4 63.9 2,367 52.5 1,512
Northern 9.4 45.4 1,786 43.6 811
Upper East 12.8 55.1 854 49.3 471
Upper West 15.5 43.1 628 47.6 271
Education
No education 12.2 51.8 4,585 39.3 2,376
Primary 16.6 58.8 3,934 54.9 2,311
Middle/JSS/JHS 25.0 69.8 10,081 62.6 7,035
Secondary/SSS/SHS 42.4 87.3 4,550 72.4 3,972
More than secondary 89.6 98.9 1,912 85.7 1,892
Wealth quintile
Lowest 3.8 36.4 4,064 37.2 1,479
Second 11.5 57.7 4,721 51.0 2,723
Middle 21.9 72.0 5,111 61.4 3,681
Fourth 38.1 82.7 5,443 68.6 4,504
Highest 60.9 90.8 5,723 73.3 5,199
Total 29.5 70.2 25,062 63.1 17,586

Characteristics of Households, Household Population, and Respondents • 25

 Table 2.14 Internet usage
Percentage of women age 15-49 who have ever used the internet, and percentage who have used the internet in the past 12 months; and among
women who have used the internet in the past 12 months, percent distribution by frequency of internet use in the past month, according to
background characteristics, Ghana MHS 2017
Among respondents who have used the internet in the past 12
months, percentage who, in the past month, used internet:
Used the
internet in At least Less than
Background Ever used the past Almost once a once a
characteristic the internet 12 months Number every day week week Not at all Total Number
Age
15-19 23.8 21.4 4,785 50.2 28.1 14.8 6.9 100.0 1,023
20-24 41.6 38.2 4,208 65.7 21.8 7.5 5.0 100.0 1,606
25-29 35.0 32.2 4,229 65.8 19.0 10.8 4.4 100.0 1,360
30-34 24.9 22.7 3,709 67.6 21.4 7.1 3.9 100.0 843
35-39 16.0 14.4 3,313 68.8 20.2 7.4 3.6 100.0 479
40-44 9.0 8.3 2,481 65.8 16.9 12.6 4.6 100.0 206
45-49 6.0 5.4 2,337 65.4 27.9 5.9 0.8 100.0 126
Residence
Urban 36.5 33.6 13,752 66.1 20.7 8.7 4.4 100.0 4,618
Rural 10.3 9.1 11,310 51.5 27.9 14.0 6.6 100.0 1,025
Zone
Coastal 29.3 26.8 12,121 65.3 20.5 9.4 4.9 100.0 3,248
Middle 24.0 22.0 9,674 61.5 23.3 10.3 4.9 100.0 2,127
Northern 9.6 8.2 3,267 57.9 30.8 8.0 3.3 100.0 267
Region
Western 22.9 19.7 3,230 48.6 27.1 18.3 6.0 100.0 638
Central 20.6 19.0 2,218 60.5 25.4 9.2 4.8 100.0 422
Greater Accra 44.7 41.5 4,673 70.8 17.6 6.8 4.8 100.0 1,938
Volta 13.3 12.5 2,000 73.3 16.9 7.1 2.7 100.0 249
Eastern 21.2 19.6 2,517 60.9 19.7 15.4 3.9 100.0 494
Ashanti 29.6 27.8 4,790 64.0 23.2 8.2 4.5 100.0 1,329
Brong Ahafo 15.6 12.8 2,367 51.1 29.5 11.3 8.0 100.0 304
Northern 9.4 8.4 1,786 61.8 26.4 7.7 4.1 100.0 150
Upper East 10.4 8.4 854 48.5 41.5 7.6 2.5 100.0 72
Upper West 9.1 7.2 628 59.8 28.5 10.1 1.7 100.0 46
Education
No education 1.4 1.0 4,585 (54.4) (23.7) (19.1) (2.8) (100.0) 47
Primary 4.4 3.7 3,934 54.1 24.9 10.4 10.6 100.0 146
Middle/JSS/JHS 14.5 12.6 10,081 46.5 29.3 16.6 7.6 100.0 1,272
Secondary/SSS/SHS 59.7 53.9 4,550 60.9 24.0 9.7 5.4 100.0 2,453
More than secondary 92.5 90.1 1,912 80.7 13.5 4.3 1.5 100.0 1,723
Wealth quintile
Lowest 2.0 1.3 4,064 33.0 33.2 30.0 3.7 100.0 51
Second 6.6 5.4 4,721 39.1 34.7 16.4 9.8 100.0 253
Middle 15.8 13.6 5,111 49.7 27.9 14.3 8.1 100.0 698
Fourth 29.7 27.1 5,443 55.2 27.0 11.0 6.7 100.0 1,477
Highest 58.7 55.3 5,723 72.8 17.2 7.2 2.8 100.0 3,163
Total 24.7 22.5 25,062 63.5 22.0 9.7 4.8 100.0 5,642

Note: Figures in parentheses are based on 25-49 unweighted cases.

26 • Characteristics of Households, Household Population, and Respondents

Table 2.15 Health insurance registration and coverage
Percentage of women age 15-49 registered with any health insurance, percentage covered by any health insurance, percentage covered by specific
types of health insurance, and percentage neither registered with nor covered by any health insurance, according to background characteristics, Ghana
MHS 2017
Covered by2:
Mutual
health Privately
National/ organisation/ purchased
Registered Covered by district Employer community- commercial Neither
Background with any any health based based health registered Number of
characteristic insurance1 insurance insurance insurance insurance insurance Other nor covered women
Age
15-19 72.7 43.1 43.0 0.2 0.1 0.0 0.0 27.3 4,785
20-24 79.5 45.4 45.3 0.2 0.0 0.1 0.0 20.5 4,208
25-29 82.1 50.2 49.8 0.8 0.2 0.1 0.0 17.9 4,229
30-34 84.2 50.9 50.2 0.7 0.3 0.5 0.2 15.8 3,709
35-39 81.7 45.3 45.0 0.6 0.1 0.4 0.0 18.3 3,313
40-44 80.1 45.5 45.3 0.8 0.0 0.1 0.0 19.9 2,481
45-49 76.0 41.6 40.7 0.4 0.1 0.3 0.0 24.0 2,337
Residence
Urban 80.2 47.2 46.6 0.8 0.2 0.3 0.1 19.8 13,752
Rural 78.4 45.1 45.0 0.1 0.0 0.1 0.0 21.6 11,310
Zone
Coastal 73.5 40.9 40.3 0.6 0.2 0.3 0.1 26.5 12,121
Middle 84.6 49.5 49.4 0.6 0.0 0.2 0.0 15.4 9,674
Northern 85.5 56.2 56.1 0.2 0.0 0.0 0.0 14.5 3,267
Region
Western 76.2 45.6 45.5 0.2 0.1 0.1 0.0 23.8 3,230
Central 74.4 39.7 39.6 0.2 0.0 0.1 0.0 25.6 2,218
Greater Accra 73.1 38.7 37.2 1.2 0.3 0.6 0.2 26.9 4,673
Volta 69.0 40.0 39.9 0.1 0.2 0.1 0.0 31.0 2,000
Eastern 84.5 57.9 57.8 0.6 0.1 0.0 0.0 15.5 2,517
Ashanti 82.5 42.4 42.2 0.7 0.0 0.2 0.0 17.5 4,790
Brong Ahafo 89.1 55.0 54.9 0.3 0.0 0.2 0.0 10.9 2,367
Northern 80.7 55.7 55.6 0.2 0.0 0.0 0.0 19.3 1,786
Upper East 91.8 54.4 54.4 0.1 0.0 0.0 0.0 8.2 854
Upper West 90.5 60.0 60.0 0.1 0.1 0.0 0.0 9.5 628
Education
No education 75.5 43.5 43.5 0.1 0.0 0.0 0.0 24.5 4,585
Primary 74.5 38.8 38.7 0.2 0.0 0.0 0.0 25.5 3,934
Middle/JSS/JHS 79.6 44.2 44.0 0.2 0.0 0.1 0.0 20.4 10,081
Secondary/SSS/SHS 83.0 51.9 51.7 0.6 0.1 0.1 0.0 17.0 4,550
More than secondary 88.2 65.2 62.4 3.7 1.1 2.1 0.4 11.8 1,912
Wealth quintile
Lowest 74.5 40.9 40.9 0.0 0.0 0.0 0.0 25.5 4,064
Second 76.9 41.0 41.0 0.1 0.0 0.0 0.0 23.1 4,721
Middle 78.4 44.0 43.9 0.1 0.0 0.1 0.0 21.6 5,111
Fourth 81.8 49.1 49.0 0.5 0.0 0.1 0.0 18.2 5,443
Highest 83.3 53.6 52.3 1.6 0.4 0.7 0.2 16.7 5,723
Total 79.4 46.2 45.9 0.5 0.1 0.2 0.0 20.6 25,062

1
Registered includes those who are covered.
2
Respondents may be covered by more than one type of health insurance.

Characteristics of Households, Household Population, and Respondents • 27

 Table 2.16 Health insurance and maternity benefits
Among women age 15-49 with health insurance coverage, percentage whose insurance covers specific maternity benefits, and percent distribution by payment for
drugs and services, according to background characteristics, Ghana MHS 2017
Insurance covers Required to pay for drugs and services
Postnatal Cash
Childbirth health Postnatal benefits Number
Antenatal health care for health during Other No of women
Background health care in the care for maternity maternity maternity Some- Don’t with
characteristic care a facility mother the child leave benefits benefits Always times Never know Total insurance
Age
15-19 58.7 54.1 54.2 51.6 1.1 1.0 36.8 12.0 61.2 21.8 5.0 100.0 2,062
20-24 83.4 77.5 78.0 76.1 2.0 1.6 14.4 14.3 68.1 15.7 1.9 100.0 1,912
25-29 89.3 85.4 85.5 83.9 3.5 1.6 9.4 15.8 68.7 14.6 0.9 100.0 2,122
30-34 93.4 87.5 88.5 86.5 4.0 1.8 5.3 15.7 70.0 13.7 0.6 100.0 1,888
35-39 90.5 87.0 85.6 84.4 2.5 1.6 8.6 19.2 66.9 13.2 0.8 100.0 1,502
40-44 87.1 84.7 84.2 80.8 3.5 1.2 10.9 18.7 70.7 10.0 0.7 100.0 1,130
45-49 81.1 80.0 77.7 77.1 2.1 1.1 15.8 18.0 69.6 10.8 1.6 100.0 971
Residence
Urban 80.0 75.1 75.3 72.9 3.6 1.6 17.3 18.9 66.9 12.2 1.9 100.0 6,489
Rural 86.4 83.0 82.4 81.0 1.5 1.2 12.1 11.8 68.2 18.4 1.6 100.0 5,098
Zone
Coastal 81.5 76.0 76.1 72.4 3.9 1.6 16.0 17.8 69.8 10.1 2.3 100.0 4,961
Middle 83.6 79.5 79.5 78.4 1.8 1.3 14.2 17.6 65.6 15.4 1.4 100.0 4,791
Northern 84.0 83.1 81.9 82.4 1.6 1.6 14.4 5.6 66.2 27.0 1.2 100.0 1,836
Region
Western 83.8 80.3 73.8 71.4 1.4 0.3 14.4 13.3 77.2 7.4 2.1 100.0 1,473
Central 84.1 79.3 80.7 77.7 3.0 2.3 13.6 10.0 74.6 13.9 1.5 100.0 881
Greater Accra 76.1 66.6 71.2 67.7 7.8 3.0 20.2 21.9 65.3 9.1 3.7 100.0 1,807
Volta 86.8 85.8 86.4 79.1 0.9 0.0 12.2 25.4 61.1 13.0 0.5 100.0 800
Eastern 87.1 84.0 84.4 82.6 1.9 2.3 11.4 8.6 77.3 13.6 0.5 100.0 1,456
Ashanti 81.5 76.6 76.9 75.7 1.7 0.4 16.3 26.5 55.3 15.9 2.3 100.0 2,033
Brong Ahafo 82.9 79.0 78.0 78.0 1.7 1.5 14.1 13.7 68.7 16.6 1.0 100.0 1,302
Northern 84.0 83.0 80.5 82.0 1.6 0.4 14.9 3.6 60.6 34.3 1.6 100.0 995
Upper East 87.3 86.6 86.5 86.4 1.8 4.0 10.7 6.2 80.0 13.3 0.5 100.0 465
Upper West 80.2 79.0 79.6 78.6 1.4 1.6 17.5 9.9 64.1 24.6 1.4 100.0 377
Education
No education 91.3 89.0 86.8 86.2 1.8 1.0 7.8 10.8 68.1 19.7 1.4 100.0 1,995
Primary 82.8 80.5 79.7 77.5 1.8 1.8 15.4 14.2 67.6 15.9 2.3 100.0 1,528
Middle/JSS/JHS 82.1 77.1 78.0 75.6 2.2 1.3 15.6 17.3 67.5 13.5 1.6 100.0 4,454
Secondary/SSS/
SHS 76.7 71.0 71.5 69.2 1.9 1.6 19.8 16.1 68.0 14.0 1.9 100.0 2,363
More than
secondary 83.2 78.9 78.4 76.6 8.3 2.2 14.8 19.5 65.4 13.1 2.0 100.0 1,247
Wealth quintile
Lowest 85.1 83.4 80.8 79.7 1.1 1.2 13.7 10.2 64.1 24.1 1.6 100.0 1,663
Second 87.0 83.6 83.3 81.5 1.2 1.8 11.3 11.1 68.8 18.0 2.1 100.0 1,937
Middle 85.1 80.2 80.5 77.9 1.7 1.1 12.7 17.7 67.9 13.0 1.4 100.0 2,248
Fourth 82.0 77.7 78.3 76.2 2.5 1.4 15.9 16.3 69.6 13.0 1.1 100.0 2,673
Highest 77.9 72.3 72.6 70.7 5.3 1.8 18.9 19.9 66.4 11.2 2.5 100.0 3,066
Total 82.8 78.6 78.4 76.5 2.7 1.5 15.0 15.8 67.5 15.0 1.8 100.0 11,588

28 • Characteristics of Households, Household Population, and Respondents

MARRIAGE AND SEXUAL ACTIVITY 3
Key Findings

 Marital status: Fifty-seven percent of women age 15-49

are currently in union, and 34% have never been married.
 Age at first marriage: The median age at first marriage
among women age 25-49 is 21.5 years.
 Polygyny: Fourteen percent of currently married women
age 15-49 reported that their husband or partner has
multiple wives.
 Age at first sexual intercourse: The median age at first
sexual intercourse among women age 25-49 is 18.1
years.

M
arriage and sexual activity help determine the extent to which women are exposed to the risk
of pregnancy. Thus, they are important determinants of fertility levels. The timing and
circumstances of marriage and sexual activity also have profound consequences for
women’s lives.

3.1 MARITAL STATUS

Currently married
Women who report being married or living together with a partner as though
married at the time of the survey.
Sample: Women age 15-49

More than half of women age 15-49 are currently in union (36% are married and 21% are living together
with a partner as though married), just over one-third have never been married (34%), and smaller
percentages are divorced (3%), separated (5%), or widowed (2%) (Table 3.1). The percentage of women
who have never been married decreases dramatically with age; only 3% of women age 45-49 have never
been married.

Trends: The percentage of women age 15-49 who are in union decreased from 70% in 1988 and 1993 to
57% in 2014 and 2017.

Marriage and Sexual Activity • 29

 3.2 POLYGYNY

Polygyny
Women who report that their husband or partner has other wives are
considered to be in a polygynous marriage.
Sample: Currently married women age 15-49

Fourteen percent of women age 15-49 who are currently in a union reported that their husband or partner
has other wives. Twelve percent indicated that they have one co-wife, and 2% indicated that they have two
or more co-wives (Table 3.2).

Trends: The percentage of currently married women Figure 3.1 Trends in polygyny
age 15-49 who are in a polygynous union has Percentage of married women age 15-49
generally decreased over time, from 33% in 1988 to in a polygynous union
23% in 1998, 19% in 2008, and 14% in 2017
(Figure 3.1).
33
Patterns by background characteristics 28
23 23
19
 The percentage of married women with one or 16 14
more co-wives increases with age, from 5%
among those age 15-19 to 22% among those age
45-49.
1988 1993 1998 2003 2008 2014 2017
GDHS GDHS GDHS GDHS GDHS GDHS GMHS
 Women living in rural areas are more likely to
report having one or more co-wives (19%) than
their counterparts living in urban areas (10%).

 The percentage of married women with one or more co-wives ranges from 7% in Eastern region to
38% in Northern region.

 Increases in education and wealth correspond to decreases in the percentage of married women with
one or more co-wives.

3.3 AGE AT FIRST MARRIAGE

Median age at first marriage

Age by which half of respondents have been married.
Sample: Women age 20-49 and 25-49

The median age at first marriage among women age 25-49 in Ghana is 21.5 years (Table 3.3).

The percentage of women age 25-49 who were first married by exact age 15 is 8%. More than one-quarter
of women age 25-49 were first married by age 18 (26%), 41% were first married by age 20, and more than
half were first married by age 22 (53%). Women currently age 25 or older (7% or higher) are more likely
than women currently age 20-24 (5%) or age 15-19 (2%) to have been married by age 15. The percentage
of women age 15-49 who have never been married drops quickly from 91% among those age 15-19 to
52% among those age 20-24 and 25% among those age 25-29. Among women age 45-49, only 3% have
never been married.

Trends: The median age at first marriage among women age 25-49 has increased steadily over time, from
18.1 years in 1988 to 19.4 years in 2003, 20.7 years in 2014, and 21.5 years in 2017.

30 • Marriage and Sexual Activity

Patterns by background characteristics

 Rural women marry about 3 years earlier than urban women; the median age at first marriage among
rural women age 25-49 is 19.8 years, as compared with 23.1 years for their urban counterparts
(Table 3.4).

 The median age at first marriage among women age 25-49 ranges from 19.3 years in Upper East
region to 24.8 years in Greater Accra region.

 Median age at first marriage among women age 25-49 increases markedly with increasing education
and wealth. For example, the median age at first marriage increases from 19.2 years among women
with no education to 24.9 years among those with a secondary education. Similarly, median age at first
marriage increases from 19.0 years in the lowest wealth quintile to 22.1 years in the fourth wealth
quintile. The median age at first marriage among women age 25-49 in the highest education and
wealth categories cannot be reported because less than half of the women in these groups were married
by age 25 (indicating that the median age is greater than 25.0 years).

3.4 AGE AT FIRST SEXUAL INTERCOURSE

Median age at first sexual intercourse

Age by which half of respondents have had sexual intercourse.
Sample: Women age 20-49 and 25-49

The median age at first sexual intercourse among Figure 3.2 Women’s median age at first
women age 20-49 and age 25-49 is 18.1 years. Three sex and first marriage
percent of women age 20-49, 1% of women age 25- Median age in years
49, and 38% of women age 15-24 have never had
sexual intercourse. Among women age 25-49 in
Ghana, the median age at first intercourse (18.1
years) is more than 3 years below the median age at 21.5
first marriage (21.5 years), indicating that many 18.1
women engage in sex before marriage (Table 3.5
and Figure 3.2).

Twelve percent of women age 20-49 had sexual

intercourse by age 15. Among women currently age
15-19, the percentage who had sex by age 15 is Median age at first Median age at first
sex marriage
somewhat lower, at 9%. Nearly half of women age
20-49 had sex by age 18 (49%) and almost three-
quarters by age 20 (73%).

Marriage and Sexual Activity • 31

 Trends: The percentage of women age 25-49 who Figure 3.3 Trends in early sexual
had sexual intercourse by age 18 declined steadily intercourse among women
from 63% in 1993 to 44% in 2008, remained at 44% Percentage of women age 25-49 who had
in 2014, and then increased to 49% in 2017 first sexual intercourse by age 18
(Figure 3.3).

Patterns by background characteristics

63
54
 Rural women age 20-49 start having sex a year 48 49
44 44
earlier than urban women. The median age at
first sex is 17.5 years among rural women, as
compared with 18.5 years among urban women
(Table 3.6).
1993 1998 2003 2008 2014 2017
 The median age at first sexual intercourse among GDHS GDHS GDHS GDHS GDHS GMHS
women age 20-49 ranges from 17.5 years in
Volta and Eastern regions to 19.1 years in
Greater Accra region.

 Among women age 20-49 and 25-49, median age at first sex generally increases with increasing
education and wealth. For example, among women age 25-49, the median age at first sex increases
from 17.2 years among those with no education to 21.4 years among those with more than a secondary
education.

3.5 RECENT SEXUAL ACTIVITY

Among women age 15-49, 43% reported having sexual intercourse during the 4 weeks preceding the
survey. Three in 10 women had sex within the past year but not in the 4 weeks preceding the survey
(30%), and 13% last had sex more than 1 year before the survey. More than 1 in 10 women (14%) have
never had sexual intercourse (Table 3.7).

Trends: There is no clear trend over time in the percentage of women age 15-49 who had sex in the past 4
weeks, with percentages ranging from a low of 38% in the 1998 GDHS to a high of 47% in the 1993
GDHS.

Patterns by background characteristics

 The percentage of women who had sex in the past 4 weeks increases from 13% among those age 15-19
to 56% among those age 30-34 before decreasing to 46% among those age 45-49.

 Sixty-three percent of currently married women had sex in the past 4 weeks, as compared with 15% of
never-married women and 17% of women who are divorced, widowed, or separated.

 Rural women are more likely to have had sex in the past 4 weeks than urban women (47%
versus 39%).

LIST OF TABLES

For more information on marriage and sexual activity, see the following tables:

 Table 3.1 Current marital status

 Table 3.2 Number of women’s co-wives
 Table 3.3 Age at first marriage

32 • Marriage and Sexual Activity

 Table 3.4 Median age at first marriage by background characteristics
 Table 3.5 Age at first sexual intercourse
 Table 3.6 Median age at first sexual intercourse by background characteristics
 Table 3.7 Recent sexual activity

Table 3.1 Current marital status

Percent distribution of women age 15-49 by current marital status, according to age, Ghana MHS 2017
Marital status Percentage
of
respondents
Never Living currently in Number of
Age married Married together Divorced Separated Widowed Total union respondents
15-19 90.9 1.8 6.6 0.1 0.6 0.0 100.0 8.4 4,785
20-24 52.2 16.6 27.2 0.4 3.5 0.2 100.0 43.7 4,208
25-29 25.1 36.9 31.2 1.1 5.1 0.6 100.0 68.0 4,229
30-34 10.8 54.0 25.8 2.7 5.7 1.0 100.0 79.8 3,709
35-39 6.2 57.4 22.5 4.1 6.4 3.4 100.0 79.8 3,313
40-44 4.1 60.8 18.1 5.4 6.2 5.4 100.0 78.9 2,481
45-49 3.4 57.4 14.2 7.7 6.6 10.6 100.0 71.6 2,337
Total 33.5 36.3 21.0 2.5 4.5 2.3 100.0 57.3 25,062

Table 3.2 Number of women’s co-wives

Percent distribution of currently married women age 15-49 by number of co-wives, and percentage of currently married women with one or more
co-wives, according to background characteristics, Ghana MHS 2017
Number of co-wives Percentage
with one or
Background more Number of
characteristic 0 1 2+ Don’t know Total co-wives1 women
Age
15-19 93.7 4.7 0.3 1.2 100.0 5.1 404
20-24 89.7 8.4 0.7 1.2 100.0 9.0 1,841
25-29 89.7 8.4 0.8 1.1 100.0 9.2 2,878
30-34 86.0 12.0 1.2 0.7 100.0 13.3 2,961
35-39 83.1 13.5 2.7 0.6 100.0 16.2 2,646
40-44 80.5 15.7 3.4 0.4 100.0 19.1 1,957
45-49 77.6 18.0 3.9 0.5 100.0 21.9 1,674
Residence
Urban 89.5 8.1 1.4 1.0 100.0 9.5 7,226
Rural 80.8 16.1 2.5 0.6 100.0 18.6 7,135
Zone
Coastal 87.7 10.0 1.4 0.8 100.0 11.5 6,622
Middle 89.9 8.2 0.9 0.9 100.0 9.1 5,452
Northern 66.6 27.2 5.8 0.3 100.0 33.1 2,287
Region
Western 90.2 8.3 0.8 0.7 100.0 9.1 1,799
Central 87.6 10.9 0.9 0.6 100.0 11.8 1,285
Greater Accra 90.7 7.1 1.1 1.2 100.0 8.1 2,354
Volta 78.1 17.7 3.7 0.5 100.0 21.3 1,183
Eastern 92.3 6.5 0.7 0.5 100.0 7.2 1,414
Ashanti 90.7 7.5 0.8 1.0 100.0 8.3 2,655
Brong Ahafo 86.1 11.4 1.3 1.3 100.0 12.7 1,384
Northern 61.3 32.2 6.2 0.3 100.0 38.4 1,309
Upper East 74.0 20.5 5.1 0.5 100.0 25.6 569
Upper West 73.5 20.6 5.7 0.2 100.0 26.3 409
Education
No education 71.7 23.2 4.5 0.5 100.0 27.8 3,736
Primary 83.8 13.4 1.7 1.1 100.0 15.1 2,458
Middle/JSS/JHS 89.9 8.2 1.0 0.9 100.0 9.2 5,479
Secondary/SSS/SHS 94.9 4.1 0.2 0.8 100.0 4.3 1,724
More than secondary 96.8 2.1 0.7 0.4 100.0 2.8 963
Wealth quintile
Lowest 72.5 23.3 3.8 0.5 100.0 27.1 2,766
Second 82.5 14.3 2.5 0.7 100.0 16.8 2,765
Middle 86.8 10.7 1.7 0.8 100.0 12.4 2,796
Fourth 89.6 8.1 1.2 1.1 100.0 9.3 2,899
Highest 93.2 5.3 0.6 0.9 100.0 5.9 3,135
Total 85.2 12.1 1.9 0.8 100.0 14.0 14,361

1
Excludes women who responded “don’t know” when asked if their husband has other wives

Marriage and Sexual Activity • 33

 Table 3.3 Age at first marriage

Percentage of women age 15-49 who were first married by specific exact ages and median age at first marriage, according to current age,
Ghana MHS 2017
Percentage first married by exact age: Percentage Median age
never Number of at first
Current age 15 18 20 22 25 married respondents marriage
15-19 2.3 na na na na 90.9 4,785 a
20-24 4.9 20.5 33.7 na na 52.2 4,208 a
25-29 7.1 22.6 35.5 47.6 65.4 25.1 4,229 22.4
30-34 7.8 25.1 37.7 49.5 65.4 10.8 3,709 22.1
35-39 7.8 26.0 41.4 55.5 68.4 6.2 3,313 21.2
40-44 9.6 29.6 45.9 58.3 73.2 4.1 2,481 20.6
45-49 7.9 28.2 47.9 61.5 76.6 3.4 2,337 20.3
20-49 7.3 24.7 39.2 na na 20.0 20,277 a
25-49 7.9 25.8 40.6 53.3 68.9 11.5 16,069 21.5

Note: The age at first marriage is defined as the age at which the respondent began living with her first spouse/partner.
na = Not applicable due to censoring
a = Omitted because less than 50% of the respondents began living with their spouse or partner for the first time before reaching the beginning
of the age group

Table 3.4 Median age at first marriage by background characteristics

Median age at first marriage among women age 20-49 and age 25-49,
according to background characteristics, Ghana MHS 2017
Women age
Background
characteristic 20-49 25-49
Residence
Urban a 23.1
Rural 20.0 19.8
Zone
Coastal a 22.2
Middle a 21.3
Northern 19.8 19.7
Region
Western a 21.1
Central a 21.0
Greater Accra a 24.8
Volta a 20.1
Eastern a 21.0
Ashanti a 22.2
Brong Ahafo a 20.2
Northern 19.9 19.9
Upper East 19.6 19.3
Upper West 20.0 19.7
Education
No education 19.1 19.2
Primary 19.5 19.6
Middle/JSS/JHS a 21.4
Secondary/SSS/SHS a 24.9
More than secondary a a
Wealth quintile
Lowest 19.0 19.0
Second 19.9 19.7
Middle a 20.8
Fourth a 22.1
Highest a a
Total a 21.5

Note: The age at first marriage is defined as the age at which the
respondent began living with her first spouse/partner.
a = Omitted because less than 50% of the respondents began living with
their spouse or partner for the first time before reaching the beginning of the
age group

34 • Marriage and Sexual Activity

Table 3.5 Age at first sexual intercourse

Percentage of women age 15-49 who had first sexual intercourse by specific exact ages, percentage who never had sexual intercourse, and
median age at first sexual intercourse, according to current age, Ghana MHS 2017
Percentage who had first sexual intercourse by exact age: Percentage
who never Median age
had at first
Current age 15 18 20 22 25 intercourse Number intercourse
15-19 9.2 na na na na 60.5 4,785 a
20-24 10.5 47.2 74.8 na na 12.0 4,208 18.2
25-29 11.7 45.9 70.3 84.9 93.8 2.9 4,229 18.3
30-34 11.3 45.5 69.4 82.9 91.8 0.7 3,709 18.3
35-39 11.9 48.6 72.3 85.5 92.3 0.3 3,313 18.1
40-44 13.0 54.2 76.3 87.9 93.2 0.2 2,481 17.7
45-49 12.6 55.2 78.5 90.8 94.9 0.1 2,337 17.7
20-49 11.7 48.6 73.1 na na 3.3 20,277 18.1
25-49 12.0 49.0 72.6 85.9 93.1 1.0 16,069 18.1
15-24 9.8 na na na na 37.8 8,993 a

na = Not applicable due to censoring

a = Omitted because less than 50% of the respondents had sexual intercourse for the first time before reaching the beginning of the age group

Table 3.6 Median age at first sexual intercourse by background

characteristics

Median age at first sexual intercourse among women age 20-49 and age
25-49, according to background characteristics, Ghana MHS 2017
Women age
Background
characteristic 20-49 25-49
Residence
Urban 18.5 18.5
Rural 17.5 17.4
Zone
Coastal 18.3 18.3
Middle 17.8 17.8
Northern 18.0 17.9
Region
Western 17.8 17.8
Central 18.1 18.0
Greater Accra 19.1 19.1
Volta 17.5 17.5
Eastern 17.5 17.5
Ashanti 18.1 18.0
Brong Ahafo 17.7 17.7
Northern 18.0 18.0
Upper East 18.0 17.8
Upper West 18.1 18.0
Education
No education 17.2 17.2
Primary 17.0 17.1
Middle/JSS/JHS 17.9 18.1
Secondary/SSS/SHS 19.1 19.3
More than secondary a 21.4
Wealth quintile
Lowest 17.2 17.1
Second 17.4 17.4
Middle 17.8 17.7
Fourth 18.2 18.2
Highest 19.5 19.5
Total 18.1 18.1

a = Omitted because less than 50% of the respondents had intercourse

for the first time before reaching the beginning of the age group

Marriage and Sexual Activity • 35

 Table 3.7 Recent sexual activity

Percent distribution of women age 15-49 by timing of last sexual intercourse, according to background characteristics, Ghana MHS 2017
Timing of last sexual intercourse Never had
Background Within the past Within One or more sexual Number of
characteristic 4 weeks 1 year1 years Missing intercourse Total women
Age
15-19 13.1 19.1 7.3 0.0 60.5 100.0 4,785
20-24 37.0 37.9 13.1 0.0 12.0 100.0 4,208
25-29 52.6 33.7 10.8 0.0 2.9 100.0 4,229
30-34 56.0 32.5 10.7 0.0 0.7 100.0 3,709
35-39 55.3 29.9 14.5 0.0 0.3 100.0 3,313
40-44 53.7 29.2 16.8 0.0 0.2 100.0 2,481
45-49 45.8 26.2 27.9 0.0 0.1 100.0 2,337
Marital status
Never married 14.7 27.0 16.0 0.0 42.4 100.0 8,397
Married or living together 63.4 30.9 5.6 0.0 0.0 100.0 14,361
Divorced/separated/widowed 16.6 32.7 50.6 0.0 0.1 100.0 2,305
Marital duration2
0-4 years 61.7 34.2 4.0 0.0 0.1 100.0 3,013
5-9 years 64.6 30.5 4.9 0.0 0.0 100.0 2,437
10-14 years 65.6 29.3 5.1 0.0 0.0 100.0 1,858
15-19 years 65.6 28.3 6.1 0.0 0.0 100.0 1,620
20-24 years 61.0 30.6 8.3 0.1 0.0 100.0 1,128
25+ years 60.9 28.8 10.3 0.0 0.0 100.0 1,113
Married more than once 63.6 31.4 5.0 0.0 0.0 100.0 3,193
Residence
Urban 39.4 30.2 15.1 0.0 15.2 100.0 13,752
Rural 46.9 29.3 10.8 0.0 13.0 100.0 11,310
Zone
Coastal 41.5 30.0 14.0 0.0 14.5 100.0 12,121
Middle 43.4 29.8 13.0 0.0 13.7 100.0 9,674
Northern 45.8 29.0 10.6 0.0 14.6 100.0 3,267
Region
Western 45.9 28.5 12.1 0.0 13.5 100.0 3,230
Central 42.0 30.3 13.3 0.0 14.4 100.0 2,218
Greater Accra 36.6 29.4 17.1 0.0 16.9 100.0 4,673
Volta 45.1 33.3 10.7 0.0 10.8 100.0 2,000
Eastern 45.2 30.1 11.4 0.0 13.4 100.0 2,517
Ashanti 43.2 28.7 13.4 0.0 14.7 100.0 4,790
Brong Ahafo 42.0 31.8 14.0 0.0 12.2 100.0 2,367
Northern 49.3 29.1 8.8 0.0 12.8 100.0 1,786
Upper East 41.7 28.9 13.4 0.0 16.1 100.0 854
Upper West 41.7 28.7 11.9 0.0 17.7 100.0 628
Education
No education 54.1 29.6 14.3 0.0 2.1 100.0 4,585
Primary 46.4 29.1 11.6 0.0 12.9 100.0 3,934
Middle/JSS/JHS 41.5 29.5 12.2 0.0 16.8 100.0 10,081
Secondary/SSS/SHS 32.5 30.9 14.1 0.0 22.5 100.0 4,550
More than secondary 39.4 30.6 17.2 0.0 12.8 100.0 1,912
Wealth quintile
Lowest 47.4 29.7 11.0 0.0 11.8 100.0 4,064
Second 44.3 29.8 12.6 0.0 13.3 100.0 4,721
Middle 40.4 32.1 14.0 0.0 13.5 100.0 5,111
Fourth 40.5 31.4 14.0 0.0 14.1 100.0 5,443
Highest 42.6 26.1 13.9 0.0 17.4 100.0 5,723
Total 42.8 29.8 13.2 0.0 14.2 100.0 25,062

1
Excludes women who had sexual intercourse within the last 4 weeks
2
Excludes women who are not currently married or living together with a partner as if married

36 • Marriage and Sexual Activity

FERTILITY AND FAMILY PLANNING 4
Key Findings

 Total fertility rate: The total fertility rate in Ghana for the
3 years preceding the survey is 3.9 children per woman,
which is a decline from 4.2 children per woman in 2014.
 Birth intervals: The median birth interval is 38.8 months,
with 16% of births occurring less than 24 months after the
preceding birth.
 Age at first birth: The median age at first birth among
women age 25-49 is 21.5 years.
 Teenage childbearing: Fourteen percent of women age
15-19 have begun childbearing.
 Contraceptive use: One in four married women age
15-49 use a modern method of contraception (25%). The
three most commonly used methods among married
women are injectables (8%), implants (7%), and the pill
(4%).
 Knowledge of a source of family planning among
nonusers: Four in five women age 15-49 who are not
currently using any method of family planning (80%)
know of a source where family planning methods can be
obtained.

T
he number of children that a woman bears depends on many factors, including the age she begins
childbearing, how long she waits between births, and her fecundity. Postponing first births and
extending the interval between births have played a role in reducing fertility levels in many
countries. These factors also have positive health consequences. In contrast, short birth intervals (of less
than 24 months) can lead to harmful outcomes for both newborns and their mothers, such as preterm birth,
low birth weight, and death. Childbearing at a very young age is associated with an increased risk of
complications during pregnancy and childbirth and higher rates of neonatal mortality.

This chapter describes the current level of fertility in Ghana and some of its proximate determinants. It
presents information on the total fertility rate, birth intervals, age at first birth, and teenage childbearing.

Couples can use contraceptive methods to limit or space the number of children they have. Information on
knowledge and use of contraceptive methods is also presented.

Fertility and Family Planning • 37

 4.1 CURRENT FERTILITY

Total fertility rate

The average number of children a woman would have by the end of her
childbearing years if she bore children at the current age-specific fertility rates.
Age-specific fertility rates are calculated for the 3 years before the survey,
based on detailed birth histories provided by women.
Sample: Women age 15-49

The total fertility rate (TFR) in Figure 4.1 Trends in fertility by residence
Ghana is 3.9 children per woman TFR for the 3 years before each survey
(Table 4.1).

Trends: The TFR in Ghana 7.0

declined steeply from 1988 (6.4 6.0
5.6 5.5
children per woman) to 1993 (5.2 6.4 5.3 5.1
children per woman) and 1998 (4.4 5.2 4.7 Rural
5.3
children per woman), remained 4.4 4.4 4.6
4.2 3.9 Total
stable in 2003 (4.4 children per 3.7 Urban
woman), rose slightly in 2007 (4.6 3.4 3.4 3.3
3.0 3.1
children per woman), and declined
somewhat in 2014 (4.2 children per
woman) and 2017 (3.9 children per
woman) (Figure 4.1). 1988 1993 1998 2003 2007 2014 2017
GDHS GDHS GDHS GDHS GMHS GDHS GMHS
The findings from the 2007 GMHS,
2014 GDHS, and 2017 GMHS Figure 4.2 Trends in age-specific fertility
show that the age-specific fertility rate consistently
Births per 1,000 women
peaks among women age 25-29 (Table 4.3.2 and
250
Figure 4.2).
200
Patterns by background characteristics
2007 GMHS
150
 Age-specific fertility initially increases with age, 2014 GDHS
peaks among women age 25-29 (196 births per 100
1,000 women), and then declines with age
(Table 4.1). 50
2017 GMHS
0
 Fertility is higher among women in rural areas 15-19 20-24 25-29 30-34 35-39 40-44 45-49
than women in urban areas (4.7 versus 3.3 Age group
children per woman) (Table 4.2).

38 • Fertility and Family Planning

 The TFR is lowest in Greater Accra region Figure 4.3 Fertility by region
(2.8 children per woman) and highest in Total fertility rate for the 3 years before the survey
Northern region (5.8 children per woman)
(Figure 4.3).

 As education and wealth increase, the TFR

decreases (Table 4.2).

4.2 CHILDREN EVER BORN AND LIVING

Women age 45-49 (at the end of their reproductive
years) have given birth to 4.80 children on
average, and 4.28 of these children were still living
at the time of the survey. Currently married women
age 45-49 have given birth to an average of 5.08
children, of whom 4.53 were still living at the time
of the survey (Table 4.4).

4.3 BIRTH INTERVALS

Median birth interval

Number of months since the preceding birth by which half of children are born.
Sample: Non-first births in the 5 years before the survey

Short birth intervals (less than 24 months) are Figure 4.4 Birth intervals
associated with increased health risks for both Percent distribution of non-first births
mothers and newborns. In Ghana, the median birth by number of months since the
interval is 38.8 months (Table 4.5). Sixteen percent preceding birth
of births occurred within 24 months after the
preceding birth (Figure 4.4). 7-17
6%
Trends: Between 1988 and 2017, the median birth 60+ 18-23
interval increased from 34.6 to 38.8 months. The 22% 10%
percentage of children born after a short interval (less
than 24 months) decreased from 18% in 1988 to a
low of 13% in 1998 before rising to 16% in 2017. 48-59 24-35
13% 29%
Patterns by background characteristics 36-47
21%
 Median birth intervals increase with mother’s
age, from 27.1 months among women age 15-19
to 50.7 months among women age 40-49.

 The median birth interval is 10.1 months longer if the child from the preceding birth is living than if
the child has died (39.3 versus 29.2 months).

 There is regional variation in birth intervals, from 36.7 months in Northern region to 43.8 months in
Upper East region.

 The median birth interval is longest among women with a primary education (40.6 months) and
shortest among women with more than a secondary education (32.9 months).

Fertility and Family Planning • 39

 4.4 AGE AT FIRST BIRTH

Median age at first birth

Age by which half of women have had their first child.
Sample: Women age 20-49 and 25-49

The age at which childbearing begins has a direct Figure 4.5 Median age at first birth
influence on a woman’s cumulative fertility, by residence
particularly when there is little or no contraceptive Median age at first birth among
use. Earlier childbearing may lengthen the women age 25-49
reproductive period, result in higher fertility, and
increase health risks for both mother and child. In 21.5 22.7
20.3
Ghana, the median age at first birth among women
age 25-49 is 21.5 years (Table 4.6).

Patterns by background characteristics

 The median age at first birth is more than 2 years

later among women age 25-49 in urban areas
than among those in rural areas (22.7 years Total Urban Rural
versus 20.3 years) (Table 4.7 and Figure 4.5).

 The median age at first birth among women age 25-49 ranges from 20.4 years in Upper East region to
24.0 years in Greater Accra region (Table 4.7).

4.5 TEENAGE CHILDBEARING

Teenage childbearing
Percentage of women age 15-19 who have given birth or are pregnant with
their first child.
Sample: Women age 15-19

Teenage pregnancy and motherhood has been a major health concern and social issue in Ghana for some
time. Fourteen percent of women age 15-19 have begun childbearing; 12% have had a live birth, and 3%
are pregnant with their first child (Table 4.8).

Trends: The percentage of teenage women who have begun childbearing was stable between 1988 (23%)
and 1993 (22%), dropped in 1998 (14%), and has remained stable since, at 14% in 2003, 15% in 2007, and
14% in 2014 and 2017.

Patterns by background characteristics

 The proportion of women age 15-19 who have begun childbearing increases with age, from 3% among
those age 15 to 32% among those age 19.

 Eighteen percent of women age 15-19 in rural areas and 11% of women age 15-19 in urban areas have
begun childbearing (Figure 4.6).

 The percentage of women age 15-19 who have begun childbearing ranges from 7% in Greater Accra
region to 19% in Western region (Figure 4.7).

 The proportion of women age 15-19 who have begun childbearing generally decreases with increasing
education and wealth.

40 • Fertility and Family Planning

 Figure 4.6 Teenage pregnancy and Figure 4.7 Teenage pregnancy and
motherhood by residence motherhood by region
Percentage of women age 15-19 who Percentage of women age 15-19 who have
have begun childbearing begun childbearing

14 18
11

Total Urban Rural

4.6 CONTRACEPTIVE KNOWLEDGE AND USE

Knowledge of contraceptive methods is almost universal in Ghana; 99% of women age 15-49 have heard
of any contraceptive method (Table 4.10). The most commonly known modern method is the male
condom (98% of women age 15-49). The mean number of methods known by all women is 9.2.

Contraceptive prevalence rate

Percentage of women who use any contraceptive method
Sample: All women age 15-49, currently married women age 15-49, and
sexually active unmarried women age 15-49

The contraceptive prevalence rate (CPR) among all women age 15-49 is 25%, with 20% using modern
methods. Twenty-five percent of currently married women age 15-49 and 31% of sexually active
unmarried women age 15-49 use a modern method of contraception (Table 4.12).

Modern methods
Include male and female sterilisation, injectables, intrauterine devices (IUDs),
contraceptive pills, implants, female and male condoms, lactational
amenorrhea method, and emergency contraception

Fertility and Family Planning • 41

 The most commonly used methods among currently Figure 4.8 Contraceptive use
married women are injectables (8%), implants (7%),
Percentage of women age 15-49 currently
and pills (4%). Among sexually active unmarried using a contraceptive method
women, injectables are the most commonly used
31
method (8%), followed by implants (6%), male Any method
38
condoms (6%), and pills (5%) (Table 4.13.1 and
Any modern method 25
Figure 4.8). 31

Injectables 8
Trends: Modern contraceptive use among currently 8
married women age 15-49 increased from 5% in 1
1988 to 25% in 2017. The use of traditional methods Male condom
6
has seen less change (8% in 1988 and 6% in 2017) 4
Pill
(Figure 4.9). 5

Implants 7
Patterns by background characteristics 6

IUD 1
 Six percent of sexually active unmarried women <1 Currently married
use male condoms, as compared with 1% of women
Female sterilisation 2
currently married women (Table 4.12). <1
Sexually active
Traditional method 6 unmarried women
 Currently married women age 45-49 (17%) are 8
less likely than younger women (22%-28%) to
use a modern contraceptive method. Figure 4.9 Trends in contraceptive use
 Modern contraceptive use increases with number Percentage of currently married women
currently using a contraceptive method
of living children, from 11% among currently
married women with no children to 30% among
those with five or more children (Table 4.13.1).
Any modern method
 There is a small difference by residence in 22
25
modern contraceptive use among currently 19
16
married women; 23% of urban women use a 13
10
modern contraceptive method, as compared with 8 Any traditional method

27% of rural women (Figure 4.10). 10 9

5 7 7 5 6
1988 1993 1998 2003 2007 2014 2017
GDHS GDHS GDHS GDHS GMHS GDHS GMHS

Figure 4.10 Use of modern methods

by residence
Percentage of currently married
women age 15-49

25 27
23

Total Urban Rural

42 • Fertility and Family Planning

 Modern contraceptive use among married Figure 4.11 Modern contraceptive use
women ranges from a low of 17% in Northern by region
region to a high of 32% in Upper East region Percentage of currently married women age 15-49
(Figure 4.11).

 Currently married women with a primary (29%)

or middle (27%) education are more likely than
those with no (22%) or a higher (21%-22%)
education to use a modern method of
contraception.

Knowledge of a Source of Family Planning

among Non-Users

Eight in 10 women age 15-49 who are not using

contraceptives know of a place where they can obtain
a method of family planning (80%). Seventy-six
percent know of a public sector source, and 21%
know of a private sector source. Knowledge of any
source is highest among women age 30-34 (90%)
and lowest among women age 15-19 (59%)
(Table 4.14).

Knowledge of the Fertile Period

Sixty-five percent of users of the rhythm method reported correctly that the most fertile time in a woman’s
cycle is halfway between two menstrual periods (Table 4.15).

LIST OF TABLES
For more information on fertility levels, some of the determinants of fertility, and contraceptive knowledge
and use, see the following tables:

 Table 4.1 Current fertility

 Table 4.2 Fertility by background characteristics
 Table 4.3.1 Trends in age-specific fertility rates
 Table 4.3.2 Trends in age-specific and total fertility
 Table 4.4 Children ever born and living
 Table 4.5 Birth intervals
 Table 4.6 Age at first birth
 Table 4.7 Median age at first birth
 Table 4.8 Teenage pregnancy and motherhood
 Table 4.9 Sexual and reproductive health behaviours before age 15
 Table 4.10 Knowledge of contraceptive methods
 Table 4.11 Knowledge of contraceptive methods according to background characteristics
 Table 4.12 Current use of contraception according to age
 Table 4.13.1 Current use of contraception by background characteristics
 Table 4.13.2 Trends in current use of contraception
 Table 4.14 Knowledge of a source of family planning among nonusers
 Table 4.15 Knowledge of fertile period
 Table 4.16 Knowledge of fertile period by age

Fertility and Family Planning • 43

 Table 4.1 Current fertility

Age-specific and total fertility rates, general fertility rate, and crude birth
rate for the 3 years preceding the survey, according to residence,
Ghana MHS 2017
Residence
Age group Urban Rural Total
10-14 [1] [3] [2]
15-19 57 95 75
20-24 123 200 156
25-29 171 230 196
30-34 168 188 177
35-39 100 139 118
40-44 38 59 47
45-49 [10] [23] [16]
TFR (15-49) 3.3 4.7 3.9
GFR 115 158 134
CBR 28.3 31.7 30.0

Note: Age-specific fertility rates are per 1,000 women. Estimates in

brackets are truncated. Rates are for the period 1-36 months prior to
interview. Rates for women age 10-14 are based on retrospective data
from women age 15-17.
TFR: Total fertility rate, expressed per woman
GFR: General fertility rate, expressed per 1,000 women age 15-44
CBR: Crude birth rate, expressed per 1,000 population

Table 4.2 Fertility by background characteristics

Total fertility rate for the 3 years preceding the survey, percentage of women age 15-49 currently
pregnant, and mean number of children ever born to women age 40-49, according to background
characteristics, Ghana MHS 2017
Percentage of Mean number of
women age children ever
Background Total 15-49 currently born to women
characteristic fertility rate pregnant age 40-49
Residence
Urban 3.3 5.5 3.8
Rural 4.7 7.4 5.5
Zone
Coastal 3.6 5.8 4.3
Middle 3.8 6.2 4.6
Northern 5.3 9.2 6.0
Region
Western 4.1 6.4 4.8
Central 4.3 6.1 5.1
Greater Accra 2.8 5.0 3.3
Volta 4.1 6.0 4.6
Eastern 3.8 5.9 4.6
Ashanti 3.8 6.0 4.5
Brong Ahafo 4.0 6.8 5.0
Northern 5.8 10.1 6.3
Upper East 4.7 8.5 5.4
Upper West 4.6 7.4 5.9
Education
No education 5.5 8.3 5.5
Primary 4.7 6.5 5.0
Middle/JSS/JHS 4.0 6.0 4.1
Secondary/SSS/SHS 3.1 5.2 3.0
More than secondary 2.7 6.3 2.4
Wealth quintile
Lowest 5.7 8.6 6.3
Second 4.5 7.1 5.4
Middle 3.9 5.9 4.8
Fourth 3.4 5.8 3.9
Highest 2.8 5.2 3.0
Total 3.9 6.4 4.6

Note: Total fertility rates are for the period 1-36 months prior to interview.

44 • Fertility and Family Planning

 Table 4.3.1 Trends in age-specific fertility rates

Age-specific fertility rates for 5-year periods preceding the survey, according to
age group, Ghana MHS 2017
Number of years preceding survey
Age group 0-4 5-9 10-14 15-19
10-14 [2] 4 5 8
15-19 76 77 88 92
20-24 154 173 180 201
25-29 203 200 207 222
30-34 180 189 187 [217]
35-39 119 132 [143]
40-44 50 [66]
45-49 [17]

Note: Age-specific fertility rates are per 1,000 women. Estimates in brackets are
truncated. Rates exclude the month of interview. Rates for women age 10-14 for
the 0-4 year period are based on retrospective data from women age 15-19.

Table 4.3.2 Trends in age-specific and total fertility

Age-specific and total fertility rates (TFR) for the 3-year period preceding several
surveys, according to mother’s age at the time of the birth, Ghana MHS 2017
2007 GMHS 2014 GDHS 2017 GMHS
Mother’s age at birth 2004-2007 2012-2014 2014-2017
15-19 84 76 75
20-24 187 161 156
25-29 216 201 196
30-34 197 197 177
35-39 133 135 118
40-44 68 52 47
45-49 [33] [17] [16]
TFR (15-49) 4.6 4.2 3.9

Note: Age-specific fertility rates are per 1,000 women. Rates for age group 45-49
may be slightly biased due to truncation and are therefore displayed in brackets.

Table 4.4 Children ever born and living

Percent distribution of all women and currently married women age 15-49 by number of children ever born, mean number of children ever born,
and mean number of living children, according to age group, Ghana MHS 2017
Number of children ever born Mean Mean
number of number of
Age Number of children living
group 0 1 2 3 4 5 6 7 8 9 10+ Total women ever born children
ALL WOMEN

15-19 88.2 10.5 1.2 0.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 4,785 0.13 0.13
20-24 50.3 29.6 14.8 4.1 1.0 0.2 0.0 0.0 0.0 0.0 0.0 100.0 4,208 0.77 0.73
25-29 24.4 23.5 24.7 16.3 7.6 2.6 0.8 0.1 0.0 0.0 0.0 100.0 4,229 1.71 1.60
30-34 9.6 14.8 20.7 21.4 15.1 11.0 5.4 1.2 0.6 0.1 0.1 100.0 3,709 2.83 2.65
35-39 5.1 8.6 13.0 21.7 18.4 15.8 9.5 4.3 2.5 0.8 0.4 100.0 3,313 3.70 3.44
40-44 3.4 7.3 9.9 15.1 17.8 13.9 13.2 9.5 5.9 2.8 1.3 100.0 2,481 4.44 3.99
45-49 3.0 6.9 9.3 12.3 16.8 12.9 12.4 11.5 7.5 4.6 2.9 100.0 2,337 4.80 4.28
Total 32.1 15.6 13.5 12.1 9.4 6.8 4.7 2.8 1.7 0.8 0.5 100.0 25,062 2.24 2.06

CURRENTLY MARRIED WOMEN

15-19 33.5 55.3 9.7 1.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 404 0.79 0.77
20-24 17.4 44.5 27.8 8.0 1.8 0.5 0.0 0.0 0.0 0.0 0.0 100.0 1,841 1.34 1.27
25-29 9.6 24.2 29.6 21.8 10.1 3.5 1.0 0.1 0.0 0.0 0.0 100.0 2,878 2.14 2.01
30-34 4.5 12.4 20.8 23.3 17.4 12.8 6.4 1.4 0.7 0.1 0.1 100.0 2,961 3.14 2.94
35-39 3.4 5.8 12.0 21.9 19.5 17.4 10.7 4.9 3.1 0.8 0.4 100.0 2,646 3.96 3.68
40-44 1.9 6.1 8.3 15.0 17.8 14.6 14.4 10.4 6.7 3.3 1.5 100.0 1,957 4.70 4.24
45-49 1.6 6.3 7.6 10.9 17.0 13.1 13.6 12.7 8.5 5.4 3.1 100.0 1,674 5.08 4.53
Total 7.1 17.3 18.3 17.6 13.8 10.1 7.0 4.1 2.6 1.3 0.7 100.0 14,361 3.23 2.98

Fertility and Family Planning • 45

 Table 4.5 Birth intervals

Percent distribution of non-first births in the 5 years preceding the survey by number of months since preceding birth, and median number of
months since preceding birth, according to background characteristics, Ghana MHS 2017
Median
number of
Months since preceding birth months
Number of since
Background non-first preceding
characteristic 7-17 18-23 24-35 36-47 48-59 60+ Total births birth
Age
15-19 17.7 20.0 50.0 4.6 7.7 0.0 100.0 67 27.1
20-29 7.9 11.3 33.5 22.9 11.5 12.9 100.0 3,700 35.1
30-39 5.6 9.0 27.4 20.6 13.2 24.2 100.0 5,654 40.2
40-49 3.0 5.9 19.2 18.9 14.0 38.9 100.0 1,386 50.7
Sex of preceding birth
Male 6.0 8.5 28.7 21.5 12.2 23.1 100.0 5,522 39.3
Female 6.3 10.5 28.4 20.6 13.2 20.9 100.0 5,284 38.2
Survival of preceding birth
Living 4.9 9.2 29.0 21.4 12.9 22.6 100.0 10,183 39.3
Dead 26.8 14.0 20.7 15.5 9.5 13.5 100.0 624 29.2
Birth order
2-3 6.0 9.9 27.8 20.7 12.3 23.4 100.0 5,790 39.1
4-6 6.4 8.7 29.0 21.7 13.0 21.1 100.0 4,092 38.7
7+ 6.0 10.4 31.3 20.8 13.7 17.9 100.0 924 36.8
Residence
Urban 6.1 9.6 27.0 20.1 12.3 24.9 100.0 4,893 39.9
Rural 6.2 9.4 29.8 21.8 13.0 19.7 100.0 5,914 38.1
Zone
Coastal 6.3 9.8 27.7 19.8 12.2 24.2 100.0 4,788 39.0
Middle 6.9 10.0 28.2 20.2 12.1 22.6 100.0 4,128 38.4
Northern 4.0 7.6 31.5 26.2 15.1 15.6 100.0 1,891 38.9
Region
Western 5.7 10.7 26.4 22.4 12.9 22.0 100.0 1,475 38.9
Central 7.7 7.9 30.2 20.2 7.7 26.3 100.0 1,005 38.1
Greater Accra 5.8 11.0 25.8 16.1 14.4 26.9 100.0 1,369 40.8
Volta 6.3 8.7 30.1 20.8 12.9 21.2 100.0 939 38.1
Eastern 8.3 11.5 27.8 19.0 10.3 23.1 100.0 1,037 37.0
Ashanti 7.2 10.3 28.2 19.2 12.2 23.0 100.0 1,959 38.3
Brong Ahafo 5.3 8.2 28.6 23.0 13.5 21.5 100.0 1,131 39.3
Northern 4.4 8.6 35.2 26.4 12.4 13.1 100.0 1,188 36.7
Upper East 2.6 6.0 23.3 25.5 20.3 22.3 100.0 392 43.8
Upper West 4.3 5.8 27.6 26.3 19.0 17.0 100.0 310 40.9
Education
No education 5.5 8.3 31.0 24.7 12.3 18.3 100.0 3,290 38.0
Primary 6.8 9.3 25.6 20.3 14.2 23.8 100.0 2,068 40.6
Middle/JSS/JHS 5.6 9.5 28.0 19.6 12.7 24.5 100.0 4,037 39.3
Secondary/SSS/SHS 8.4 10.7 26.9 18.3 10.7 24.9 100.0 905 37.9
More than secondary 7.4 15.8 32.4 17.2 12.4 14.8 100.0 507 32.9
Wealth quintile
Lowest 6.4 9.5 34.0 24.5 11.5 14.1 100.0 2,701 36.0
Second 5.8 8.8 30.2 21.0 13.3 20.8 100.0 2,447 38.3
Middle 6.1 8.7 24.6 20.4 13.6 26.7 100.0 2,065 41.7
Fourth 5.9 8.5 24.2 20.2 13.2 28.0 100.0 1,989 42.7
Highest 6.5 12.8 27.4 17.3 11.8 24.1 100.0 1,605 38.3
Total 6.1 9.5 28.6 21.1 12.7 22.1 100.0 10,807 38.8

Note: First-order births are excluded. The interval for multiple births is the number of months since the preceding pregnancy that ended in a live
birth.

46 • Fertility and Family Planning

Table 4.6 Age at first birth

Percentage of women age 15-49 who gave birth by specific exact ages, percentage who have never given birth, and median age at first birth,
according to current age, Ghana MHS 2017
Percentage
Percentage who gave birth by exact age who have
never given Number of Median age
Current age 15 18 20 22 25 birth women at first birth
15-19 1.1 na na na na 88.2 4,785 a
20-24 2.2 16.0 32.3 na na 50.3 4,208 a
25-29 2.5 18.2 33.4 48.0 65.4 24.4 4,229 22.3
30-34 3.7 19.1 34.5 50.5 68.2 9.6 3,709 21.9
35-39 3.5 20.6 39.0 55.3 72.4 5.1 3,313 21.3
40-44 4.8 26.1 44.0 60.6 76.8 3.4 2,481 20.6
45-49 4.8 22.8 43.9 63.0 80.7 3.0 2,337 20.6
20-49 3.4 19.8 36.8 na na 18.8 20,277 a
25-49 3.7 20.8 38.0 54.2 71.5 10.6 16,069 21.5

na = Not applicable due to censoring

a = Omitted because less than 50% of women had a birth before reaching the beginning of the age group

Table 4.7 Median age at first birth

Median age at first birth among women age 20-49 and age 25-49, according to
background characteristics, Ghana MHS 2017
Women age Women age
Background
characteristic 20-49 25-49
Residence
Urban a 22.7
Rural a 20.3
Zone
Coastal a 21.9
Middle a 21.2
Northern a 20.7
Region
Western a 20.9
Central a 21.1
Greater Accra a 24.0
Volta a 20.7
Eastern a 21.3
Ashanti a 21.6
Brong Ahafo a 20.6
Northern a 20.8
Upper East a 20.4
Upper West a 21.0
Education
No education 19.6 19.7
Primary 19.7 19.8
Middle/JSS/JHS a 21.3
Secondary/SSS/SHS a a
More than secondary a a
Wealth quintile
Lowest 19.8 19.7
Second a 20.1
Middle a 20.5
Fourth a 21.8
Highest a a
Total a 21.5

a = Omitted because less than 50% of the women had a birth before reaching the
beginning of the age group

Fertility and Family Planning • 47

 Table 4.8 Teenage pregnancy and motherhood

Percentage of women age 15-19 who have had a live birth or who are pregnant with their first child, and percentage
who have begun childbearing, according to background characteristics, Ghana MHS 2017
Percentage of women age 15-19 who: Percentage who
Background Have had Are pregnant with have begun Number
characteristic a live birth first child childbearing of women
Age
15-17 5.7 1.8 7.5 3,080
15 2.7 0.7 3.4 1,046
16 4.3 2.3 6.6 936
17 9.7 2.5 12.3 1,098
18 17.7 4.8 22.5 974
19 29.9 2.5 32.3 731
Residence
Urban 9.2 1.8 11.0 2,411
Rural 14.5 3.3 17.8 2,374
Zone
Coastal 11.9 2.2 14.1 2,206
Middle 12.2 2.4 14.6 1,916
Northern 10.5 4.0 14.5 663
Region
Western 15.6 3.3 18.9 650
Central 13.6 2.2 15.8 413
Greater Accra 6.8 0.2 7.0 748
Volta 13.7 4.3 17.9 396
Eastern 11.1 1.9 13.0 490
Ashanti 12.2 2.6 14.8 936
Brong Ahafo 13.3 2.7 16.0 490
Northern 11.6 4.2 15.8 351
Upper East 12.7 4.6 17.3 176
Upper West 4.7 2.8 7.5 136
Education
No education 27.1 7.7 34.7 164
Primary 19.9 3.2 23.1 835
Middle/JSS/JHS 12.3 2.7 15.0 2,595
Secondary/SSS/SHS 3.1 1.0 4.2 1,152
More than secondary * * * 39
Wealth quintile
Lowest 16.8 4.4 21.1 869
Second 18.5 2.9 21.4 1,027
Middle 13.2 3.2 16.3 1,051
Fourth 7.4 1.9 9.3 953
Highest 2.5 0.2 2.7 886
Total 11.8 2.5 14.4 4,785

Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed.

Table 4.9 Sexual and reproductive health behaviours before age 15

Among women age 15-19, percentage who initiated sexual intercourse, were married, and had a live birth
before age 15, Ghana MHS 2017
Had sexual
intercourse before Married before Gave birth before
age 15 age 15 age 15 Number
Women 9.2 2.3 1.1 4,785

48 • Fertility and Family Planning

Table 4.10 Knowledge of contraceptive methods

Percentage of all women, currently married women, and sexually active unmarried women
age 15-49 who have heard of any contraceptive method, according to specific method,
Ghana MHS 2017
Sexually active
Currently unmarried
Method All women married women women1
Any method 98.9 99.4 99.8
Any modern method 98.9 99.4 99.8
Female sterilisation 79.5 82.8 79.3
Male sterilisation 37.9 40.2 38.8
Pill 90.5 95.0 93.5
IUD 58.9 65.6 57.3
Injectables 93.3 97.2 94.7
Implants 90.5 95.9 93.1
Male condom 97.6 98.1 99.1
Female condom 86.8 88.3 91.4
Emergency contraception 68.7 70.5 80.2
Lactational amenorrhoea (LAM) 47.2 57.6 41.8
Other modern method 0.1 0.1 0.0
Any traditional method 91.0 94.0 96.6
Rhythm 82.0 84.9 87.0
Withdrawal 82.4 87.7 91.8
Other traditional method 7.8 8.7 9.4
Mean number of methods known by
respondents 15-49 9.2 9.7 9.6
Number of respondents 25,062 14,361 1,616

1
Had last sexual intercourse within 30 days preceding the survey

Fertility and Family Planning • 49

 Table 4.11 Knowledge of contraceptive methods according to background
characteristics

Percentage of currently married women age 15-49 who have heard of at least one
contraceptive method and who have heard of at least one modern method, by background
characteristics, Ghana MHS 2017
Heard of
Background Heard of any modern
characteristic any method method1 Number
Age
15-19 98.8 98.7 404
20-24 99.2 99.2 1,841
25-29 99.6 99.6 2,878
30-34 99.5 99.5 2,961
35-39 99.5 99.5 2,646
40-44 99.3 99.3 1,957
45-49 99.0 99.0 1,674
Residence
Urban 99.8 99.8 7,226
Rural 98.9 98.9 7,135
Zone
Coastal 99.8 99.8 6,622
Middle 99.7 99.7 5,452
Northern 97.5 97.4 2,287
Region
Western 99.4 99.4 1,799
Central 99.9 99.9 1,285
Greater Accra 99.9 99.9 2,354
Volta 100.0 100.0 1,183
Eastern 99.8 99.8 1,414
Ashanti 99.7 99.7 2,655
Brong Ahafo 99.7 99.7 1,384
Northern 96.0 96.0 1,309
Upper East 99.6 99.5 569
Upper West 99.4 99.2 409
Education
No education 98.0 98.0 3,736
Primary 99.6 99.6 2,458
Middle/JSS/JHS 99.9 99.9 5,479
Secondary/SSS/SHS 100.0 100.0 1,724
More than secondary 100.0 100.0 963
Wealth quintile
Lowest 97.7 97.6 2,766
Second 99.7 99.6 2,765
Middle 99.7 99.7 2,796
Fourth 99.9 99.9 2,899
Highest 100.0 100.0 3,135
Total 99.4 99.4 14,361

1
Female sterilisation, male sterilisation, pill, IUD, injectables, implants, male condom,
female condom, emergency contraception, lactational amenorrhoea method (LAM), and
other modern methods

50 • Fertility and Family Planning

 Table 4.12 Current use of contraception according to age

Percent distribution of all women, currently married women, and sexually active unmarried women age 15-49 by contraceptive method currently used, according to age, Ghana MHS 2017
Modern method Traditional method
Emer-
Any Female Male gency Any tradi- Not Number
Any modern sterili- sterili- Inject- Male Female Dia- Foam/ contra- tional With- currently of
Age method method sation sation Pill IUD ables Implants condom condom phragm jelly ception LAM method Rhythm drawal Other using Total women
ALL WOMEN
15-19 9.8 6.9 0.0 0.1 1.1 0.1 1.3 1.7 1.6 0.0 0.0 0.0 1.0 0.0 2.9 2.0 0.7 0.2 90.2 100.0 4,785
20-24 28.6 22.7 0.0 0.0 3.7 0.2 6.4 6.2 2.8 0.1 0.0 0.0 3.0 0.1 5.9 4.1 1.5 0.3 71.4 100.0 4,208
25-29 32.1 25.2 0.0 0.1 4.7 0.1 9.0 7.3 2.3 0.0 0.0 0.0 1.5 0.3 6.9 5.0 1.5 0.3 67.9 100.0 4,229
30-34 31.9 25.5 0.6 0.0 4.6 1.2 8.5 7.5 1.2 0.0 0.0 0.0 1.2 0.5 6.4 4.5 1.3 0.6 68.1 100.0 3,709
35-39 28.8 23.1 2.5 0.1 4.1 0.8 7.6 6.1 1.0 0.0 0.1 0.0 0.6 0.3 5.6 4.4 1.0 0.2 71.2 100.0 3,313
40-44 24.5 19.5 3.6 0.1 2.7 1.0 5.8 4.7 1.0 0.0 0.0 0.0 0.3 0.2 5.1 3.8 0.8 0.4 75.5 100.0 2,481
45-49 18.1 14.2 4.1 0.1 2.0 1.0 2.8 2.9 0.4 0.0 0.1 0.0 0.6 0.0 3.9 3.0 0.6 0.3 81.9 100.0 2,337
Total 24.7 19.5 1.2 0.0 3.3 0.5 6.0 5.3 1.6 0.0 0.0 0.0 1.3 0.2 5.3 3.8 1.1 0.3 75.3 100.0 25,062

CURRENTLY MARRIED WOMEN

15-19 27.6 23.8 0.0 0.0 2.5 0.0 8.7 10.3 1.1 0.0 0.0 0.0 1.2 0.0 3.8 3.0 0.8 0.0 72.4 100.0 404
20-24 32.4 27.9 0.1 0.0 4.7 0.4 9.3 9.4 1.5 0.2 0.0 0.0 1.9 0.3 4.5 3.0 1.5 0.0 67.6 100.0 1,841
25-29 33.3 26.7 0.0 0.1 4.7 0.1 10.5 8.5 1.3 0.0 0.0 0.0 1.1 0.4 6.6 4.8 1.6 0.2 66.7 100.0 2,878
30-34 33.9 27.7 0.7 0.0 5.2 1.3 9.3 8.5 1.0 0.0 0.0 0.0 1.0 0.6 6.2 4.5 1.2 0.4 66.1 100.0 2,961
35-39 31.5 25.5 3.0 0.0 4.9 0.7 8.2 6.7 0.9 0.0 0.1 0.1 0.5 0.3 6.1 4.7 1.1 0.3 68.5 100.0 2,646
40-44 28.0 22.1 4.1 0.1 3.2 1.2 6.4 5.5 1.2 0.0 0.0 0.0 0.3 0.3 5.9 4.3 1.0 0.5 72.0 100.0 1,957
45-49 22.2 17.1 4.9 0.2 2.3 1.4 3.3 3.8 0.4 0.0 0.1 0.0 0.7 0.0 5.0 3.7 0.9 0.4 77.8 100.0 1,674
Total 30.8 25.0 1.9 0.0 4.3 0.8 8.2 7.4 1.1 0.0 0.0 0.0 0.9 0.3 5.8 4.2 1.3 0.3 69.2 100.0 14,361

1
SEXUALLY ACTIVE UNMARRIED WOMEN
15-19 35.6 27.2 0.0 0.6 4.6 1.0 4.8 4.7 6.7 0.0 0.0 0.0 4.8 0.0 8.4 4.8 3.5 0.0 64.4 100.0 392
20-24 48.8 39.1 0.0 0.0 6.2 0.1 8.0 8.0 7.5 0.0 0.0 0.0 9.2 0.0 9.7 7.3 2.4 0.0 51.2 100.0 455
25+ 33.7 27.2 0.5 0.2 4.4 0.3 8.6 5.2 4.5 0.0 0.0 0.0 3.5 0.0 6.5 3.9 1.7 0.9 66.3 100.0 769
Total 38.4 30.6 0.3 0.3 4.9 0.4 7.5 5.9 5.9 0.0 0.0 0.0 5.4 0.0 7.8 5.1 2.3 0.4 61.6 100.0 1,616

Note: If more than one method is used, only the most effective method is considered in this tabulation.
LAM = Lactational amenorrhoea method
1
Women who have had sexual intercourse within 30 days preceding the survey
Fertility and Family Planning • 51
52 • Fertility and Family Planning

Table 4.13.1 Current use of contraception by background characteristics

Percent distribution of currently married and sexually active unmarried women age 15-49 by contraceptive method currently used, according to background characteristics, Ghana MHS 2017
Modern method Traditional method
Emer-
Any Female Male gency Any tradi- Not Number
Background Any modern sterili- sterili- Inject- Male Female Dia- Foam/ contra- tional With- currently of
characteristic method method sation sation Pill IUD ables Implants condom condom phragm jelly ception LAM method Rhythm drawal Other using Total women
CURRENTLY MARRIED WOMEN

Number of living children

0 16.9 11.1 0.3 0.0 2.8 0.2 2.1 2.0 1.8 0.2 0.0 0.0 1.8 0.0 5.9 4.7 1.1 0.1 83.1 100.0 1,131
1-2 29.0 23.2 0.3 0.0 3.6 0.6 8.6 7.3 1.3 0.0 0.0 0.0 1.0 0.4 5.8 4.2 1.6 0.1 71.0 100.0 5,417
3-4 34.2 27.4 2.3 0.0 5.1 1.0 8.9 7.6 1.0 0.0 0.1 0.0 0.7 0.5 6.8 5.2 1.2 0.4 65.8 100.0 4,768
5+ 33.8 29.7 4.5 0.2 4.7 1.1 8.8 9.2 0.4 0.0 0.0 0.0 0.7 0.1 4.1 2.7 0.9 0.6 66.2 100.0 3,045
Disability status1
A lot of difficulty or unable to
function in at least one domain 31.2 25.3 2.0 0.1 4.8 0.6 9.3 7.2 0.2 0.0 0.0 0.0 0.7 0.3 5.9 3.7 1.8 0.4 68.8 100.0 1,605
Some or no difficulty in all domains 30.8 25.0 1.8 0.0 4.2 0.8 8.1 7.4 1.2 0.0 0.0 0.0 0.9 0.3 5.8 4.3 1.2 0.3 69.2 100.0 12,756
Residence
Urban 30.2 22.6 1.8 0.0 3.9 1.1 6.6 6.0 1.6 0.0 0.0 0.0 1.2 0.4 7.6 5.7 1.5 0.4 69.8 100.0 7,226
Rural 31.4 27.4 1.9 0.1 4.7 0.5 9.9 8.8 0.5 0.1 0.1 0.0 0.7 0.3 4.0 2.8 1.0 0.2 68.6 100.0 7,135
Zone
Coastal 29.3 23.5 2.2 0.1 4.0 0.9 6.9 7.2 1.1 0.1 0.0 0.0 0.6 0.4 5.9 3.8 1.7 0.3 70.7 100.0 6,622
Middle 35.2 27.7 2.1 0.0 5.1 0.9 8.3 8.0 1.3 0.0 0.1 0.0 1.7 0.4 7.5 6.0 1.1 0.4 64.8 100.0 5,452
Northern 24.5 23.0 0.3 0.0 3.2 0.3 11.9 6.4 0.4 0.0 0.0 0.0 0.2 0.3 1.5 1.2 0.3 0.0 75.5 100.0 2,287
Region
Western 32.3 27.0 2.9 0.2 5.8 0.0 8.9 7.1 1.0 0.1 0.0 0.0 0.4 0.6 5.2 3.8 1.1 0.3 67.7 100.0 1,799
Central 28.1 24.6 2.8 0.1 3.9 0.7 6.1 10.4 0.4 0.0 0.0 0.0 0.1 0.1 3.5 2.4 0.7 0.4 71.9 100.0 1,285
Greater Accra 28.4 20.8 1.6 0.0 3.0 1.9 5.3 5.5 1.7 0.1 0.1 0.0 1.2 0.3 7.7 5.1 2.2 0.3 71.6 100.0 2,354
Volta 27.9 22.2 1.7 0.0 3.4 0.4 7.8 7.3 0.9 0.0 0.0 0.1 0.2 0.5 5.7 2.8 2.7 0.2 72.1 100.0 1,183
Eastern 35.6 27.7 1.6 0.1 3.1 1.6 7.9 10.5 1.7 0.0 0.0 0.0 0.7 0.4 7.9 5.8 1.7 0.4 64.4 100.0 1,414
Ashanti 35.0 26.0 2.6 0.0 5.2 0.8 6.6 6.2 1.4 0.0 0.1 0.0 2.7 0.4 9.0 7.4 1.1 0.5 65.0 100.0 2,655
Brong Ahafo 35.3 31.1 1.5 0.0 6.8 0.5 12.0 8.9 0.5 0.0 0.0 0.0 0.7 0.2 4.2 3.5 0.6 0.0 64.7 100.0 1,384
Northern 18.5 16.8 0.2 0.0 3.6 0.3 9.3 2.3 0.4 0.0 0.0 0.0 0.1 0.4 1.7 1.3 0.4 0.1 81.5 100.0 1,309
Upper East 32.4 31.6 0.3 0.0 2.2 0.3 15.3 13.2 0.3 0.0 0.0 0.0 0.0 0.1 0.8 0.6 0.2 0.0 67.6 100.0 569
Upper West 32.6 30.7 0.9 0.0 3.1 0.3 15.3 10.1 0.6 0.0 0.1 0.0 0.3 0.0 2.0 1.7 0.3 0.0 67.4 100.0 409
Education
No education 23.8 21.8 1.6 0.1 3.2 0.4 8.5 7.2 0.3 0.0 0.1 0.0 0.4 0.2 1.9 1.5 0.3 0.1 76.2 100.0 3,736
Primary 32.7 28.7 2.5 0.1 4.7 1.2 9.4 9.2 0.6 0.1 0.0 0.0 0.7 0.3 4.0 2.3 1.2 0.5 67.3 100.0 2,458
Middle/JSS/JHS 34.3 27.2 2.1 0.0 4.9 0.7 8.9 8.1 1.0 0.0 0.0 0.0 1.1 0.4 7.1 5.0 1.7 0.4 65.7 100.0 5,479
Secondary/SSS/SHS 30.6 21.2 0.5 0.1 4.8 0.8 5.7 4.9 2.1 0.0 0.1 0.0 2.0 0.4 9.4 7.6 1.6 0.3 69.4 100.0 1,724
More than secondary 33.8 22.4 2.3 0.0 3.1 2.5 4.8 4.1 4.3 0.0 0.0 0.0 0.5 0.7 11.4 9.2 2.2 0.0 66.2 100.0 963
Wealth quintile
Lowest 25.6 23.4 1.0 0.1 3.2 0.4 10.5 7.7 0.1 0.0 0.0 0.0 0.2 0.2 2.3 1.3 0.8 0.1 74.4 100.0 2,766
Second 32.6 28.9 1.8 0.1 4.6 0.5 10.5 10.2 0.4 0.1 0.0 0.0 0.6 0.2 3.7 2.3 1.1 0.3 67.4 100.0 2,765
Middle 34.9 28.7 2.6 0.0 5.5 0.8 8.9 8.4 0.9 0.1 0.0 0.1 1.1 0.4 6.1 4.5 1.2 0.4 65.1 100.0 2,796
Fourth 31.0 24.1 1.7 0.0 5.1 0.8 6.8 7.0 1.1 0.0 0.0 0.0 1.2 0.4 6.8 5.2 1.4 0.2 69.0 100.0 2,899
Highest 30.0 20.6 2.2 0.0 3.1 1.5 4.9 4.0 2.6 0.0 0.2 0.0 1.5 0.5 9.5 7.4 1.6 0.5 70.0 100.0 3,135
Total 30.8 25.0 1.9 0.0 4.3 0.8 8.2 7.4 1.1 0.0 0.0 0.0 0.9 0.3 5.8 4.2 1.3 0.3 69.2 100.0 14,361

Continued
 Table 4.13.1—Continued
Modern method Traditional method
Emer-
Any Female Male gency Any tradi- Not Number
Background Any modern sterili- sterili- Inject- Male Female Dia- Foam/ contra- tional With- currently of
characteristic method method sation sation Pill IUD ables Implants condom condom phragm jelly ception LAM method Rhythm drawal Other using Total women
SEXUALLY ACTIVE UNMARRIED WOMEN2

Residence
Urban 35.8 28.1 0.1 0.3 4.0 0.1 6.1 3.7 7.1 0.0 0.0 0.0 6.8 0.0 7.7 4.9 2.4 0.5 64.2 100.0 951
Rural 42.1 34.1 0.5 0.3 6.0 0.9 9.6 8.9 4.2 0.0 0.0 0.0 3.4 0.0 8.0 5.4 2.3 0.3 57.9 100.0 665
Total 38.4 30.6 0.3 0.3 5 0.4 7.5 5.9 5.9 0.0 0.0 0.0 5.4 0.0 7.8 5.1 2.3 0.4 61.6 100.0 1,616

Note: If more than one method is used, only the most effective method is considered in this tabulation.
LAM = Lactational amenorrhoea method
1
If a woman reported having difficulty in more than one domain, only the highest level of difficulty is shown. Domains are seeing, hearing, communicating, remembering or concentrating, walking or climbing steps, and washing all over or
dressing.
2
Women who have had sexual intercourse within 30 days preceding the survey
Fertility and Family Planning • 53
 Table 4.13.2 Trends in current use of contraception
Percent distribution of currently married women age 15-49 by contraceptive method currently used, according
to several surveys, Ghana MHS 2017
Method 1998 GDHS 2003 GDHS 2008 GDHS 2014 GDHS 2017 GMHS
Any method 22.0 25.2 23.5 26.7 30.8
Any modern method 13.3 18.7 16.6 22.2 25.0
Female sterilisation 1.3 1.9 1.6 1.9 1.9
IUD 0.7 0.9 0.2 0.8 0.8
Pill 3.9 5.5 4.7 4.7 4.3
Male condom 2.7 3.1 2.4 1.2 1.1
Injectables 3.1 5.4 6.2 8.0 8.2
Implants 0.1 1.0 0.9 5.2 7.4
Other modern method 1.5 0.9 0.4 0.4 1.2
Any traditional method 8.7 6.5 6.9 4.5 5.8
Rhythm 6.6 5.1 4.7 3.2 4.2
Withdrawal 1.5 0.8 1.4 1.1 1.3
Other 0.6 0.6 0.8 0.2 0.3
Not currently using 78.0 74.8 76.5 73.3 69.2
Total 100.0 100.0 100.0 100.0 100.0
Number of women 3,131 3,549 2,876 5,321 14,361

Table 4.14 Knowledge of a source of family planning among nonusers

Percentage of women age 15-49 who are not using contraception and know of a place where they could obtain a method of family planning, and
percentage who know of specific sources, according to background characteristics, Ghana MHS 2017
Number of women not
Background Know Know a public sector Know a private sector Know any other currently using
characteristic any source source1 source2 source3 contraception
Age
15-19 59.4 56.1 16.3 0.8 4,317
20-24 81.3 77.5 22.7 1.1 3,004
25-29 87.9 83.4 26.6 1.4 2,873
30-34 90.4 87.4 25.0 0.7 2,526
35-39 87.0 82.7 22.9 1.0 2,361
40-44 86.1 83.3 19.4 0.7 1,872
45-49 81.1 78.1 15.0 2.0 1,914
Residence
Urban 79.2 74.4 27.9 1.2 10,525
Rural 80.3 78.2 12.4 0.9 8,343
Zone
Coastal 79.8 75.7 25.1 1.6 9,322
Middle 80.0 76.4 19.3 0.5 6,956
Northern 78.4 76.7 11.2 0.8 2,590
Region
Western 79.4 76.9 13.5 1.4 2,384
Central 79.7 77.8 17.1 0.1 1,738
Greater Accra 78.2 71.6 39.6 2.9 3,666
Volta 84.4 81.4 17.5 0.2 1,534
Eastern 85.0 82.8 8.4 0.4 1,800
Ashanti 78.7 74.2 24.9 0.5 3,447
Brong Ahafo 77.3 74.2 19.4 0.5 1,710
Northern 77.8 75.9 11.6 0.5 1,483
Upper East 79.2 77.7 13.6 1.0 638
Upper West 79.3 77.6 7.0 1.3 469
Education
No education 78.5 75.9 11.5 0.7 3,570
Primary 75.9 73.0 15.8 0.8 2,917
Middle/JSS/JHS 78.4 75.0 19.4 1.0 7,515
Secondary/SSS/SHS 81.8 77.0 28.6 1.3 3,473
More than secondary 92.4 87.0 46.4 2.3 1,393
Wealth quintile
Lowest 76.8 74.6 8.3 0.6 3,165
Second 78.8 76.3 13.2 0.9 3,499
Middle 80.5 77.3 19.1 1.0 3,699
Fourth 80.5 76.5 24.4 0.8 4,095
Highest 81.1 75.6 34.9 1.9 4,410
Total 79.7 76.1 21.1 1.1 18,868

1
Public sources include government hospital, government health centre/clinic, government health post/CHPS, mobile clinic/outreach, family
planning clinic, fieldworker, and other public sector.
2
Private sources include private hospital/clinic, private doctor, mobile clinic/outreach, pharmacy/chemist/drugstore, fieldworker, FP/PPAG clinic,
maternity home, and other private sector.
3
Other sources include shop, church, friend/relative, and other.

54 • Fertility and Family Planning

Table 4.15 Knowledge of fertile period

Percent distribution of rhythm users and all women age 15-49 by knowledge
of the fertile period during the ovulatory cycle, Ghana MHS 2017
Users of
rhythm
Perceived fertile period method All women
Just before her menstrual period begins 6.2 8.9
During her menstrual period 1.6 2.4
Right after her menstrual period has ended 22.8 28.9
Halfway between two menstrual periods 65.2 38.4
Other 0.0 0.2
No specific time 1.7 7.5
Don’t know 2.4 13.6
Total 100.0 100.0
Number of women 957 25,062

Table 4.16 Knowledge of fertile period by age

Percentage of women age 15-49 with correct knowledge of the fertile period
during the ovulatory cycle, according to age, Ghana MHS 2017
Percentage with
correct
knowledge of the Number of
Age fertile period women
15-19 23.9 4,785
20-24 39.2 4,208
25-29 43.0 4,229
30-34 44.1 3,709
35-39 42.0 3,313
40-44 41.1 2,481
45-49 41.0 2,337
Total 38.4 25,062

Note: Correct knowledge of the fertile period is defined as halfway between

two menstrual periods.

Fertility and Family Planning • 55

MATERNAL HEALTH CARE 5
Key Findings

 Antenatal care: Almost all women age 15-49 with a live

birth or stillbirth in the 5 years preceding the survey
received antenatal care (ANC) from a skilled provider
during their most recent pregnancy (98%). Sixty-four
percent of women had their first ANC visit during the first
trimester of pregnancy, and 89% attended the
recommended four or more ANC visits during pregnancy.
 Components of ANC: Almost all women who attended
ANC had their blood pressure measured (99%), had a
urine sample taken (98%), had a blood sample taken
(98%), and were weighed (99%) during pregnancy as
part of any ANC visit.
 Delivery: Institutional deliveries increased from 54% in
2007 to 79% in 2017.
 Postnatal care: Eighty-four percent of women received a
postnatal check for their most recent live birth or stillbirth,
and 81% of newborns received a postnatal check within 2
days of birth.
 Problems in accessing health care: Fifty-seven percent
of women age 15-49 reported having at least one
problem in accessing health care. Getting money for
treatment is the most prominent problem (48%).

H
ealth care services during pregnancy and childbirth and after delivery are important for the
survival and well-being of both the mother and the infant. Skilled care during pregnancy and
childbirth, as well as access to emergency obstetric care, would accelerate Ghana’s progress
towards reducing maternal and neonatal morbidity and mortality.

Several high-level initiatives have been launched in Ghana to enhance progress towards Millennium
Development Goal (MDG) 5. Notable examples include the Making Pregnancy Safer Initiative, the
Campaign for Accelerated Reduction of Maternal Mortality in Africa (CARMMA), and the MDG 5
Acceleration Framework (MAF).

This chapter presents information from the 2017 GMHS on several aspects of maternal and newborn
health, including antenatal care (ANC), number and timing of ANC visits, components of maternal health
care during ANC, places of delivery, assistance during delivery, types of delivery, and postnatal care
(PNC) for mothers and newborns.

Maternal Health Care • 57

 5.1 ANTENATAL CARE COVERAGE AND CONTENT
5.1.1 Skilled Providers

Antenatal care (ANC) from a skilled provider

Pregnancy care received from skilled providers, such as doctors and
nurses/midwives.
Sample: Women age 15-49 who had a live birth or stillbirth in the 5 years
before the survey

Almost all (98%) women age 15-49 who had a live birth or stillbirth in the 5 years preceding the survey
received ANC from a skilled provider for their most recent birth or stillbirth. Care was most often provided
by nurses/midwives (70%), followed by doctors (24%) (Table 5.1).

Trends: The percentage of women Figure 5.1 Trends in antenatal care coverage
age 15-49 who had a live birth or
Percentage of women age 15-49 who had a live birth
stillbirth in the 5 years preceding or stillbirth in the 5 years before the survey
the survey and received ANC from (for the most recent live birth or stillbirth)
a skilled provider for their most
Received any
recent live birth or stillbirth 98 ANC from
96
remained high, increasing very skilled provider
slightly from 96% in 2007 to 98% 89 Had 4+
in 2017 (Figure 5.1). ANC visits
77 Had ANC in
64 first trimester
Patterns by background 53
characteristics

There is little variation in receipt of

antenatal care from a skilled 2007 GMHS 2017 GMHS
provider by selected background
characteristics; there is, however,
variation in the kind of provider
seen.

 The percentage of women who saw a doctor increases with the mother’s age at birth, from 17% among
women younger than age 20 to 24% among women age 20-34 and 29% among those age 35-49.

 Thirty-one percent of urban women saw a doctor, as compared with 18% of rural women; larger
percentages of rural women saw a nurse/midwife (74%) or community health officer/nurse (6%) than
their urban counterparts (66% and 0.8%, respectively).

 The percentage of women who saw a doctor ranges from 11% in Northern and Upper East regions to
41% in Greater Accra region.

 The percentage of women who saw a doctor increases with increasing education (from 15% among
women with no education to 51% among women with more than a secondary education) and wealth
(from 12% among women in the lowest wealth quintile to 46% among women in the highest quintile).

Reasons for Seeking or Not Seeking ANC

Women age 15-49 who had a live birth or stillbirth in the 5 years preceding the survey and did not receive
ANC for their most recent birth or stillbirth were asked why they did not seek ANC. The most commonly
cited reason was lack of money (42%), and a larger percentage of rural women (47%) reported this reason
than urban women (31%) . The second most common reason, the perception that ANC is not necessary

58 • Maternal Health Care

(26%), was cited more often by urban (33%) than rural (23%) women. Transportation problems were cited
by 20% of rural women but not by any urban women (Table 5.2).

Women age 15-49 who had a live birth or stillbirth in the 5 years preceding the survey and did receive
ANC for their most recent birth or stillbirth were asked if they first went to ANC for that pregnancy
because of a problem or just for a checkup; 86% went for the first time just for a checkup, and 14% went
because of a problem (Table 5.3). Women who went because of a problem were asked to name the
problem(s); the most commonly reported problem was excessive vomiting (33%), followed by lower
abdominal pain (26%), headache (24%), and blurry vision and anaemia/body pains/fever (18% each).

Payments for ANC

The 2017 GMHS collected data on whether women age 15-49 who had a live birth or stillbirth in the 5
years preceding the survey and received ANC for their most recent birth or stillbirth at a public facility
were asked to make any payments for ANC. More than 4 in 10 women who received ANC at a public
facility were asked to make payments for ANC (45%); 37% paid for laboratory tests, 32% paid for drugs,
22% paid for other supplies, and 8% paid to see a provider (doctor or nurse) (Table 5.4).

5.1.2 Timing and Number of ANC Visits

Overall, 89% of women age 15-49 with a live birth or stillbirth in the 5 years before the survey attended
the recommended number (four or more) of ANC visits during the pregnancy for their most recent live
birth or stillbirth (Table 5.5). The percentage of urban women who made 4 or more ANC visits is higher
(93%) than rural women (86%). Sixty-four percent of women had their first ANC visit during the first
trimester of pregnancy, as recommended.

Trends: The percentage of women who had the recommended four or more ANC visits increased by 12
percentage points between 2007 and 2017, from 77% to 89%. The percentage of women who received
ANC in the first trimester also increased over this period, from 53% to 64% (Figure 5.1).

5.2 COMPONENTS OF ANC VISITS

Among women age 15-49 with a live birth or stillbirth in the 5 years before the survey who received ANC
during the pregnancy for their most recent live birth or stillbirth, almost all received critical components of
care at least once: 99% of women had their blood pressure measured, 98% had a urine sample taken, 98%
had a blood sample taken, and 99% were weighed. Most were told about signs of pregnancy complications
(85%); among those who were told about signs of complications, almost all (98%) were told about where
to go in case they had any complications (Table 5.6).

Trends: There was an increase in Figure 5.2 Components of antenatal care

receipt of most of the components Among women who received ANC for their most
of ANC between 2007 and 2017. recent live birth or stillbirth, the percentage
The percentage of women who had with selected services
a urine sample taken and the 2007 GMHS 2017 GMHS
percentage who had a blood sample
98 98 98 99
taken rose from 89% to 98%. Over 89 89 85
the same period, the percentage of 70
women who were told about signs
of pregnancy complications
increased from 70% to 85%
(Figure 5.2).
Blood sample Urine sample Blood pressure Told about signs
taken taken measured of pregnancy
complications

Maternal Health Care • 59

 Iron Tablets/Syrup and Intestinal Parasite Drugs

Women age 15-49 with a live birth or stillbirth in the 5 years preceding the survey, whether or not they
attended ANC, were asked if they took iron tablets or syrup and intestinal parasite drugs during their most
recent pregnancy.

Most women (93%) reported taking iron tablets/syrup during pregnancy. Surprisingly, only 40% took
intestinal parasite drugs. At the regional level, the percentage of women who took iron tablets/syrup is
lowest (82%) in Volta region and highest (98%) in Upper East region (Table 5.6).

5.3 PROTECTION AGAINST NEONATAL TETANUS

Protection against neonatal tetanus

The number of tetanus toxoid injections needed to protect a baby from
neonatal tetanus depends on the mother’s vaccinations. A birth is protected
against neonatal tetanus if the mother has received any of the following:
 Two tetanus toxoid injections during the pregnancy
 Two or more injections, the last one within 3 years of the birth
 Three or more injections, the last one within 5 years of the birth
 Four or more injections, the last one within 10 years of the birth
 Five or more injections at any time prior to the birth
Sample: Last live birth or stillbirth in the 5 years before the survey to women
age 15-49

Just over three quarters of the most recent live births or stillbirths in the 5 years before the survey to
women age 15-49 were protected against neonatal tetanus (77%) (Table 5.7).

Trends: The percentage of most recent live births or stillbirths in the 5 years before the survey to women
age 15-49 that were protected against neonatal tetanus decreased slightly between 2007 (79%) and 2017
(77%).

Patterns by background characteristics

 The percentage of most recent live births or stillbirths in the 5 years before the survey to women age
15-49 that were protected against neonatal tetanus is higher in urban areas (80%) than in rural areas
(73%).

 There is regional variation in the percentage of most recent live births or stillbirths protected against
neonatal tetanus, from 62% in Upper East region to 82% in Central and Greater Accra regions.

 The percentage of most recent live births or stillbirths protected against neonatal tetanus increases with
increasing mother’s education, from 70% among women with no education to 89% among those with
more than a secondary education.

 The percentage of most recent live births or stillbirths protected against neonatal tetanus also increases
with increasing wealth, from 66% among women in the lowest quintile to 86% among those in the
highest quintile.

60 • Maternal Health Care

5.4 DELIVERY SERVICES
5.4.1 Institutional Deliveries

Institutional deliveries
Deliveries that occur in a health facility.
Sample: Last live birth or stillbirth in the 5 years before the survey to women
age 15-49

Nearly 8 in 10 of the most recent live births or stillbirths in the 5 years before the survey to women age
15-49 were delivered in a health facility (79%) (Table 5.8).

Trends: Institutional deliveries increased from 54% Figure 5.3 Trends in place of birth
in 2007 to 79% in 2017. Within the same time frame, Percentage of most recent live births or
home deliveries declined from 45% to 20% stillbirths in the 5 years before the survey
(Figure 5.3).
79
Patterns by background characteristics
54 Delivered in
 The percentage of most recent live births and health facility
stillbirths in the 5 years preceding the survey that
were delivered in a health facility decreases with 45 Delivered
birth order, from 85% among first births to 69% at home
among sixth- or higher-order births. 20

 The percentage of most recent live births or 2007 GMHS 2017 GMHS
stillbirths delivered at home is three times higher
in rural areas (30%) than in urban areas (9%). Figure 5.4 Health facility births
by education
 Ninety-two percent of births to women in
Greater Accra region were delivered in a health Percentage of most recent live births or
stillbirths in the 5 years before the survey
facility, as compared with 59% of births to that were delivered in a health facility
women in Northern region.
98
92
 The percentage of most recent live births and 85
73
stillbirths delivered in a facility increases from
61
61% among women with no education to 98%
among women with more than a secondary
education (Figure 5.4).

Reasons for Not Delivering in a Health Facility

No Primary Middle Secondary More than
education secondary
Women with a live birth or stillbirth in the 5 years
preceding the survey who did not deliver the most
recent birth or stillbirth in a health facility were asked about their reason(s) for not delivering in a facility.
The most common reason was that the baby came earlier than expected (25%), and this reason was more
often reported by urban (33%) than rural (23%) women; 24% cited transportation problems (11% of urban
women and 28% of rural women). Eleven percent said that going to a health facility was not necessary, a
decline from 32% in 2007 (Table 5.9).

Payments for Delivery Care

Among women with a live birth or stillbirth in the past 5 years who delivered their most recent birth or
stillbirth in a public health facility, 52% were asked to make any type of payment for delivery care; 39%

Maternal Health Care • 61

 paid for drugs, 32% paid for other supplies, 22% paid for laboratory tests, and 9% paid to see the
doctor/nurse. A larger percentage of women in urban areas (57%) than rural areas (47%) were asked to pay
for some aspect of delivery care, and there is wide variation by region, from 15% among women in Upper
West region to 78% among women in Western region (Table 5.10).

5.4.2 Skilled Assistance during Delivery

Skilled assistance during delivery

Births delivered with the assistance of doctors, nurses/midwives, and/or
community health officers/nurses.
Sample: Last live birth or stillbirth in the 5 years before the survey

Seventy-nine percent of last live births or stillbirths in the 5 years before the 2017 GMHS to women age
15-49 were delivered by a skilled provider (Table 5.11).

Trends: The percentage of last live births and Figure 5.5 Trends in skilled assistance
stillbirths in the 5 years preceding the survey that at delivery
were delivered by a skilled provider increased from Percentage of most recent live births or
55% in 2007 to 79% in 2017. While the increase was stillbirths in the 5 years preceding the
not large among urban women (from 86% to 91%), survey assisted by a skilled provider
there was a tremendous increase among rural women 91
86 Urban
(from 39% to 69%) (Figure 5.5).
79 All live
births and
Patterns by background characteristics stillbirths
55 69
Rural
 The percentage of last live births and stillbirths
in the 5 years preceding the survey that were
delivered by a skilled provider is higher among 39
urban women (91%) than among women in rural
areas (69%).
2007 GMHS 2017 GMHS
 There is variation by region in the percentage of
last live births and stillbirths delivered by a skilled provider, from 59% in Northern region to 92% in
Greater Accra and Upper East regions.

 The percentage of last live births and stillbirths delivered by a skilled provider increases with
increasing mother’s education and wealth.

5.4.3 Delivery by Caesarean and Other Interventions

Among last live births and stillbirths in the 5 years before the survey to women age 15-49 that were
delivered in a heath facility, 16% were delivered by Caesarean section (C-section); slightly more C-
sections were decided on before (9%) than after (7%) the onset of labour pains (Table 5.12). Instruments
were used for 4% of live births and stillbirths, a blood transfusion was received during 5%, and
intravenous fluid was received during 58%.

Trends: The percentage of births delivered by C-section increased slightly from 12% in 2007 to 16% in
2017; in the same period, the percentage of births during which intravenous fluid was received increased
from 36% to 58%.

62 • Maternal Health Care

Patterns by background characteristics

 The percentage of last live births and stillbirths delivered by C-section that were decided before the
onset of labour pains increases with mother’s age, from 3% of births to mothers under age 20 to 14%
of births to mothers age 35-49.

 Intravenous fluid was received for a higher percentage of first-order births (65%) and births in urban
areas (62%) than for higher-order births (55%-58%) and births in rural areas (54%). While there are
minimal variations by education or wealth in the percentage of births during which instruments were
used and blood transfusions were received, the percentage during which intravenous fluid was
received and the percentage delivered by C-section both increase with increasing education and
wealth.

Duration of Stay in Health Facility

Among women who had their most recent live birth or stillbirth in the 5 years preceding the survey in a
health facility, 92% of those who delivered by C-section spent 3 or more days at the facility after delivery,
as compared with 12% of those who had a vaginal birth (Table 5.13).

5.4.4 Problems during Delivery

Eighty-one percent of women with a live birth or stillbirth in the 5 years preceding the survey had no
problems during delivery of their most recent live birth or stillbirth; 19% reported experiencing a problem
or problems during delivery. Among women who experienced one or more problems, the most commonly
cited problem was vaginal bleeding (30%), followed by other problems (22%), oedema/pre-eclampsia
(13%), blurry vision (12%), and headache and prolonged labour (11% each). Nine in 10 women who
experienced one or more problems saw somebody to get help for the problem or problems (91%)
(Table 5.14).

5.5 POSTNATAL CARE

5.5.1 Postnatal Health Check for Mothers

For both the mother and the infant, prompt postnatal care is important for treating complications that arise
from delivery and providing the mother with important information on caring for herself and her baby.
Among women age 15-49 who had a live birth or stillbirth in the 2 years before the survey, 84% had a
postnatal check during the first 2 days after the most recent birth or stillbirth. Twelve percent of women
did not receive a postnatal check (Table 5.15).

Patterns by background characteristics

 Ninety percent of urban women received a postnatal check within 2 days, as compared with 79% of
rural women.

 A larger percentage of women who delivered in a health facility received a postnatal check within 2
days of delivery than those who delivered elsewhere (95% versus 45%).

 The percentage of women who received a postnatal check in the 2 days after delivery varies by region,
from a low of 71% in Northern region to a high of 91% in Upper West and Greater Accra regions.

Maternal Health Care • 63

  The percentage of women who received a Figure 5.6 Postnatal checks on women
postnatal check increases with increasing wealth Percentage of women who received a
(Figure 5.6). postnatal check within 2 days for the most
recent live birth or stillbirth in the 5 years
Type of Provider before the survey by wealth
91 95
Seventy-six percent of women age 15-49 who had a 83 86
live birth or stillbirth in the 2 years before the survey 71
received a postnatal check within 2 days from a
doctor, nurse, or midwife. Only 2% of women
received a postnatal check from a community health
officer, and another 6% received a check from a
traditional birth attendant (Table 5.16).

5.5.2 Postnatal Health Check for Lowest Second Middle Fourth Highest
Newborns Poorest Wealthiest

Many neonatal deaths occur within the first 48 hours of life. This period is a critical time in the lives of
newborn babies, and complications can be prevented through prompt postnatal care (PNC). Just over 8 in
10 most recent live births delivered in the 2 years before the survey (81%) received a postnatal check
within 2 days after birth; just over 5 in 10 received the check within 1 hour of birth (52%) (Table 5.17).

Patterns by background characteristics

 The percentage of newborns who received a postnatal check within 2 days decreases with birth order,
from 86% among first-order births to 69% among sixth- or higher-order births.

 A much higher percentage of newborns delivered in a health facility received a postnatal check within
2 days (94%) than those delivered elsewhere (35%).

 A higher percentage of newborns in urban areas than rural areas received a postnatal check within 2
days (88% versus 76%).

 The percentage of newborns who received a postnatal check within 2 days increases with increasing
mother’s education and wealth.

Type of Provider

Seventy-five percent of most recent live births received a postnatal check within 2 days of delivery from a
doctor, nurse, or midwife; 4% received a check from a traditional birth attendant; and 2% received a check
from a community health officer or nurse (Table 5.18). Patterns by background characteristics are
generally similar to the patterns observed for postnatal checks.

Content of Postnatal Checks

For 85% of most recent live births within the 2 years preceding the survey, at least two signal functions
were checked within the first 2 days after birth (Table 5.19). The signal function most frequently
performed was cord examination (80%), followed by counselling on breastfeeding (79%), measurement of
temperature (77%), observation of breastfeeding (76%), counselling on danger signs (73%), and
measurement of weight (66%).

Payments for Postnatal Checks

Among women age 15-49 with a live birth or stillbirth in the 5 years preceding the survey who received a
postnatal check at a public facility within 2 days after the most recent birth or stillbirth, 15% were asked to
make payment for the check on their health. Payment was requested for 12% of postnatal checks among

64 • Maternal Health Care

most recent live births in the 5 years preceding the survey that received a postnatal check at a public
facility within 2 days (Table 5.20).

5.6 COMBINATIONS OF MATERNAL CARE

Nationally, 74% of women age 15-49 with a live birth or stillbirth in the 5 years preceding the survey
received all three specified services: ANC, assistance at delivery from a skilled provider, and a postnatal
check within 2 days after delivery (Table 5.21). Ten percent received only ANC, 9% received both ANC
and PNC, and 5% received both ANC and assistance at delivery by a skilled provider.

Eighty-four percent of urban women received all three services, as compared with 64% of their
counterparts in rural localities. The percentage of women who received all three services ranges from 54%
in Northern region to 84% in Greater Accra and Upper East regions. The percentage of women who
received all three services is highest among those with more than a secondary education and those in the
highest wealth quintile (92% each).

5.7 PROBLEMS IN ACCESSING HEALTH CARE

Problems in accessing health care

Women were asked whether each of the following factors is a big problem in
seeking medical advice or treatment for themselves when they are sick:
 Getting permission to go to the doctor
 Getting money for advice or treatment
 Distance to a health facility
 Not wanting to go alone
Sample: Women age 15-49

The survey also collected information regarding problems women face in accessing health care.
Information on such problems is vital in understanding and addressing barriers women face during
pregnancy and delivery with regards to seeking care.

Fifty-seven percent of women age 15-49 reported having at least one problem in accessing health care
(Table 5.22). Getting money for treatment is the most common problem (48%), followed by distance to a
health facility (24%) and not wanting to go alone (14%); the least cited problem is getting permission to go
for treatment (7%).

Larger percentages of women with five or more living children (62%), divorced/separated/widowed
women (61%), and women with no education (63%) have a problem getting money for treatment than
other women. Distance to a health facility is a problem for larger percentages of women in rural localities
(35%) and women in Northern region (47%) than other women.

LIST OF TABLES
For more information on maternal health care, see the following tables:

 Table 5.1 Antenatal care

 Table 5.2 Reasons for not seeking antenatal care
 Table 5.3 Reasons for seeking antenatal care
 Table 5.4 Payments for antenatal care
 Table 5.5 Number of antenatal care visits and timing of first visit
 Table 5.6 Components of antenatal care
 Table 5.7 Tetanus toxoid injections
 Table 5.8 Place of delivery
 Table 5.9 Reasons for not delivering in a health facility

Maternal Health Care • 65

  Table 5.10 Payments for delivery care
 Table 5.11 Assistance during delivery
 Table 5.12 Delivery interventions including Caesarean section
 Table 5.13 Duration of stay in health facility after birth
 Table 5.14 Problems encountered during delivery
 Table 5.15 Timing of first postnatal check for the mother
 Table 5.16 Type of provider of first postnatal check for the mother
 Table 5.17 Timing of first postnatal check for the newborn
 Table 5.18 Type of provider of first postnatal check for the newborn
 Table 5.19 Content of postnatal care for newborns
 Table 5.20 Payments for postnatal checks
 Table 5.21 Combinations of antenatal care, assistance at delivery, and postnatal checks
 Table 5.22 Problems in accessing health care

Table 5.1 Antenatal care

Percent distribution of women age 15-49 who had a live birth or stillbirth in the 5 years preceding the survey by antenatal care (ANC) provider during pregnancy
for the most recent birth or stillbirth and percentage receiving antenatal care from a skilled provider for the most recent birth or stillbirth, according to background
characteristics, Ghana MHS 2017
Antenatal care provider Percentage
receiving
Community antenatal
health Traditional care from a
Background Nurse/ officer/ birth skilled Number of
characteristic Doctor midwife nurse attendant Other No ANC Total provider1 women
Age at birth
<20 17.1 76.5 3.8 0.2 0.0 2.4 100.0 97.3 1,250
20-34 24.2 70.4 3.0 0.1 0.0 2.2 100.0 97.7 7,614
35-49 28.6 64.5 4.2 0.2 0.0 2.6 100.0 97.3 2,077
Birth order
1 22.5 73.3 2.9 0.0 0.0 1.3 100.0 98.7 2,032
2-3 25.0 69.7 3.1 0.1 0.0 2.1 100.0 97.8 3,849
4-5 24.1 70.1 3.4 0.1 0.0 2.3 100.0 97.6 2,772
6+ 24.6 67.5 4.1 0.2 0.0 3.7 100.0 96.2 2,288
Disability status2
A lot of difficulty or unable to
function in at least one domain 24.2 67.1 4.8 0.0 0.0 3.9 100.0 96.1 1,021
Some or no difficulty in all domains 24.2 70.3 3.2 0.1 0.0 2.1 100.0 97.7 9,919
Residence
Urban 31.4 66.1 0.8 0.2 0.0 1.5 100.0 98.3 5,286
Rural 17.6 73.6 5.7 0.0 0.0 3.1 100.0 96.9 5,655
Zone
Coastal 30.3 63.8 2.8 0.2 0.0 3.0 100.0 96.9 4,916
Middle 22.7 73.7 1.6 0.1 0.0 1.9 100.0 98.0 4,243
Northern 11.2 78.2 8.9 0.0 0.0 1.7 100.0 98.3 1,782
Region
Western 26.2 65.7 4.7 0.1 0.0 3.3 100.0 96.6 1,415
Central 25.1 72.3 0.1 0.2 0.0 2.3 100.0 97.5 986
Greater Accra 41.3 55.7 0.5 0.4 0.0 2.2 100.0 97.5 1,613
Volta 22.5 66.1 7.0 0.0 0.0 4.4 100.0 95.6 902
Eastern 19.2 77.0 0.8 0.3 0.0 2.7 100.0 97.0 1,086
Ashanti 29.4 68.2 0.4 0.0 0.0 2.1 100.0 97.9 2,017
Brong Ahafo 14.4 80.1 4.7 0.0 0.1 0.7 100.0 99.2 1,140
Northern 11.0 77.9 8.9 0.0 0.0 2.3 100.0 97.7 1,056
Upper East 11.0 80.7 7.9 0.0 0.0 0.4 100.0 99.6 424
Upper West 12.4 76.1 10.3 0.0 0.0 1.2 100.0 98.8 301
Education
No education 14.7 73.5 7.5 0.0 0.0 4.2 100.0 95.7 2,625
Primary 19.5 73.7 3.3 0.3 0.0 3.1 100.0 96.6 1,942
Middle/JSS/JHS 26.2 70.4 1.7 0.1 0.0 1.6 100.0 98.3 4,332
Secondary/SSS/SHS 30.0 67.6 1.5 0.0 0.0 0.9 100.0 99.1 1,368
More than secondary 51.0 47.9 1.1 0.0 0.0 0.0 100.0 100.0 673
Wealth quintile
Lowest 11.9 74.2 9.5 0.1 0.0 4.3 100.0 95.6 2,344
Second 18.7 75.0 3.3 0.1 0.0 3.0 100.0 97.0 2,363
Middle 20.9 74.7 1.8 0.3 0.0 2.3 100.0 97.3 2,202
Fourth 28.0 69.6 1.1 0.1 0.0 1.1 100.0 98.7 2,151
Highest 46.2 53.3 0.2 0.0 0.0 0.3 100.0 99.7 1,881
Total 24.2 70.0 3.3 0.1 0.0 2.3 100.0 97.6 10,940

Note: If more than one source of ANC was mentioned, only the provider with the highest qualifications is considered in this tabulation.
1
Skilled provider includes doctor, nurse/midwife, and community health officer/nurse.
2
Domains are seeing, hearing, communicating, remembering or concentrating, walking or climbing steps, and washing all over or dressing. If a woman
reported having difficulty in more than one domain, only the highest level of difficulty is shown.

66 • Maternal Health Care

Table 5.2 Reasons for not seeking antenatal care

Among women with a live birth or stillbirth in the 5 years preceding the
survey who did not receive antenatal care (ANC) during the pregnancy for
the most recent birth or stillbirth, percent distribution of reasons for not
seeking ANC, according to residence, Ghana MHS 2017
Residence
Reason Urban Rural Total
Not necessary 33.1 23.4 26.4
Not customary 0.0 1.2 0.8
Lack of money 31.4 47.0 42.2
Too far 0.0 7.4 5.1
Transportation problems 0.0 19.5 13.4
No one to accompany 7.4 0.0 2.3
Good service not available 4.7 5.0 4.9
Not permitted by family 0.0 2.1 1.5
Better service at home 7.8 9.5 9.0
Did not know where to go 4.7 1.0 2.1
Inconvenient service hour 1.3 0.0 0.4
Afraid to go 13.7 4.0 7.0
Long waiting time 0.0 0.8 0.5
Religious reason 1.1 2.1 1.8
Other 19.5 9.7 12.8
Number of women 79 175 253

Note: Respondents may have mentioned more than one reason.

Table 5.3 Reasons for seeking antenatal care

Among women with a live birth or stillbirth in the 5 years preceding the
survey who received ANC during the pregnancy for the most recent birth
or stillbirth, percent distribution of reasons for making the first ANC visit,
according to residence, Ghana MHS 2017
Residence
Reason Urban Rural Total
Reason for first attending ANC
Just for a checkup 86.4 85.5 85.9
Because of a problem 13.6 14.5 14.1
Total 100.0 100.0 100.0
Number of women 5,207 5,480 10,687
Problems
Headache 20.4 26.3 23.5
Blurry vision 13.1 22.0 17.8
Oedema/pre-eclampsia 2.0 1.9 1.9
Vaginal bleeding 9.2 8.0 8.6
Convulsions/eclampsia 0.5 0.2 0.4
Tetanus 0.0 0.1 0.0
Foul-smelling discharge 1.5 1.5 1.5
Lower abdominal pain 20.7 30.0 25.7
Fell down 1.2 1.4 1.3
Baby movement was low 0.6 1.3 1.0
Varicose vein 0.2 0.0 0.1
Excessive vomiting 38.5 28.2 33.1
Anaemia/body pains/fever 18.6 17.7 18.1
Other 12.2 9.6 10.8
Number of women 709 796 1,505

Note: Respondents may have mentioned more than one reason.

Maternal Health Care • 67

 Table 5.4 Payments for antenatal care

Among women with a live birth or stillbirth in the 5 years preceding the survey who received ANC during the pregnancy for the most recent
birth or stillbirth from a public sector facility, percentage asked to make payments for ANC and percentage asked to pay for specific
components of care, according to background characteristics, Ghana MHS 2017
Percentage who paid: Number of
Asked to women who
make To see the received ANC
Background payments doctor or For laboratory For other Other from public
characteristic for ANC nurse For drugs tests supplies payments sector
Mother’s age at birth
<20 47.4 9.2 30.8 38.8 20.3 0.3 1,114
20-34 44.6 8.3 31.7 37.0 22.1 0.2 6,450
35-49 43.5 7.6 33.1 35.0 19.9 0.4 1,765
Birth order
1 46.3 7.9 31.1 38.7 22.0 0.2 1,792
2-3 44.7 8.5 31.6 37.1 22.4 0.3 3,219
4-5 44.2 7.9 33.1 36.3 20.8 0.1 2,378
6+ 44.0 8.8 31.4 35.2 20.1 0.4 1,941
Antenatal care visits2
1-3 49.3 16.2 34.2 39.6 20.8 0.7 832
4+ 44.3 7.5 31.7 36.6 21.5 0.2 8,482
Don’t know/missing * * * * * * 17
Residence
Urban 49.1 8.3 36.4 40.5 24.9 0.1 4,222
Rural 41.1 8.3 28.1 33.8 18.6 0.4 5,108
Zone
Coastal 54.0 11.4 42.9 44.1 30.4 0.3 4,062
Middle 45.4 7.0 29.7 38.1 16.4 0.3 3,568
Northern 21.3 3.6 9.9 16.6 10.7 0.0 1,701
Region
Western 61.4 14.4 48.6 48.8 34.2 0.7 1,200
Central 44.3 5.8 31.9 34.8 21.6 0.3 874
Greater Accra 48.3 9.9 40.8 41.7 31.6 0.3 1,210
Volta 62.3 15.2 49.9 51.0 32.3 0.0 777
Eastern 32.3 5.0 22.5 24.6 11.6 0.1 976
Ashanti 61.4 9.5 42.0 54.0 23.4 0.2 1,562
Brong Ahafo 33.5 5.2 17.9 26.9 10.4 0.4 1,030
Northern 19.3 3.8 10.6 14.9 10.3 0.0 1,005
Upper East 27.4 2.9 9.8 22.4 12.9 0.0 401
Upper West 19.9 3.6 7.7 14.4 9.3 0.2 294
Mother’s education
No education 34.6 8.1 22.6 28.7 17.6 0.0 2,355
Primary 44.8 9.9 33.6 36.0 20.6 0.2 1,708
Middle/JSS/JHS 49.9 8.3 35.9 40.8 22.7 0.4 3,704
Secondary/SSS/SHS 48.6 6.0 34.2 41.3 25.4 0.3 1,090
More than secondary 45.7 8.4 34.6 37.7 24.5 0.4 473
Wealth quintile
Lowest 36.8 10.5 25.4 30.4 19.0 0.2 2,139
Second 44.0 7.3 29.2 35.4 19.3 0.3 2,128
Middle 47.2 7.9 34.2 38.9 20.4 0.2 1,943
Fourth 48.9 7.0 34.6 40.8 24.8 0.3 1,782
Highest 49.4 8.5 39.3 41.1 26.0 0.3 1,337
Total 44.7 8.3 31.9 36.8 21.5 0.3 9,330

Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed.

68 • Maternal Health Care

Table 5.5 Number of antenatal care visits and timing of first visit

Percent distribution of women age 15-49 who had a live birth or stillbirth in the 5
years preceding the survey by number of antenatal care (ANC) visits for the most
recent live birth or stillbirth and by the timing of the first visit, and among women
with ANC, median months pregnant at first visit, according to residence, Ghana
MHS 2017
Residence
Number of ANC visits and timing of first visit Urban Rural Total
Number of ANC visits
None 1.5 3.1 2.3
1 0.8 1.8 1.3
2-3 4.5 9.1 6.9
4+ 93.2 85.7 89.3
Don’t know/missing 0.1 0.3 0.2
Total 100.0 100.0 100.0
Number of months pregnant at time of
first ANC visit
No antenatal care 1.5 3.1 2.3
<4 66.5 61.9 64.2
4-5 26.3 28.0 27.2
6-7 4.9 6.2 5.6
8+ 0.6 0.6 0.6
Don’t know/missing 0.1 0.2 0.2
Total 100.0 100.0 100.0
Number of women 5,286 5,655 10,940
Median months pregnant at first visit (for
those with ANC) 3.5 3.6 3.5
Number of women with ANC 5,207 5,480 10,687

Maternal Health Care • 69

 Table 5.6 Components of antenatal care

Among women age 15-49 with a live birth or stillbirth in the 5 years preceding the survey, percentages who took iron tablets or syrup and drugs for intestinal
parasites during the pregnancy of the most recent live birth or stillbirth, and among women receiving antenatal care (ANC) for the most recent live birth or
stillbirth in the 5 years preceding the survey, percentage receiving specific antenatal services, according to background characteristics, Ghana MHS 2017
Among women with a live
birth or stillbirth in the past 5
years, percentage who during Among women who received antenatal care for their most recent
the pregnancy of their most birth or stillbirth in the past 5 years, percentage with
recent live birth or stillbirth: selected services
Number of Number of
women Number of Told about women who
with a live Told about women with where to were told
Took Took birth or signs of ANC for go for about signs
iron intestinal stillbirth in Blood Urine Blood pregnancy their most pregnancy of pregnancy
Background tablets parasite the past pressure sample sample compli- recent birth compli- compli-
characteristic or syrup drugs 5 years measured taken taken Weighed cations or stillbirth cations cations
Age at birth
<20 91.3 39.7 1,250 98.8 96.8 97.6 98.9 79.9 1,219 95.5 974
20-34 92.9 39.8 7,614 99.5 98.0 98.4 99.4 85.7 7,444 97.6 6,380
35-49 92.4 39.9 2,077 99.6 97.4 98.7 99.5 86.5 2,024 98.1 1,750
Birth order
1 93.3 39.3 2,032 99.0 97.7 97.9 98.9 84.7 2,007 97.2 1,700
2-3 93.6 39.6 3,849 99.5 98.0 98.7 99.5 85.2 3,768 97.4 3,210
4-5 92.2 38.3 2,772 99.6 97.9 98.4 99.4 86.2 2,708 97.8 2,334
6+ 90.7 42.5 2,288 99.5 97.1 98.3 99.5 84.4 2,204 97.4 1,859
Residence
Urban 93.7 38.1 5,286 99.3 99.1 99.0 99.3 86.1 5,207 97.6 4,485
Rural 91.6 41.5 5,655 99.5 96.5 97.8 99.4 84.3 5,480 97.3 4,618
Zone
Coastal 90.3 39.8 4,916 99.3 99.2 98.8 99.3 86.0 4,771 98.1 4,104
Middle 93.9 37.9 4,243 99.6 99.1 98.8 99.3 85.1 4,164 96.6 3,543
Northern 95.8 44.4 1,782 99.4 90.5 96.4 99.6 83.1 1,752 97.7 1,456
Region
Western 88.8 47.2 1,415 99.1 99.2 99.2 99.7 88.2 1,368 97.7 1,207
Central 93.0 45.9 986 99.0 99.1 98.7 99.2 80.6 963 98.1 776
Greater Accra 94.7 31.1 1,613 99.2 99.5 99.0 99.1 86.4 1,578 99.0 1,363
Volta 81.7 37.0 902 99.8 98.8 98.0 99.2 88.0 862 97.2 759
Eastern 94.6 40.9 1,086 99.4 98.7 98.6 98.9 91.2 1,056 99.3 963
Ashanti 93.6 38.8 2,017 99.7 99.3 99.0 99.4 85.6 1,975 97.0 1,692
Brong Ahafo 93.9 33.6 1,140 99.5 99.3 98.5 99.5 78.5 1,132 92.9 888
Northern 95.1 37.1 1,056 99.4 87.0 95.1 99.6 82.2 1,032 98.1 849
Upper East 97.6 59.7 424 99.4 94.5 98.3 99.7 85.7 422 98.7 362
Upper West 95.9 48.3 301 99.5 97.4 98.0 99.6 82.5 298 95.2 246
Education
No education 90.2 39.4 2,625 99.6 94.2 97.4 99.1 82.7 2,514 96.8 2,080
Primary 90.0 40.4 1,942 98.9 97.5 97.5 99.0 81.6 1,881 96.9 1,535
Middle/JSS/JHS 94.2 41.4 4,332 99.6 99.3 98.9 99.6 86.9 4,262 97.5 3,702
Secondary/SSS/SHS 94.3 38.0 1,368 99.3 99.2 99.1 99.6 89.1 1,356 98.0 1,209
More than secondary 95.7 33.4 673 99.6 99.5 99.8 99.5 85.9 673 99.5 579
Wealth quintile
Lowest 89.3 37.9 2,344 99.0 92.8 96.1 99.1 80.3 2,243 96.8 1,802
Second 91.5 43.8 2,363 99.4 98.1 98.6 99.2 84.5 2,293 97.0 1,938
Middle 92.0 40.6 2,202 99.5 98.9 98.5 99.2 86.3 2,151 97.6 1,856
Fourth 95.0 40.6 2,151 99.4 99.5 99.2 99.7 87.6 2,126 98.2 1,862
Highest 96.1 35.4 1,881 99.7 99.8 99.8 99.7 87.8 1,875 97.8 1,646
Total 92.6 39.8 10,940 99.4 97.8 98.4 99.4 85.2 10,687 97.5 9,104

70 • Maternal Health Care

Table 5.7 Tetanus toxoid injections

Among mothers age 15-49 with a live birth or stillbirth in the 5 years preceding the survey,
percentage receiving two or more tetanus toxoid injections during the pregnancy for the most
recent live birth or stillbirth and percentage whose most recent live birth or stillbirth was protected
against neonatal tetanus, according to background characteristics, Ghana MHS 2017

Percentage receiving Percentage whose

two or more injections most recent live birth
during the pregnancy or stillbirth was
Background for the most recent live protected against Number
characteristic birth or stillbirth neonatal tetanus1 of mothers

Age at birth
<20 56.0 64.1 1,250
20-34 59.2 78.2 7,614
35-49 54.7 78.7 2,077
Birth order
1 62.6 69.3 2,032
2-3 60.4 77.9 3,849
4-5 57.0 80.3 2,772
6+ 51.1 76.9 2,288
Residence
Urban 61.2 80.2 5,286
Rural 55.1 73.4 5,655
Zone
Coastal 59.7 79.5 4,916
Middle 59.3 78.0 4,243
Northern 50.4 66.1 1,782
Region
Western 57.2 76.2 1,415
Central 68.4 82.3 986
Greater Accra 63.3 81.6 1,613
Volta 47.6 77.7 902
Eastern 61.0 79.8 1,086
Ashanti 62.5 81.2 2,017
Brong Ahafo 52.2 70.7 1,140
Northern 49.2 65.8 1,056
Upper East 50.8 61.9 424
Upper West 53.9 73.0 301
Education
No education 50.2 69.6 2,625
Primary 53.5 74.3 1,942
Middle/JSS/JHS 61.1 79.0 4,332
Secondary/SSS/SHS 64.4 80.4 1,368
More than secondary 68.6 88.9 673
Wealth quintile
Lowest 47.2 65.5 2,344
Second 56.2 74.9 2,363
Middle 57.4 77.9 2,202
Fourth 64.2 81.7 2,151
Highest 67.3 86.0 1,881
Total 58.0 76.7 10,940

1
Includes mothers with two injections during the pregnancy for their most recent live birth or
stillbirth, or two or more injections (the last within 3 years of the most recent live birth or stillbirth),
or three or more injections (the last within 5 years of the most recent live birth or stillbirth), or four
or more injections (the last within 10 years of the most recent live birth or stillbirth), or five or more
injections at any time prior to the most recent live birth or stillbirth

Maternal Health Care • 71

 Table 5.8 Place of delivery

Percent distribution of live births or stillbirths in the 5 years preceding the survey by place of delivery and percentage delivered in a health facility,
according to background characteristics, Ghana MHS 2017

Health facility
Percentage
Background Public Private delivered in a Number of
characteristic sector sector Home Other Total health facility births

Mother’s age at birth

<20 70.1 9.5 19.3 1.0 100.0 79.7 1,250
20-34 67.3 11.9 19.8 1.0 100.0 79.2 7,614
35-49 66.6 9.9 22.1 1.4 100.0 76.5 2,077
Birth order
1 74.0 11.1 14.2 0.6 100.0 85.2 2,032
2-3 69.5 12.8 16.7 1.1 100.0 82.3 3,849
4-5 66.3 11.0 21.6 1.1 100.0 77.4 2,772
6+ 59.8 9.0 29.6 1.7 100.0 68.8 2,288
Antenatal care visits1
None 19.4 5.5 73.9 1.2 100.0 24.9 253
1-3 45.5 6.3 46.3 1.8 100.0 51.8 897
4+ 70.8 11.8 16.3 1.1 100.0 82.6 9,769
Don’t know/missing * * * * * * 21
Disability status2
A lot of difficulty or unable to
function in at least one domain 61.9 11.1 26.0 1.0 100.0 73.0 1,021
Some or no difficulty in all
domains 68.1 11.3 19.5 1.1 100.0 79.3 9,919
Residence
Urban 73.4 16.7 9.3 0.7 100.0 90.0 5,286
Rural 62.0 6.2 30.3 1.5 100.0 68.2 5,655
Zone
Coastal 66.2 13.2 19.8 0.9 100.0 79.3 4,916
Middle 68.9 12.6 17.1 1.3 100.0 81.6 4,243
Northern 67.8 2.6 28.4 1.3 100.0 70.4 1,782
Region
Western 66.0 11.6 21.0 1.4 100.0 77.6 1,415
Central 68.0 8.4 23.0 0.6 100.0 76.4 986
Greater Accra 71.4 20.5 7.7 0.4 100.0 91.9 1,613
Volta 55.1 7.7 36.0 1.2 100.0 62.8 902
Eastern 71.1 6.3 21.9 0.7 100.0 77.4 1,086
Ashanti 66.6 18.4 13.7 1.3 100.0 85.0 2,017
Brong Ahafo 70.9 8.6 18.7 1.8 100.0 79.5 1,140
Northern 57.0 2.2 39.8 1.1 100.0 59.2 1,056
Upper East 85.8 5.2 7.6 1.3 100.0 91.0 424
Upper West 80.2 0.3 17.6 1.9 100.0 80.5 301
Mother’s education
No education 55.2 5.4 37.8 1.6 100.0 60.7 2,625
Primary 64.9 7.9 25.8 1.5 100.0 72.8 1,942
Middle/JSS/JHS 73.2 11.8 14.0 1.0 100.0 85.0 4,332
Secondary/SSS/SHS 74.1 18.2 7.1 0.6 100.0 92.4 1,368
More than secondary 72.4 25.9 1.5 0.3 100.0 98.2 673
Wealth quintile
Lowest 52.4 3.6 41.7 2.3 100.0 56.0 2,344
Second 64.2 7.0 27.3 1.4 100.0 71.3 2,363
Middle 74.8 8.6 15.6 1.1 100.0 83.4 2,202
Fourth 75.9 14.8 8.9 0.4 100.0 90.7 2,151
Highest 72.2 25.1 2.5 0.2 100.0 97.3 1,881
Total 67.5 11.2 20.1 1.1 100.0 78.7 10,940

Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed.
1
Includes only the most recent live birth or stillbirth in the 5 years preceding the survey
2
Domains are seeing, hearing, communicating, remembering or concentrating, walking or climbing steps, and washing all over or dressing. If a
woman reported having difficulty in more than one domain, only the highest level of difficulty is shown.

72 • Maternal Health Care

Table 5.9 Reasons for not delivering in a health facility

Among women with a live birth or stillbirth in the 5 years preceding the
survey who did not deliver the most recent birth or stillbirth in a health
facility, percent distribution of reasons for not delivering in a facility,
according to residence, Ghana MHS 2017
Residence
Reason Urban Rural Total
Not necessary 11.9 10.7 11.0
Not customary 1.9 1.0 1.2
Lack of money 9.0 13.6 12.6
Too far 5.7 16.3 13.9
Transportation problems 11.1 27.7 23.9
No one to accompany 5.5 6.3 6.1
Good service not available 5.1 2.8 3.4
Not permitted by family 1.3 1.4 1.4
Better service at home 8.7 5.7 6.4
Did not know where to go 0.8 0.2 0.4
No female doctor available 0.0 0.4 0.3
Inconvenient service hour 5.7 7.6 7.2
Afraid to go 5.1 2.0 2.7
Long waiting time 4.9 4.5 4.6
Religious reason 1.1 0.7 0.8
Baby came earlier than expected 32.6 23.2 25.3
Other 4.4 2.1 2.6
Number of women 527 1,799 2,326

Note: Respondents may have mentioned more than one reason.

Maternal Health Care • 73

 Table 5.10 Payments for delivery care

Among women with a live birth or stillbirth in the 5 years preceding the survey who delivered the most recent birth or stillbirth in a public
sector health facility, percentage asked to make payments for delivery care and percentage asked to pay for specific components of care,
according to background characteristics, Ghana MHS 2017

Asked to Percentage who paid: Number of

make To see the women who
Background payments for doctor or For laboratory For other Other delivered in
characteristic delivery care nurse For drugs tests supplies payments public sector
Mother’s age at birth
<20 51.1 9.7 37.0 20.1 30.2 1.8 877
20-34 52.2 9.0 38.2 22.1 32.6 1.1 5,124
35-49 52.4 10.2 40.6 22.8 32.9 1.5 1,383
Birth order
1 50.7 9.0 37.5 21.2 30.6 0.8 1,505
2-3 52.0 9.3 37.7 22.0 32.3 1.6 2,674
4-5 52.5 8.5 38.9 23.0 33.8 1.3 1,839
6+ 53.5 10.9 40.6 21.7 32.6 1.0 1,367
Antenatal care visits2
None (65.8) (35.7) (63.6) (45.7) (58.8) (0.0) 49
1-3 55.3 10.7 41.8 20.5 31.6 3.1 409
4+ 51.8 9.1 38.2 21.9 32.2 1.1 6,913
Don’t know/missing * * * * * * 13
Residence
Urban 56.5 10.2 43.8 26.6 34.2 0.9 3,878
Rural 47.2 8.4 32.6 16.9 30.3 1.6 3,506
Zone
Coastal 64.6 13.1 50.8 32.0 42.7 0.9 3,253
Middle 50.9 7.6 35.7 17.9 28.5 1.8 2,924
Northern 21.2 3.4 12.1 5.2 13.9 0.8 1,207
Region
Western 77.9 21.8 59.3 30.6 52.0 1.7 934
Central 50.3 6.0 32.6 21.4 30.6 0.9 670
Greater Accra 62.1 13.3 54.2 42.2 39.4 0.7 1,152
Volta 64.8 6.2 51.6 25.2 49.3 0.0 497
Eastern 36.6 6.5 24.3 11.4 18.2 1.1 772
Ashanti 63.4 9.4 45.9 22.7 36.8 2.4 1,344
Brong Ahafo 44.0 5.5 29.4 16.1 24.7 1.6 808
Northern 24.9 3.5 14.4 5.7 17.6 1.5 602
Upper East 19.2 3.6 10.9 5.4 10.7 0.0 364
Upper West 14.9 2.8 8.3 3.4 9.2 0.1 242
Mother’s education
No education 40.1 8.6 28.2 14.8 27.1 0.7 1,450
Primary 50.8 10.3 39.7 21.6 31.3 0.9 1,260
Middle/JSS/JHS 56.7 9.2 40.2 23.9 34.3 1.7 3,173
Secondary/SSS/SHS 57.3 9.8 44.4 26.3 36.3 0.6 1,014
More than secondary 50.4 9.4 42.7 23.3 29.9 1.9 487
Wealth quintile
Lowest 38.6 8.6 26.4 13.2 27.1 0.7 1,229
Second 50.7 8.5 35.2 19.4 31.5 1.5 1,518
Middle 56.2 10.7 40.8 21.8 35.8 1.7 1,647
Fourth 54.4 8.5 40.3 22.8 32.1 0.8 1,632
Highest 58.2 10.4 48.1 32.3 34.3 1.4 1,359
Total 52.1 9.4 38.5 22.0 32.4 1.2 7,384

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25
unweighted cases and has been suppressed.

74 • Maternal Health Care

Table 5.11 Assistance during delivery

Percent distribution of most recent live births or stillbirths in the 5 years preceding the survey by person providing assistance during delivery and percentage
of deliveries assisted by a skilled provider, according to background characteristics, Ghana MHS 2017
Person providing assistance during delivery
Com-
munity
health Traditional Percentage
Background Nurse/ officer/ birth Relative/ delivered by a Number of
characteristic Doctor midwife nurse attendant friend Other1 No one Total skilled provider2 births
Mother’s age at birth
<20 9.2 69.5 1.5 8.9 6.3 2.5 2.0 100.0 80.2 1,250
20-34 15.5 63.1 1.3 9.4 5.8 2.0 2.9 100.0 79.9 7,614
35-49 20.7 55.1 1.1 9.1 7.4 2.4 4.2 100.0 76.9 2,077
Birth order
1 15.1 69.6 1.3 6.9 4.2 1.9 1.0 100.0 86.0 2,032
2-3 15.9 66.0 1.3 8.0 5.1 1.4 2.3 100.0 83.2 3,849
4-5 15.8 60.7 1.1 9.8 6.5 2.3 3.8 100.0 77.6 2,772
6+ 16.3 51.7 1.2 12.9 9.3 3.3 5.3 100.0 69.2 2,288
Antenatal care visits3
None 3.7 19.9 0.5 32.9 25.2 7.7 10.1 100.0 24.1 253
1-3 6.7 44.8 1.6 19.9 14.9 4.6 7.5 100.0 53.1 897
4+ 17.0 65.0 1.2 7.7 4.9 1.8 2.5 100.0 83.2 9,769
Don’t know/missing * * * * * * * * * 21
Place of delivery
Health facility 20.0 78.0 1.5 0.1 0.0 0.1 0.3 100.0 99.5 8,614
Public facility 19.4 78.5 1.6 0.0 0.0 0.0 0.3 100.0 99.6 7,384
Private facility 23.6 74.8 0.8 0.4 0.1 0.4 0.0 100.0 99.1 1,230
Elsewhere 0.2 4.3 0.3 43.3 28.9 9.7 13.4 100.0 4.7 2,326
Residence
Urban 20.6 69.6 0.4 3.6 2.6 1.1 2.1 100.0 90.6 5,286
Rural 11.3 55.5 2.1 14.6 9.5 3.1 3.9 100.0 68.9 5,655
Zone
Coastal 18.2 60.5 1.1 8.8 5.9 2.6 2.8 100.0 79.9 4,916
Middle 16.4 65.1 0.9 7.6 4.8 1.5 3.7 100.0 82.4 4,243
Northern 7.7 60.7 2.4 14.5 10.3 2.4 2.1 100.0 70.8 1,782
Region
Western 13.4 62.0 2.9 10.4 4.1 2.0 5.1 100.0 78.3 1,415
Central 15.3 62.7 0.2 11.7 4.2 4.2 1.7 100.0 78.2 986
Greater Accra 25.6 65.7 0.8 3.0 2.0 1.2 1.6 100.0 92.1 1,613
Volta 15.7 46.5 0.1 13.6 17.3 4.2 2.5 100.0 62.4 902
Eastern 14.0 63.9 0.4 11.2 3.8 3.0 3.6 100.0 78.3 1,086
Ashanti 19.1 66.4 0.4 4.9 5.0 0.9 3.3 100.0 85.9 2,017
Brong Ahafo 13.8 63.8 2.4 8.9 5.5 1.0 4.6 100.0 80.0 1,140
Northern 6.6 51.6 1.2 22.5 12.3 3.3 2.5 100.0 59.3 1,056
Upper East 8.2 79.5 4.1 1.5 5.3 0.7 0.7 100.0 91.8 424
Upper West 11.0 66.2 4.0 4.5 10.0 1.5 2.8 100.0 81.3 301
Mother’s education
No education 8.7 50.7 1.8 17.4 13.0 3.6 4.9 100.0 61.2 2,625
Primary 13.1 58.6 1.4 11.9 7.7 2.6 4.8 100.0 73.1 1,942
Middle/JSS/JHS 17.0 67.7 1.1 6.6 3.6 1.8 2.2 100.0 85.8 4,332
Secondary/SSS/SHS 20.5 72.5 0.3 2.9 1.9 0.8 1.2 100.0 93.3 1,368
More than secondary 34.2 63.1 1.4 0.4 0.5 0.0 0.4 100.0 98.7 673
Wealth quintile
Lowest 6.8 47.5 2.6 19.7 14.6 3.7 5.2 100.0 56.9 2,344
Second 11.6 58.7 1.4 13.8 7.3 3.1 3.9 100.0 71.8 2,363
Middle 14.7 67.9 0.8 6.6 4.8 1.9 3.4 100.0 83.4 2,202
Fourth 18.4 73.3 0.6 3.2 2.1 1.1 1.3 100.0 92.3 2,151
Highest 30.5 66.3 0.7 0.7 0.5 0.4 1.0 100.0 97.5 1,881
Total 15.8 62.3 1.3 9.3 6.2 2.1 3.1 100.0 79.4 10,940

Note: If the respondent mentioned more than one person attending during delivery, only the most qualified person is considered in this tabulation. An asterisk
indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed.
1
Other includes village health volunteer, traditional health practitioner, and other.
2
Skilled provider includes doctor, nurse/midwife, and community health officer/nurse.
3
Includes only the most recent birth or stillbirth in the 5 years preceding the survey

Maternal Health Care • 75

 Table 5.12 Delivery interventions including Caesarean section

Among most recent live births and stillbirths in the 5 years preceding the survey delivered in a health facility, percentage for which instruments
were used, percentage where a blood transfusion was received, percentage where intravenous fluid was used, percentage delivered by Caesarean
section (C-section), percentage delivered by C-section that was planned before the onset of labour pains, and percentage delivered by C-section
that was decided after the onset of labour pains, according to background characteristics, Ghana MHS 2017
Percentage Timing of decision to conduct
where C-section
instruments
(forceps or Percentage Percentage
vacuum) were where blood where Percentage Decided Decided Number of
Background used during transfusion intravenous delivered by before onset of after onset of births in health
characteristic delivery was received fluid was used C-section labour pains labour pains facilities
Mother’s age at birth
<20 5.1 6.1 59.8 8.1 2.9 5.2 995
20-34 3.7 4.9 58.1 15.9 8.4 7.4 6,030
35-49 3.0 5.4 57.5 21.7 14.4 7.3 1,589
Birth order
1 4.3 6.5 64.6 14.1 5.1 9.0 1,731
2-3 4.1 4.6 57.7 16.4 9.3 7.1 3,166
4-5 3.1 4.9 55.9 14.2 9.0 5.2 2,144
6+ 3.1 4.9 55.3 19.8 12.0 7.8 1,573
Antenatal care visits1
None (2.1) (22.0) (52.4) (14.8) (3.3) (11.5) 63
1-3 3.5 5.8 56.4 7.6 2.9 4.7 465
4+ 3.8 5.0 58.3 16.6 9.3 7.3 8,070
Don’t know/missing * * * * * * 16
Place of delivery
Health facility 3.7 5.1 58.2 16.0 8.9 7.2 8,614
Public facility 3.8 5.4 57.7 15.8 8.5 7.3 7,384
Private facility 3.0 3.2 60.9 17.2 11.0 6.2 1,230
Residence
Urban 3.9 5.0 61.9 19.2 11.4 7.7 4,758
Rural 3.5 5.3 53.6 12.2 5.8 6.4 3,855
Zone
Coastal 3.8 5.9 66.5 18.7 10.4 8.3 3,900
Middle 3.5 4.4 54.9 16.1 9.0 7.1 3,460
Northern 4.1 4.7 41.5 7.7 4.0 3.8 1,254
Region
Western 2.7 3.8 60.1 13.7 6.4 7.3 1,098
Central 3.6 7.0 67.0 17.5 9.8 7.6 753
Greater Accra 4.6 6.1 73.7 23.6 15.0 8.6 1,483
Volta 4.2 7.8 59.6 17.0 6.5 10.5 567
Eastern 3.6 5.0 57.0 15.4 8.8 6.6 840
Ashanti 3.3 4.1 56.4 17.4 10.0 7.5 1,714
Brong Ahafo 3.7 4.3 49.9 14.1 7.4 6.7 906
Northern 2.4 4.9 45.3 8.3 4.5 3.9 625
Upper East 5.8 4.3 40.8 6.7 3.3 3.4 386
Upper West 5.9 4.9 32.4 7.8 3.7 4.1 243
Mother’s education
No education 2.3 5.0 47.0 10.7 5.6 5.1 1,592
Primary 3.0 5.2 55.0 13.0 5.9 7.1 1,413
Middle/JSS/JHS 4.3 5.2 60.6 16.3 8.5 7.8 3,684
Secondary/SSS/SHS 4.1 5.5 64.4 18.7 11.3 7.4 1,264
More than secondary 4.8 4.1 66.8 29.1 20.9 8.2 662
Wealth quintile
Lowest 3.2 5.4 46.7 8.5 4.1 4.4 1,313
Second 2.9 5.4 54.3 11.7 5.3 6.4 1,684
Middle 4.1 4.7 55.5 13.6 5.0 8.7 1,836
Fourth 4.2 5.0 62.7 17.5 9.4 8.1 1,951
Highest 4.0 5.2 67.9 26.3 19.0 7.2 1,830
Total 3.7 5.1 58.2 16.0 8.9 7.2 8,614

Note: Questions on instruments, blood transfusions, intravenous fluids, and C-section were asked only of women who delivered in a health facility.
In this table, it is assumed that women who did not give birth in a health facility did not receive any interventions. Figures in parentheses are based
on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed.
1
Includes only the most recent birth or stillbirth in the 5 years preceding the survey

76 • Maternal Health Care

Table 5.13 Duration of stay in health facility after birth

Among women with a birth or stillbirth in the 5 years preceding the survey who delivered their most recent live birth or stillbirth in a
health facility, percent distribution by duration of stay in the health facility following their most recent live birth or stillbirth, according to
type of delivery, Ghana MHS 2017
Number of
Type of delivery <6 hours 6-11 hours 12-23 hours 1-2 days 3+ days Missing Total women
Vaginal birth 15.5 20.5 15.9 36.4 11.6 0.1 100.0 7,231
Caesarean section 1.6 0.1 0.2 6.0 92.1 0.0 100.0 1,381
Missing 0.0 0.0 0.0 0.0 0.0 100.0 100.0 2

Table 5.14 Problems encountered during delivery

Among women with a live birth or stillbirth in the 5 years preceding the
survey, percentage who had problems during the delivery of the most recent
live birth or stillbirth, and percentage who had no problems; among women
who had problems during delivery, percent distribution of specific problems;
and among women who had problems during delivery, percentage who saw
somebody about the problem(s) and percentage who did not see somebody,
according to residence, Ghana MHS 2017
Residence
Problems Urban Rural Total
Problems during delivery
Any problem 19.9 17.6 18.7
No problems 80.1 82.4 81.3
Total 100.0 100.0 100.0
Number of women 5,286 5,655 10,940
Specific problem
Headache 9.2 13.1 11.1
Blurry vision 10.2 14.1 12.1
Oedema/pre-eclampsia 15.3 11.1 13.3
Vaginal bleeding 30.4 29.3 29.9
Convulsions/eclampsia 1.3 0.6 1.0
Tetanus 0.0 0.2 0.1
Foul-smelling discharge 0.9 2.3 1.6
Baby movement was low 2.8 1.9 2.4
Baby’s hands/feet came out first 2.0 0.7 1.4
Prolonged labour 11.2 11.3 11.2
Obstructed labour 1.6 1.7 1.6
Torn uterus 3.5 1.2 2.4
Placenta previa/retained 4.4 6.6 5.5
High fever 1.7 2.5 2.1
Fistula 1.0 0.8 0.9
Other 22.1 21.2 21.6
Number of women 1,052 992 2,045
Saw somebody about problems
Yes 93.8 87.2 90.6
No 6.2 12.8 9.4
Total 100.0 100.0 100.0
Number of women 1,052 992 2,045

Note: Respondents may have mentioned more than one problem.

Maternal Health Care • 77

 Table 5.15 Timing of first postnatal check for the mother

Among women age 15-49 giving birth in the 2 years preceding the survey, percent distribution of the mother’s first postnatal check for the most recent live
birth or stillbirth by time after delivery, and percentage of women with a live birth or stillbirth in the 2 years preceding the survey who received a postnatal
check during the first 2 days after giving birth, according to background characteristics, Ghana MHS 2017
Time after delivery of mother’s first postnatal check 1 Percentage of
women with a
Don’t No postnatal check
Background Less than know/ postnatal during the first 2 Number of
characteristic 4 hours 4-23 hours 1-2 days 3-6 days 7-41 days missing check2 Total days after birth1 women
Age at birth
<20 73.1 6.6 5.0 0.7 1.6 0.6 12.3 100.0 84.7 713
20-34 71.8 8.8 3.8 1.4 1.9 0.6 11.7 100.0 84.4 4,212
35-49 73.7 6.2 3.7 1.0 1.8 0.8 12.8 100.0 83.6 994
Birth order
1 72.9 8.3 5.2 0.9 1.9 0.6 10.1 100.0 86.5 1,187
2-3 74.6 8.5 3.5 1.3 1.4 0.9 9.7 100.0 86.6 2,208
4-5 72.0 7.9 3.6 1.6 1.9 0.6 12.5 100.0 83.5 1,410
6+ 67.4 7.4 3.7 1.1 2.6 0.2 17.6 100.0 78.5 1,114
Place of delivery
Health facility 81.9 9.3 3.3 0.6 1.1 0.8 3.0 100.0 94.5 4,691
Elsewhere 35.5 3.6 6.2 3.8 4.7 0.2 46.1 100.0 45.3 1,228
Residence
Urban 77.6 9.2 3.2 0.9 1.1 0.7 7.3 100.0 90.0 2,842
Rural 67.4 7.1 4.6 1.6 2.6 0.6 16.2 100.0 79.1 3,076
Zone
Coastal 70.4 9.1 4.9 1.2 2.2 0.5 11.7 100.0 84.4 2,700
Middle 79.2 6.1 1.6 1.0 1.4 0.8 9.9 100.0 86.9 2,223
Northern 61.9 10.2 6.3 2.1 2.0 0.5 17.1 100.0 78.3 995
Region
Western 76.4 6.2 2.1 1.5 2.5 0.5 10.8 100.0 84.6 813
Central 68.2 9.4 3.8 1.4 1.9 0.5 14.7 100.0 81.5 548
Greater Accra 76.5 12.2 1.8 1.0 0.6 0.6 7.2 100.0 90.6 846
Volta 52.4 7.9 16.2 0.7 4.8 0.3 17.6 100.0 76.6 494
Eastern 79.6 5.7 1.3 1.0 0.5 0.8 11.1 100.0 86.6 570
Ashanti 81.9 5.1 1.4 0.9 1.6 0.6 8.5 100.0 88.4 1,076
Brong Ahafo 74.0 8.0 2.5 1.1 1.7 1.2 11.5 100.0 84.5 577
Northern 57.5 8.4 4.6 2.6 2.3 0.1 24.5 100.0 70.5 603
Upper East 64.9 16.0 9.1 1.5 1.4 1.7 5.5 100.0 90.0 232
Upper West 73.8 8.4 8.5 0.8 1.9 0.4 6.1 100.0 90.8 161
Education
No education 61.4 6.1 4.5 1.8 2.5 0.5 23.2 100.0 72.0 1,322
Primary 67.9 7.6 3.9 1.1 2.9 0.4 16.1 100.0 79.4 1,025
Middle/JSS/JHS 76.8 8.1 4.1 1.1 1.4 0.7 7.7 100.0 89.0 2,339
Secondary/SSS/SHS 78.4 11.1 2.8 1.1 1.3 0.4 4.9 100.0 92.3 827
More than secondary 80.4 9.8 3.3 1.0 0.7 1.6 3.2 100.0 93.5 404
Wealth quintile
Lowest 58.5 6.5 5.6 2.2 3.1 0.6 23.5 100.0 70.5 1,325
Second 71.7 7.2 4.1 1.2 2.1 0.4 13.4 100.0 82.9 1,243
Middle 75.6 7.1 3.5 1.1 1.8 0.7 10.1 100.0 86.3 1,200
Fourth 77.4 10.1 3.1 0.7 1.5 0.9 6.3 100.0 90.6 1,140
Highest 81.4 10.4 3.0 1.1 0.3 0.5 3.4 100.0 94.7 1,010
Total 72.3 8.1 3.9 1.3 1.9 0.6 11.9 100.0 84.3 5,919

1
Includes women who received a check from a doctor, nurse/midwife, community health officer/nurse, traditional birth attendant, or village health volunteer
2
Includes women who received a check after 41 days

78 • Maternal Health Care

Table 5.16 Type of provider of first postnatal check for the mother

Among women age 15-49 giving birth in the 2 years preceding the survey, percent distribution by type of provider for the mother’s first postnatal
health check during the 2 days after the last live birth or stillbirth, according to background characteristics, Ghana MHS 2017
Type of health provider of mother’s first postnatal check No postnatal
Community Village Traditional check during
Background Doctor/nurse/ health health birth the first 2 days Number of
characteristic midwife officer/nurse volunteer attendant after birth Total women
Age at birth
<20 74.8 1.9 0.7 7.3 15.3 100.0 713
20-34 76.4 1.7 0.3 6.0 15.6 100.0 4,212
35-49 76.3 1.9 0.3 5.0 16.4 100.0 994
Birth order
1 79.2 2.2 0.4 4.7 13.5 100.0 1,187
2-3 79.6 1.7 0.2 5.1 13.4 100.0 2,208
4-5 75.4 1.5 0.4 6.2 16.5 100.0 1,410
6+ 67.4 1.9 0.5 8.8 21.5 100.0 1,114
Place of delivery
Health facility 92.4 2.0 0.0 0.1 5.5 100.0 4,691
Elsewhere 14.2 1.0 1.7 28.4 54.7 100.0 1,228
Residence
Urban 87.0 0.4 0.1 2.5 10.0 100.0 2,842
Rural 66.2 3.0 0.6 9.2 20.9 100.0 3,076
Zone
Coastal 76.6 1.7 0.1 6.0 15.6 100.0 2,700
Middle 79.7 1.2 0.3 5.8 13.1 100.0 2,223
Northern 67.3 3.4 1.2 6.4 21.7 100.0 995
Region
Western 72.6 3.8 0.2 8.1 15.4 100.0 813
Central 75.4 0.7 0.0 5.5 18.5 100.0 548
Greater Accra 87.0 1.0 0.0 2.5 9.4 100.0 846
Volta 67.0 0.5 0.0 9.0 23.4 100.0 494
Eastern 74.9 1.1 0.0 10.7 13.4 100.0 570
Ashanti 84.7 0.0 0.6 3.2 11.6 100.0 1,076
Brong Ahafo 75.1 3.5 0.2 5.7 15.5 100.0 577
Northern 56.9 1.8 1.8 10.0 29.5 100.0 603
Upper East 85.3 4.1 0.2 0.5 10.0 100.0 232
Upper West 80.5 8.4 0.4 1.5 9.2 100.0 161
Education
No education 57.3 2.4 0.9 11.5 28.0 100.0 1,322
Primary 69.9 2.2 0.1 7.3 20.6 100.0 1,025
Middle/JSS/JHS 82.4 1.6 0.4 4.7 11.0 100.0 2,339
Secondary/SSS/SHS 89.8 0.5 0.0 2.0 7.7 100.0 827
More than secondary 90.5 2.8 0.0 0.2 6.5 100.0 404
Wealth quintile
Lowest 53.3 3.6 1.0 12.7 29.5 100.0 1,325
Second 71.1 2.5 0.5 8.9 17.1 100.0 1,243
Middle 81.5 0.9 0.1 3.9 13.7 100.0 1,200
Fourth 87.7 0.6 0.1 2.2 9.4 100.0 1,140
Highest 93.3 1.0 0.0 0.4 5.3 100.0 1,010
Total 76.2 1.8 0.4 6.0 15.7 100.0 5,919

Maternal Health Care • 79

 Table 5.17 Timing of first postnatal check for the newborn

Percent distribution of most recent live births in the 2 years preceding the survey by time after birth of first postnatal check, and percentage of births
with a postnatal check during the first 2 days after birth, according to background characteristics, Ghana MHS 2017

Percentage of
births with a
Time after birth of newborn’s first postnatal check1
postnatal
Don’t No check during
Background Less than know/ postnatal the first 2 days Number of
characteristic 1 hour 1-3 hours 4-23 hours 1-2 days 3-6 days missing check2 Total after birth1 live births
Mother’s age at birth
<20 52.8 19.1 5.5 3.7 1.7 1.0 16.3 100.0 81.1 701
20-34 51.6 19.3 7.0 3.9 2.2 1.1 14.8 100.0 81.9 4,125
35-49 50.5 20.4 5.1 3.8 1.7 1.5 17.1 100.0 79.8 973
Birth order
1 55.4 20.2 6.4 4.0 1.9 1.5 10.7 100.0 86.0 1,549
2-3 53.4 20.0 6.9 3.5 2.0 1.5 12.7 100.0 83.9 2,363
4-5 48.8 18.8 6.2 4.3 2.3 0.7 18.9 100.0 78.1 1,209
6+ 41.6 17.0 6.1 3.8 2.3 0.3 29.0 100.0 68.5 678
Place of delivery
Health facility 59.9 23.1 7.5 3.2 0.8 1.4 4.0 100.0 93.8 4,590
Elsewhere 20.1 5.5 2.7 6.3 6.7 0.2 58.6 100.0 34.6 1,210
Residence
Urban 53.7 23.2 7.3 3.6 1.6 1.7 9.0 100.0 87.7 2,783
Rural 49.7 16.0 5.8 4.1 2.5 0.6 21.2 100.0 75.6 3,016
Zone
Coastal 47.3 21.8 7.5 4.7 2.2 1.1 15.5 100.0 81.2 2,652
Middle 61.6 16.4 4.2 2.3 1.0 1.5 13.0 100.0 84.5 2,165
Northern 41.3 19.9 9.1 5.1 3.8 0.7 20.2 100.0 75.3 982
Region
Western 63.8 13.8 3.7 1.2 0.8 0.3 16.4 100.0 82.5 793
Central 37.8 31.4 6.7 3.5 2.2 1.0 17.3 100.0 79.5 536
Greater Accra 47.3 26.3 11.7 2.3 3.2 2.3 7.0 100.0 87.5 832
Volta 30.9 16.4 7.5 15.5 3.1 0.3 26.3 100.0 70.3 491
Eastern 70.1 9.6 3.8 2.4 0.8 0.3 13.1 100.0 85.8 561
Ashanti 60.0 20.7 4.5 1.8 1.1 1.0 10.7 100.0 87.1 1,038
Brong Ahafo 56.0 15.4 3.9 3.0 1.2 3.5 17.0 100.0 78.3 566
Northern 36.2 19.9 6.6 3.4 4.9 0.5 28.5 100.0 66.1 595
Upper East 46.8 15.9 17.6 9.0 2.2 1.2 7.3 100.0 89.3 229
Upper West 52.2 25.3 5.9 6.3 1.8 0.4 8.0 100.0 89.8 159
Mother’s education
No education 40.8 17.1 5.1 4.3 3.5 0.9 28.3 100.0 67.3 1,299
Primary 50.6 17.0 6.5 4.0 2.2 0.7 19.0 100.0 78.1 1,004
Middle/JSS/JHS 55.8 20.4 6.0 4.0 1.3 1.2 11.3 100.0 86.2 2,288
Secondary/SSS/SHS 55.8 20.9 9.0 3.4 2.4 1.4 7.1 100.0 89.1 810
More than secondary 57.0 24.9 9.2 2.2 0.7 2.0 4.0 100.0 93.3 399
Wealth quintile
Lowest 38.2 15.7 6.4 4.8 3.1 0.5 31.3 100.0 65.1 1,307
Second 52.4 18.5 5.1 3.7 1.8 1.6 17.0 100.0 79.6 1,215
Middle 56.2 18.7 5.7 4.1 1.9 1.2 12.2 100.0 84.6 1,168
Fourth 56.8 22.2 7.2 3.9 1.4 0.9 7.6 100.0 90.2 1,123
Highest 57.0 23.5 8.7 2.5 1.9 1.7 4.7 100.0 91.7 986
Total 51.6 19.5 6.5 3.9 2.1 1.2 15.4 100.0 81.4 5,799

1
Includes newborns who received a check from a doctor, nurse/midwife, community health officer/nurse, traditional birth attendant, or village health
volunteer
2
Includes newborns who received a check after the first week of life

80 • Maternal Health Care

Table 5.18 Type of provider of first postnatal check for the newborn

Percent distribution of most recent live births in the 2 years preceding the survey by type of provider for the newborn’s first postnatal health
check during the 2 days after the birth, according to background characteristics, Ghana MHS 2017
Type of health provider of newborn’s first postnatal checkup No postnatal
Community Village Traditional check during
Background Doctor/nurse/ health health birth the first 2 days Number of
characteristic midwife officer/nurse volunteer attendant after birth Total births
Mother’s age at birth
<20 73.6 2.3 0.5 4.7 18.9 100.0 701
20-34 75.7 2.1 0.1 4.0 18.1 100.0 4,125
35-49 74.0 2.1 0.2 3.6 20.2 100.0 973
Birth order
1 80.6 2.6 0.2 2.5 14.0 100.0 1,549
2-3 78.1 1.7 0.1 4.0 16.1 100.0 2,363
4-5 71.6 1.7 0.3 4.6 21.9 100.0 1,209
6+ 58.9 2.8 0.2 6.5 31.5 100.0 678
Place of delivery
Health facility 91.4 2.3 0.0 0.1 6.2 100.0 4,590
Elsewhere 13.4 1.4 0.9 18.8 65.4 100.0 1,210
Residence
Urban 85.0 0.7 0.0 2.1 12.3 100.0 2,783
Rural 66.1 3.4 0.4 5.8 24.4 100.0 3,016
Zone
Coastal 74.8 2.2 0.0 4.2 18.8 100.0 2,652
Middle 78.9 1.2 0.3 4.2 15.5 100.0 2,165
Northern 68.0 3.7 0.4 3.2 24.7 100.0 982
Region
Western 72.6 4.2 0.1 5.5 17.5 100.0 793
Central 71.9 0.8 0.0 6.8 20.5 100.0 536
Greater Accra 84.2 1.7 0.0 1.6 12.5 100.0 832
Volta 65.4 1.4 0.0 3.5 29.7 100.0 491
Eastern 76.7 1.1 0.0 8.1 14.2 100.0 561
Ashanti 83.8 0.2 0.5 2.7 12.9 100.0 1,038
Brong Ahafo 72.0 3.2 0.2 2.9 21.7 100.0 566
Northern 57.9 2.6 0.6 5.1 33.9 100.0 595
Upper East 84.9 4.1 0.2 0.1 10.7 100.0 229
Upper West 81.5 7.4 0.1 0.7 10.2 100.0 159
Mother’s education
No education 57.6 3.0 0.4 6.2 32.7 100.0 1,299
Primary 69.7 2.0 0.1 6.2 21.9 100.0 1,004
Middle/JSS/JHS 80.6 2.1 0.2 3.3 13.8 100.0 2,288
Secondary/SSS/SHS 87.1 0.6 0.0 1.5 10.9 100.0 810
More than secondary 90.6 2.5 0.0 0.2 6.7 100.0 399
Wealth quintile
Lowest 53.8 4.1 0.5 6.8 34.9 100.0 1,307
Second 69.5 2.8 0.4 6.8 20.4 100.0 1,215
Middle 80.1 1.2 0.0 3.3 15.4 100.0 1,168
Fourth 87.8 0.7 0.0 1.6 9.8 100.0 1,123
Highest 90.1 1.3 0.0 0.3 8.3 100.0 986
Total 75.2 2.1 0.2 4.0 18.6 100.0 5,799

Maternal Health Care • 81

 Table 5.19 Content of postnatal care for newborns

Among most recent live births in the 2 years preceding the survey, percentage for whom selected functions were performed during the first 2 days
after birth and percentage with at least two signal functions performed during the first 2 days after birth, according to background characteristics,
Ghana MHS 2017
Percentage
Among most recent live births in the 2 years preceding the survey, percentage for with at least
whom the selected function was performed during the first 2 days after birth: two signal
functions
performed
Counselling Counselling Observation during the
Background Cord Temperature on danger on breast- of breast- first 2 days Number of
characteristic examined measured signs feeding feeding Weighed1 after birth births
Mother’s age at birth
<20 78.3 74.7 69.9 80.3 76.4 60.9 84.3 701
20-34 80.2 77.7 73.9 79.2 75.8 67.8 84.8 4,125
35-49 81.3 77.2 73.7 78.5 74.2 64.3 85.2 973
Birth order
1 82.6 80.1 74.8 82.9 79.9 72.4 88.4 1,549
2-3 80.2 78.7 74.7 80.5 76.2 70.6 85.6 2,363
4-5 79.0 75.5 72.5 76.2 73.4 61.9 82.7 1,209
6+ 76.6 68.9 67.4 71.4 67.5 45.6 77.6 678
Place of delivery
Health facility 84.2 83.9 79.3 84.9 80.8 81.0 90.1 4,590
Elsewhere 64.7 51.9 51.1 57.5 55.7 10.6 64.7 1,210
Residence
Urban 83.3 81.8 77.2 82.9 78.7 79.2 88.7 2,783
Rural 77.2 73.1 69.9 75.8 72.7 54.5 81.2 3,016
Zone
Coastal 79.6 76.6 73.6 78.9 74.4 67.5 84.1 2,652
Middle 84.8 80.6 74.8 82.4 79.9 67.4 89.3 2,165
Northern 71.4 71.7 69.9 72.8 69.4 61.0 76.9 982
Region
Western 78.8 75.0 70.1 74.0 69.2 62.7 80.2 793
Central 84.4 77.2 72.7 81.8 78.2 65.2 89.5 536
Greater Accra 78.5 78.2 74.8 79.1 74.6 85.3 83.0 832
Volta 77.5 75.8 78.0 83.3 78.2 47.3 86.2 491
Eastern 84.0 76.5 81.2 84.3 83.9 62.9 88.8 561
Ashanti 86.9 84.3 75.4 83.7 79.4 72.2 90.5 1,038
Brong Ahafo 81.7 77.7 67.5 78.3 77.0 63.2 87.5 566
Northern 68.2 68.3 66.8 68.6 64.9 47.5 73.5 595
Upper East 68.6 69.3 67.1 73.3 70.7 86.6 76.1 229
Upper West 87.4 88.3 85.5 87.7 84.1 74.8 90.8 159
Mother’s education
No education 72.8 68.2 66.0 70.3 67.6 46.6 75.8 1,299
Primary 78.5 74.8 69.3 76.0 72.7 54.2 81.4 1,004
Middle/JSS/JHS 83.7 81.1 77.8 83.7 80.4 70.8 89.0 2,288
Secondary/SSS/SHS 82.8 82.3 77.0 83.1 78.2 85.4 90.1 810
More than secondary 82.2 80.3 75.4 82.7 76.0 97.4 87.9 399
Wealth quintile
Lowest 69.9 65.1 63.9 68.7 66.8 41.2 73.8 1,307
Second 80.1 76.7 72.8 79.2 75.8 56.4 84.5 1,215
Middle 83.8 79.8 74.3 81.5 78.0 69.8 87.8 1,168
Fourth 86.7 86.1 79.4 84.2 80.7 80.2 91.6 1,123
Highest 82.0 80.9 78.8 84.6 78.3 92.0 88.4 986
Total 80.1 77.2 73.4 79.2 75.6 66.3 84.8 5,799

1
Captures newborns who were weighed at birth. May exclude some newborns who were weighed during the 2 days after birth.

82 • Maternal Health Care

Table 5.20 Payments for postnatal checks

Among women age 15-49 with a live birth or stillbirth in the 5 years preceding the survey who received a
postnatal check at a public sector health facility within 2 days after the most recent birth or stillbirth,
percentage asked to make payments for the check on the mother, and among women’s most recent live
births in the 5 years preceding the survey that received a check at a public sector health facility within 2 days
after birth, percentage for which women were asked to make payments for the check on the newborn,
according to background characteristics, Ghana MHS 2017
Number of Number of
Asked to make women who Asked to make newborns who
payment for received a payment for received a
Background check on postnatal check check on check within
1
characteristic mother within 2 days newborn 2 days2
Mother’s age at birth
<20 13.2 843 12.9 830
20-34 15.1 5,014 11.2 4,906
35-49 16.2 1,351 13.6 1,294
Birth order
1 14.2 1,418 11.8 1,891
2-3 15.0 2,620 11.4 2,834
4-5 16.3 1,810 12.7 1,522
6+ 14.4 1,360 11.6 783
Antenatal care visits3
None (29.4) 50 (31.2) 41
1-3 18.6 408 16.3 408
4+ 14.8 6,739 11.4 6,568
Don’t know/missing * 11 * 13
Place of delivery
Public facility 14.9 6,930 11.5 6,751
Elsewhere 20.2 277 18.5 279
Residence
Urban 16.8 3,735 13.1 3,583
Rural 13.2 3,473 10.5 3,447
Zone
Coastal 19.1 3,161 15.9 3,071
Middle 15.3 2,866 10.9 2,751
Northern 3.8 1,181 3.5 1,208
Region
Western 19.3 910 18.6 902
Central 15.4 638 10.4 625
Greater Accra 19.0 1,080 14.8 1,022
Volta 23.1 532 20.3 522
Eastern 12.8 765 9.3 770
Ashanti 19.9 1,324 14.7 1,258
Brong Ahafo 10.0 777 5.9 723
Northern 4.6 583 4.3 609
Upper East 2.5 347 1.8 347
Upper West 3.8 251 3.8 251
Mother’s education
No education 10.7 1,445 8.8 1,445
Primary 15.3 1,239 11.5 1,215
Middle/JSS/JHS 16.9 3,088 13.2 2,983
Secondary/SSS/SHS 16.3 978 12.0 934
More than secondary 13.3 458 13.1 453
Wealth quintile
Lowest 10.5 1,234 9.7 1,253
Second 12.7 1,526 10.2 1,486
Middle 16.2 1,592 12.4 1,524
Fourth 18.2 1,554 13.0 1,539
Highest 17.0 1,303 13.7 1,228
Total 15.1 7,208 11.8 7,030

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is
based on fewer than 25 unweighted cases and has been suppressed.
1
Includes checks made on women who delivered in a facility and received a check before leaving the facility
and checks made on women who did not deliver in a facility; does not include checks made on women who
delivered in a facility and had a check after leaving the facility. Includes women who received a check from
a doctor, nurse/midwife, community health officer/nurse, traditional birth attendant, or village health volunteer.
2
Includes checks made on newborns delivered in a facility who received a check before leaving the facility
and checks made on newborns who were not delivered in a facility; does not include checks made on
newborns delivered in a facility who had a check after leaving the facility. Includes newborns who received a
check from a doctor, nurse/midwife, community health officer/nurse, traditional birth attendant, or village
health volunteer.
3
Includes only the most recent live birth or stillbirth in the 5 years preceding the survey

Maternal Health Care • 83

 Table 5.21 Combinations of antenatal care, assistance at delivery, and postnatal checks

Percent distribution of women age 15-49 with a live birth or stillbirth in the 5 years preceding the survey by whether they received antenatal care (ANC) from a
skilled provider, assistance at delivery from a skilled provider, and/or a postnatal check within 2 days after delivery for the most recent live birth or stillbirth, according
to background characteristics, Ghana MHS 2017
ANC,
Assistance assistance
at delivery at delivery,
Assistance ANC and ANC and and and
Background at delivery Postnatal assistance postnatal postnatal postnatal Number of
characteristic ANC only only check only at delivery check check check None Total women
Mother’s age at birth
<20 9.5 0.1 0.7 6.1 8.6 1.0 73.0 0.9 100.0 1,250
20-34 9.7 0.1 0.6 5.1 8.6 0.5 74.2 1.2 100.0 7,614
35-49 12.2 0.0 0.3 4.5 8.7 0.6 71.8 1.8 100.0 2,077
Birth order
1 6.6 0.0 0.3 6.8 6.5 0.4 78.8 0.6 100.0 2,032
2-3 7.9 0.1 0.6 5.3 7.4 0.5 77.2 0.9 100.0 3,849
4-5 11.3 0.0 0.5 4.7 9.4 0.8 72.1 1.2 100.0 2,772
6+ 16.0 0.0 0.8 3.8 11.6 0.5 64.8 2.5 100.0 2,288
Number of months
pregnant at time of
first ANC visit
No antenatal care 0.0 2.3 21.6 0.0 0.0 21.9 0.0 54.3 100.0 253
<4 8.3 0.0 0.1 5.3 7.9 0.1 78.5 0.0 100.0 7,019
4-5 13.1 0.0 0.1 5.3 10.4 0.0 71.2 0.0 100.0 2,973
6-7 19.8 0.0 0.0 5.2 12.2 0.0 62.8 0.0 100.0 610
8+ (28.5) (0.0) (0.0) (4.9) (12.1) (0.0) (54.4) (0.0) (100.0) 67
Don’t know/missing * * * * * * * * * 18
Residence
Urban 4.1 0.1 0.4 5.7 4.3 0.6 84.2 0.6 100.0 5,286
Rural 15.8 0.0 0.7 4.6 12.7 0.5 63.7 1.9 100.0 5,655
Zone
Coastal 9.6 0.0 0.6 5.2 8.1 0.8 73.9 1.7 100.0 4,916
Middle 8.2 0.1 0.5 4.9 8.0 0.4 76.9 0.9 100.0 4,243
Northern 16.5 0.0 0.4 5.5 11.4 0.2 65.0 1.0 100.0 1,782
Region
Western 9.6 0.0 0.5 4.7 9.5 0.7 72.9 2.2 100.0 1,415
Central 11.6 0.0 0.6 6.6 8.3 0.6 70.9 1.3 100.0 986
Greater Accra 3.1 0.0 0.7 7.0 3.5 1.2 83.9 0.6 100.0 1,613
Volta 19.4 0.0 0.6 1.3 14.1 0.3 60.8 3.5 100.0 902
Eastern 9.0 0.0 1.6 3.5 10.3 0.7 74.2 0.8 100.0 1,086
Ashanti 5.7 0.2 0.3 5.3 6.9 0.3 80.0 1.2 100.0 2,017
Brong Ahafo 11.8 0.0 0.0 5.6 7.8 0.4 74.1 0.4 100.0 1,140
Northern 23.8 0.1 0.7 5.1 14.9 0.3 53.9 1.3 100.0 1,056
Upper East 4.3 0.0 0.0 7.5 3.7 0.1 84.2 0.3 100.0 424
Upper West 7.9 0.0 0.2 4.3 9.8 0.1 76.8 0.9 100.0 301
Mother’s education
No education 20.8 0.0 0.8 4.6 14.3 0.6 56.0 2.9 100.0 2,625
Primary 13.6 0.1 1.1 5.1 10.6 0.6 67.3 1.6 100.0 1,942
Middle/JSS/JHS 6.0 0.1 0.3 5.2 7.2 0.6 80.0 0.7 100.0 4,332
Secondary/SSS/SHS 3.1 0.0 0.3 5.5 3.3 0.5 87.3 0.1 100.0 1,368
More than secondary 0.3 0.0 0.0 6.5 1.0 0.0 92.2 0.0 100.0 673
Wealth quintile
Lowest 24.0 0.0 1.1 4.3 15.2 0.5 52.1 2.8 100.0 2,344
Second 12.8 0.0 0.6 4.2 12.8 0.4 67.1 2.0 100.0 2,363
Middle 8.1 0.0 0.5 5.3 7.2 1.3 76.7 0.8 100.0 2,202
Fourth 2.9 0.2 0.5 7.1 4.0 0.3 84.7 0.3 100.0 2,151
Highest 0.5 0.1 0.0 4.8 2.0 0.2 92.4 0.0 100.0 1,881
Total 10.2 0.1 0.5 5.1 8.6 0.6 73.6 1.3 100.0 10,940

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been
suppressed.

84 • Maternal Health Care

Table 5.22 Problems in accessing health care

Percentage of women age 15-49 who reported that they have serious problems in accessing health care for themselves when they are sick, by type
of problem, according to background characteristics, Ghana MHS 2017
Problems in accessing health care
At least one
Getting problem
Background permission to go Getting money Distance to Not wanting to accessing Number of
characteristic for treatment for treatment health facility go alone health care women
Age
15-19 9.1 44.5 24.5 25.8 59.9 4,785
20-34 5.9 45.0 22.3 12.3 54.6 12,146
35-49 6.4 52.9 25.1 10.1 60.0 8,132
Disability status1
A lot of difficulty or unable to
function in at least one domain 10.9 58.5 31.0 21.9 69.7 2,554
Some or no difficulty in all domains 6.2 46.2 22.8 13.3 56.0 22,508
Number of living children
0 7.5 40.7 21.0 20.9 54.5 8,216
1-2 5.7 45.4 22.3 10.3 53.9 7,684
3-4 6.3 51.1 23.3 10.1 58.5 5,652
5+ 7.2 62.0 33.4 13.6 69.7 3,510
Marital status
Never married 7.8 43.6 22.0 19.9 56.5 8,397
Married or living together 6.1 47.5 25.0 11.4 56.4 14,361
Divorced/separated/widowed 5.8 61.4 21.5 10.5 66.4 2,305
Residence
Urban 6.0 40.6 14.4 11.6 50.0 13,752
Rural 7.5 55.7 34.9 17.3 66.3 11,310
Zone
Coastal 5.9 46.2 20.1 11.5 55.3 12,121
Middle 6.3 44.8 21.5 13.5 55.5 9,674
Northern 10.7 59.8 43.0 26.1 70.3 3,267
Region
Western 4.5 48.6 24.6 9.2 58.4 3,230
Central 6.1 46.8 16.4 9.0 53.6 2,218
Greater Accra 7.0 37.6 13.4 12.0 48.1 4,673
Volta 5.4 61.9 32.7 16.8 69.3 2,000
Eastern 10.2 50.4 32.1 15.7 63.1 2,517
Ashanti 4.3 44.9 16.9 12.2 54.7 4,790
Brong Ahafo 6.1 38.9 19.6 13.9 49.2 2,367
Northern 8.1 60.5 47.3 24.6 71.4 1,786
Upper East 13.4 59.3 37.0 27.5 68.4 854
Upper West 14.3 58.5 39.2 28.5 69.6 628
Education
No education 8.8 62.6 37.3 17.5 70.8 4,585
Primary 8.0 56.4 27.0 15.3 64.9 3,934
Middle/JSS/JHS 6.1 47.8 20.9 13.5 57.2 10,081
Secondary/SSS/SHS 5.3 35.5 17.3 13.1 47.7 4,550
More than secondary 5.1 19.4 13.5 10.2 33.3 1,912
Wealth quintile
Lowest 10.5 71.0 53.7 25.7 81.4 4,064
Second 6.5 57.1 28.1 14.0 66.4 4,721
Middle 5.9 49.5 17.4 11.8 57.9 5,111
Fourth 5.3 42.2 15.4 10.4 50.2 5,443
Highest 6.0 26.0 12.0 11.9 39.2 5,723
Total 6.7 47.5 23.7 14.2 57.4 25,062

1
Domains are seeing, hearing, communicating, remembering or concentrating, walking or climbing steps, and washing all over or dressing. If a woman
reported having difficulty in more than one domain, only the highest level of difficulty is shown.

Maternal Health Care • 85

INDUCED ABORTION AND MISCARRIAGE 6
Key Findings

 Induced abortion: Seven percent of women age 15-49

had an induced abortion in the past 5 years.
 Main reason for induced abortion: Twenty-one percent
of women age 15-49 who had an induced abortion in the
5 years preceding the survey reported that the main
reason for the most recent induced abortion was that they
were not ready, were too young, or wanted to delay
childbearing.
 Methods to induce abortion: Thirty-eight percent of
women age 15-49 who had an induced abortion in the 5
years preceding the survey used a medical pill (20%
mifepristone and misoprostol, 18% misoprostol) as the
last or only method to induce the most recent abortion.
 Contraceptive use and induced abortion: Among
women age 15-49 who had an induced abortion in the
past 5 years, 19% received contraception support after
the most recent induced abortion.
 Legality of induced abortion: Among women age 15-49
who know what abortion is, 11% know that abortion is
legal in Ghana.

A
lthough abortion has been legal in Ghana under certain circumstances since 1985, integration of
safe abortion into Ghana’s reproductive health policy did not take place until 2003, and it was not
until 2006 that comprehensive abortion care services, as permitted by law, became one of the five
components of the key reducing maternal morbidity and mortality objective of the 2007-2011 Ghana
Reproductive Health Strategic Plan (GHS 2011). Not surprisingly, misconceptions continue to exist
regarding the legality of abortion in Ghana.

Respondents provided a chronological history of all pregnancies they had experienced, beginning with the
first one. For each pregnancy, respondents provided information on the outcome (live birth, stillbirth,
miscarriage, or induced abortion). Women who had a pregnancy that ended in an induced abortion or a
miscarriage in the 5 years preceding the survey were asked follow-up questions about the most recent
induced abortion and/or the most recent miscarriage.

6.1 PREGNANCY OUTCOMES

Seventy-six percent of pregnancies among women age 15-49 in the 5 years preceding the survey ended in a
live birth, 2% resulted in a stillbirth, 12% were miscarried, and 10% ended in an induced abortion
(Table 6.1).

Induced Abortion and Miscarriage • 87

 Patterns by background characteristics

 The percentage of pregnancies ending in miscarriage increases with women’s age, while the
percentage ending in induced abortion decreases with age.

 Fourteen percent of pregnancies among women in rural areas ended in an induced abortion, as
compared with 7% among women in rural areas.

 The percentage of pregnancies culminating in a live birth ranges from 70% in Greater Accra region to
90% in Northern region.

 The percentage of pregnancies culminating in a live birth decreases with increasing wealth. The
percentage culminating in a live birth falls steadily with increasing education up to the secondary
level, from 86% among women with no education to 66% among women with a secondary education,
before increasing slightly among women with a postsecondary education (72%).

6.2 INDUCED ABORTIONS

Twenty percent of women age 15-49 have ever had an induced abortion (Table 6.2); 7% had an induced
abortion in the 5 years preceding the survey (Table 6.3).

Trends: The percentage of women age 15-49 who had an induced abortion in the 5 years preceding the
survey remained relatively unchanged between 2007 (5%) and 2017 (7%).

Patterns by background characteristics

 The percentage of women who have ever had an induced abortion increases from 3% among those age
15-19 to 16% among those age 20-24 and 24% among those age 25-29, with little change in older age
groups (25%-27%) (Table 6.2). Twelve percent of women age 20-24 and age 25-29 had an induced
abortion in the 5 years preceding the survey, as compared with 1%-8% of women in other age groups
(Table 6.3).

 Three percent of women in the Northern zone have ever had an induced abortion, compared with 22%
of women in both the Middle and Coastal zones (Table 6.2).

 The percentage of women who had an induced abortion in the past 5 years ranges from 1% in Northern
region to 9% in Western and Ashanti regions (Table 6.3).

 The percentage of women who had an induced abortion in the past 5 years is lower among those with
no education (3%) than among those with any level of education (6%-8%). Also, the percentage is
lower among women in the lowest wealth quintile (2%) than among women in higher quintiles
(6%-9%).

6.2.1 Main Reason for Induced Abortion

Women age 15-49 who had an induced abortion in the 5 years preceding the survey had varied reasons for
the most recent induced abortion. Just over one-fifth of women cited being not ready, too young, or
wanting to delay childbearing (21%); 15% cited not having money to care for a baby; 12% cited wanting
to space their births; and 10% cited wanting to continue going to school or other life circumstances
(including nobody to help look after a baby, wanting to continue working, or wanting no more children).
Smaller percentages (4%-9%) cited other reasons (Table 6.4).

88 • Induced Abortion and Miscarriage

Partner’s Attitude towards Induced Abortion

Women age 15-49 who had an induced abortion in the 5 years preceding the survey were asked about their
partner’s attitude towards the most recent induced abortion. Half of women reported that their partner was
in favour of the most recent induced abortion (52%), 8% said that their partner was neutral, 18% said that
their partner was opposed, and 20% reported that their partner was unaware of the induced abortion; 1% of
respondents did not know or did not remember their partner’s attitude (Table 6.5).

6.2.2 Methods to Induce Abortion

Women age 15-49 who had an induced abortion in Figure 6.1 Induced abortion methods
the 5 years preceding the survey were asked if they Percent distribution of most recent
made one or more than one attempt to induce the induced abortions among women age
most recent abortion. If a woman made more than 15-49 in the 5 years before the survey
by only/final method
one attempt, she was asked about the method of the
first attempt and the method of the last attempt; if she
Misoprostol
made only one attempt, she was asked about the or Mifepristone+
method of that attempt. Fourteen percent of women misoprostol
made more than one attempt to induce the most 38%
recent abortion. Slightly over a third used pills, either Non-medical
misoprostol (18%) or a combination of mifepristone methods
27% D&C/D&E*
and misoprostol (20%), for the only or final attempt; 24%
just under a quarter used dilation and curettage Other
(D&C) or dilation and evacuation (D&E) (24%). medical
10%
Slightly more than a quarter of women used a non-
* Dilation and curettage or dilation and evacuation
medical method (27%). Non-medical methods,
which include drinking milk/coffee/alcohol/other
liquid with sugar, drinking an herbal concoction,
drinking another home remedy, using an herbal enema, inserting a substance into the vagina, heavy
massage, excessive physical activity, tablets (exact kind unknown), and other, may come with a greater
risk of poor health outcomes (Table 6.6 and Figure 6.1).

Patterns by background characteristics

 The percentage of women age who had an induced abortion in the 5 years preceding the survey who
used pills (misoprostol or mifepristone and misoprostol) as the only or final method to induce the most
recent abortion generally decreases with age.

 The percentage of women who had an induced Figure 6.2 Non-medical methods
abortion in the 5 years preceding the survey and by education
used a non-medical method as the only or final Among women age 15-49 who had an
method to induce the most recent abortion is induced abortion in the 5 years before the
higher among those in rural (32%) than urban survey, percentage who used a non-
(25%) areas. medical method for the only/final attempt
for the most recent induced abortion
 The percentage of women who had an induced
abortion in the 5 years preceding the survey and
41 38
used a non-medical method as the only or final 28
method to induce the most recent abortion 19
generally decreases with increasing education 9
(Figure 6.2) and wealth.
No Primary Middle Secondary More than
education secondary

Induced Abortion and Miscarriage • 89

 6.2.3 Assistance for and Location of Induced Abortion

Among women age 15-49 who had an induced abortion in the 5 years preceding the survey, 41% sought
help from health care personnel for the only or final induced abortion attempt, 33% sought help from a
pharmacist or chemical seller, 16% sought help from someone else, and 10% did not seek help from
anyone. Among 40% of women, the location of the last or only attempt of the most recent induced abortion
was a public (20%) or private (20%) health facility. Among 37% of women, the location was a home;
among 22%, it was a pharmacy or drugstore; and among 1%, it was elsewhere (Table 6.7).

Patterns by background characteristics

 The percentage of women who had an induced abortion in the 5 years preceding the survey who
sought assistance from health care personnel for the only or final attempt of the most recent induced
abortion increases with age, from 31% among those less than age 20 to 43% among those age 20-34
and 52% among those age 35-49.

 The percentage of women who had an induced abortion in the 5 years preceding the survey who
sought assistance from health care personnel for the most recent induced abortion ranges from 37% in
the Middle zone to 44% in the Coastal zone and 52% in the Northern zone.

 The percentage of women who had an induced abortion in the 5 years preceding the survey and sought
assistance from health care personnel for the only or final attempt of the most recent induced abortion
is similar among women with no, only primary, and only middle level education (36%-39%), and
higher for women with secondary (46%) or more than secondary (56%) education.

Payment for Induced Abortion

Ninety-three percent of women age 15-49 who had an induced abortion in the 5 years preceding the survey
made a payment for the only or final method of the most recent induced abortion. A smaller percentage of
women in the Northern zone made a payment (83%) than in the Middle (91%) or Coastal (95%) zones; a
smaller percentage of women in the lowest wealth quintile (82%) made a payment than those in higher
wealth quintiles (92%-95%) (Table 6.8).

Medication and Health Problems after Induced Abortion

More than 6 in 10 women age 15-49 who had an induced abortion in the 5 years preceding the survey took
antibiotics (64%) or pain relievers (63%) after the only or final attempt for their most recent induced
abortion, and 14% experienced some health problems in the 1 month after the only or final attempt
(Table 6.8).

90 • Induced Abortion and Miscarriage

Eighty-six percent of women who Figure 6.3 Problems within 1 month of most recent
had an induced abortion in the 5 induced abortion
years preceding the survey had no Among women age 15-49 who had an induced abortion
health problems in the 1 month after in the 5 years preceding the survey, percentage who
experienced various health problems 1 month
the only or final attempt of the most after the only/final method of the most recent induced abortion
recent induced abortion. Fourteen
percent did experience a health Experienced problem Did not experience problem

problem: 12% experienced pain, 8%

14 8 12 6 1 4 4
experienced bleeding, 6% had a
fever, 4% experienced a foul-
smelling discharge, 4% had other
problems, and 0.5% experienced an 86 92 88 94 99 96 96
injury (Table 6.9 and Figure 6.3).
Fifty-seven percent of women who
experienced some problems
received treatment (Table 6.9). Any Bleeding Pain Fever Injury/ Foul- Other
problem perforation smelling
discharge
6.2.4 Contraceptive Use
and Induced Abortion

Twenty percent of women age 15-49 who had an induced abortion in the 5 years preceding the survey
reported using contraception when they became pregnant before their most recent induced abortion. Thirty-
one percent had ever discussed contraception with a health care worker, and 19% received contraceptive
support from a health care worker after the most recent induced abortion. Among women who had
discussed contraception with a health care worker, one-third discussed it only before the most recent
induced abortion (33%), half discussed it only after the most recent induced abortion (50%), and the
remaining one-sixth (17%) discussed it both before and after the most recent induced abortion. Among
women who received contraceptive support after the induced abortion, 36% were given a method by a
health care worker, 59% were prescribed a method, 5% received a referral to another provider for
contraception, and 0.5% could not remember what form the support took (Table 6.10).

6.3 INDUCED ABORTION KNOWLEDGE AND ACCESS

Ninety-five percent of women age 15-49 know what abortion is (either they have had an induced abortion
or they have not had an induced abortion but know what it is). Among women who have never had an
induced abortion but know what abortion is, 25% say that they could get an abortion if they needed one,
and 57% know of a place to get an induced abortion (Table 6.11). The place most commonly cited by
women age 15-49 who have never had an abortion but know what it is and know of a place to get one is a
government hospital (72%) (Table 6.12).

Trends: The percentage of women age 15-49 who know what abortion is increased slightly from 90% in
2007 to 95% in 2017. Over the same period, the percentage who have never had an abortion but know
what it is and report that they could get an abortion if they needed to increased from 12% to 25%, and the
percentage who know of a place to get an abortion increased from 39% to 57%.

Patterns by background characteristics

 Women in the Northern zone (83%), those with no education (88%), and those in the lowest wealth
quintile (86%) are less likely to know what abortion is than women in the other zones (96%-97%),
those with more education (93%-99%), and those in higher wealth quintiles (95%-98%).

 The percentage of women who say that they could get an abortion if necessary and the percentage who
know of a place to get an abortion increase with increasing education and wealth.

Induced Abortion and Miscarriage • 91

 6.4 LEGALITY OF INDUCED ABORTION
Only 11% of women age 15-49 who know what abortion is (including women who have had an induced
abortion) know that abortion is legal in Ghana (Table 6.11).

Trends: The percentage of women age 15-49 who know what abortion is and know that abortion is legal
in Ghana increased from 4% in 2007 to 11% in 2017.

Patterns by background characteristics Figure 6.4 Knowledge of legality of

abortion by education
 Fourteen percent of urban women who know
Among women age 15-49 who know what
what abortion is know that it is legal, as induced abortion is, percentage who know
compared with 8% of rural women. that induced abortion is legal in Ghana

 The percentage of women who know what

abortion is and know that it is legal ranges from
7% in Western and Brong Ahafo regions to 18%
in Eastern region. 38

18
 The percentage of women who know what 7 8
4
abortion is and that it is legal increases with
increasing education (Figure 6.4) and wealth. No Primary Middle Secondary More than
education secondary
6.5 MISCARRIAGE
Twelve percent of pregnancies among women age 15-49 in the 5 years preceding the survey ended in a
miscarriage (Table 6.1); 7% of women age 15-49 had a miscarriage in the 5 years preceding the survey
(Table 6.3). It is possible that some respondents characterised pregnancies that ended in an induced
abortion as ending in miscarriage.

Patterns by background characteristics

 The percentage of pregnancies in the last 5 years that ended in a miscarriage increases with age, from
7% among women under age 20 to 11% among women age 20-34 and 19% among women age 35-49.

 The percentage of pregnancies in the last 5 years that ended in a miscarriage increases with increasing
education and wealth.

Miscarriage Causes

Nearly three quarters of women age 15-49 who had a miscarriage in the 5 years preceding the survey
reported that the most recent miscarriage was spontaneous (74%); 10% attributed the most recent
miscarriage to either an accident or other causes, and 3% or less attributed it to something they ate,
somebody hurting them, or unknown causes (Table 6.13).

6.5.1 Help Seeking after Miscarriage

Seventy-four percent of women age 15-49 who had a miscarriage in the 5 years preceding the survey
sought help after the most recent miscarriage. Among women who sought help following a miscarriage, 6
in 10 sought assistance from a doctor (63%) and nearly 5 in 10 sought assistance from a nurse (47%).
Slightly more than 5 in 10 went to a government hospital (54%) for help (Table 6.14).

Patterns by background characteristics

 The percentage of women who had a miscarriage in the 5 years preceding the survey and sought help
after the most recent miscarriage ranges from 68% in Volta region to 83% in Upper East region.

92 • Induced Abortion and Miscarriage

 The percentage of women who had a miscarriage in the 5 years preceding the survey and sought help
after the most recent miscarriage increases with increasing education (from 67% among women with
no education to 87% among women with more than a secondary education) and wealth (from 65%
among women in the lowest quintile to 79% among women in the highest quintile).

Treatment after Miscarriage

Slightly more than three quarters of women age 15-49 who had a miscarriage in the 5 years preceding the
survey took antibiotics (76%) or painkillers (77%) after the most recent miscarriage. Just under half had
their uterus cleaned (45%) (Table 6.15).

Health Problems 1 Month after Miscarriage

Among women age 15-49 who had Figure 6.5 Problems within 1 month of most recent
a miscarriage in the 5 years miscarriage
preceding the survey, 87% did not Among women age 15-49 who had a miscarriage in the 5 years
experience any health problems in preceding the survey, percentage who experienced various
health problems 1 month after the most recent miscarriage
the 1 month after the most recent
miscarriage (Table 6.16). Ten Experienced problem Did not experience problem
percent experienced pain in the 1
13 6 10 6 1 4 3
month after the most recent
miscarriage, 6% experienced
bleeding, 6% had a fever, 4% 94 94 99 97 97
87 90
experienced a foul-smelling
discharge, 3% had other problems,
and 0.7% experienced an injury
(Figure 6.5). Any Bleeding Pain Fever Injury/ Foul- Other
problem perforation smelling
discharge*
* Adds up to more than 100 due to rounding.

6.5.2 Contraceptive Use and Miscarriage

Thirteen percent of women age 15-49 who had a miscarriage in the 5 years preceding the survey reported
using contraception when they became pregnant before the most recent miscarriage; 28% had ever
discussed contraception with a health care worker, and 13% received contraceptive support from a health
care worker after the most recent induced abortion. Among women who had discussed contraception with
a health care worker, 40% discussed it only before the most recent miscarriage, 45% discussed it only after
the most recent miscarriage, and 15% discussed it both before and after the most recent miscarriage.
Among women who received contraceptive support after the miscarriage, 33% were given a method by a
health care worker, 58% were prescribed a method, 9% received a referral to another provider for
contraception, and 0.3% could not remember what form the support took (Table 6.17).

LIST OF TABLES

For more information on induced abortion and miscarriage, see the following tables:

 Table 6.1 Pregnancy outcomes

 Table 6.2 Lifetime experience with induced abortion
 Table 6.3 Induced abortion and miscarriage in the past 5 years
 Table 6.4 Main reason for most recent induced abortion
 Table 6.5 Partner’s attitude towards most recent induced abortion
 Table 6.6 Only/final method of most recent induced abortion
 Table 6.7 Assistance for and location of most recent induced abortion

Induced Abortion and Miscarriage • 93

  Table 6.8 Payment for, medications used during, and experience of health problems after
most recent induced abortion
 Table 6.9 Health problems and treatment after induced abortion
 Table 6.10 Contraception use before and discussions of contraception before and after
induced abortion
 Table 6.11 Abortion knowledge and access
 Table 6.12 Knowledge of places to get an abortion
 Table 6.13 Miscarriage causes
 Table 6.14 Seeking help after miscarriage
 Table 6.15 Treatment after miscarriage
 Table 6.16 Health problems and treatment after miscarriage
 Table 6.17 Contraception use before and discussions of contraception before and after
miscarriage

Table 6.1 Pregnancy outcomes

Percent distribution of pregnancies among women age 15-49 ending in the 5 years preceding the survey by pregnancy outcome,
according to background characteristics, Ghana MHS 2017
Pregnancy outcome
Background Live Induced Number of
characteristic birth Stillbirth Miscarriage abortion Total pregnancies
Woman’s age at time of
pregnancy
<201 73.1 1.3 6.8 18.8 100.0 2,351
20-34 77.4 1.7 10.8 10.1 100.0 13,602
35-49 73.2 2.5 18.5 5.9 100.0 3,257
Residence
Urban 71.7 1.7 12.6 14.0 100.0 9,675
Rural 80.6 1.9 10.6 6.8 100.0 9,536
Zone
Coastal 74.0 1.7 12.4 12.0 100.0 8,896
Middle 74.3 2.0 12.1 11.6 100.0 7,550
Northern 88.3 1.7 7.9 2.1 100.0 2,764
Region
Western 73.5 1.9 11.6 13.0 100.0 2,645
Central 77.0 2.2 12.0 8.8 100.0 1,731
Greater Accra 69.8 1.3 14.2 14.7 100.0 2,992
Volta 79.5 1.3 10.6 8.6 100.0 1,528
Eastern 78.0 1.7 10.6 9.7 100.0 1,857
Ashanti 70.7 2.4 13.7 13.3 100.0 3,763
Brong Ahafo 77.6 1.7 10.5 10.1 100.0 1,931
Northern 90.3 1.7 6.8 1.2 100.0 1,655
Upper East 87.3 1.3 9.4 2.0 100.0 625
Upper West 82.7 2.1 9.9 5.4 100.0 485
Education
No education 86.2 1.8 8.2 3.9 100.0 4,294
Primary 78.0 1.9 10.4 9.7 100.0 3,320
Middle/JSS/JHS 73.8 1.8 12.2 12.1 100.0 7,701
Secondary/SSS/SHS 66.1 1.6 15.4 16.8 100.0 2,639
More than secondary 72.4 1.6 15.4 10.7 100.0 1,256
Wealth quintile
Lowest 88.4 1.6 6.9 3.1 100.0 3,797
Second 80.5 2.0 9.0 8.5 100.0 3,954
Middle 74.0 2.2 11.6 12.3 100.0 3,851
Fourth 69.9 1.4 13.6 15.0 100.0 3,960
Highest 67.7 1.8 17.4 13.1 100.0 3,648
Total 76.1 1.8 11.6 10.4 100.0 19,210

1
The youngest age at time of pregnancy is 11 years.

94 • Induced Abortion and Miscarriage

Table 6.2 Lifetime experience with induced abortion

Percentage of women age 15-49 who have ever had an induced abortion and among women who have
ever had an abortion, mean number of induced abortions, according to background characteristics, Ghana
MHS 2017
Number of
Percentage who Mean number women who ever
Background ever had an Number of of induced had an induced
characteristic induced abortion women abortions abortion
Age
15-19 3.3 4,785 1.1 156
20-24 15.9 4,208 1.3 667
25-29 24.1 4,229 1.4 1,018
30-34 25.5 3,709 1.5 945
35-39 26.5 3,313 1.6 877
40-44 27.0 2,481 1.6 671
45-49 24.9 2,337 1.8 583
Number of living children
0 9.2 8,216 1.3 752
1 24.9 4,095 1.5 1,021
2-3 27.4 6,752 1.5 1,849
4+ 21.6 5,999 1.6 1,296
Marital status
Never married 10.1 8,397 1.3 845
Married or living together 23.5 14,361 1.5 3,378
Divorced/separated/widowed 30.1 2,305 1.6 694
Residence
Urban 23.6 13,752 1.5 3,246
Rural 14.8 11,310 1.4 1,672
Zone
Coastal 21.8 12,121 1.5 2,637
Middle 22.4 9,674 1.5 2,170
Northern 3.4 3,267 1.3 110
Region
Western 20.8 3,230 1.5 673
Central 18.4 2,218 1.4 409
Greater Accra 26.4 4,673 1.5 1,236
Volta 15.9 2,000 1.5 319
Eastern 19.9 2,517 1.5 501
Ashanti 24.9 4,790 1.6 1,194
Brong Ahafo 20.1 2,367 1.4 475
Northern 2.8 1,786 1.3 50
Upper East 3.5 854 1.1 30
Upper West 4.8 628 1.4 30
Education
No education 11.6 4,585 1.4 531
Primary 21.0 3,934 1.6 826
Middle/JSS/JHS 23.8 10,081 1.6 2,398
Secondary/SSS/SHS 18.7 4,550 1.4 849
More than secondary 16.3 1,912 1.4 313
Wealth quintile
Lowest 6.1 4,064 1.3 248
Second 16.3 4,721 1.4 770
Middle 21.4 5,111 1.5 1,093
Fourth 26.9 5,443 1.6 1,465
Highest 23.5 5,723 1.6 1,342
Total 19.6 25,062 1.5 4,917

Induced Abortion and Miscarriage • 95

 Table 6.3 Induced abortion and miscarriage in the past 5 years

Percentage of women age 15-49 who had an induced abortion and percentage who had a
miscarriage in the 5 years preceding the survey, according to background characteristics,
Ghana MHS 2017
Percentage of women who
in the past 5 years had:
Background An induced Number of
characteristic abortion A miscarriage women
Age
15-19 3.0 1.1 4,785
20-24 11.6 6.8 4,208
25-29 11.5 10.6 4,229
30-34 7.7 10.5 3,709
35-39 5.5 9.6 3,313
40-44 2.6 8.3 2,481
45-49 1.2 4.2 2,337
Number of living children
0 6.2 4.5 8,216
1 11.0 10.8 4,095
2-3 7.7 8.7 6,752
4+ 3.4 6.6 5,999
Marital status
Never married 6.2 2.2 8,397
Married or living together 6.8 10.2 14,361
Divorced/separated/widowed 7.8 6.1 2,305
Residence
Urban 8.1 7.1 13,752
Rural 5.0 7.2 11,310
Zone
Coastal 7.5 7.0 12,121
Middle 7.5 7.8 9,674
Northern 1.5 5.7 3,267
Region
Western 8.9 7.4 3,230
Central 6.0 7.5 2,218
Greater Accra 8.0 6.7 4,673
Volta 5.4 6.5 2,000
Eastern 5.9 6.6 2,517
Ashanti 8.6 8.8 4,790
Brong Ahafo 7.0 7.1 2,367
Northern 1.0 5.4 1,786
Upper East 1.4 5.7 854
Upper West 2.7 6.6 628
Education
No education 3.1 6.5 4,585
Primary 6.9 7.2 3,934
Middle/JSS/JHS 7.7 7.4 10,081
Secondary/SSS/SHS 8.2 7.0 4,550
More than secondary 6.2 7.5 1,912
Wealth quintile
Lowest 2.2 5.6 4,064
Second 6.1 6.4 4,721
Middle 7.8 7.1 5,111
Fourth 9.2 8.1 5,443
Highest 7.0 8.0 5,723
Total 6.7 7.1 25,062

96 • Induced Abortion and Miscarriage

Table 6.4 Main reason for most recent induced abortion

Among women age 15-49 who had an induced abortion in the 5 years preceding the survey, percent distribution by main reason for the most recent induced
abortion, according to background characteristics, Ghana MHS 2017
Not ready/
too
young/ Other Shame/
wanted to partner- afraid of
No money delay Wanted to Wanted to Other life Partner related Health- parents/
Background to care for child- space continue circumst- did not circumst- related parents Number
characteristic baby bearing child in school ances 1
want child ances2 reasons3 insisted Other4 Total of women
Woman’s age at time
of abortion
<20 7.8 29.4 4.2 23.0 5.5 7.1 3.9 1.1 15.0 3.0 100.0 365
20-24 16.4 23.1 11.2 11.3 10.6 11.0 5.0 2.4 4.8 4.1 100.0 529
25-34 17.6 18.0 16.7 3.5 7.9 8.3 7.6 11.9 4.7 3.9 100.0 617
35-49 20.8 7.7 11.5 0.5 20.1 4.5 9.5 18.9 2.4 4.1 100.0 169
Residence
Urban 16.5 22.2 11.1 9.1 10.2 6.9 5.7 7.4 6.4 4.4 100.0 1,111
Rural 13.2 18.7 12.9 11.4 8.1 11.8 7.1 6.9 7.4 2.6 100.0 570
Zone
Coastal 15.6 20.6 11.9 7.2 9.3 9.5 6.1 9.2 7.2 3.5 100.0 905
Middle 15.7 21.5 11.7 12.7 9.7 7.2 6.6 4.7 6.0 4.2 100.0 728
Northern 6.9 22.0 8.5 19.1 9.0 9.6 1.4 10.5 9.7 3.3 100.0 48
Region
Western 16.5 16.0 11.0 9.1 15.5 9.3 6.9 8.2 6.1 1.4 100.0 288
Central 17.5 16.3 9.0 10.4 6.6 14.5 9.4 6.3 6.0 4.0 100.0 133
Greater Accra 14.7 25.5 12.8 4.6 6.2 7.4 4.6 11.7 8.5 3.9 100.0 376
Volta 13.7 20.9 14.6 7.1 7.2 11.6 4.6 6.4 7.2 6.7 100.0 108
Eastern 12.1 27.6 17.8 7.7 6.8 11.5 2.6 7.1 2.0 4.7 100.0 148
Ashanti 19.1 22.8 10.3 8.3 11.6 5.2 7.4 3.8 6.6 4.7 100.0 414
Brong Ahafo 10.5 12.8 9.8 27.9 7.4 8.3 8.1 4.7 8.0 2.5 100.0 166
Northern (7.6) (14.7) (7.0) (22.8) (8.5) (11.9) (2.0) (2.5) (16.6) (6.2) (100.0) 19
Upper East (4.4) (23.8) (12.9) (10.7) (7.5) (13.3) (0.0) (18.5) (5.2) (3.7) (100.0) 12
Upper West 7.8 28.6 7.1 20.9 10.5 4.5 1.7 13.6 5.3 0.0 100.0 17
Education
No education 29.1 12.0 9.7 0.8 13.5 6.2 9.8 11.5 3.2 4.2 100.0 142
Primary 20.4 15.2 18.7 0.6 10.3 10.4 7.7 5.4 5.4 5.8 100.0 271
Middle/JSS/JHS 16.9 20.6 12.8 8.2 9.7 9.0 5.5 6.9 6.3 4.1 100.0 772
Secondary/SSS/SHS 6.1 23.5 7.2 21.7 7.3 8.6 6.7 6.2 10.0 2.7 100.0 375
More than secondary 7.1 40.3 5.6 15.7 7.7 4.0 0.8 12.1 6.6 0.0 100.0 119
Wealth quintile
Lowest 6.9 16.3 10.0 13.1 12.4 13.7 4.3 13.3 6.3 3.7 100.0 91
Second 19.3 20.4 10.0 11.2 10.7 9.6 5.2 3.4 7.0 3.1 100.0 287
Middle 20.3 16.7 10.3 11.7 10.2 9.5 5.7 4.1 6.1 5.4 100.0 401
Fourth 15.6 17.5 13.2 8.2 8.9 9.3 6.6 7.8 8.9 3.9 100.0 499
Highest 9.3 31.2 12.9 8.5 8.0 4.7 7.2 11.1 4.6 2.5 100.0 402
Total 15.4 21.0 11.7 9.9 9.5 8.5 6.2 7.3 6.7 3.8 100.0 1,680

Note: Figures in parentheses are based on 25-49 unweighted cases.

1
Including nobody to help look after the baby, wanted to continue working, wanted no more children
2
Including did not want to stay with partner, did not love the father, father of child died
3
Including health of mother, foetus not viable, risk of birth defect
4
Including rape and other

Induced Abortion and Miscarriage • 97

 Table 6.5 Partner’s attitude towards most recent induced abortion

Percent distribution of partner’s attitude towards most recent induced abortion in the 5 years preceding the survey among
women age 15-49, according to background characteristics, Ghana MHS 2017
Partner’s attitude towards most recent induced abortion
Background Don’t know/ Number of
characteristic Favoured Opposed Neutral Not aware don’t remember Total women
Woman’s age at time
of abortion
<20 54.9 18.4 8.4 16.0 2.3 100.0 365
20-34 51.6 18.9 8.6 20.3 0.6 100.0 1,146
35-49 52.2 12.0 5.2 29.5 1.1 100.0 169
Residence
Urban 52.3 19.4 7.8 19.6 0.9 100.0 1,111
Rural 52.5 15.6 9.1 21.7 1.1 100.0 570
Zone
Coastal 57.6 15.7 6.7 19.4 0.6 100.0 905
Middle 46.1 21.4 9.7 21.2 1.6 100.0 728
Northern 48.4 14.0 14.6 23.0 0.0 100.0 48
Region
Western 63.8 8.9 7.4 19.9 0.0 100.0 288
Central 52.9 16.1 7.9 23.0 0.0 100.0 133
Greater Accra 54.8 20.9 6.4 16.5 1.4 100.0 376
Volta 56.5 15.0 4.9 23.6 0.0 100.0 108
Eastern 46.1 21.6 8.5 21.5 2.3 100.0 148
Ashanti 44.5 22.6 9.8 22.0 1.1 100.0 414
Brong Ahafo 50.1 18.2 10.4 19.1 2.2 100.0 166
Northern (53.6) (8.4) (17.4) (20.6) (0.0) (100.0) 19
Upper East (59.2) (24.6) (9.7) (6.6) (0.0) (100.0) 12
Upper West 35.5 13.0 14.8 36.7 0.0 100.0 17
Education
No education 58.7 11.5 9.5 17.8 2.5 100.0 142
Primary 49.3 15.3 8.5 26.5 0.3 100.0 271
Middle/JSS/JHS 49.0 18.5 9.7 21.4 1.4 100.0 772
Secondary/SSS/SHS 56.9 22.1 5.3 15.3 0.5 100.0 375
More than secondary 59.1 17.4 5.9 17.5 0.0 100.0 119
Wealth quintile
Lowest 56.8 16.9 5.0 20.4 0.9 100.0 91
Second 46.0 15.1 14.7 22.6 1.7 100.0 287
Middle 55.6 17.8 6.0 20.4 0.2 100.0 401
Fourth 53.6 17.4 8.0 19.6 1.4 100.0 499
Highest 51.2 21.8 6.8 19.4 0.8 100.0 402
Total 52.4 18.1 8.2 20.3 1.0 100.0 1,680

Note: Figures in parentheses are based on 25-49 unweighted cases.

98 • Induced Abortion and Miscarriage

Table 6.6 Only/final method of most recent induced abortion

Percentage of women age 15-49 who made more than one attempt to induce the most recent induced abortion in the 5 years preceding the survey and percent distribution
of only/final method, according to background characteristics, Ghana MHS 2017
Percentage
who made Only/final method
more than
one attempt Mife-
to induce pristone
the most Miso- and miso-
recent prostol/ prostol/ Non-
Background induced Cytotec Medabon Oxytocin/ D&C/ Vacuum Saline Other medical Number of
characteristic abortion tablets tablets IV D&E1 aspiration instillation Catheter injection methods2 Total women
Woman’s age at time
of abortion
<20 15.3 25.4 18.7 0.9 18.2 4.6 0.6 0.0 1.6 29.9 100.0 365
20-34 14.1 16.1 21.8 0.3 25.3 7.3 0.7 0.1 1.9 26.5 100.0 1,146
35-49 12.0 15.1 11.8 0.7 31.7 11.4 1.7 0.0 0.4 27.3 100.0 169
Residence
Urban 13.3 18.5 22.1 0.2 25.1 7.3 0.6 0.0 1.4 24.8 100.0 1,111
Rural 15.8 17.2 16.3 1.1 23.0 6.7 1.1 0.1 2.2 32.3 100.0 570
Zone
Coastal 11.0 18.6 19.1 0.8 22.1 10.0 0.7 0.0 1.6 27.1 100.0 905
Middle 17.8 17.4 21.7 0.2 26.6 3.7 0.9 0.0 1.9 27.5 100.0 728
Northern 18.6 16.7 14.1 0.0 33.2 4.4 0.3 1.4 0.8 29.1 100.0 48
Region
Western 16.3 18.5 12.8 2.0 21.3 10.9 0.2 0.0 2.0 32.3 100.0 288
Central 12.5 14.0 41.0 0.0 17.7 1.1 0.0 0.0 0.0 26.2 100.0 133
Greater Accra 6.6 19.0 20.7 0.0 23.0 12.4 1.2 0.0 1.6 22.2 100.0 376
Volta 10.5 23.1 3.7 1.1 27.0 10.1 1.2 0.0 2.3 31.6 100.0 108
Eastern 19.5 21.4 17.1 0.0 34.6 3.2 0.6 0.0 0.5 22.6 100.0 148
Ashanti 19.4 17.1 23.5 0.0 26.4 2.0 1.1 0.0 3.0 27.0 100.0 414
Brong Ahafo 12.1 14.8 21.4 0.9 20.1 8.4 0.7 0.0 0.5 33.2 100.0 166
Northern (14.4) (19.3) (11.6) (0.0) (34.9) (7.0) (0.0) (3.6) (2.1) (21.5) (100.0) 19
Upper East (16.3) (14.4) (10.7) (0.0) (35.3) (0.0) (0.0) (0.0) (0.0) (39.5) (100.0) 12
Upper West 24.6 15.4 19.0 0.0 29.8 4.6 0.9 0.0 0.0 30.2 100.0 17
Education
No education 15.7 11.7 12.3 0.0 20.2 12.6 2.4 0.0 0.0 40.9 100.0 142
Primary 16.4 17.3 17.2 0.0 18.4 5.5 1.6 0.0 2.3 37.7 100.0 271
Middle/JSS/JHS 13.3 17.9 18.8 0.6 25.2 7.0 0.6 0.0 1.6 28.3 100.0 772
Secondary/SSS/
SHS 15.8 22.4 23.2 1.0 26.0 6.3 0.1 0.2 2.1 18.7 100.0 375
More than
secondary 7.8 14.3 35.0 0.0 33.1 7.6 0.0 0.0 1.4 8.6 100.0 119
Wealth quintile
Lowest 24.2 12.0 7.0 1.6 27.1 9.0 0.0 0.0 4.5 38.8 100.0 91
Second 16.9 15.4 18.5 0.8 14.5 3.2 1.3 0.0 2.7 43.6 100.0 287
Middle 12.5 18.3 21.0 0.9 21.2 7.6 1.9 0.2 1.2 27.7 100.0 401
Fourth 15.7 22.3 20.2 0.2 25.8 8.8 0.2 0.0 0.4 22.1 100.0 499
Highest 9.6 15.7 23.3 0.0 32.2 6.9 0.1 0.0 2.5 19.3 100.0 402
Total 14.2 18.0 20.1 0.5 24.4 7.1 0.8 0.0 1.7 27.3 100.0 1,680

Note: Figures in parentheses are based on 25-49 unweighted cases.

1
Dilation and curettage or dilation and evacuation
2
Non-medical methods include drinking milk/coffee/alcohol/other liquid with sugar, drinking an herbal concoction, drinking another home remedy, using an herbal enema,
inserting a substance into the vagina, heavy massage, excessive physical activity, tablets (exact kind unknown), and other.

Induced Abortion and Miscarriage • 99

 Table 6.7 Assistance for and location of most recent induced abortion

Percent distribution of source of assistance for and location of the only/final method used for the most recent induced abortion in the 5 years preceding the survey
among women age 15-49, according to background characteristics, Ghana MHS 2017
Assistance Location
Phar- Phar-
Health macist/ macy/
care chemi- Health Health chemist/
Background person- cal Relative facility: facility: drug- Number
characteristic nel 1
seller or friend Other2 Nobody Total public3 private4 store Home5 Other Total of women
Woman’s age at time of
abortion
<20 30.5 37.5 19.4 4.5 8.1 100.0 16.3 12.6 24.8 44.8 1.5 100.0 365
20-34 43.1 32.1 10.6 2.7 11.4 100.0 20.0 21.6 22.5 35.1 0.8 100.0 1,146
35-49 52.2 26.6 8.7 4.5 7.9 100.0 27.0 23.7 15.1 32.6 1.6 100.0 169
Residence
Urban 41.6 36.1 10.7 2.3 9.3 100.0 18.9 20.9 23.4 35.9 0.9 100.0 1,111
Rural 40.6 26.2 15.6 5.2 12.4 100.0 21.9 17.7 20.1 38.9 1.4 100.0 570
Zone
Coastal 43.9 32.5 9.8 3.1 10.7 100.0 18.0 23.5 24.5 33.3 0.6 100.0 905
Middle 37.2 33.7 15.6 3.5 10.0 100.0 20.8 16.0 19.9 41.7 1.5 100.0 728
Northern 52.1 23.6 11.1 4.3 9.0 100.0 41.8 8.1 15.4 33.2 1.5 100.0 48
Region
Western 40.9 26.7 14.5 5.5 12.4 100.0 20.0 19.5 23.0 36.8 0.8 100.0 288
Central 34.7 48.9 7.7 2.3 6.4 100.0 12.3 20.1 33.0 34.6 0.0 100.0 133
Greater Accra 48.1 34.7 7.0 1.6 8.5 100.0 16.0 28.7 23.9 30.9 0.5 100.0 376
Volta 49.0 19.8 9.5 2.6 19.0 100.0 26.9 20.3 20.5 30.7 1.6 100.0 108
Eastern 49.1 18.0 18.8 0.8 13.3 100.0 33.2 15.2 21.4 30.2 0.0 100.0 148
Ashanti 34.0 39.4 13.9 3.4 9.3 100.0 16.4 17.0 18.0 47.2 1.4 100.0 414
Brong Ahafo 34.5 33.7 16.8 6.0 8.9 100.0 20.9 14.3 23.2 38.4 3.3 100.0 166
Northern (58.2) (25.0) (6.4) (2.1) (8.2) (100.0) (43.1) (13.4) (14.1) (29.4) (0.0) (100.0) 19
Upper East (54.7) (20.3) (6.9) (7.5) (10.7) (100.0) (41.5) (7.1) (13.7) (31.6) (6.1) (100.0) 12
Upper West 43.6 24.2 18.9 4.6 8.7 100.0 40.5 3.1 18.1 38.3 0.0 100.0 17
Education
No education 36.8 33.7 7.2 5.3 17.1 100.0 15.6 19.9 24.1 39.4 1.1 100.0 142
Primary 35.6 28.4 17.8 5.2 13.1 100.0 20.4 13.5 23.3 41.6 1.2 100.0 271
Middle/JSS/JHS 39.3 35.0 12.8 3.6 9.4 100.0 19.3 18.7 19.1 41.6 1.3 100.0 772
Secondary/SSS/SHS 46.3 32.5 10.9 1.5 8.8 100.0 22.2 21.8 25.8 30.0 0.3 100.0 375
More than secondary 56.4 28.0 7.8 0.0 7.8 100.0 21.0 35.5 26.8 15.4 1.2 100.0 119
Wealth quintile
Lowest 48.1 17.6 12.5 3.3 18.4 100.0 37.8 8.5 12.8 37.9 3.0 100.0 91
Second 31.7 32.5 15.8 6.9 13.1 100.0 17.8 13.2 26.5 40.6 1.9 100.0 287
Middle 36.1 36.6 16.1 3.3 7.9 100.0 16.9 17.6 21.8 43.0 0.7 100.0 401
Fourth 43.0 35.9 9.1 2.5 9.5 100.0 21.4 19.7 21.6 36.4 0.9 100.0 499
Highest 49.5 28.6 10.1 1.6 10.1 100.0 18.6 29.6 22.7 28.7 0.4 100.0 402
Total 41.3 32.8 12.3 3.3 10.4 100.0 19.9 19.8 22.3 36.9 1.0 100.0 1,680

Note: Figures in parentheses are based on 25-49 unweighted cases.

1
Doctor, nurse/midwife, or community health officer/nurse
2
Traditional birth attendant, community health volunteer, traditional practitioner, or other
3
Government hospital, government health centre/clinic, government health post/CHPS, mobile clinic/outreach, other public sector
4
Private hospital/clinic, family planning/Planned Parenthood Association of Ghana clinic, mobile clinic/outreach, maternity home, other private medical sector
5
Respondent’s home, traditional birth attendant’s home, other home

100 • Induced Abortion and Miscarriage

 Table 6.8 Payment for, medications used during, and experience of health problems after most recent induced abortion
Percentage of women age 15-49 who had an induced abortion in the 5 years preceding the survey who made a payment for the
only/final method of the most recent induced abortion, percentage who took antibiotics after the only/final method, percentage who
took pain relievers during/after the only/final method, and percentage who had any health problems in the month after the only/final
method, according to background characteristics, Ghana MHS 2017
Any health
problems in month
Background Payment made for Took Took pain after only/final Number
characteristic only/final method antibiotics relievers method of women
Woman’s age at time of
abortion
<20 96.0 62.0 58.0 17.1 365
20-34 91.6 63.4 63.4 14.0 1,146
35-49 94.9 74.8 73.6 7.3 169
Residence
Urban 94.7 65.8 64.9 13.4 1,111
Rural 89.5 61.2 60.0 15.1 570
Zone
Coastal 94.8 64.6 67.3 13.5 905
Middle 91.3 64.0 58.1 14.1 728
Northern 82.7 63.1 63.3 20.6 48
Region
Western 94.2 62.2 62.2 14.1 288
Central 93.5 58.4 63.0 12.4 133
Greater Accra 95.8 68.1 71.8 13.3 376
Volta 94.0 66.4 70.6 14.4 108
Eastern 88.4 67.9 61.8 17.4 148
Ashanti 92.7 61.2 58.3 13.7 414
Brong Ahafo 90.3 67.2 54.5 12.1 166
Northern (89.1) (72.0) (74.0) (23.5) 19
Upper East (88.7) (65.7) (65.7) (12.5) 12
Upper West 71.8 51.7 50.1 23.0 17
Education
No education 89.3 65.1 60.4 12.9 142
Primary 90.7 55.1 56.9 9.7 271
Middle/JSS/JHS 92.6 65.3 63.7 13.3 772
Secondary/SSS/SHS 95.9 62.9 63.1 18.8 375
More than secondary 94.9 81.4 78.6 14.2 119
Wealth quintile
Lowest 82.3 50.0 52.9 15.7 91
Second 91.9 59.8 59.2 14.6 287
Middle 92.7 61.9 57.2 14.1 401
Fourth 94.8 67.1 66.4 14.1 499
Highest 93.9 69.5 70.5 12.9 402
Total 92.9 64.3 63.2 14.0 1,680

Note: Figures in parentheses are based on 25-49 unweighted cases.

Table 6.9 Health problems and treatment after induced abortion

Among women age 15-49 who had an induced abortion in the 5 years preceding the survey, percentage who did not experience problems in the 1 month
after the only/final method of the most recent induced abortion, and percentage who experienced problems; among women who experienced problems,
percentage who got treatment; and among women who got treatment, percentage who received various types of treatment, according to problems,
Ghana MHS 2017
Problems in the 1 month
after the only/final
Number of
method of
Number of women who
induced abortion women Type of treatment experienced
Did not who experi- problems
experience Experienced Number of Got enced Blood and got
Problem problem problem women treatment problems Operation transfusion Antibiotics Other treatment
Bleeding 91.6 8.4 1,680 58.5 142 10.8 0.9 61.7 33.1 83
Pain 88.3 11.7 1,680 57.6 196 7.9 1.0 62.3 36.3 113
Fever 94.4 5.6 1,680 68.4 93 (11.3) (0.6) (68.1) (34.5) 64
Injury/perforation 99.5 0.5 1,680 * 8 * * * * 5
Foul-smelling
discharge 95.6 4.4 1,680 56.0 75 (4.9) (0.0) (69.2) (39.8) 42
Other 96.3 3.7 1,680 (58.8) 62 (3.8) (3.1) (57.1) (45.2) 36
Total 86.0 14.0 1,680 57.3 235 6.6 1.1 63.9 36.1 135

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and
has been suppressed.

Induced Abortion and Miscarriage • 101

 Table 6.10 Contraception use before and discussions of contraception before and after induced abortion

Percentage of women age 15-49 who had an induced abortion in the past 5 years and were using any method of contraception at the time they got pregnant before
the most recent induced abortion, percentage with whom a health professional discussed contraception before or after the most recent induced abortion, and percentage
who received contraceptive support from a health worker after the most recent induced abortion; among women with whom a health worker discussed contraception,
percent distribution by timing of discussion vis-à-vis most recent induced abortion; and among women to whom a health worker provided contraceptive support after
the most recent induced abortion, percent distribution by kind of support, according to background characteristics, Ghana MHS 2017
Number How contraceptive support after most Number
Timing of contraception of recent induced abortion of
discussion women was provided women
with to whom
whom a a health
Discus- Re- Both health worker
Using sed ceived Before After before profes- provided
contra- contra- contra- most most and after sional contra-
ception ception ception recent recent most discus- ceptive
when with a support Number induced induced recent sed Pre- support
Background became health after of abortion abortion induced contra- Gave scribed Gave Don’t after
characteristic pregnant worker abortion women only only abortion Total ception method method referral know Total abortion
Woman’s age
at time of
abortion
<20 12.2 22.6 18.6 365 25.7 62.5 11.8 100.0 82 40.9 55.2 3.9 0.0 100.0 68
20-34 21.8 33.9 19.5 1,146 33.0 48.8 18.1 100.0 389 32.5 61.0 5.8 0.7 100.0 223
35-49 21.2 31.2 20.2 169 43.8 41.9 14.4 100.0 53 (46.3) (51.3) (2.4) (0.0) (100.0) 34
Residence
Urban 18.8 29.5 17.3 1,111 34.2 46.4 19.4 100.0 328 29.0 64.5 6.5 0.0 100.0 192
Rural 21.4 34.5 23.5 570 30.9 56.7 12.4 100.0 196 45.3 50.6 3.0 1.1 100.0 134
Zone
Coastal 15.6 30.1 20.5 905 30.1 50.4 19.5 100.0 272 27.2 68.6 3.4 0.8 100.0 185
Middle 24.9 31.3 17.3 728 38.4 48.3 13.3 100.0 228 46.8 46.7 6.5 0.0 100.0 126
Northern 18.1 50.2 29.3 48 13.3 68.4 18.2 100.0 24 49.2 36.9 13.9 0.0 100.0 14
Region
Western 21.0 26.2 18.9 288 29.7 49.5 20.8 100.0 76 (31.7) (66.4) (1.9) (0.0) (100.0) 55
Central 10.0 31.0 12.8 133 (61.1) (28.4) (10.5) (100.0) 41 * * * * * 17
Greater Accra 14.4 33.5 25.4 376 22.8 52.1 25.1 100.0 126 (23.0) (73.1) (3.9) (0.0) (100.0) 96
Volta 12.1 27.5 16.9 108 (19.2) (75.7) (5.1) (100.0) 30 * * * * * 18
Eastern 27.7 42.4 32.3 148 24.7 62.9 12.4 100.0 63 (47.3) (50.0) (2.8) (0.0) (100.0) 48
Ashanti 22.8 26.1 11.8 414 44.4 44.5 11.1 100.0 108 (34.6) (51.2) (14.2) (0.0) (100.0) 49
Brong Ahafo 27.6 34.3 17.8 166 42.3 39.1 18.6 100.0 57 (66.1) (33.9) (0.0) (0.0) (100.0) 29
Northern (10.0) (51.9) (32.0) 19 (12.0) (77.6) (10.4) (100.0) 10 * * * * * 6
Upper East (29.4) (50.1) (32.1) 12 * * * * 6 * * * * * 4
Upper West 19.2 48.3 24.5 17 (7.1) (61.2) (31.6) (100.0) 8 * * * * * 4
Education
No education 24.0 25.8 18.1 142 (22.4) (61.9) (15.7) (100.0) 37 (32.0) (62.8) (5.2) (0.0) (100.0) 26
Primary 13.3 27.7 16.4 271 32.2 55.5 12.3 100.0 75 (70.1) (29.9) (0.0) (0.0) (100.0) 44
Middle/JSS/
JHS 18.3 31.2 19.3 772 36.5 43.3 20.1 100.0 241 33.4 58.6 8.0 0.0 100.0 149
Secondary/
SSS/SHS 19.9 36.4 23.1 375 29.2 58.3 12.5 100.0 136 26.2 70.9 1.1 1.7 100.0 87
More than
secondary 37.1 28.8 16.3 119 (36.1) (43.3) (20.6) (100.0) 34 * * * * * 19
Wealth
quintile
Lowest 17.5 35.5 23.9 91 16.7 54.7 28.6 100.0 32 (42.2) (55.5) (2.3) (0.0) (100.0) 22
Second 15.4 26.3 22.1 287 37.4 51.5 11.0 100.0 76 40.2 55.4 4.5 0.0 100.0 63
Middle 18.7 29.3 15.7 401 37.1 44.2 18.7 100.0 117 52.4 45.2 2.4 0.0 100.0 63
Fourth 17.6 33.7 17.8 499 30.4 56.8 12.8 100.0 168 33.5 57.5 9.0 0.0 100.0 89
Highest 26.7 32.4 22.0 402 34.0 45.5 20.5 100.0 130 21.3 73.0 4.1 1.7 100.0 89
Total 19.7 31.2 19.4 1,680 33.0 50.3 16.8 100.0 524 35.7 58.8 5.1 0.5 100.0 326

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been
suppressed.

102 • Induced Abortion and Miscarriage

Table 6.11 Abortion knowledge and access

Among women age 15-49, percentage who ever had an abortion, percentage who have not had an abortion but know what abortion is, and percentage who
know what abortion is; among women who have not had an abortion but know what it is, percentage who are able to get an abortion and percentage who know
a place to get an abortion; and among women who have had an abortion or who know what abortion is, percentage who know that abortion is legal, according
to background characteristics, Ghana MHS 2017
Know what
abortion is Women who have not had
(ever had an an abortion but know Number of
Never had abortion or what it is and women who
an abortion never had an have had an
but know abortion but Are able to Know a place Know that abortion or
Background Ever had an what know what Number of get an to get an Number of abortion is know what
characteristic abortion abortion is abortion is) women abortion abortion women legal it is
Age
<20 3.3 90.4 93.7 4,785 20.6 53.5 4,326 10.1 4,482
20-34 21.7 74.0 95.7 12,146 27.6 60.3 8,992 13.1 11,622
35-49 26.2 68.4 94.6 8,132 24.7 53.7 5,565 9.6 7,696
Residence
Urban 23.6 73.1 96.7 13,752 28.2 59.7 10,052 14.2 13,298
Rural 14.8 78.1 92.9 11,310 21.7 53.5 8,831 7.8 10,503
Zone
Coastal 21.8 74.7 96.4 12,121 24.5 54.0 9,052 11.3 11,689
Middle 22.4 74.7 97.2 9,674 28.6 60.8 7,231 11.2 9,401
Northern 3.4 79.6 82.9 3,267 17.9 55.3 2,600 12.1 2,710
Region
Western 20.8 74.9 95.7 3,230 20.5 46.6 2,419 6.8 3,092
Central 18.4 78.4 96.8 2,218 34.2 55.7 1,739 9.4 2,148
Greater Accra 26.4 69.9 96.3 4,673 28.0 57.9 3,265 16.6 4,501
Volta 15.9 81.5 97.4 2,000 13.1 55.7 1,629 8.5 1,948
Eastern 19.9 76.5 96.4 2,517 12.3 72.3 1,925 17.8 2,426
Ashanti 24.9 73.1 98.0 4,790 37.3 61.6 3,499 9.9 4,693
Brong Ahafo 20.1 76.3 96.4 2,367 28.9 46.9 1,806 6.9 2,281
Northern 2.8 76.9 79.7 1,786 15.3 55.6 1,373 11.7 1,423
Upper East 3.5 82.5 86.0 854 14.2 54.0 705 13.3 734
Upper West 4.8 83.2 88.0 628 29.8 56.3 523 11.5 553
Education
No education 11.6 75.9 87.5 4,585 18.1 42.6 3,482 4.0 4,013
Primary 21.0 72.1 93.1 3,934 21.0 50.3 2,838 6.5 3,664
Middle/JSS/JHS 23.8 73.2 97.0 10,081 25.9 56.9 7,377 8.1 9,775
Secondary/SSS/SHS 18.7 79.3 97.9 4,550 29.0 65.6 3,607 17.8 4,456
More than secondary 16.3 82.6 99.0 1,912 35.9 79.3 1,580 38.4 1,892
Wealth quintile
Lowest 6.1 79.7 85.8 4,064 15.9 44.7 3,241 6.2 3,488
Second 16.3 79.1 95.4 4,721 23.1 52.4 3,734 6.4 4,504
Middle 21.4 75.0 96.4 5,111 26.4 56.2 3,834 7.1 4,927
Fourth 26.9 70.1 97.0 5,443 27.5 61.4 3,814 12.5 5,279
Highest 23.5 74.4 97.9 5,723 30.8 66.2 4,260 21.3 5,602
Total 19.6 75.3 95.0 25,062 25.2 56.8 18,883 11.4 23,801

Induced Abortion and Miscarriage • 103

 Table 6.12 Knowledge of places to get an abortion

Among women age 15-49 who have not had an abortion but know what one is and know of a place to get an abortion, percentage who report
specific places to get an abortion, according to background characteristics, Ghana MHS 2017
Number of
women who
Public sources Private sources have not had an
abortion but
Government Pharmacy/ know what it is
Background Government health Other Private chemist/ Other Other and know of a
characteristic hospital centre/clinic public1 hospital/clinic drugstore private2 sources3 place to get one
Age
15-19 72.7 24.5 4.2 26.8 22.9 5.8 10.3 2,316
20-24 70.4 25.0 5.6 32.4 22.6 8.8 10.9 2,117
25-29 71.9 24.5 5.1 33.7 22.3 9.0 11.0 1,778
30-34 72.0 24.6 4.9 33.1 17.6 10.3 10.6 1,523
35-39 74.1 22.1 4.1 27.8 15.8 7.2 9.4 1,218
40-44 69.5 22.5 2.7 28.9 15.7 9.7 7.8 932
45-49 76.9 25.2 4.0 24.9 12.6 7.3 9.3 841
Residence
Urban 72.6 21.2 3.8 39.8 21.9 10.5 10.2 6,002
Rural 71.8 28.1 5.5 17.7 17.1 5.2 10.2 4,723
Zone
Coastal 73.1 27.3 5.3 35.2 18.0 11.6 11.1 4,892
Middle 69.9 17.1 2.6 29.9 23.0 5.6 10.3 4,394
Northern 76.2 35.3 7.9 13.1 15.6 4.3 6.4 1,439
Region
Western 68.0 32.9 3.5 19.4 13.4 10.6 10.6 1,127
Central 76.6 28.3 5.6 26.2 17.4 7.8 13.4 968
Greater Accra 70.5 23.0 4.0 57.1 22.5 14.7 13.1 1,889
Volta 81.1 28.0 10.0 19.1 14.9 10.6 5.2 907
Eastern 76.5 13.4 2.2 16.3 14.0 5.2 7.2 1,391
Ashanti 68.8 17.0 2.8 40.6 29.4 4.9 12.2 2,156
Brong Ahafo 61.9 23.5 3.1 25.2 21.8 8.0 10.6 847
Northern 80.2 28.7 8.9 12.5 20.8 6.0 8.9 764
Upper East 75.1 45.0 6.4 18.0 7.2 2.5 2.4 381
Upper West 67.4 40.0 7.4 8.1 13.2 2.0 5.3 294
Education
No education 70.6 28.4 6.8 15.6 14.5 5.8 9.7 1,483
Primary 72.8 24.9 4.4 18.3 17.0 7.7 9.6 1,427
Middle/JSS/JHS 71.5 24.0 4.4 27.9 20.1 6.9 11.3 4,198
Secondary/SSS/SHS 72.0 22.2 2.8 38.5 23.6 8.9 9.4 2,365
More than secondary 76.3 22.7 6.1 52.1 20.5 14.3 9.2 1,252
Wealth quintile
Lowest 69.2 31.6 7.3 10.3 15.2 3.8 8.9 1,450
Second 74.2 26.7 5.5 17.1 16.2 6.3 9.8 1,956
Middle 72.6 24.4 2.8 24.3 21.3 6.8 11.0 2,156
Fourth 71.6 21.7 4.2 35.1 21.8 9.7 10.5 2,342
Highest 72.6 20.6 4.2 49.6 21.7 11.5 10.2 2,821
Total 72.2 24.2 4.6 30.1 19.8 8.2 10.2 10,725

1
Government health post/CHPS, mobile clinic/outreach, family planning clinic, fieldworker, other public sector
2
Private doctor, mobile clinic/outreach, fieldworker, family planning/Planned Parenthood Association of Ghana clinic, maternity home, other private
medical sector
3
Shop, church, friend/relative, other

104 • Induced Abortion and Miscarriage

Table 6.13 Miscarriage causes

Percent distribution of cause of most recent miscarriage in the 5 years preceding the survey among women age 15-49, according to
background characteristics, Ghana MHS 2017
Cause of miscarriage
Background Something Someone Number of
characteristic Accident she ate hurt her Spontaneous Other Don’t know Total miscarriages
Woman’s age at time of
miscarriage
<20 12.0 4.1 5.5 68.6 9.1 0.6 100.0 142
20-34 10.8 2.4 3.1 73.1 9.7 0.8 100.0 1,177
35-49 8.9 1.7 1.1 78.6 9.3 0.5 100.0 472
Residence
Urban 9.8 2.7 2.9 72.5 11.4 0.7 100.0 973
Rural 11.0 2.0 2.7 76.2 7.4 0.7 100.0 819
Zone
Coastal 10.5 1.6 3.8 74.2 9.3 0.7 100.0 849
Middle 11.3 3.3 1.9 72.0 11.0 0.5 100.0 756
Northern 6.2 2.0 2.0 83.2 5.1 1.5 100.0 186
Region
Western 7.8 3.0 6.6 71.6 10.2 0.9 100.0 240
Central 14.4 1.2 2.0 72.2 9.6 0.5 100.0 167
Greater Accra 12.4 1.1 1.7 72.8 11.4 0.5 100.0 313
Volta 5.7 0.7 5.9 84.6 2.0 1.1 100.0 129
Eastern 14.0 2.5 2.8 76.0 4.7 0.0 100.0 166
Ashanti 10.8 4.0 1.6 68.7 14.5 0.4 100.0 421
Brong Ahafo 9.7 2.4 1.6 76.4 8.6 1.4 100.0 169
Northern 4.9 1.3 2.4 86.3 2.9 2.1 100.0 96
Upper East 4.8 3.8 0.5 81.5 7.7 1.7 100.0 49
Upper West 10.7 1.5 3.0 77.8 6.9 0.0 100.0 41
Education
No education 6.3 1.2 3.6 83.3 4.6 1.0 100.0 300
Primary 11.6 2.5 3.7 71.4 9.9 0.9 100.0 282
Middle/JSS/JHS 9.4 3.1 2.7 74.3 10.3 0.3 100.0 748
Secondary/SSS/SHS 16.4 2.7 1.5 68.1 10.1 1.1 100.0 318
More than secondary 7.5 0.2 2.9 73.7 14.4 1.3 100.0 144
Wealth quintile
Lowest 9.1 2.4 2.9 82.0 2.9 0.8 100.0 227
Second 8.4 1.2 2.9 77.1 8.4 1.9 100.0 300
Middle 11.5 2.7 5.7 67.8 11.9 0.4 100.0 365
Fourth 11.3 3.2 2.1 73.4 9.5 0.4 100.0 441
Highest 10.4 2.0 1.0 74.3 11.9 0.4 100.0 458
Total 10.4 2.4 2.8 74.2 9.6 0.7 100.0 1,791

Induced Abortion and Miscarriage • 105

 Table 6.14 Seeking help after miscarriage

Percentage of women age 15-49 who had a miscarriage in the 5 years preceding the survey who sought help after the most recent miscarriage, and among women
who sought help, from whom and where they sought help, according to background characteristics, Ghana MHS 2017
Assistance Location: public sources Location: private sources
Govern- Phar- Number
ment macy/ of women
Number Govern- health Private chemist/ who
Background Sought of Nurse/ ment centre/ Other hospital/ drug- Other Other sought
characteristic help women Doctor midwife Other hospital clinic public1 clinic store private2 sources3 help
Woman’s age at time
of miscarriage
<20 70.2 142 51.0 61.7 10.8 56.3 26.8 5.2 4.4 4.5 0.0 3.2 100
20-34 75.7 1,177 62.7 45.5 10.8 53.2 20.2 2.1 16.3 3.3 2.8 5.2 891
35-49 71.4 472 68.3 48.1 10.1 56.5 20.1 1.6 16.6 3.6 3.9 4.9 337
Residence
Urban 75.4 973 71.0 42.2 9.0 54.8 16.0 1.2 19.4 2.8 4.2 5.3 734
Rural 72.6 819 53.8 53.8 12.6 53.7 26.5 3.4 10.7 4.2 1.2 4.5 594
Zone
Coastal 71.4 849 64.9 45.3 10.3 52.0 19.3 1.4 16.6 4.3 2.6 5.8 606
Middle 76.0 756 62.7 48.6 10.8 57.0 19.2 1.5 17.0 2.5 3.7 4.7 575
Northern 78.9 186 58.9 51.1 10.9 53.5 32.0 8.0 5.0 3.5 0.7 2.6 147
Region
Western 70.8 240 60.4 47.3 8.7 47.5 23.9 1.2 22.1 2.9 2.3 3.3 170
Central 76.8 167 59.5 66.5 8.4 68.4 14.9 4.3 5.5 2.8 0.8 5.5 128
Greater Accra 70.5 313 72.3 30.1 12.1 47.3 17.7 0.5 18.5 6.3 4.7 6.5 220
Volta 67.8 129 63.0 48.5 11.9 48.3 20.9 0.0 17.2 3.9 0.6 9.1 88
Eastern 68.5 166 55.2 49.7 11.2 68.0 11.1 2.8 12.4 4.7 0.0 4.6 114
Ashanti 81.3 421 67.5 48.9 7.7 53.0 19.7 0.4 22.3 1.7 4.5 3.8 342
Brong Ahafo 70.2 169 56.3 46.9 19.5 57.8 25.5 3.4 6.2 2.9 4.7 7.4 119
Northern 78.2 96 57.1 47.6 11.4 53.0 28.0 10.9 4.2 5.9 0.8 2.0 75
Upper East 82.9 49 64.9 54.8 13.1 53.5 32.2 5.2 9.7 1.2 0.7 4.4 41
Upper West 75.6 41 55.2 54.7 6.7 54.8 41.7 4.5 0.6 0.7 0.3 1.7 31
Education
No education 66.8 300 56.6 48.6 15.2 48.2 33.5 5.1 6.7 2.2 2.5 7.4 201
Primary 73.7 282 55.8 51.9 10.1 56.9 23.9 4.8 11.2 4.9 4.2 2.0 208
Middle/JSS/JHS 71.6 748 59.9 51.9 10.7 53.1 23.2 1.1 14.6 3.8 2.7 5.0 535
Secondary/SSS/SHS 81.7 318 72.7 42.6 10.0 59.3 9.5 0.5 19.5 3.9 2.9 5.1 260
More than secondary 86.6 144 81.7 28.7 5.0 54.2 7.1 1.1 32.6 0.3 2.0 5.4 124
Wealth quintile
Lowest 65.1 227 47.6 56.8 16.2 46.6 37.8 5.6 4.5 3.5 0.2 9.1 148
Second 68.3 300 47.5 58.9 14.3 49.5 27.7 6.3 11.2 6.9 2.3 1.4 205
Middle 75.2 365 65.2 57.4 7.4 64.3 21.5 0.7 10.0 2.6 0.8 2.6 275
Fourth 76.9 441 63.8 43.3 9.6 55.9 19.5 1.6 15.5 1.9 3.4 6.4 339
Highest 78.9 458 76.7 33.2 9.5 51.0 10.1 0.2 26.6 3.5 5.4 5.7 361
Total 74.1 1,791 63.3 47.4 10.6 54.3 20.7 2.2 15.5 3.4 2.9 4.9 1,328

1
Government health post/CHPS, mobile clinic/outreach, other public sector
2
Mobile clinic/outreach, family planning/Planned Parenthood Association of Ghana clinic, maternity home, other private medical sector
3
Respondent’s home, other home, traditional birth attendant’s home, other

106 • Induced Abortion and Miscarriage

 Table 6.15 Treatment after miscarriage

Percentage of women age 15-49 who had a miscarriage in the 5 years preceding the survey who had their uterus cleaned,
percentage who took antibiotics, percentage who took pain relievers, and percentage who experienced any health problems
in the 1 month after the most recent miscarriage, according to background characteristics, Ghana MHS 2017
Background Uterus Pain Experienced Number of
characteristic cleaned Antibiotics relievers health problems women
Woman’s age at time of
miscarriage
<20 44.5 71.5 70.2 13.4 142
20-34 46.0 76.7 76.9 12.1 1,177
35-49 43.4 74.2 78.1 13.5 472
Residence
Urban 46.3 74.5 77.6 10.4 973
Rural 43.9 76.9 75.6 15.2 819
Zone
Coastal 42.7 72.2 75.6 10.8 849
Middle 46.4 78.2 77.8 13.8 756
Northern 51.8 80.8 77.6 15.6 186
Region
Western 48.8 75.7 72.0 8.9 240
Central 45.0 75.9 79.1 10.9 167
Greater Accra 40.7 72.0 77.5 10.9 313
Volta 33.3 61.3 73.0 14.1 129
Eastern 51.5 79.4 79.9 14.8 166
Ashanti 47.9 80.5 79.7 14.2 421
Brong Ahafo 37.6 71.1 70.8 12.0 169
Northern 51.3 82.7 82.8 16.3 96
Upper East 56.5 82.0 71.6 13.2 49
Upper West 47.5 75.1 72.4 16.7 41
Education
No education 42.8 70.0 73.1 10.5 300
Primary 43.5 77.2 78.5 17.0 282
Middle/JSS/JHS 40.6 73.2 73.9 10.9 748
Secondary/SSS/SHS 54.5 79.8 81.6 13.1 318
More than secondary 57.1 87.6 84.5 15.7 144
Wealth quintile
Lowest 36.8 69.5 66.0 11.9 227
Second 35.0 72.3 73.9 16.2 300
Middle 52.0 77.4 76.3 12.9 365
Fourth 47.4 77.6 79.8 11.3 441
Highest 48.5 77.5 81.2 11.4 458
Total 45.2 75.6 76.7 12.6 1,791

Table 6.16 Health problems and treatment after miscarriage

Among women age 15-49 who had a miscarriage in the 5 years preceding the survey, percentage who did not experience problems in the 1 month after
the most recent miscarriage, and percentage who experienced problems; among women who experienced problems, percentage who got treatment;
and among women who got treatment, percentage who received various types of treatment, according to problems, Ghana MHS 2017
Problems in the 1 month Number of
after the miscarriage Type of treatment women who
Number of experienced
Did not women who problems
experience Experienced Number of Got experienced Blood and got
Problem problem problem women treatment problems Operation transfusion Antibiotics Other treatment
Bleeding 93.8 6.2 1,791 72.4 112 4.8 1.7 67.3 37.1 81
Pain 90.3 9.7 1,791 71.6 174 4.8 0.7 74.0 31.3 125
Fever 94.2 5.8 1,791 73.7 105 4.1 2.9 70.8 36.5 77
Injury/perforation 99.3 0.7 1,791 * 12 * * * * 5
Foul-smelling
discharge 96.5 3.5 1,791 70.8 63 10.9 0.2 63.4 40.1 44
Other 97.1 2.9 1,791 88.9 52 (4.9) (0.2) (52.8) (59.4) 46
Total 87.4 12.6 1,791 72.4 225 4.3 1.4 73.1 32.6 163

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases
and has been suppressed.

Induced Abortion and Miscarriage • 107

108 • Induced Abortion and Miscarriage

Table 6.17 Contraception use before and discussions of contraception before and after miscarriage
Percentage of women age 15-49 who had a miscarriage in the past 5 years and were using any method of contraception at the time they got pregnant before the most recent miscarriage, percentage with whom a health professional
discussed contraception before or after the most recent miscarriage, and percentage who received contraceptive support from a health worker after the most recent miscarriage; among women with whom a health worker discussed
contraception, percent distribution by timing of discussion vis-à-vis most recent miscarriage; and among women to whom a health worker provided contraceptive support after the most recent miscarriage, percent distribution by
kind of support, according to background characteristics, Ghana MHS 2017
Number of How contraceptive support after most recent Number of
Timing of contraception discussion women with miscarriage was provided women to
Using Received whom a whom a health
contra- Discussed contra- health worker
ception contra- ception Before most After most Both before professional provided
when ception with support recent recent and after discussed contraceptive
Background became a health after Number of miscarriage miscarriage most recent contra- Gave Prescribed Gave support after
characteristic pregnant worker miscarriage women only only miscarriage Total ception method method referral Don’t know Total miscarriage
Woman’s age at time
of miscarriage
<20 9.2 29.6 19.6 142 (24.2) (57.0) (18.8) (100.0) 42 * * * * * 28
20-34 15.8 29.7 13.2 1,177 39.1 45.9 15.0 100.0 349 35.3 55.9 8.3 0.5 100.0 156
35-49 8.5 24.8 11.7 472 49.7 36.1 14.2 100.0 117 36.3 57.8 5.9 0.0 100.0 55
Residence
Urban 11.6 28.3 11.5 973 38.5 43.7 17.8 100.0 276 31.2 54.9 13.2 0.7 100.0 112
Rural 15.5 28.5 15.5 819 42.5 45.6 11.9 100.0 233 34.3 60.5 5.2 0.0 100.0 127
Zone
Coastal 10.9 30.0 13.2 849 44.6 41.1 14.3 100.0 255 24.3 65.9 9.7 0.0 100.0 112
Middle 16.3 24.6 11.7 756 32.1 52.3 15.6 100.0 186 35.8 55.8 7.5 0.9 100.0 88
Northern 12.7 36.3 20.4 186 46.7 36.5 16.8 100.0 68 51.0 38.8 10.2 0.0 100.0 38
Region
Western 14.5 32.5 17.5 240 42.3 46.3 11.3 100.0 78 (18.2) (80.3) (1.5) (0.0) (100.0) 42
Central 13.8 31.4 7.5 167 (45.8) (40.8) (13.5) (100.0) 52 * * * * * 12
Greater Accra 8.5 32.1 13.6 313 50.3 33.1 16.6 100.0 100 * * * * * 43
Volta 6.0 18.5 11.7 129 * * * * 24 * * * * * 15
Eastern 25.8 28.7 14.0 166 (32.3) (50.8) (16.9) (100.0) 48 * * * * * 23
Ashanti 11.8 20.7 9.4 421 23.5 60.3 16.2 100.0 87 (27.7) (60.3) (12.0) (0.0) (100.0) 40
Brong Ahafo 18.1 30.3 15.0 169 (46.6) (40.1) (13.3) (100.0) 51 * * * * * 25
Northern 11.5 36.7 11.7 96 59.2 23.5 17.2 100.0 35 (38.6) (49.0) (12.4) (0.0) (100.0) 11
Upper East 14.9 38.4 33.4 49 31.5 55.5 13.0 100.0 19 (62.0) (38.0) (0.0) (0.0) (100.0) 16
Upper West 13.0 32.7 25.0 41 35.1 43.7 21.2 100.0 13 (47.1) (29.0) (23.9) (0.0) (100.0) 10
Education
No education 14.3 26.7 12.8 300 48.5 39.4 12.1 100.0 80 32.9 63.6 3.5 0.0 100.0 39
Primary 11.7 31.3 13.1 282 42.0 39.8 18.1 100.0 88 (38.9) (54.7) (6.4) (0.0) (100.0) 37
Middle/JSS/JHS 13.5 27.9 14.2 748 35.9 51.8 12.3 100.0 208 35.9 55.5 8.5 0.0 100.0 107
Secondary/SSS/SHS 12.3 26.7 11.6 318 43.5 41.6 14.9 100.0 85 (12.8) (67.9) (19.3) (0.0) (100.0) 37
More than secondary 16.1 32.6 13.7 144 37.0 35.7 27.3 100.0 47 (41.9) (46.6) (7.4) (4.2) (100.0) 20
Wealth quintile
Lowest 14.1 31.4 16.6 227 43.0 41.2 15.8 100.0 71 46.2 51.1 2.7 0.0 100.0 38
Second 16.1 30.2 17.4 300 48.4 42.6 9.0 100.0 91 27.2 69.0 3.9 0.0 100.0 52
Middle 12.5 23.9 10.2 365 28.6 56.7 14.7 100.0 87 (42.1) (40.5) (17.4) (0.0) (100.0) 37
Fourth 12.8 33.8 13.9 441 43.7 38.5 17.9 100.0 149 24.7 63.1 10.9 1.3 100.0 61
Highest 12.3 24.0 11.0 458 36.6 47.1 16.3 100.0 110 (31.6) (58.0) (10.4) (0.0) (100.0) 50
Total 13.3 28.4 13.3 1,791 40.3 44.6 15.1 100.0 509 32.8 57.9 9.0 0.3 100.0 239

Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed.
INFANT AND CHILD MORTALITY 7
Key Findings

 Current status: Infant and under-5 mortality rates in the

5-year period preceding the survey are 37 and 52 deaths
per 1,000 live births, respectively. This means that 1 in 27
children die before celebrating their first birthday, while 1
in 19 children die before reaching age 5.
 Trends: Under-5 mortality has steadily decreased over
time, from 155 deaths per 1,000 live births in 1988 to 52
deaths per 1,000 live births in 2017. During the same
period, infant mortality declined from 77 to 37 deaths per
1,000 live births.
 Perinatal mortality: The perinatal mortality rate is 43
deaths per 1,000 pregnancies.
 High-risk fertility behaviour: Forty-nine percent of
births in the 5 years preceding the survey were in a high-
risk category (31% were in a single high-risk category,
and 17% were in multiple high-risk categories).

I
nformation on infant and child mortality is relevant to a demographic assessment of a country’s
population and is an important indicator of the country’s socioeconomic development and quality of
life. It can also help identify children who may be at higher risk of death and lead to strategies to
reduce this risk, such as promoting birth spacing.

This chapter presents information on levels, trends, and differentials in perinatal, neonatal, infant, and
under-5 mortality rates. It also examines biodemographic factors and fertility behaviours that increase
mortality risks for infants and children. The information was collected as part of a retrospective birth
history in which female respondents listed all of the children to whom they have given birth, along with
each child’s date of birth, survivorship status, and current age or age at death.

The quality of mortality estimates calculated from birth histories depends on the mother’s ability to recall
all of the children she has given birth to, as well as their birth dates and ages at death. Potential data quality
problems include:

 The selective omission from birth histories of those births that did not survive, which can result in
underestimation of childhood mortality.

 The displacement of birth dates, which may distort mortality trends. This can occur if an interviewer
knowingly records a birth as occurring in a different year than the one in which it occurred. This may
happen if an interviewer is trying to cut down on his or her overall work load, because live births
occurring during the 5 years before the interview are the subject of a lengthy set of additional
questions.

Infant and Child Mortality • 109

  The quality of reporting of age at death. Misreporting the child’s age at death may distort the age
pattern of mortality, especially if the net effect of the age misreporting is to transfer deaths from one
age bracket to another.

 Any method of measuring childhood mortality that relies on mothers’ reports (e.g., birth histories)
assumes that female adult mortality is not high or, if it is high, that there is little or no correlation
between the mortality risks of mothers and those of their children.

Selected indicators of the quality of the mortality data on which the estimates of mortality in this chapter
are based are presented in Appendix C, Tables C.3-C.6.

7.1 INFANT AND CHILD MORTALITY

Neonatal mortality: The probability of dying within the first month of life.
Postneonatal mortality: The probability of dying between the first month of life
and the first birthday (computed as the difference between infant and neonatal
mortality).
Infant mortality: The probability of dying between birth and the first birthday.
Child mortality: The probability of dying between the first and the fifth birthday.
Under-5 mortality: The probability of dying between birth and the fifth birthday.

In the 5-year period preceding the 2017 GMHS, infant mortality was 37 deaths per 1,000 live births and
under-5 mortality was 52 deaths per 1,000 live births. This means that 1 in 27 children die before their first
birthday, while 1 in 19 children die before reaching age 5. Neonatal mortality over the same period was 25
deaths per 1,000 live births, while postneonatal mortality was 12 deaths per 1,000 live births. Sixty-eight
percent of infant deaths occur within the first month of life (Table 7.1).

Trends: All three indicators of Figure 7.1 Trends in early childhood mortality rates
childhood mortality declined from
Deaths per 1,000 live births in the 5-year
1988 to 1998, rose slightly in 2003, period before the survey
and have since declined. Under-5
mortality decreased from 155 deaths 155
per 1,000 live births in 1988 to 52
deaths per 1,000 live births in 2017. 119
108 111
Over the same period, infant Under-5 mortality
mortality decreased from 77 to 37 77 82
deaths per 1,000 live births, while 66 64 60
57 52
50
neonatal mortality fell from 43 to 25 Infant mortality 41
37
deaths per 1,000 live births 43 41 43
(Figure 7.1). Neonatal mortality 30 29 29 25

1988 1993 1998 2003 2007 2014 2017

GDHS GDHS GDHS GDHS GMHS GDHS GMHS

7.2 BIODEMOGRAPHIC AND SOCIODEMOGRAPHIC RISK FACTORS

Researchers have identified multiple risk factors for early childhood mortality, including biodemographic
and sociodemographic factors, based on the characteristics of the mother and child and the circumstances
at birth.

Mortality estimates by sex of the child and mother’s place of residence (Table 7.2) were calculated for the
5-year period before the survey; mortality estimates by additional background characteristics of the mother

110 • Infant and Child Mortality

were calculated for the 10-year period before the survey to ensure that there were sufficient cases to
produce statistically reliable estimates (Table 7.3).

Patterns by background characteristics Figure 7.2 Childhood mortality

by previous birth interval
 Neonatal, infant, and under-5 mortality are all
Deaths per 1,000 live births for the
higher among male (28, 40, and 57 deaths per 10-year period before the survey
1,000 live births, respectively) than female (21,
Previous birth interval:
34, and 47 deaths per 1,000 live births,
<2 years 2 years 3 years 4+ years
respectively) children (Table 7.2).
90
 While there is little difference between urban
63
and rural areas with respect to neonatal (25 52 50 46
versus 24 deaths per 1,000 live births) or infant
32 33 34
(36 versus 38 deaths per 1,000 live births)
mortality, under-5 mortality is higher in rural (56
deaths per 1,000 live births) than urban (48
deaths per 1,000 live births) areas (Table 7.2). Infant mortality Under-5 mortality

 Neonatal (36 versus 21-24 deaths per 1,000 live Figure 7.3 Under-5 mortality by region
births), infant (63 versus 32-34 deaths per 1,000 Deaths per 1,000 live births for the 10-year period
live births), and under-5 (90 versus 46-52 deaths before the survey
per 1,000 live births) mortality are much higher
when the interval from the previous birth is less
than 2 years (Table 7.3 and Figure 7.2).

 Under-5 mortality ranges from 42 deaths per

1,000 live births in Greater Accra region to 78
deaths per 1,000 live births in Upper West region
(Table 7.3 and Figure 7.3).

 Neonatal mortality is lowest in Greater Accra

region (19 deaths per 1,000 live births) and
Upper East region (20 deaths per 1,000 live
births) and highest in Volta region (33 deaths per
1,000 live births), Central region (31 deaths per
1,000 live births), and Western region (30 deaths
per 1,000 live births) (Table 7.3).

7.3 PERINATAL MORTALITY

Perinatal mortality rate

Perinatal deaths comprise stillbirths (pregnancy loss that occurs after 7 months
of gestation) and early neonatal deaths (deaths of live births within the first 7
days of life). The perinatal mortality rate is calculated as the number of perinatal
deaths per 1,000 pregnancies of 7 or more months’ duration.
Sample: Number of pregnancies of 7 or more months’ duration to women age
15-49 in the 5 years before the survey

It can be difficult to distinguish between stillbirths and early neonatal deaths; perinatal mortality looks at
the proportion of pregnancies of 7 or more months’ duration that ended in a stillbirth or early neonatal
death. During the 5-year period preceding the 2017 GMHS, there were 347 stillbirths and 297 early

Infant and Child Mortality • 111

 neonatal deaths out of a total of 14,987 pregnancies of 7 or more months’ duration, yielding a perinatal
mortality rate of 43 deaths per 1,000 pregnancies of 7 or more months’ duration (Table 7.4).

Patterns by background characteristics

 Perinatal mortality increases steadily with mother’s age at birth.

 Perinatal mortality is highest when the previous pregnancy interval is less than 15 months (55 deaths
per 1,000 pregnancies) and when the pregnancy is a first pregnancy (47 deaths per 1,000 pregnancies);
perinatal mortality is lowest when the previous interval is 15 months or more (39-42 deaths per 1,000
pregnancies).

 At the regional level, perinatal mortality ranges from 29 deaths per 1,000 pregnancies in Upper East
region to 54 deaths per 1,000 pregnancies in Western region.

7.4 HIGH-RISK FERTILITY BEHAVIOUR

The survival of infants and children depends in part on the demographic and biological characteristics of
their mothers; child mortality is likely to be higher among mothers with one or more risk factors. Infants
and children have an elevated risk of dying if their mothers are under age 18 or over age 35, if they are
born after too short a birth interval (less than 24 months), and if they are of a high birth order (fourth or
higher). First births also have a higher mortality risk, but this risk is unavoidable.

Thirty percent of births in the 5 years preceding the survey were not in any high-risk category. Twenty-one
percent were in the unavoidable risk category (first births to women between age 18 and 34). Just under
half of births (49%) were in at least one avoidable high-risk category: 31% were in a single high-risk
category, and 17% were in multiple high-risk categories (Table 7.5).

Risk ratios represent the relationship between risk factors and mortality. The risk ratio is highest for births
in multiple high-risk categories (1.75), followed by births in the unavoidable risk category (1.48) and
births in a single high-risk category (1.23). Overall, the risk ratio is highest for births in which the mother
was older than age 34, the birth interval was less than 24 months, and the birth order was four or higher
(2.43); however, only 1% of births fell in this category.

Twenty percent of currently married women age 15-49 would not have been in any high-risk category had
they conceived at the time of the survey, 6% would have been in the unavoidable risk category, and nearly
three quarters (74%) would have been in an avoidable high-risk category (30% in a single high-risk
category and 45% in multiple high-risk categories).

LIST OF TABLES
For more information on infant and child mortality, see the following tables:

 Table 7.1 Early childhood mortality rates

 Table 7.2 Five-year early childhood mortality rates according to background characteristics
 Table 7.3 Ten-year early childhood mortality rates according to additional characteristics
 Table 7.4 Perinatal mortality
 Table 7.5 High-risk fertility behaviour

112 • Infant and Child Mortality

Table 7.1 Early childhood mortality rates

Neonatal, postneonatal, infant, child, and under-5 mortality rates for 5-year periods preceding the survey, Ghana
MHS 2017
Postneonatal Infant Child Under-5
Neonatal mortality mortality mortality mortality
Years preceding the survey mortality (NN) (PNN)1 (1q0) (4q1) (5q0)
0-4 25 12 37 16 52
5-9 28 16 44 23 66
10-14 32 19 51 30 80

1
Computed as the difference between the infant and neonatal mortality rates

Table 7.2 Five-year early childhood mortality rates according to background characteristics

Neonatal, postneonatal, infant, child, and under-5 mortality rates for the 5-year period preceding the survey,
according to background characteristics, Ghana MHS 2017
Postneonatal Infant Child Under-5
Background Neonatal mortality mortality mortality mortality
characteristic mortality (NN) (PNN)1 (1q0) (4q1) (5q0)
Child’s sex
Male 28 12 40 17 57
Female 21 12 34 14 47
Residence
Urban 25 10 36 12 48
Rural 24 14 38 18 56
Total 25 12 37 16 52
1
Computed as the difference between the infant and neonatal mortality rates

Infant and Child Mortality • 113

 Table 7.3 Ten-year early childhood mortality rates according to additional characteristics

Neonatal, postneonatal, infant, child, and under-5 mortality rates for the 10-year period preceding the survey,
according to additional characteristics, Ghana MHS 2017
Postneonatal Infant Child Under-5
Neonatal mortality mortality mortality mortality
Characteristic mortality (NN) (PNN)1 (1q0) (4q1) (5q0)
Mother’s age at birth
<20 26 16 42 24 65
20-29 26 12 38 20 58
30-39 26 15 41 16 56
40-49 40 15 55 (12) (67)
Birth order
1 31 14 46 20 65
2-3 24 11 36 17 52
4-6 23 15 38 22 59
7+ 35 20 55 20 74
Previous birth interval2
<2 years 36 26 63 30 90
2 years 21 11 32 20 52
3 years 22 11 33 18 50
4+ years 24 10 34 13 46
Birth size3
Small/very small 23 11 33 na na
Average or larger 17 8 26 na na
Zone
Coastal 28 15 43 17 59
Middle 26 12 37 16 53
Northern 25 15 40 32 71
Region
Western 30 17 47 23 69
Central 31 18 49 15 64
Greater Accra 19 13 32 10 42
Volta 33 12 45 21 65
Eastern 28 10 37 15 52
Ashanti 26 10 36 13 49
Brong Ahafo 22 17 39 22 61
Northern 26 16 42 37 77
Upper East 20 9 28 20 48
Upper West 28 19 47 33 78
Mother’s education
No education 26 17 43 29 71
Primary 28 16 44 21 64
Middle/JSS/JHS 24 11 36 14 49
Secondary/SSS/SHS 34 13 46 8 54
More than secondary 21 6 27 4 31
Wealth quintile
Lowest 28 14 42 27 68
Second 28 17 45 22 66
Middle 23 14 37 22 59
Fourth 32 12 44 14 58
Highest 21 9 30 6 35

Note: Figures in parentheses are based on 250-499 unweighted exposed children.

na = Not available
1
Computed as the difference between the infant and neonatal mortality rates
2
Excludes first-order births
3
Rates for the 5-year period before the survey

114 • Infant and Child Mortality

Table 7.4 Perinatal mortality

Number of stillbirths and early neonatal deaths, and the perinatal mortality rate for the 5-year period preceding the
survey, according to background characteristics, Ghana MHS 2017
Number of
Background Number of Number of early Perinatal pregnancies of 7+
characteristic stillbirths1 neonatal deaths2 mortality rate3 months’ duration
Mother’s age at birth
<20 30 29 34 1,755
20-29 157 146 40 7,485
30-39 137 106 48 5,058
40-49 23 17 57 689
Previous pregnancy
interval in months4
First pregnancy 70 68 47 2,939
<15 28 23 55 929
15-26 67 41 39 2,778
27-38 78 55 41 3,255
39+ 104 110 42 5,086
Residence
Urban 167 138 43 7,112
Rural 180 159 43 7,876
Zone
Coastal 148 150 44 6,739
Middle 153 109 45 5,762
Northern 46 38 34 2,487
Region
Western 51 56 54 1,999
Central 38 29 49 1,372
Greater Accra 39 42 38 2,130
Volta 20 23 35 1,237
Eastern 31 30 41 1,479
Ashanti 89 57 53 2,750
Brong Ahafo 33 22 36 1,532
Northern 28 23 33 1,522
Upper East 8 8 29 554
Upper West 10 7 41 411
Mother’s education
No education 78 66 38 3,781
Primary 64 46 41 2,660
Middle/JSS/JHS 142 113 44 5,829
Secondary/SSS/SHS 43 52 53 1,788
More than secondary 20 19 42 929
Wealth quintile
Lowest 59 68 37 3,421
Second 79 59 42 3,262
Middle 85 46 45 2,938
Fourth 57 78 48 2,828
Highest 67 45 44 2,538
Total 347 297 43 14,987

1
Stillbirths are foetal deaths in pregnancies lasting 7 or more months.
2
Early neonatal deaths are deaths at age 0-6 days among live-born children.
3
The sum of the number of stillbirths and early neonatal deaths divided by the number of pregnancies of 7 or more
months’ duration, expressed per 1,000.
4
Categories correspond to birth intervals of <24 months, 24-35 months, 36-47 months, and 48+ months.

Infant and Child Mortality • 115

 Table 7.5 High-risk fertility behaviour

Percent distribution of children born in the 5 years preceding the survey by category of elevated risk of mortality
and the risk ratio, and percent distribution of currently married women by category of risk if they were to conceive
a child at the time of the survey, Ghana MHS 2017
Births in the 5 years
preceding the survey Percentage of
Percentage Risk currently married
Risk category of births ratio women1
Not in any high-risk category 30.3 1.00 20.0a
Unavoidable risk category
First-order births between age 18 and age 34 21.0 1.48 5.8
In any avoidable high-risk category 48.7 1.42 74.2
Single high-risk category
Mother’s age <18 only 5.0 1.30 0.3
Mother’s age >34 only 3.1 1.30 8.1
Birth interval <24 months only 5.9 1.26 9.5
Birth order >3 only 17.3 1.19 11.5
Subtotal 31.3 1.23 29.5
Multiple high-risk category
Age <18 and birth interval <24 months2 0.2 * 0.2
Age >34 and birth interval <24 months 0.2 * 0.6
Age >34 and birth order >3 11.8 1.55 31.2
Age >34 and birth interval <24 months and birth order >3 1.3 2.43 4.9
Birth interval <24 months and birth order >3 4.0 1.99 7.9
Subtotal 17.4 1.75 44.7
Total 100.0 na 100.0
Subtotals by individual avoidable high-risk category
Mother’s age <18 5.2 1.35 0.5
Mother’s age >34 16.3 1.60 44.8
Birth interval <24 months 11.5 1.70 23.1
Birth order >3 34.3 1.45 55.5
Number of births/women 14,628 na 14,361

Note: Risk ratio is the ratio of the proportion dead among births in a specific high-risk category to the proportion
dead among births not in any high-risk category. An asterisk indicates that a figure is based on fewer than 25
unweighted cases and has been suppressed.
na = Not applicable
1
Women are assigned to risk categories according to the status they would have at the birth of a child if they were
to conceive at the time of the survey: current age less than 17 years and 3 months or older than 34 years and 2
months, latest birth less than 15 months ago, or latest birth being of order 3 or higher.
2
Includes the category age <18 and birth order >3
a
Includes sterilised women

116 • Infant and Child Mortality

ADULT AND MATERNAL MORTALITY 8
Key Findings

 Adult mortality: If age- and gender-specific

mortality rates for the 7 years preceding the survey
remain constant, 134 of every 1,000 women and
181 of every 1,000 men age 15 would be expected
to die before age 50.
 Maternal mortality ratio: The maternal mortality
ratio for the 7 years preceding the survey is
estimated at 310 maternal deaths per 100,000 live
births.
 Lifetime risk of maternal death: At current fertility
and mortality rates, 1% of women in Ghana will die
from maternal causes.
 Percentage of maternal deaths: Twelve percent of
deaths among women in the 7 years preceding the
survey were due to maternal causes.

A
dult and maternal mortality indicators can be used to assess the health status of a population.
Mortality indicators are also used to determine the life expectancy of the population and
subsequently to assess a country’s level of development. The issue of reproductive health care has
been of major concern to governments in most developing countries, and Ghana is no exception. It is for
this reason that the Government of Ghana is committed to making health care delivery accessible to all
people to reduce the level of mortality, and most especially maternal mortality, in the country. In view of
this, free maternal and child health care has been introduced as part of the reproductive health policy to
improve maternal health care delivery and reduce maternal deaths in Ghana.

Estimation of mortality rates requires complete and accurate data on adult and maternal deaths. In the 2017
GMHS, data were collected from all female respondents on the survival of their sisters and brothers to
obtain an estimate of adult mortality. Questions were included to determine if any of the sisters’ deaths
were maternity-related, which permits the estimation of maternal mortality—a key indicator of maternal
health and well-being.

This chapter presents information on levels of and trends in adult mortality and maternal mortality in
Ghana. The chapter includes a summary measure (35q15) that represents the probability of dying between
exact ages 15 and 50, that is, between the 15th and 50th birthdays.

8.1 DATA
To obtain a sibling history, the respondent was asked to provide a list of all brothers and sisters born to her
mother. The respondent was then probed for any brothers or sisters from the same mother who may not
have been mentioned because they do not live with the respondent, they may have died, or they may have a
different father. Once the total number of siblings was determined, the list of siblings was placed in birth

Adult and Maternal Mortality • 117

 order, beginning with the first born, and the respondent was asked to identify whether each sibling was
alive at the time of the survey. The current age was recorded for living siblings. For deceased siblings, the
age at death and number of years since death were recorded. Interviewers were instructed that when a
respondent could not provide precise information on age at death or years since death, approximate but
quantitative answers were acceptable.

For sisters who died at age 12 or older, several questions were used to determine if the death was
maternity-related: “Was (NAME OF SISTER) pregnant when she died?” and, if not, “Did she die during
childbirth?” and, if not, “Did she die within 2 months after the end of a pregnancy or childbirth?” and, if
yes, “How many days after the end of the pregnancy did she die?” Since accidental and incidental deaths
are not counted as maternal deaths, respondents were asked if each of the sisters who died had died from
an act of violence or an accident (these deaths are included in the estimate of pregnancy-related deaths; see
section 8.5).

Table C.7 shows the number of siblings (both those still living and those dead) reported by respondents
and the completeness of data on siblings: current age for living siblings and both age at death and years
since death for siblings who had died (see Appendix C). A total of 123,207 siblings were recorded in the
adult and maternal mortality section of the 2017 GMHS Woman’s Questionnaire. Survival status was not
reported for 13 siblings (0.01%). Current age was reported for all 108,041 surviving siblings. Age at death
and years since death were reported for all 15,153 dead siblings.

8.2 DIRECT ESTIMATES OF ADULT MORTALITY

Adult mortality rate

The number of adult deaths per 1,000 population age 15-49. Adult mortality
rates by 5-year age groups are calculated as follows: the number of deaths to
respondent’s siblings in each age group are divided by the number of person-
years of exposure to the risk of dying in that age group during the 7 years
preceding the survey. The number of deaths is the number of siblings
(brothers or sisters) reported as having died within the 7 years preceding the
survey. The person-years of exposure in each age group are calculated for
both surviving and dead siblings based on their current age (living siblings) or
age at death and years since death (dead siblings).
Sample: Siblings (both living and dead) who were age 15-49 in the 7 years
preceding the survey, by sex and 5-year age groups

Evaluating the plausibility and stability of overall Figure 8.1 Adult mortality rates by age
adult mortality is one way to assess the quality of the Deaths per 1,000 population
data used to estimate maternal mortality. If the
estimated rates of overall adult mortality are 14
implausible, rates based on a subset of deaths 12
(maternal deaths in particular) may have serious 10
problems. Men
8
The reported ages at death and years since death of 6
the respondents’ brothers and sisters are used to 4
Women
make direct estimates of adult mortality. Because of
2
differentials in exposure to the risk of dying, this
report presents age- and sex-specific death rates. 0
Table 8.1.1 and Figure 8.1 show age-specific 15-19 20-24 25-29 30-34 35-39 40-44 45-49
mortality rates among women and men age 15-49 for
the 7 years before the 2017 GMHS. To ensure a sufficiently large number of adult deaths to generate a
robust estimate, the rates are calculated for the 7-year period before the survey (roughly between mid- to
late 2010 and mid- to late 2017). Nevertheless, age-specific mortality rates obtained in this manner are

118 • Adult and Maternal Mortality

subject to considerable sampling variation. Use of this 7-year period is a compromise between the desire
for the most recent data and the need to minimise the level of sampling error.

 Adult mortality is higher among men (4.88 deaths per 1,000 population) than among women (3.57
deaths per 1,000 population).

 Mortality generally increases with age among both men and women, and mortality is higher among
men than women in all age groups.

 Mortality is lower among women in the Northern zone (2.88 per 1,000 population) than among women
in the Coastal (3.62 per 1,000) and Middle (3.74 per 1,000) zones (Table 8.1.2). The result for the
Northern zone is unexpected and may indicate under-reporting of siblings and/or other data quality
issues in that zone.

 Mortality among men varies from 4.66 per 1,000 population in the Coastal zone and 4.88 per 1,000 in
the Northern zone to 5.12 per 1,000 in the Middle zone.

8.3 TRENDS IN ADULT MORTALITY

Table 8.2 shows the probability of dying between exact ages 15 and 50 (35q15) in the 7 years before the
2007 and 2017 GMHS surveys. 35q15 is the probability that a woman or man who reaches age 15 will die
before reaching age 50 (if the age- and gender-specific mortality rates in the 7 years before the survey hold
constant).

Women in Ghana have a lower probability of dying between ages 15 and 50 than men: 134 of every 1,000
women age 15 would be expected to die by age 50, as compared with 181 of every 1,000 men.

The probability of dying between ages 15 and 50 decreased from 148 per 1,000 in 2007 to 134 per 1,000 in
2017 among women but increased from 172 to 181 per 1,000 among men.

8.4 DIRECT ESTIMATES OF MATERNAL MORTALITY

Maternal mortality rate

The number of maternal deaths per 1,000 women age 15-49. Maternal
mortality rates by 5-year age groups are calculated by dividing the number of
maternal deaths to female siblings of respondents in each age group by the
total person-years of exposure of the sisters to the risk of dying in that age
group during the 7 years preceding the survey. The number of deaths is the
number of sisters reported as having died in the 7 years preceding the survey
either during pregnancy or delivery, or in the 42 days following the delivery, by
their age group at the time of death; deaths due to accident or violence are
excluded. The person-years of exposure in each age group are calculated for
both surviving and dead sisters based on their reported current age (living
sisters) or age at death and years since death (dead sisters).
Sample: Sisters (both living and dead) age 15-49 in the 7 years preceding the
survey, by 5 year age groups

Maternal mortality ratio

The number of maternal deaths per 100,000 live births. The maternal mortality
ratio is calculated by dividing the age-standardised maternal mortality rate for
women age 15-49 in the 7 years preceding the survey by the general fertility
rate (GFR) for the same period.

Maternal deaths are a subset of all female deaths. They are defined as any deaths that occur during
pregnancy or childbirth or within 42 days after the birth of a child or termination of a pregnancy; maternal

Adult and Maternal Mortality • 119

 deaths do not include deaths due to accidents or violence. This is the first DHS Program survey in Ghana
to collect data on whether siblings’ deaths were due to accidents or violence, and the data presented in this
section cannot be used to discuss trends (see section 8.5 for more information).

Two methods are generally used to estimate maternal mortality in developing countries: the indirect
sisterhood method (Graham et al. 1989) and a direct variant of the sisterhood method (Rutenberg and
Sullivan 1991; Stanton et al. 1997). Table 8.3.1 presents age-specific direct estimates of maternal
mortality from the reported survivorship of sisters for the 7-year period prior to the 2017 GMHS. These
rates were calculated by dividing the number of maternal deaths by woman-years of exposure. To remove
the effect of truncation bias (the lower boundary for eligibility among women interviewed in the survey is
15 years, and the upper boundary is 49 years), the overall rate for women age 15-49 was standardised by
the age distribution of survey respondents.

 The maternal mortality rate is 0.39 deaths per 1,000 woman-years of exposure.

 Age-specific patterns should be interpreted with extreme caution because of the small number of
events: only 118 maternal deaths reported among women of all ages in the 7-year period preceding the
survey. The maternal mortality rate initially increases with age, peaks at age 30-34 (0.90), and then
decreases with increasing age.

 Maternal deaths constitute 12% of all deaths that occurred among women age 15-49 in the 7 years
preceding the survey.

 As with age-specific rates, zonal rates should be interpreted with caution. The maternal mortality rate
in the Coastal (0.38) and Middle (0.37) zones is lower than the rate in the Northern zone (0.45), which
(as for adult mortality overall) is unexpected and may indicate under-reporting of siblings and/or other
data quality issues in that zone (Table 8.3.2). In addition, these estimates assume that sisters’ deaths
took place in the zone where the respondent was interviewed, which may not always be the case.

 The estimate of the maternal mortality ratio in Figure 8.2 Zonal differences in Maternal
Ghana during the 7 years preceding the survey is Mortality Ratio (MMR) with
310 deaths per 100,000 live births with a confidence intervals
confidence interval of 217 to 402 deaths per Maternal mortality per 100,000
100,000 live births. There are slight differences live births
in the point estimates for each zone, but the
confidence intervals for these estimates overlap, National
making it unlikely that the differences are 310
statistically significant (Table 8.4 and Northern
zone
Figure 8.2). 276
Middle
 The current fertility and mortality rates indicate zone 296
that 1% of women in the country will die from
Coastal
maternal causes while in their reproductive years zone 336
(age 15-49).
0 100 200 300 400 500 600
Note: MMR includes deaths during pregnancy, delivery,
and within 42 days of the end of a pregnancy; it excludes
deaths due to accident and violence. This is a new
indicator that requires different data than were collected in
previous surveys, and is different than the PRMR estimate
in Figure 8.3.

120 • Adult and Maternal Mortality

8.5 TRENDS IN PREGNANCY-RELATED MORTALITY

Pregnancy-related mortality rate

The number of pregnancy-related deaths per 1,000 women age 15-49.
Pregnancy-related mortality rates by 5-year age groups are calculated by
dividing the number of pregnancy-related deaths to female siblings of
respondents in each age group by the total person-years of exposure of the
sisters to the risk of dying in that age group during the 7 years preceding the
survey. The number of deaths is the number of sisters reported as having died
in the 7 years preceding the survey either during pregnancy or delivery, or in
the 2 months following the delivery, by their age group at the time of death.
The person-years of exposure in each age group are calculated for both
surviving and dead sisters based on their reported current age (living sisters)
or age at death and years since death (dead sisters).
Sample: Sisters (both living and dead) age 15-49 in the 7 years preceding the
survey, by 5-year age groups

Pregnancy-related mortality ratio

The number of pregnancy-related deaths per 100,000 live births. The
pregnancy-related mortality ratio is calculated by dividing the age-standardised
pregnancy-related mortality rate for women age 15-49 in the 7 years preceding
the survey by the general fertility rate (GFR) for the same time period.

The 2007 GMHS defined a pregnancy-related death as the death of a woman while pregnant or within 2
months of termination of pregnancy, irrespective of the cause of death. Estimates of pregnancy-related
mortality are therefore based solely on the timing of the death in relationship to the pregnancy. Note that
this definition varies from the WHO definition of a pregnancy-related death, which limits the window to
42 days. To produce an indicator suitable for comparison with the 2007 GMHS, an estimate of pregnancy-
related mortality was also obtained from the 2017 GMHS data set.

Comparing Maternal mortality (MMR) Pregnancy-related mortality (PRMR)

MMR and Women who died when pregnant, during Women who died when pregnant, during
PRMR delivery, or within 42 days of delivery or delivery, or within 2 months of delivery or
the termination of a pregnancy, except the termination of a pregnancy, including
when death was due to accident or deaths due to accident or violence
violence

Adult and Maternal Mortality • 121

 Figure 8.3 presents estimates of the pregnancy- Figure 8.3 Trends in Pregnancy-Related
related mortality ratio (PRMR) with confidence Mortality Ratio (PRMR) with
intervals for the 2007 and 2017 GMHS surveys. The confidence intervals
point estimates show a decline from 451 maternal
deaths per 100,000 live births in 2007 to 343 Pregnancy-related deaths per 100,000
maternal deaths per 100,000 live births in 2017; live births
since the confidence interval for the 2007 estimate 600
overlaps with the 2017 point estimate, however, the
difference between the 2007 and 2017 estimates is 500
451
not statistically significant. 400
343
Figure 8.4 presents estimates of the pregnancy- 300
related mortality ratio with confidence intervals for
200
Ghana and other West African countries from DHS
surveys conducted between 2010 and 2017. The 100
point estimates range from 341 maternal deaths per
0
100,000 live births in Burkina Faso to 724 maternal 2000-2007 2010-2017
deaths per 100,000 live births in Guinea. Although
(7 years preceding (7 years preceding
Ghana’s point estimate is the second lowest (343 per the 2007 GMHS) the 2017 GMHS)
100,000 live births) among these countries, work
Note: PRMR includes all deaths during pregnancy,
remains to be done to improve the maternal mortality delivery, and within 2 months of the end of a pregnancy; it
situation in the country. includes deaths due to accident and violence during these
time periods. This indicator is consistent with how data
were collected in 2007, and is different than the MMR
estimate in Figure 8.2.

Figure 8.4 Pregnancy-related mortality ratio in West Africa,

2010-2017
Pregnancy-related deaths per 100,000 live births

1,000

800

600

400

200

0
Burkina Senegal Côte Guinea Niger Nigeria Gambia Togo Ghana
Faso 2010-11 d'Ivoire 2012 2012 2013 2013 2013-14 2017
2010 DHS 2011-12 DHS DHS DHS DHS DHS MHS
DHS DHS

LIST OF TABLES
For more information on adult and maternal mortality, see the following tables:

 Table 8.1.1 Adult mortality rates: national

 Table 8.1.2 Adult mortality rates: zones
 Table 8.2 Adult mortality probabilities
 Table 8.3.1 Maternal mortality: national
 Table 8.3.2 Maternal mortality: zones
 Table 8.4 Maternal mortality ratio
 Table C.9 Pregnancy-related mortality

122 • Adult and Maternal Mortality

 Table 8.1.1 Adult mortality rates: national

Direct estimates of female and male mortality rates for the 7 years preceding
the survey by 5-year age groups, Ghana MHS 2017
Exposure Mortality
Age Deaths years rate1
FEMALE

15-19 72 46,486 1.54

20-24 63 54,463 1.15
25-29 148 54,462 2.71
30-34 201 48,003 4.18
35-39 194 38,515 5.04
40-44 155 27,269 5.68
45-49 154 18,476 8.35
Total 15-49 986 287,673 3.57a

MALE

15-19 108 46,301 2.34

20-24 130 55,325 2.34
25-29 174 54,601 3.19
30-34 219 48,854 4.49
35-39 233 39,354 5.92
40-44 257 27,701 9.26
45-49 225 18,351 12.24
Total 15-49 1,346 290,486 4.88a

1
Expressed per 1,000 population
a
Age-adjusted rate

Table 8.1.2 Adult mortality rates: zones

Direct estimates of female and male mortality rates for the 7 years preceding the survey at the zonal level by 5-year age groups, Ghana
MHS 2017
Coastal Middle Northern
Exposure Mortality Exposure Mortality Exposure Mortality
Age Deaths years rate1 Deaths years rate1 Deaths years rate1
FEMALE

15-19 35 21,340 1.65 25 18,325 1.37 11 6,820 1.68

20-24 26 25,302 1.02 24 21,462 1.11 13 7,699 1.69
25-29 74 25,406 2.90 56 21,635 2.60 18 7,422 2.39
30-34 107 22,749 4.71 76 18,928 4.00 18 6,326 2.80
35-39 78 18,608 4.21 95 14,951 6.34 21 4,956 4.23
40-44 66 13,209 5.01 74 10,809 6.86 14 3,252 4.44
45-49 80 8,740 9.15 64 7,746 8.28 10 1,990 5.08
Total 15-49 466 135,354 3.62a 414 113,855 3.74a 105 38,464 2.88a

MALE

15-19 42 21,521 1.94 51 18,142 2.83 15 6,638 2.32

20-24 58 25,891 2.24 47 21,360 2.18 25 8,073 3.11
25-29 78 25,879 3.03 62 20,876 2.97 34 7,846 4.30
30-34 81 23,576 3.44 105 18,752 5.60 33 6,526 5.05
35-39 109 18,941 5.77 102 15,449 6.57 22 4,964 4.48
40-44 131 13,362 9.81 96 11,111 8.64 30 3,229 9.14
45-49 112 9,238 12.10 93 7,241 12.88 20 1,872 10.50
Total 15-49 611 138,408 4.66a 556 112,932 5.12a 179 39,147 4.88a

1
Expressed per 1,000 population
a
Age-adjusted rate

Adult and Maternal Mortality • 123

 Table 8.2 Adult mortality probabilities

The probability of dying between the ages of 15 and 50 for

women and men during the 7 years preceding the survey,
Ghana MHS 2017
Female Male
1 1
Survey 35q15 35q15

National
2017 Ghana MHS 134 181
2007 Ghana MHS 148 172
Zone (2017)
Coastal 134 174
Middle 142 188
Northern 106 177

1
The probability of dying between exact ages 15 and 50,
expressed per 1,000 persons at age 15

Table 8.3.1 Maternal mortality: national

Direct estimates of maternal mortality rates for the 7 years preceding the survey by 5-year age
groups, Ghana MHS 2017
Percentage of
female deaths Maternal Exposure Maternal
Age that are maternal deaths1 years mortality rate2
15-19 7.3 5 46,486 0.11
20-24 15.6 10 54,463 0.18
25-29 14.9 22 54,462 0.40
30-34 21.4 43 48,003 0.90
35-39 12.8 25 38,515 0.64
40-44 7.8 12 27,269 0.44
45-49 0.7 1 18,476 0.06
Total 15-49 12.0 118 287,673 0.39a

1
A maternal death is defined as the death of a woman while pregnant or within 42 days of
termination of pregnancy from any cause except accident or violence.
2
Expressed per 1,000 woman-years of exposure
a
Age-adjusted rate

Table 8.3.2 Maternal mortality: zones

Direct estimates of maternal mortality rates for the 7 years preceding the survey at the zonal level by 5-year age groups, Ghana MHS 2017
Coastal Middle Northern
Percent- Percent- Percent-
age of age of age of
female female female
deaths Maternal deaths Maternal deaths Maternal
that are Maternal Exposure mortality that are Maternal Exposure mortality that are Maternal Exposure mortality
Age maternal deaths1 years rate2 maternal deaths1 years rate2 maternal deaths1 years rate2
15-19 0.0 0 21,340 0.00 14.9 4 18,325 0.20 13.0 1 6,820 0.22
20-24 17.8 5 25,302 0.18 11.0 3 21,462 0.12 19.5 3 7,699 0.33
25-29 8.9 7 25,406 0.26 19.8 11 21,635 0.52 23.7 4 7,422 0.57
30-34 24.3 26 22,749 1.14 17.1 13 18,928 0.69 22.7 4 6,326 0.64
35-39 20.5 16 18,608 0.86 5.8 5 14,951 0.37 15.7 3 4,956 0.66
40-44 4.2 3 13,209 0.21 9.3 7 10,809 0.64 16.9 2 3,252 0.75
45-49 0.0 0 8,740 0.00 1.3 1 7,746 0.11 2.4 0 1,990 0.12
Total 15-49 12.0 56 135,354 0.38a 10.5 44 113,855 0.37a 17.3 18 38,464 0.45a

1
A maternal death is defined as the death of a woman while pregnant or within 42 days of termination of pregnancy from any cause except accident or
violence.
2
Expressed per 1,000 woman-years of exposure
a
Age-adjusted rate

124 • Adult and Maternal Mortality

Table 8.4 Maternal mortality ratio

Total fertility rate, general fertility rate, maternal mortality ratio, and lifetime risk of maternal death for the 7 years preceding the survey, Ghana
MHS 2017
Zone
Coastal Middle Northern Total
Total fertility rate (TFR) 3.7 4.0 5.5 4.0
General fertility rate (GFR)1 115 124 164 125
Maternal mortality ratio (MMR)2 336 296 276 310
CI: (151, 521) CI: (177, 414) CI: (186, 365) CI: (217, 402)
Lifetime risk of maternal death3 0.012 0.012 0.015 0.012

CI: Confidence interval

1
Age-adjusted rate expressed per 1,000 women age 15-49
2
Expressed per 100,000 live births; calculated as the age-adjusted maternal mortality rate (shown in Tables 8.3.1 and 8.3.2) times 100 divided by
the age-adjusted general fertility rate
3
Calculated as 1-(1-MMR)TFR, where TFR represents the total fertility rate for the 7 years preceding the survey

Adult and Maternal Mortality • 125

CAUSES OF DEATH 9
Key Findings

 All-cause mortality: The most frequent cause of death

among women age 12-49 is infectious and parasitic
disease (24%). Direct maternal causes account for 10% of
deaths and indirect maternal causes for 4%.
 Maternal causes of death: Among deaths due to maternal
causes, 67% were due to direct maternal causes, 27%
were due to indirect maternal causes, and 6% were due to
unspecified maternal causes.
 Direct maternal causes of death: Among deaths due to
direct maternal causes, the most frequent cause was
obstetric haemorrhage (30%), followed by hypertensive
disorders (14%).
 Timing of obstetric-coded deaths: Among deaths with
an obstetric code (direct, indirect, or unspecified), 41%
took place within 42 days of the end of a pregnancy, 32%
took place during childbirth, and 22% took place during
pregnancy.

T
his chapter presents results of the verbal autopsy interviews conducted for deaths of women age 12-
49 in the 5 years preceding the 2017 GMHS, including causes of death. Knowing the causes of
maternal death can help in formulating policies to prevent those deaths. However, obtaining data
on deaths requires robust vital registration systems, which are lacking in most developing countries
including Ghana. In the absence of such systems, the verbal autopsy method (an interview with family
members or caregivers of the deceased person) has been developed as a way of collecting information that
can be used to determine the cause or causes of death.

9.1 VERBAL AUTOPSY QUESTIONNAIRE

The Verbal Autopsy Questionnaire used in the 2017 GMHS is based on the 2016 WHO standard verbal
autopsy questionnaire for adults age 15 and above (version 1.4), with some adaptations to the country-
specific context and to preserve comparability with the 2007 GMHS instrument. It contains questions on
the deceased woman’s background, whether she experienced any accident or violence leading to death,
specific diagnoses she may have received, signs and symptoms in the period preceding death, maternal
signs and symptoms in the period preceding death, and treatment by or contact with health care providers
before death.

9.2 VERBAL AUTOPSY FIELDWORK

During the household listing phase, every household in every cluster was asked if any household member
had died since January 2012. If the answer was yes, information on name, sex, age at death, and year of
death was collected. Fieldwork teams were provided with a list of all households in each cluster where a
female resident had died when she was between age 10 and age 54; this range was used in case of
inaccuracies in the recall of the listing informant. Interviews were completed only for deaths that were

Causes of Death • 127

 truly eligible, that is, deaths that took place on or after 1 January 2012 when the female resident was age
12-49 and for which the household could furnish a respondent with knowledge of the circumstances of
the death.

During fieldwork, 1,367 Verbal Autopsy Questionnaires were completed for women who died on or after 1
January 2012 and were age 12-49 at the time of death; 1,240 questionnaires were completed for women
who died in the 5 years preceding the survey (5 years before the date of the interview) at age 12-49.

9.3 CAUSE OF DEATH CERTIFICATION AND ICD-10 CODING

For the verbal autopsy process to be complete, each questionnaire must be reviewed so that a death
certificate with the immediate and underlying cause(s) of death for the deceased person can be completed.
Coding the cause(s) of death recorded in the death certificate according to the International Statistical
Classification of Diseases and Related Health Problems, 10th revision (ICD-10; WHO 2016), is a further
step that produces internationally comparable data on the final underlying cause of death.

Six Ghanaian physicians were trained to review the 2017 GMHS Verbal Autopsy Questionnaires, fill out
death certificates according to WHO guidelines, and code the cause or causes of death using the ICD-10 to
determine the final underlying cause of death.

Death Certification

The WHO standard death certificate requires certifiers to identify a sequence of conditions and/or events
leading to death that make both chronological and pathological sense. Conditions and events (for example,
a road traffic accident) that have a causal relationship to death are listed in Part 1 of the certificate. The
immediate (direct) cause of death is listed on the first line (a) of Part 1. There must always be an entry on
line 1(a), and it is possible that in Part 1 only line 1(a) is filled out. When there are two or more conditions
and/or events that form part of the sequence leading directly to death, each condition/event should be
recorded on a separate line in Part 1. The last-listed condition/event in Part 1 is considered the underlying
cause of death (the “tentative starting point” in the process of ICD-10 coding, described below); if it had
not taken place, the death would have been averted. In the example below, line “c” is the underlying cause
of death.

Conditions and events that are significant and contributory but not causally related to death are listed in
Part 2 of the certificate.

Administrative Data
Sex Female Male Unknown
Date of birth 3 0 0 1 1 9 6 2 Date of death 3 1 0 1 2 0 1 7
Death Certificate: Part 1 and 2
1 Time interval from
Cause of death
Report disease or condition onset to death
directly leading to death on a Haemorrhagic shock 1 hour
line a Due to:
b
Abdominal haemorrhage 2 hours
Report chain of events in due Due to:
to order (if applicable) c 2 hours
Passenger in car that hit another car
State the underlying cause on Due to
d :
the lowest used line
2 Other significant conditions contributing to Diabetes mellitus (5 years)
death (time intervals can be included in brackets
after the condition)

128 • Causes of Death

ICD-10 Coding

The coding of causes of death was done by applying the standard ICD coding procedures. This process is
essential for a correct application of the ICD-10 instructions and for selection and modification of the
tentative starting point.

The ICD-10 categorises diseases and health conditions into four-digit codes. In hard copy, it consists of
three books. Volume 1 is a tabular list by ICD-10 code of diseases and conditions; Volume 2 provides
guidance on use of the ICD-10, including coding procedures; and Volume 3 is an alphabetical index of
diseases and health conditions.

To code a death certificate and determine the final underlying cause of death, coders first look up each
entry on each line of the death certificate in the alphabetical index (Volume 3) to obtain the ICD-10 code
for the entry and then look up each code in Volume 1 to verify that it is the correct one and see if there are
any special instructions on how to use the code (which may lead to modification of the tentative starting
point).

After the code for each entry on the death certificate has been obtained, coders determine the tentative
underlying cause of death by applying steps SP1 through SP8 to the codes in the death certificate as
described in Volume 2. Next, coders apply the special instructions for modifications of the starting point
(steps M1 to M4) as described in Volume 2, check for age and sex inconsistencies, and arrive at the final
underlying cause of death. It is this final underlying cause of death that has ultimately been tabulated in the
2017 GMHS final report.

Each Verbal Autopsy Questionnaire was independently reviewed by two physicians. When both physicians
identified the same underlying cause of death and the same subsequent conditions (if any) in Part 1 of the
death certificate (although the subsequent conditions did not need to be in the same order), the death
certificate and the final underlying cause of death were considered complete. When questionnaires had
discordant results between the two original reviewers; these questionnaires were re-reviewed by two of the
physicians who arrived at a consensus to write a third, final death certificate.

9.4 LIMITATIONS
There are several limitations to the verbal autopsy component of the 2017 GMHS that must be
acknowledged. They can be grouped into two areas: identifying eligible deaths and obtaining adequate
information to determine the cause or causes of death.

Identifying Eligible Deaths

The linchpin of the death identification process is the screening that took place during the household
listing. Any number of things could have gone wrong: the individual providing information for a
household during the screening did not understand the screening questions, was reluctant to disclose
deaths, misreported the year of death and/or the age at death, or did not possess complete information on
the household and/or its deceased members in the past 5 years; the household had moved from some other
place in the past 5 years; a household was composed just of the deceased person; or a household dissolved
upon the death of a member. In addition, deaths that took place between the listing and fieldwork were of
course not captured by the listing.

The 2017 GMHS attempted to correct for some of these problems by using fieldwork as an opportunity to
review the list of deaths with community members/leaders and add deaths that had not been identified
during the listing. However, despite best efforts, we cannot be certain that all deaths in the past 5 years
among women age 12-49 at the time of death in all 900 clusters were captured by the survey.

Causes of Death • 129

 Adequate Information on Eligible Deaths

Once a death is confirmed to be eligible, the problem remains of identifying someone who is familiar
enough with the circumstances of the death to respond to the Verbal Autopsy Questionnaire; this issue is
not unique to the 2017 GMHS. Fieldworkers were trained to discuss this with household members; the
respondent was not required to be a member of the deceased woman’s household but, in the interests of
time and feasibility, was expected to be a resident of the same community. Even if a well-informed
respondent is found, he or she may not have been made aware of all of the signs and symptoms
experienced by the deceased, may not have been allowed to be with her at all times when receiving
medical treatment, or may have difficulty remembering the circumstances or understanding the questions.

Finally, even if the respondent has and provides perfect knowledge, depending on the sensitivity and
specificity of different symptoms and pieces of information contained in the questionnaire, it may be
difficult for coders to distinguish the exact cause or causes of death. Again, this issue is not unique to the
2017 GMHS.

9.5 CHARACTERISTICS OF DECEASED WOMEN

Due to the issues discussed in identifying eligible deaths in section 9.4, the deaths described in this chapter
cannot definitively be said to be representative of all deaths among women age 12-49 in Ghana from 2012
to 2017; the characteristics of the deceased women pertain only to themselves and not to all such deaths.

The Verbal Autopsy Questionnaire was completed and a final death certificate was written for 1,260
women (weighted) who died at age 12-49 in the 5 years preceding the survey (Table 9.1).

Patterns by background characteristics

 Just over half of the deaths took place in 2016 (27%) or 2015 (25%). The percentage of deaths in a
given year decreases further back in time; presumably, deaths in earlier years were less well
recollected by respondents. Since fieldwork finished before the end of 2017, a smaller percentage of
deaths took place in that year (8%).

 About 1 in 10 deaths occurred among adolescents (4% age 12-14, 7% age 15-19).

 Sixty-one percent of deceased women were rural dwellers, as compared with 39% who were urban
dwellers, and a much larger share of deaths took place in the Coastal zone (48%) than in the Northern
zone (19%). These results should be interpreted in light of the overall distribution of the population in
Ghana.

Respondents to the Verbal Autopsy Questionnaire

Almost all of the respondents to the Verbal Autopsy Questionnaire were family members of the deceased
woman: a sibling (22%), parent or child (both 21%), other family member (17%), or husband/partner
(16%). Two percent had some other relationship to the deceased, and 0.4% were a friend (Table 9.2).

130 • Causes of Death

9.6 CAUSE-SPECIFIC MORTALITY

Underlying cause of death

The disease or injury that initiated the train of morbid events leading directly to
death, or the circumstances of the accident or violence that produced the fatal
injury (WH0 2016).
Sample: Women who died at age 12-49 in the 5 years preceding the survey

The most important causes of death included Figure 9.1 All-cause mortality
infectious and parasitic disease (24%); conditions of
Percent distribution of causes of death
the nervous, digestive, and respiratory systems among women age 12-49 in the 5 years
(14%); other classified causes (13%); and circulatory before the survey
disease (11%). Direct maternal causes account for
10% of deaths and indirect maternal causes for 4%. Infectious &
Maternal
A cause of death could not be determined for 10% of (direct & parasitic
deaths (Table 9.3.1 and Figure 9.1). Not indirect) disease
classified 14% 24%
Trends: Table 9.3.2 is based on 2017 GMHS data 10%
tabulated to be comparable to the tabulation used in
the 2007 GMHS, which did not include deaths not
Other disease
due to maternal causes (deaths with non-obstetric Transport 45%
codes, i.e., other than A34 and O00-O99) that took accidents
& other
place during pregnancy, childbirth, or within 42 days external
of the end of a pregnancy (excluding those due to 7%
accidents or violence) among indirect maternal
deaths. A slightly smaller percentage of deaths in 2017 were due to maternal causes (11%) than in 2007
(14%); a much smaller percentage of deaths in 2017 were due to infectious and parasitic disease (24%
versus 41%). The percentage of deaths for which a cause could not be determined was higher in 2017
(10%) than in 2007 (0.2%), although the 2017 figure is not dissimilar from those reported in other studies
in similar settings using physician review of verbal autopsy questionnaires (Mwanyangala et al. 2011; Oti
and Kyobutungi 2010).

Patterns by background characteristics

 Unsurprisingly, a higher percentage of deaths among women age 20-39 (10%-19%) than among
younger or older women (4%-7%) were due to direct maternal causes (Table 9.3.1).

 Although not increasing consistently with age, the percentage of deaths due to infectious and parasitic
disease is lowest for women age 15-19 (15%) and highest for women age 45-49 (31%).

 A smaller percentage of women age 20 and above died of other external causes (2%-7%) or conditions
of the nervous, digestive, and respiratory systems (11%-13%) than women age 15-19 (13% and 27%,
respectively.)

 The percentage of deaths for which a cause could not be determined is slightly higher for rural (12%)
than urban (8%) women.

 A slightly higher percentage of deaths in the Coastal zone (12%) than deaths in the other zones (8%-
9%) were due to direct maternal causes.

9.7 MATERNAL CAUSES OF DEATH

Appendix E provides details on how underlying causes of death due to obstetric codes in the 2017 GMHS
verbal autopsy data were tabulated in Tables 9.4.1, 9.4.2, and 9.5. Table 9.4.1 follows the tabulation

Causes of Death • 131

 recommendations outlined in WHO’s Application of ICD-10 to deaths during pregnancy, childbirth, and
the puerperium: ICD-Maternal Mortality (ICD-MM; WHO 2012).

Two-thirds of deaths due to maternal causes were Figure 9.2 Maternal causes of death
direct maternal deaths (67%); the most frequent
Percent distribution of maternal causes of
cause was obstetric haemorrhage (30%), followed by death among women age 12-49 in the
hypertensive disorders (14%). Just over a quarter of 5 years before the survey
deaths due to maternal causes were the result of
indirect causes (27%), and most deaths with indirect
Unspecified
causes (22%) had non-obstetric codes (excluding maternal
accidents and violence) and took place during causes Direct
pregnancy, childbirth, or within 42 days of the end of 6% maternal
causes
a pregnancy. Six percent of deaths due to maternal 67%
causes were attributable to unspecified maternal Indirect
maternal
causes (Table 9.4.1 and Figure 9.2).
causes
27%
Among deaths with an obstetric code (direct,
indirect, or unspecified), just over 4 in 10 took place
within 42 days of the end of a pregnancy (41%), just
over 3 in 10 took place during childbirth (32%), and
just over 2 in 10 took place during pregnancy (22%); the remainder took place between 43 days and 1 year
after the end of a pregnancy (6%) (Table 9.5).

Trends: Table 9.4.2 follows the tabulation of maternal causes of death used in the 2007 GMHS, although
in 2007 obstructed labour was considered a valid underlying cause of death, which was not the case in
2017. As in Table 9.3.2, deaths with non-obstetric codes (i.e., other than A34 and O00-O99) that took
place during pregnancy, childbirth, or within 42 days of the end of a pregnancy (excluding those due to
accidents or violence) are not included among indirect maternal deaths.

132 • Causes of Death

Some causes of death decreased as a Figure 9.3 Causes of obstetric-coded deaths
percentage of all obstetric causes Percent distribution of deceased women age 12-49
between 2007 and 2017: induced in the 5 years preceding the survey whose deaths
abortion fell from 11% to 4%, not were due to obstetric causes
elsewhere classified (infectious)
decreased from 15% to 0.4%, and Spontaneous 4 2007
abortion/miscarriage 5
not elsewhere classified (non- 2017
infectious) decreased from 13% to Abortion (medical,
11
attempted, failed, other
6%. Others increased, although this unspecified) 4
does not mean that there were more
Haemorrhage (ante- 24
deaths due to these causes; rather, it and post-partum) 38
means that their relative proportion
in the overall distribution of Hypertensive disorders 9
obstetric causes grew. These causes (including eclampsia) 18
include haemorrhage (from 24% to 7
38%), hypertensive disorders (9% Sepsis
10
to 18%), and other (miscellaneous)
(from 13% to 18%) (Figure 9.3). 13
Other, miscellaneous
18

Other not elsewhere 15

classified: infectious <1
Other not elsewhere
13
classified: non-
infectious 6

4
Obstructed labour*
0

* Obstructed labour was not used as an underlying cause of death in 2017

9.8 DECEASED WOMEN AND HEALTH CARE

9.8.1 Treatment Seeking for Deceased Women

Seventy-one percent of women who died at age 12-49 in the 5 years preceding the survey sought medical
care at either public or private sector health facilities. Six percent sought care at private facilities only, and
a much higher percentage (58%) sought care at public facilities only (Table 9.6).

In addition, questions were asked about the use of traditional/herbal and spiritual medicine; women using
these kinds of medicine may also have sought medical care. Six in 10 women who died at age 12-49 in the
5 years preceding the survey did not use either traditional/herbal or spiritual medicine (61%); 16% used
traditional/herbal medicine, 9% used spiritual medicine, and 12% used both traditional/herbal and spiritual
medicine (Table 9.7).

Causes of Death • 133

 Patterns by background characteristics

 The percentage of women who sought medical care from public and/or private sector facilities ranges
from 65% in the Coastal zone to 71% in the Northern zone and 80% in the Middle zone (Table 9.6).

 A slightly smaller percentage of Figure 9.4 Use of medical care and traditional/herbal
women who died of direct and/or spiritual medicine by cause of death
maternal causes sought medical
Percentage of deceased women age 12-49 in the
care (64%) than women who 5 years before the survey who received care
died of non-maternal causes
Medical care (public and/or private sector)
(71%), and a noticeably smaller
percentage of women who died Any combination of traditional/herbal and/or spiritual medicine
of direct maternal causes (15%)
than women who died of non-
Maternal 64
maternal causes (40%) used
(direct) 15
any combination of
traditional/herbal and/or
spiritual medicine (Table 9.6, Maternal (91)
(indirect &
Table 9.7, and Figure 9.4). unspecified) (28)

 The percentage of women who

did not use either 71
Non-maternal
traditional/herbal or spiritual 40
medicine generally decreases
with age (Table 9.7). Note: Figures in parentheses are based on 25-49 unweighted cases.

 Differences by zone in the

percentage of women who did not use traditional/herbal or spiritual medicine are small (60%-64%);
however, there are larger differences in the percentage who used traditional/herbal (13%-28%) versus
spiritual (2%-11%) medicine (Table 9.7).

9.8.2 Sources of Care for Deceased Women

Among women who died at age 12-49 in the 5 years preceding the survey and had sought care, 84%
sought care in the public medical sector, 16% sought care in the private medical sector, 9% received care at
home, and 20% went to a prayer camp/shrine; care may have been received from more than one source
(Table 9.8).

Patterns by background characteristics

 A slightly larger percentage of women who sought care and died of direct maternal causes went to
public sector medical facilities (89%) than women who died of non-maternal causes (83%), while a
slightly smaller percentage of women who died of direct maternal causes went to private sector
medical facilities (11%) than women who died of non-maternal causes (17%).

 A larger percentage of women who sought care in urban areas (21%) than in rural areas (13%) went to
private sector medical facilities.

 A larger percentage of women who died of non-maternal causes, who lived in rural areas, and who
lived in the Northern zone sought care at home.

 The percentage of women who went to a prayer camp/shrine rises from 9% in the Northern zone to
20% in the Middle zone and 26% in the Coastal zone.

134 • Causes of Death

9.8.3 Visits to Health Facilities before Death

Sixty-seven percent of women who died at age 12-49 in the 5 years preceding the survey travelled to a
health care facility in the final days before death. Among these women, 95% used motorised transport to
get to the health facility. Regardless of means of transportation, the median travel time to the health facility
was 34.3 minutes. About 1 in 10 women encountered problems with being received (11%), obtaining
treatment (12%), or getting medications and diagnostic tests (10%) at the facility (Table 9.9).

Patterns by background characteristics

 A larger percentage of women who died of direct maternal causes travelled to a health care facility in
the final days before death (84%) than women who died of non-maternal causes (64%).

 A larger percentage of women in urban areas (71%) than in rural areas (64%) travelled to a health care
facility in the final days before death.

 The median travel time to the health facility was longer for rural women (44.5 minutes) than for urban
women (29.0 minutes); the median travel time was 4 minutes shorter than the national average of 34.3
minutes for women in the Coastal (30.0 minutes) and Middle (29.7 minutes) zones and nearly 13
minutes longer than the national average for women in the Northern zone (46.9 minutes).

 A larger percentage of women who died of direct maternal causes and travelled to a health facility in
the final days before death encountered problems obtaining treatment at the facility (18%), nearly
twice as often as women who died of non-maternal causes (10%).

9.8.4 Logistical and Financial Issues

Among the households of nearly 6 in 10 women who died at age 12-49 in the 5 years preceding the survey
(59%), it takes 30 minutes or less to reach the nearest health facility; among 6%, it takes more than 1 hour.
For 40% of deceased women, a telephone or cell phone was used to call for help in the final days before
death, and among the households of 49%, the costs of care for the deceased woman prohibited the payment
of other household expenses (Table 9.10).

Patterns by background characteristics

 A smaller percentage of women Figure 9.5 Logistical and financial issues by zone
whose households are more
Percentage of deceased women age 12-49 in
than 1 hour from the nearest the 5 years before the survey
health facility travelled to a
health facility in the final days Coastal Middle Northern
before death (3%) than did not
travel to a health facility in the 71
final days before death (11%). 54 54
48 46 48
43 43
 There are differences among 34
zones in the percentage of
households within 30 minutes
of the nearest health facility,
where a phone call was made <30 minutes from Called for help in final Costs of care
household to nearest days before death prohibited other
for help, and where costs of
health facility household payments
care prohibited other payments
(Figure 9.5).

Causes of Death • 135

 9.9 DEATH CERTIFICATES AND BURIAL PERMITS
For 12% of women who died at age 12-49 in the 5 years preceding the survey, the verbal autopsy
respondent was in possession of a death certificate, and for 9% he or she was in possession of a burial
permit (Table 9.11).

Patterns by background characteristics

 The percentage of verbal autopsy respondents who were in possession of death certificates and burial
permits was larger for women who died of direct maternal causes (19% and 16%, respectively) than
for women who died of non-maternal causes (11% and 8%, respectively).

 A larger percentage of verbal autopsy respondents in urban areas than in rural areas had death
certificates (18% versus 8%) and burial permits (15% versus 6%).

 The percentage of verbal autopsy respondents in possession of a death certificate and a burial permit is
smaller in the Northern zone (2% and 1%) than in the Coastal (17% and 13%) and Middle (10% and
9%) zones.

LIST OF TABLES
For more information on the verbal autopsy data, see the following tables:

 Table 9.1 Background characteristics of deceased women

 Table 9.2 Respondents to verbal autopsy questionnaires
 Table 9.3.1 All cause-specific mortality with provision for indirect maternal deaths
 Table 9.3.2 All cause-specific mortality
 Table 9.4.1 Causes of maternal deaths following ICD-MM
 Table 9.4.2 Causes of obstetric-coded deaths
 Table 9.5 Timing and onset period of causes of obstetric-coded deaths
 Table 9.6 Treatment seeking for deceased women in the medical sector
 Table 9.7 Treatment seeking for deceased women in the non-medical sector
 Table 9.8 Source of care for deceased women
 Table 9.9 Visits to health facilities before death
 Table 9.10 Logistical and financial issues
 Table 9.11 Death certificates and burial permits

136 • Causes of Death

Table 9.1 Background characteristics of deceased women

Percent distribution of deceased women age 12-49 in the 5 years before the survey for whom
verbal autopsies were completed, by selected background characteristics, Ghana MHS 2017
Deceased women
Background Weighted Weighted Unweighted
characteristic percent number number
Year of death
2012 5.1 64 65
2013 14.6 184 178
2014 20.0 252 254
2015 25.1 316 315
2016 27.3 343 331
2017 8.0 101 97
Age at death
12-14 3.9 49 44
15-19 7.1 90 85
20-24 11.2 141 128
25-29 13.4 169 161
30-34 18.0 227 218
35-39 17.3 218 215
40-44 15.3 193 201
45-49 13.7 173 188
Religion
Catholic 9.6 121 156
Anglican/Methodist/Presbyterian 11.2 141 128
Pentecostal/Charismatic 37.8 477 405
Other Christian 13.8 174 154
Muslim 15.7 198 253
Traditional/Spiritualist 4.1 52 48
No religion 7.5 94 93
Don’t know 0.3 4 3
Ethnic group
Akan 40.7 512 445
Ga/Dangme 9.0 114 92
Ewe 16.7 210 160
Guan 5.4 67 62
Mole-Dagbani 16.5 208 306
Grusi 1.8 23 43
Gurma 8.2 103 108
Mande 0.8 10 10
Other 1.0 13 14
Marital status
Never married 26.2 330 311
Married 43.8 552 596
Living together 14.0 177 143
Divorced/separated 11.1 140 128
Widowed 4.9 62 62
Residence
Urban 38.7 488 589
Rural 61.3 772 651
Region
Western 11.1 139 111
Central 10.1 127 109
Greater Accra 11.8 148 111
Volta 14.9 188 126
Eastern 13.7 173 152
Ashanti 9.8 124 100
Brong Ahafo 9.7 123 114
Northern 12.5 157 227
Upper East 3.7 46 99
Upper West 2.7 34 91
Zone
Coastal 47.9 603 457
Middle 33.3 419 366
Northern 18.9 238 417
Education
No education 25.4 319 369
Primary 23.9 301 268
Middle/JSS/JHS 37.5 473 422
Secondary/SSS/SHS 9.9 125 129
More than secondary 2.0 25 37
Don’t know 1.3 16 15
Total 100.0 1,260 1,240

Note: Education categories refer to the highest level of education attended, whether or not that
level was completed.

Causes of Death • 137

 Table 9.2 Respondents to Verbal Autopsy
Questionnaires

Percent distribution of relationship of respondent to

verbal autopsy questionnaire to the deceased woman,
Ghana MHS 2017
Deceased
Relationship women
Husband/partner 16.3
Parent 21.3
Child 21.0
Sibling 22.0
Other family member 17.1
Friend 0.4
Another relationship 2.0
Total 100.0
Number of deceased women 1,260

Table 9.3.1 All cause-specific mortality with provision for indirect maternal deaths

Percent distribution of deceased women age 12-49 in the 5 years preceding the survey by cause of death, according to background characteristics, Ghana
MHS 2017
Maternal Nervous
Infectious system, Other
and Other digestive, causes No cause Number of
Background parasitic Neo- Circulatory Transport external respir- (clas- deter- deceased
characteristic Direct1 Indirect2 disease3 plasms4 disease5 accidents6 causes7 atory8 sified)9 mined10 Total women
Age at death
12-14 (2.6) (0.0) (22.4) (9.4) (2.6) (1.1) (1.3) (38.4) (9.0) (13.3) 100.0 49
15-19 6.8 5.3 15.1 1.9 1.0 3.4 12.8 26.5 23.8 3.6 100.0 90
20-24 13.7 5.6 21.4 3.1 6.4 3.7 6.0 11.7 18.2 10.1 100.0 141
25-29 18.9 4.5 25.0 1.3 5.4 0.9 6.6 13.4 9.8 14.2 100.0 169
30-34 10.1 5.5 21.3 9.3 11.4 1.6 5.5 12.2 11.5 11.5 100.0 227
35-39 14.1 5.2 26.0 11.9 10.7 1.8 4.3 12.1 8.6 5.4 100.0 218
40-44 4.6 1.3 24.1 8.2 16.2 1.0 3.4 13.0 15.2 12.8 100.0 193
45-49 3.6 0.7 30.6 8.2 18.1 0.8 1.9 11.4 13.5 11.3 100.0 173
Residence
Urban 8.4 3.2 26.1 7.9 12.3 1.9 4.5 13.7 14.5 7.6 100.0 488
Rural 11.1 4.2 22.6 6.7 9.4 1.6 5.4 14.8 12.3 12.1 100.0 772
Zone
Coastal 12.1 3.3 24.0 6.7 10.2 2.0 3.6 13.2 12.5 12.3 100.0 603
Middle 8.5 4.4 22.2 9.2 11.4 0.8 4.8 15.9 15.8 6.9 100.0 419
Northern 7.9 3.9 26.8 4.7 9.6 2.4 8.9 14.4 9.9 11.6 100.0 238
Total 10.1 3.8 23.9 7.1 10.5 1.7 5.0 14.3 13.1 10.3 100.0 1,260

Note: Figures in parentheses are based on 25-49 unweighted cases.

1
ICD-10 codes A34, O00-O8, O11-O23, O24.4, O25-O97
2
ICD-10 codes O10, O24.0-O24.3, O24.9, O98, O99, and deaths due to non-obstetric causes (excluding accident and violence) that took place during
pregnancy, childbirth, or within 42 days of the end of a pregnancy
3
ICD-10 codes A00-A33, A35-B99
4
ICD-10 codes C00-D48
5
ICD-10 codes I00-I99
6
ICD-10 codes V01-V99
7
ICD-10 codes S00-T98, W00-Y98
8
ICD-10 codes G00-G99, J00-J99, K00-K93
9
ICD-10 codes D50-D89, E00-E90, F00-F99, G00-G99, H00-H59, H60-H95, L00-L99, M00-M99, N00-N99, Q00-Q99, R00-R94
10
ICD-10 codes R95-R99

138 • Causes of Death

Table 9.3.2 All cause-specific mortality

Percent distribution of deceased women age 12-49 in the 5 years preceding the survey by cause of death, according to background characteristics, Ghana
MHS 2017
Infectious Nervous
and Other system, Other No cause Number of
Background parasitic Neo- Circulatory Transport external digestive, causes deter- deceased
1
characteristic Maternal disease2 plasms3 disease4 accidents5 causes6 7
respiratory (classified) 8
mined9 Total women
Age at death
12-14 (2.6) (22.4) (9.4) (2.6) (1.1) (1.3) (38.4) (9.0) (13.3) 100.0 49
15-19 7.6 15.1 1.9 1.0 3.4 12.8 28.5 26.2 3.6 100.0 90
20-24 15.3 23.5 3.1 6.4 3.7 6.0 11.7 19.2 11.1 100.0 141
25-29 20.2 25.0 2.1 6.7 0.9 6.6 13.4 10.5 14.5 100.0 169
30-34 11.1 22.4 9.3 12.2 1.6 5.5 12.5 12.1 13.3 100.0 227
35-39 14.7 26.0 14.4 11.1 1.8 4.3 12.1 10.2 5.5 100.0 218
40-44 4.6 25.1 8.2 16.2 1.0 3.4 13.0 15.2 13.1 100.0 193
45-49 3.6 31.3 8.2 18.1 0.8 1.9 11.4 13.5 11.3 100.0 173
Residence
Urban 9.3 26.9 8.2 13.1 1.9 4.5 13.7 14.7 7.8 100.0 488
Rural 11.8 23.2 7.4 9.5 1.6 5.4 15.1 13.4 12.8 100.0 772
Zone
Coastal 12.2 24.5 7.7 10.8 2.0 3.6 13.3 13.3 12.4 100.0 603
Middle 9.6 23.1 9.2 11.4 0.8 4.8 16.4 16.9 7.8 100.0 419
Northern 9.4 27.4 5.1 10.0 2.4 8.9 14.4 10.1 12.3 100.0 238
Total 10.8 24.6 7.7 10.9 1.7 5.0 14.5 13.9 10.9 100.0 1,260

Note: This table follows the tabulation used in the 2007 GMHS final report to enable comparisons. In this table, deaths with non-obstetric codes that took
place during pregnancy, childbirth, or within 42 days of the end of a pregnancy are coded in the column for the direct cause of death. Figures in parentheses
are based on 25-49 unweighted cases.
1
ICD-10 codes A34, O00-O99
2
ICD-10 codes A00-A33, A35-B99
3
ICD-10 codes C00-D48
4
ICD-10 codes I00-I99
5
ICD-10 codes V01-V99
6
ICD-10 codes S00-T98, W00-Y98
7
ICD-10 codes G00-G99, J00-J99, K00-K93
8
ICD-10 codes D50-D89, E00-E90, F00-F99, G00-G99, H00-H59, H60-H95, L00-L99, M00-M99, N00-N99, Q00-Q99, R00-R94
9
ICD-10 codes R95-R99

Table 9.4.1 Causes of maternal deaths following ICD-MM

Percent distribution of deceased women age 12-49 in the 5 years

preceding the survey who died from maternal causes, by cause of
death, Ghana MHS 2017
Maternal
Cause of death deaths
Maternal death: direct 67.2
Pregnancy with abortive outcome 7.1
Hypertensive disorders in pregnancy, childbirth,
and the puerperium 14.3
Obstetric haemorrhage 29.7
Pregnancy-related infection 7.4
Other obstetric complications 8.7
Unanticipated complications of management 0.0
Maternal death: indirect 27.3
Non-obstetric complications 5.0
Non-obstetric codes1 22.3
Maternal death: unspecified
Unknown/undetermined 5.5
Total 100.0
Number of deceased women who died from
maternal causes (direct, indirect, and unspecified) 175

Note: Coding in this table follows the recommendations of WHO’s

Application of ICD-10 to deaths during pregnancy, childbirth, and
the puerperium: ICD-Maternal Mortality (ICD-MM). For the specific
categorisation of ICD-10 codes in this table, see Appendix E.
1
Deaths due to non-obstetric causes (excluding accidents and
violence) that took place during pregnancy, childbirth, or within 42
days of the end of a pregnancy; not included in Appendix E

Causes of Death • 139

 Table 9.4.2 Causes of obstetric-coded deaths

Percent distribution of deceased women age 12-49 in the 5

years preceding the survey due to obstetric causes, by
cause of death, Ghana MHS 2017
Obstetric-coded
Cause of death deaths
Spontaneous abortion/miscarriage 5.3
Abortion (medical, attempted, failed,
other unspecified) 3.9
Haemorrhage (ante- and postpartum) 38.2
Hypertensive disorders (including
eclampsia) 18.3
Sepsis 9.5
Other, miscellaneous 18.3
Other not elsewhere classified:
infectious 0.4
Other not elsewhere classified: non-
infectious 6.0
Total 100.0
Number of deceased women due to
obstetric-coded causes 136

Note: This table follows the tabulation used in the 2007

GMHS final report to enable comparisons. All deaths with
obstetric codes (direct, indirect, and unspecified) are
included. For the specific categorisation of ICD-10 codes in
this table, see Appendix E.

Table 9.5 Timing and onset period of causes of

obstetric-coded deaths

Percent distribution of deceased women age 12-49 in the 5

years before the survey due to obstetric-coded causes by
timing of death and by onset period of cause of death,
Ghana MHS 2017
Background Obstetric-coded
characteristic deaths
Timing of death
During pregnancy 21.7
During childbirth 31.7
Within 42 days of the end of a
pregnancy 41.2
Between 43 days and 1 year of the
end of a pregnancy 5.5
Total 100.0
Onset period of cause of death
Before pregnancy 0.6
Pregnancy 23.6
Pregnancy or childbirth 6.1
Childbirth 14.0
Puerperium 39.4
Any period 16.2
Total 100.0
Number of deceased women due to
obstetric-coded causes 136

Note: All deaths with obstetric codes (direct, indirect, and

unspecified) are included. The onset period is not
necessarily when the individual died. This categorisation is
based on the onset period of the cause of death,
regardless of the actual timing of the death.

140 • Causes of Death

 Table 9.6 Treatment seeking for deceased women in the medical sector

Percentage of deceased women age 12-49 in the 5 years before the survey who received medical
care, according to background characteristics, Ghana MHS 2017
Medical care Number of
Background Public sector Private sector Public and/or deceased
characteristic only1 only2 private sector women
Cause of death
Maternal (direct) 56.8 2.9 64.3 127
Maternal (indirect and unspecified) (80.7) (3.7) (90.5) 48
Non-maternal 57.6 6.2 70.5 1,085
Age at death
12-14 (45.8) (12.0) (64.9) 49
15-19 65.0 5.4 72.9 90
20-24 64.0 6.3 72.0 141
25-29 53.3 7.4 66.2 169
30-34 57.3 5.1 72.8 227
35-39 63.8 3.5 73.3 218
40-44 58.1 7.3 73.3 193
45-49 54.1 4.0 65.3 173
Residence
Urban 55.5 7.7 71.7 488
Rural 60.2 4.5 70.0 772
Zone
Coastal 52.4 5.4 64.5 603
Middle 65.3 7.4 79.5 419
Northern 61.5 3.9 70.7 238
Total 58.4 5.8 70.7 1,260

Note: Figures in parentheses are based on 25-49 unweighted cases.

1
Includes government hospital, government health centre/clinic, government health post/CHPS,
mobile clinic, and other public sector
2
Includes private hospital/clinic, FP/PPAG clinic, mobile clinic, maternity home, pharmacy/
chemist/drugstore, and other private medical sector

Table 9.7 Treatment seeking for deceased women in the non-medical sector

Percent distribution of deceased women age 12-49 in the 5 years before the survey by use of traditional/herbal and spiritual medicine, according
to background characteristics, Ghana MHS 2017
Use of traditional/herbal and spiritual medicine
Both
traditional/ Number of
Background Traditional/ Spiritual herbal and Don’t deceased
characteristic herbal only only spiritual Neither know Total women
Cause of death
Maternal (direct) 3.5 6.6 4.7 80.5 4.7 100.0 127
Maternal (indirect and
unspecified) (4.6) (12.4) (10.6) (72.4) (0.0) (100.0) 48
Non-maternal 18.4 8.8 12.6 58.7 1.4 100.0 1,085
Age at death
12-14 (15.8) (18.7) (12.3) (53.2) (0.0) (100.0) 49
15-19 6.9 6.1 9.7 77.3 0.0 100.0 90
20-24 14.5 12.0 10.6 61.6 1.4 100.0 141
25-29 20.6 5.6 7.6 62.5 3.7 100.0 169
30-34 13.3 6.9 12.0 65.8 2.0 100.0 227
35-39 15.8 6.2 17.1 60.8 0.0 100.0 218
40-44 20.1 9.0 12.8 56.1 2.0 100.0 193
45-49 19.4 13.1 9.3 55.5 2.7 100.0 173
Residence
Urban 15.3 9.0 11.7 62.0 1.9 100.0 488
Rural 17.1 8.6 11.8 61.1 1.6 100.0 772
Zone
Coastal 12.8 10.6 13.3 59.8 3.5 100.0 603
Middle 15.1 9.9 11.0 63.9 0.1 100.0 419
Northern 27.6 1.9 9.2 61.3 0.0 100.0 238
Total 16.4 8.7 11.7 61.4 1.7 100.0 1,260

Note: Figures in parentheses are based on 25-49 unweighted cases.

Causes of Death • 141

 Table 9.8 Source of care for deceased women

Among deceased women age 12-49 in the 5 years before the survey who received care, percentage who received care from various sources,
according to cause of death, residence, and zone, Ghana MHS 2017
Cause of death Residence Zone
Maternal
(indirect
Maternal and Non-
Source of care (direct) unspecified) maternal Urban Rural Coastal Middle Northern Total
Public sector 89.4 (92.1) 83.3 82.7 85.2 83.7 85.4 83.3 84.2
Government hospital 81.3 (88.6) 73.0 75.8 73.6 73.9 78.6 68.3 74.5
Government health
centre/clinic 16.8 (16.2) 20.6 13.6 24.1 19.8 15.3 29.3 20.0
Government health
post/CHPS 3.9 (1.2) 1.2 0.1 2.3 0.8 0.6 4.6 1.5
Mobile clinic 0.0 (0.0) 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Other public sector 0.0 (0.0) 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Private sector 10.8 (10.3) 16.7 21.0 12.7 17.1 16.9 11.4 15.9
Private hospital/clinic 8.8 (10.3) 14.6 18.7 10.8 15.8 14.7 8.1 13.9
FP/PPAG clinic 0.0 (0.0) 0.1 0.2 0.0 0.1 0.0 0.0 0.1
Mobile clinic 0.0 (0.0) 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Maternity home 2.0 (0.0) 0.0 0.5 0.0 0.4 0.0 0.0 0.2
Pharmacy/chemist/drugst
ore 0.0 (0.0) 2.4 2.6 1.8 1.7 1.7 3.8 2.1
Other private medical
sector 0.0 (0.0) 0.2 0.1 0.2 0.0 0.5 0.0 0.2
Home 4.4 (2.8) 10.1 6.5 11.0 4.5 9.7 19.0 9.2
Deceased woman’s
home 2.3 (0.0) 4.0 1.8 4.9 2.0 3.7 7.4 3.7
Other home 1.4 (2.8) 6.2 4.5 6.3 2.9 6.0 11.0 5.6
Traditional birth
attendant’s home 0.7 (0.0) 0.2 0.3 0.2 0.2 0.0 1.0 0.3
Prayer camp/shrine 6.3 (9.8) 22.4 17.6 22.1 26.0 19.7 8.8 20.3
Other 3.1 (8.1) 1.0 1.0 1.8 1.1 1.4 2.6 1.5
Number of deceased
women who received
care 87 45 838 378 593 425 354 191 970

Note: Care may have been received from more than one source. Figures in parentheses are based on 25-49 unweighted cases.

142 • Causes of Death

Table 9.9 Visits to health facilities before death

Percentage of deceased women age 12-49 in the 5 years before the survey who travelled to a health facility before death, and among deceased
women who travelled to a health facility, percentage who used motorised transport, median travel time to health facility, and percentage who
encountered problems being received, with treatment, or getting medications or diagnostic tests at the health facility, according to background
characteristics, Ghana MHS 2017
Deceased women who travelled to a health facility:
Number of
Encountered problems at the
deceased
Travelled to Used Median health facility with:
women who
a health motorised travel time to Getting travelled to a
facility in final Number of transport to the health medications health facility
Background days before deceased get to the facility in Being Obtaining or diagnostic in final days
characteristic death women health facility minutes1 received treatment tests before death
Cause of death
Maternal (direct) 84.1 127 90.5 29.8 11.5 17.8 11.6 107
Maternal (indirect and
unspecified) (88.1) 48 (100.0) (44.3) (23.5) (28.9) (12.5) 42
Non-maternal 63.6 1,085 95.9 34.5 10.5 10.4 9.2 690
Age at death
12-14 (53.7) 49 (91.4) (44.1) (23.2) (30.5) (18.3) 26
15-19 65.5 90 97.4 44.3 15.5 13.6 16.8 59
20-24 68.2 141 98.5 29.8 10.6 18.8 13.0 96
25-29 59.1 169 97.6 39.8 8.6 5.6 8.0 100
30-34 74.0 227 95.6 39.4 12.2 13.3 4.9 168
35-39 69.0 218 94.5 29.9 8.2 12.9 10.9 151
40-44 73.2 193 92.3 29.8 16.5 11.2 10.3 141
45-49 57.1 173 95.6 29.6 4.4 5.6 6.7 99
Residence
Urban 71.2 488 95.4 29.0 11.8 13.1 9.5 347
Rural 63.7 772 95.4 44.5 10.9 11.6 9.7 492
Zone
Coastal 63.4 603 96.3 30.0 13.3 11.3 10.1 382
Middle 70.9 419 95.1 29.7 10.9 15.3 8.4 297
Northern 67.4 238 93.8 46.9 6.9 8.8 11.1 160
Total 66.6 1,260 95.4 34.3 11.3 12.2 9.7 839

Note: Figures in parentheses are based on 25-49 unweighted cases.

1
Medians are calculated excluding respondents who gave non-numeric responses.

Causes of Death • 143

 Table 9.10 Logistical and financial issues

Among deceased women, percentage with various travel times from deceased woman’s household to the nearest health facility, percentage for
whom a telephone or cell phone was used to call for help in the final days before death, and percentage for whom the cost of care prohibited
other household payments, according to background characteristics, Ghana MHS 2017
Over the
course of
Telephone or illness, costs
Travel time to nearest health facility1,2 cell phone of care
was used to prohibited
call for help in other Number of
Background 30 minutes to 61 minutes to final days household deceased
characteristic <30 minutes 1 hour 2 hours >2 hours before death payments women
Travelled to a health facility in
final days before death
Yes 65.0 30.1 2.3 1.1 46.2 48.4 839
No3 45.8 38.8 8.1 2.6 27.6 49.6 420
Cause of death
Maternal (direct) 55.7 32.0 3.4 3.3 46.7 43.7 127
Maternal (indirect and
unspecified) (51.9) (38.8) (2.9) (6.3) (42.8) (41.6) 48
Non-maternal 59.2 32.8 4.4 1.2 39.1 49.7 1,085
Residence
Urban 71.6 24.8 0.6 0.4 39.4 44.4 488
Rural 50.3 38.2 6.5 2.4 40.3 51.6 772
Zone
Coastal 54.2 35.7 4.6 2.2 42.6 45.5 603
Middle 70.9 24.7 1.8 0.7 34.4 54.2 419
Northern 47.8 40.9 7.6 1.8 43.2 47.7 238
Total 58.6 33.0 4.2 1.6 40.0 48.8 1,260

Note: Figures in parentheses are based on 25-49 unweighted cases.

1
Hypothetical question on travel time to nearest facility, not necessarily the facility that was visited (if the deceased woman travelled to any
facility)
2
Excludes respondents who gave non-numeric responses
3
Includes 4 individuals who responded don’t know

Table 9.11 Death certificates and burial permits

Percentage of deceased women age 12-49 in the 5 years before the survey for whom the verbal
autopsy respondent had a death certificate and percentage for whom the respondent had a burial
permit, according to background characteristics, Ghana MHS 2017
Respondent in Respondent in
Background possession of possession of Number of
characteristic death certificate burial permit deceased women
Cause of death
Maternal (direct) 18.8 16.4 127
Maternal (indirect and unspecified) (13.3) (11.0) 48
Non-maternal 10.7 8.3 1,085
Age at death
12-14 (4.2) (4.3) 49
15-19 17.2 13.2 90
20-24 6.6 5.8 141
25-29 12.0 7.4 169
30-34 13.6 12.2 227
35-39 14.5 9.7 218
40-44 9.4 10.0 193
45-49 10.6 7.9 173
Residence
Urban 17.8 15.1 488
Rural 7.7 5.5 772
Zone
Coastal 16.5 13.0 603
Middle 9.8 8.5 419
Northern 2.2 1.2 238
Total 11.6 9.2 1,260

Note: Figures in parentheses are based on 25-49 unweighted cases.

144 • Causes of Death

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InterVA Model versus Physician Review in Determining Causes Of Death in the Nairobi DSS”.
Population Health Metrics. 2010, 8:21. doi:10.1186/1478-7954-8-21

Rutenberg, N., and J. Sullivan. 1991. “Direct and Indirect Estimates of Maternal Mortality from the
Sisterhood Method.” Proceedings of the Demographic and Health Surveys World Conference 3:1669-
1696. Columbia, Maryland, USA: IRD/Macro International Inc.

Stanton, C., N. Abderrahim, and K. Hill. 1997. DHS Maternal Mortality Indicators: An Assessment of
Data Quality and Implications for Data Use. DHS Analytical Reports No. 4. Calverton, Maryland, USA:
Macro International Inc.

World Health Organization (WHO). 2012. The WHO Application of ICD-10 to deaths during pregnancy,
childbirth, and puerperium: ICD Maternal Mortality (ICD-MM). Geneva: World Health Organization,
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References • 145
SAMPLE DESIGN Appendix A
A.1 INTRODUCTION

T
he 2017 Ghana Maternal Health Survey (2017 GMHS) was the second of its kind following the
original conducted in 2007 (2007 GMHS). The survey was planned to collect information on
maternal health and mortality in Ghana through data collection at the household and individual
woman’s level. As in the 2007 GMHS, the 2017 GMHS collected data from a nationally representative
sample. The 2017 GMHS sample consisted of 900 clusters and 27,000 households randomly selected from
the entire country. In the first phase, during the household listing operation, a screening on death of all
household members occurring since January 2012 was conducted in all households in each of the selected
clusters. A list of households where a female resident age 10-54 at time of death occurred in the past 5
years was constructed. In the second phase, interviewer visited all the households in this list to confirm the
death, and conduct a verbal autopsy interview for all deaths of female residents age 12-49 occurring in the
past 5 years to obtain information on the cause of death. Also in the second phase, 30 households were
randomly selected from all households listed in the first phase, in each of the 900 selected clusters. This
selection was independent of whether the household was also on the list for verbal autopsy interviews. In
the selected households, a household questionnaire was applied to collect basic household information. All
women age 15-49 in the selected households were eligible for an interview using a woman’s questionnaire,
including both members and visitors who stayed in the selected household the night before the survey. The
woman’s questionnaire collected information on key demographic and health indicators including
antenatal, maternity, and emergency obstetric care in the event of a birth, abortion, or miscarriage in the
past 5 years. In addition, a sibling history module was applied to every eligible woman to collect their
sibling’s survival information which was used to calculate direct estimates of adult and maternal mortality
rates.

The survey was designed to produce representative estimates for maternal mortality indicators for the
country as a whole, and for each of the three geographical zones, namely Coastal (Western, Central,
Greater Accra and Volta), Middle (Eastern, Ashanti and Brong Ahafo) and Northern (Northern, Upper East
and Upper West). For other indicators such as maternal care, fertility and child mortality, the survey was
designed to produce representative results for the country as whole, for the urban and rural areas, and for
each of the country’s 10 administrative regions.

A.2 SAMPLING FRAME

The sampling frame used for 2017 GMHS is the frame of the Population and Housing Census (PHC)
conducted in Ghana in 2010, provided by the Ghana Statistical Service (GSS), with updated information
on identification of the 216 administrative districts defined after the census. The census frame is a
complete list of all census enumeration areas (EA) created for the PHC 2010. Ghana is administratively
divided into 10 administrative regions, and each region is sub-divided into a number of districts; in total
there are 216 districts in Ghana. Table A.1 below gives the population distribution by region and by type
of residence. The proportion of the population varies greatly by region, from 2.8% in Upper West region to
19.4% in Ashanti region. The urbanization of the regions varies also greatly, with Greater Accra region
being 90.5% urban, while in Upper West region only 16.3% of the population lives in urban areas. In
Ghana, 50.9% of the population lives in urban areas. Table A.2 below gives the distribution of residential
households by region and by type of residence. The household distribution is slightly different from the
population distribution because the average urban household size is smaller than the average rural
household size. In Ghana, 55.8% of households are in urban areas. Table A.3 below gives the distribution
of EAs and their average size (number of households) by region and by type of residence. There are in total
37,675 EAs; 16,503 are in urban areas and 21,172 are in rural areas. The average EA size is 145

Appendix A • 147
 households; urban EAs have a slightly larger size, with an average of 185 households per EA; the rural
EAs have a smaller size with an average of 114 households per EA. The EA size is adequate to serve as a
primary sampling unit (PSU) with a sample take of 30 households per EA.

Table A.1 Distribution of population by region and by type of residence

Distribution of Population Percentage
Region Name Urban Rural Total Urban Region
Western 1,007,969 1,368,052 2,376,021 42.4 9.6
Central 1,037,878 1,163,985 2,201,863 47.1 8.9
Greater Accra 3,630,955 379,099 4,010,054 90.5 16.3
Volta 713,735 1,404,517 2,118,252 33.7 8.6
Eastern 1,143,918 1,489,236 2,633,154 43.4 10.7
Ashanti 2,897,290 1,883,090 4,780,380 60.6 19.4
Brong Ahafo 1,028,473 1,282,510 2,310,983 44.5 9.4
Northern 750,712 1,728,749 2,479,461 30.3 10.1
Upper East 219,646 826,899 1,046,545 21.0 4.2
Upper West 114,653 587,457 702,110 16.3 2.8
Ghana 12,545,229 12,113,594 24,658,823 50.9 100.0

Source: 2010 Population and Housing Census, including institutional population

Table A.2 Distribution of residential households by region and by type of residence

Distribution of Residential Households Percentage
Region Name Urban Rural Total Urban Region
Western 248,919 304,715 553,634 45.0 10.1
Central 255,365 271,398 526,763 48.5 9.6
Greater Accra 950,336 86,034 1,036,370 91.7 19.0
Volta 178,814 316,786 495,600 36.1 9.1
Eastern 293,547 338,498 632,045 46.4 11.6
Ashanti 715,462 410,743 1,126,205 63.5 20.6
Brong Ahafo 236,283 254,232 490,515 48.2 9.0
Northern 106,071 212,048 318,119 33.3 5.8
Upper East 41,941 135,688 177,629 23.6 3.2
Upper West 22,628 87,546 110,174 20.5 2.0
Ghana 3,049,366 2,417,688 5,467,054 55.8 100.0

Source: 2010 Population and Housing Census

Table A.3 Distribution of enumeration areas and their average size in number of households
Distribution of EAs Average EA size
Region Name Urban Rural Total Urban Rural Total
Western 1,239 2,300 3,539 201 132 156
Central 1,350 1,885 3,235 189 144 163
Greater Accra 4,724 699 5,423 201 123 191
Volta 964 2,646 3,610 185 120 137
Eastern 1,708 2,705 4,413 172 125 143
Ashanti 3,618 3,442 7,060 198 119 160
Brong Ahafo 1,425 2,246 3,671 166 113 134
Northern 998 2,873 3,871 106 74 82
Upper East 324 1,403 1,727 129 97 103
Upper West 153 973 1,126 148 90 98
Ghana 16,503 21,172 37,675 185 114 145

Source: 2010 Population and Housing Census

A.3 SAMPLE DESIGN AND THE SAMPLING PROCEDURE

The sample for the 2017 GMHS is a stratified sample selected in two stages from the sampling frame.
Stratification was achieved by separating each region into urban and rural areas; in total, 20 sampling strata
were created. Samples were selected independently in each sampling stratum by a two stage selection. In
the first stage, 900 EAs were selected with probability proportional to size (PPS) selection procedure
according to the sample allocation given in Table A.4 below. The EA size is the number of residential
households in the EA per the 2010 PHC. Implicit stratification with proportional allocation was achieved

148 • Appendix A
at each of the lower administrative unit levels by sorting the EA frame before the sample selection
according to a certain geographical order, within each of the explicit strata, and by using a probability
proportional to size selection procedure.

After the selection of EAs and before the main survey, a household listing operation was carried out in all
of the selected EAs. The household listing operation consisted of visiting each of the 900 selected EAs,
drawing a location map and a detailed sketch map of the EA, recording a all residential structures and
households within each structure with the address (location description) and the name of the head of the
household. Questions on deaths of household members in the past 5 years were also asked. The resulting
list of households served as sampling frame for the selection of 30 sample households in the second stage
for the main survey in the second phase. All households identified with death of female resident age 10-54
in the past 5 years were followed up during data collection to conduct a verbal autopsy interview. Some of
the households selected for the verbal autopsy component might also have been selected for the main
survey.

In the second stage of selection, a fixed number of 30 households was selected in every cluster, by an equal
probability systematic sampling based on the newly updated household listing. A spreadsheet indicating
the selected household numbers for each cluster was prepared. The survey interviewers were asked to
interview only the pre-selected households. No replacements and no changes of the pre-selected
households were allowed during fieldwork in order to prevent bias.

Table A.4 below gives the sample allocation of clusters and households by zone, by region and by type of
residence. The sample allocation featured an equal size allocation for each of the three zones, that is, 300
clusters and 9,000 households per zone. The sample allocated to each zone was then allocated to the
regions within each zone by using a power allocation with small adjustment because a proportional
allocation will result a very small sample size for less populous regions such as Upper East and Upper
West regions. Since the Northern zone is much smaller compared to the other two, the Northern zone was
oversampled in order to have comparable survey precision for the maternal mortality indicators. The
sample allocation of EAs and households were converted to the expected number of interviews with
women by taking into account non-response and the average number of women 15-49 per household, as
shown in Table A.5 below.

Table A.4 Sample allocation of clusters and households by region and by type of residence
Allocation of clusters Allocation of households
Zone Name Region Name Urban Rural Region Urban Rural Region
Western 34 34 68 1,020 1,020 2,040
Central 36 31 67 1,080 930 2,010
Coastal
Greater Accra 93 7 100 2,790 210 3,000
Volta 27 38 65 810 1,140 1,950
Coastal Total 190 110 300 5,700 3,300 9,000
Eastern 47 46 93 1,410 1,380 2,790
Middle Ashanti 83 42 125 2,490 1,260 3,750
Brong Ahafo 42 40 82 1,260 1,200 2,460
Middle Total 172 128 300 5,160 3,840 9,000
Northern 53 75 128 1,590 2,250 3,840
Northern Upper East 30 66 96 900 1,980 2,880
Upper West 21 55 76 630 1,650 2,280
Northern Total 104 196 300 3,120 5,880 9,000

Ghana 466 434 900 13,980 13,020 27,000

Appendix A • 149
 Table A.5 Sample allocation of expected number of women interviews
Women 15-49
Zone Name Region Name Urban Rural Region
Western 723 772 1,495
Central 765 704 1,469
Coastal
Greater Accra 1,977 159 2,136
Volta 574 862 1,436
Coastal Total 4,039 2,497 6,536
Eastern 999 1,044 2,043
Middle Ashanti 1,764 953 2,717
Brong Ahafo 893 908 1,801
Middle Total 3,656 2,905 6,561
Northern 1,127 1,702 2,829
Northern Upper East 638 1,498 2,136
Upper West 446 1,249 1,695
Northern Total 2,211 4,449 6,660

Ghana 9,906 9,851 19,757

The parameters used in the sample calculation came from the previous DHS conducted in Ghana in 2014
(GDHS 2014). In that survey, the survey results showed that the household completion rates were 91.5%
and 93% for urban and rural areas, respectively; there were on average 0.80 and 0.83 women 15-49 per
urban and rural households, respectively; women’s response rates were 96.8% and 97.8% for the urban and
rural areas respectively.

A.4 SELECTION PROBABILITY AND SAMPLING WEIGHT

Due to the non-proportional allocation of the sample to the different regions and the differences in
response rates, sampling weights are required for any analysis using 2017 GMHS data to ensure the actual
representation of the survey results at national level and as well as at domain level. Since the 2017 GMHS
sample was a two-stage stratified cluster sample, sampling weights were calculated based on sampling
probabilities separately for each sampling stage and for each cluster. We use the following notations:

P1hi: first-stage sampling probability of the ith EA in stratum h from the sampling frame
P2hi: second-stage sampling probability within the ith EA (household selection)

Let nh be the number of EAs selected in stratum h, Mhi the measure of size (number of residential
households) according to the sampling frame in the ith EA, and  M hi the total measure of size (total
number of residential households) in the stratum h. The probability of selecting the ith EA in stratum h
from the sampling frame was calculated as follows:

nh M hi
P1hi 
 M hi

In case of a selected cluster with a very large number of households, the listing team decided to segment
the cluster into several segments, only one segment was randomly selected to be covered by the 2017
GMHS. Household listing was conducted only in the selected segment.

Let shi be the proportion of households in the selected segment compared to the estimated total number of

households in EA i in stratum h if the EA was segmented, otherwise let shi  1. Then the selection
probability of a segmented cluster was recalculated as:

nh M hi
P1hi   shi
 M hi

150 • Appendix A
Let
Lhi be the number of households listed in the household listing operation in cluster i in stratum h, let
mhi
be the number of households selected in the cluster. The second stage’s selection probability for each
household in the cluster was calculated as follows:

mhi
P2 hi 
Lhi

The overall selection probability of each household in cluster i of stratum h was therefore the production of
the selection probabilities:

Phi  P1hi  P2hi

The design weight for each household in cluster i of stratum h was the inverse of its overall selection
probability:

Whi  1 / Phi

A spreadsheet containing all the sampling parameters and selection probabilities were prepared to facilitate
the calculation of the design weights. Design weights were adjusted for household non-response and as
well as for women individual non-response to get the sampling weights, for households and for women
individuals, respectively. The differences of the household sampling weights and the women individual
sampling weights are introduced by women individual non-response. The final sampling weights were
normalized in order to achieve the total number of un-weighted cases equal to the total number of weighted
cases at national level, for both household weights and individual weights, respectively. The normalized
weights are relative weights which are valid for estimating means, proportions and ratios, but not valid for
estimating population totals and for pooled data.

The design weight for the verbal autopsy indicators were the inverse of the cluster selection probability for
the first stage selection. Correction of cluster level non-response as well as case level nonresponse may
apply if there was non-response, either at cluster level or at case level.

Sampling errors were calculated for selected indicators for the national sample, for the urban and rural
areas separately, and for each of the 10 regions.

Appendix A • 151
 A.5 SURVEY IMPLEMENTATION RESULTS

Table A.6 Sample implementation: Women

Percent distribution of households and eligible women age 15-49 by results of the household and individual interviews, and household, eligible women and overall
women response rates, according to urban-rural residence and region (unweighted), Ghana MHS 2017
Residence Region
Greater Brong Upper Upper
Result Urban Rural Western Central Accra Volta Eastern Ashanti Ahafo Northern East West Total
Selected households
Completed (C) 97.2 97.8 98.6 98.2 95.2 97.1 96.2 96.7 98.6 99.4 96.3 99.3 97.5
Household present but no
competent respondent at
home (HP) 0.7 0.3 0.6 0.7 1.7 0.4 0.4 0.4 0.2 0.1 0.2 0.1 0.5
Postponed (P) 0.0 0.0 0.0 0.0 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Refused (R) 0.2 0.0 0.0 0.1 0.3 0.0 0.0 0.1 0.0 0.1 0.1 0.0 0.1
Dwelling not found (DNF) 0.1 0.1 0.1 0.1 0.1 0.0 0.0 0.1 0.0 0.1 0.1 0.0 0.1
Household absent (HA) 0.7 1.0 0.2 0.4 0.9 1.1 1.3 0.8 0.6 0.3 2.4 0.3 0.8
Dwelling vacant/address not
a dwelling (DV) 1.1 0.7 0.5 0.4 1.3 1.3 1.8 1.7 0.4 0.1 0.9 0.3 0.9
Dwelling destroyed (DD) 0.0 0.0 0.0 0.0 0.0 0.1 0.0 0.1 0.0 0.1 0.0 0.0 0.0
Other (O) 0.1 0.1 0.0 0.0 0.2 0.0 0.3 0.1 0.2 0.0 0.1 0.0 0.1
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Number of sampled
households 13,980 13,021 2,040 2,010 3,000 1,950 2,790 3,751 2,460 3,840 2,880 2,280 27,001
Household response rate
(HRR)1 99.1 99.6 99.3 99.0 97.6 99.6 99.6 99.3 99.8 99.8 99.6 99.9 99.3
Eligible women
Completed (EWC) 98.9 99.2 98.9 98.0 98.4 98.8 99.4 99.4 98.9 99.6 98.7 99.5 99.0
Not at home (EWNH) 0.5 0.4 0.5 1.2 0.9 0.4 0.1 0.3 0.6 0.1 0.8 0.0 0.5
Postponed (EWP) 0.1 0.0 0.0 0.1 0.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Refused (EWR) 0.2 0.0 0.2 0.1 0.2 0.1 0.0 0.1 0.1 0.1 0.1 0.0 0.1
Incapacitated (EWI) 0.3 0.4 0.4 0.6 0.2 0.7 0.5 0.2 0.4 0.2 0.5 0.4 0.4
Other (EWO) 0.0 0.0 0.0 0.1 0.1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0
Number of women 12,681 12,623 2,359 1,636 2,576 1,484 2,185 3,155 2,328 4,220 2,746 2,615 25,304
Eligible women response rate
(EWRR)2 98.9 99.2 98.9 98.0 98.4 98.8 99.4 99.4 98.9 99.6 98.7 99.5 99.0
Overall women response rate
(ORR)3 98.0 98.8 98.3 97.0 96.1 98.4 99.0 98.7 98.6 99.3 98.3 99.4 98.4

1
Using the number of households falling into specific response categories, the household response rate (HRR) is calculated as:

100 * C
___________________________________________________

C + HP + P + R + DNF
2
The eligible women response rate (EWRR) is equivalent to the percentage of interviews completed (EWC)
3
The overall women response rate (OWRR) is calculated as:
OWRR = HRR * EWRR/100

152 • Appendix A
ESTIMATES OF SAMPLING ERRORS Appendix B
T
he estimates from a sample survey are affected by two types of errors: nonsampling errors and
sampling errors. Nonsampling errors are the results of mistakes made in implementing data
collection and data processing, such as failure to locate and interview the correct household,
misunderstanding of the questions on the part of either the interviewer or the respondent, and data entry
errors. Although numerous efforts were made during the implementation of the 2017 Ghana Maternal
Health Survey (2017 GMHS) to minimize this type of error, nonsampling errors are impossible to avoid
and difficult to evaluate statistically.

Sampling errors, on the other hand, can be evaluated statistically. The sample of respondents selected in
the 2017 GMHS is only one of many samples that could have been selected from the same population,
using the same design and sample size. Each of these samples would yield results that differ somewhat
from the results of the actual sample selected. Sampling errors are a measure of the variability among all
possible samples. Although the degree of variability is not known exactly, it can be estimated from the
survey results.

Sampling error is usually measured in terms of the standard error for a particular statistic (mean,
percentage, etc.), which is the square root of the variance. The standard error can be used to calculate
confidence intervals within which the true value for the population can reasonably be assumed to fall in.
For example, for any given statistic calculated from a sample survey, the true value of that statistic will fall
within a range of plus or minus two times the standard error of that statistic in 95% of all possible samples
of identical size and design.

If the sample of respondents had been selected by simple random sampling, it would have been possible to
use straightforward formulas for calculating sampling errors. However, the 2017 GMHS sample is the
result of a multi-stage stratified sampling, and, consequently, it was necessary to use more complex
formulas. Sampling errors are computed by SAS programs developed by ICF International. These
programs use the Taylor linearization method to estimate variances for survey estimates that are means,
proportions, or ratios. The Jackknife repeated replication method is used for variance estimation of more
complex statistics such as fertility and mortality rates.

The Taylor linearization method treats any percentage or average as a ratio estimate, r = y/x, where y
represents the total sample value for variable y, and x represents the total number of cases in the group or
subgroup under consideration. The variance of r is computed using the formula given below, with the
standard error being the square root of the variance:

1 f H  mh  mh 2 zh2 
2
SE ( r )  var( r )  2
x
    zhi 
h 1  mh  1  i 1

mh 
in which

z hi  yhi  rxhi , and z h  yh  rxh

Appendix B • 153
 where h represents the stratum which varies from 1 to H,
mh is the total number of clusters selected in the hth stratum,
yhi is the sum of the weighted values of variable y in the ith cluster in the hth stratum,
xhi is the sum of the weighted number of cases in the ith cluster in the hth stratum, and
f is the overall sampling fraction, which is so small that it is ignored.

The Jackknife repeated replication method derives estimates of complex rates from each of several
replications of the parent sample, and calculates standard errors for these estimates using simple formulas.
Each replication considers all but one cluster in the calculation of the estimates. Pseudo-independent
replications are thus created. In the 2017 GMHS there were 900 non-empty clusters. Hence, 900
replications were created. The variance of a rate r is calculated as follows:

1 k
2
SE (r )  var (r )  
k ( k  1) i 1
(ri  r ) 2

in which

ri  kr  (k  1)r(i )

where r is the estimate computed from the full sample of 900 clusters,
r(i) is the estimate computed from the reduced sample of 899 clusters (ith cluster excluded),
and
k is the total number of clusters.

In addition to the standard error, the design effect (DEFT) for each estimate is also calculated. The design
effect is defined as the ratio between the standard error using the given sample design and the standard
error that would result if simple random sampling had been used. A DEFT value of 1.0 indicates that the
sample design is as efficient as a simple random sampling, while a value greater than 1.0 indicates the
increase in the sampling error due to the use of a more complex and less statistically efficient design.
Relative standard errors for the estimates are also calculated. A relative standard error, also known as
coefficient of variation, is the standard error relative to the estimated value of the statistic, calculated as the
ratio of the standard error over the estimated value SE/R. Relative standard error reflects the magnitude of
sampling error compared to the indicator value; it indicates the survey precision in another way.

Sampling errors for the 2017 GMHS are calculated for selected variables considered to be of primary
interest. The results are presented in this appendix for the country as a whole, for urban and rural areas, for
the three ecological zones, and for each of the 10 regions. For each variable, the type of statistic (mean,
proportion, or rate) and the base population are given in Table B.1. Tables B.2 through B.18 present the
value of the statistic (R), its standard error (SE), the number of unweighted (N) and weighted (WN) cases,
the design effect (DEFT), the relative standard error (SE/R), and the 95% confidence limits (R±2SE), for
each variable. The sampling errors for mortality rates are presented for the 5-year period preceding the
survey for the national sample and for the 10-year period preceding the survey at domain levels. The
DEFT is considered undefined when the standard error considering a simple random sample is zero (when
the estimate is close to 0 or 1).

The confidence interval (e.g., as calculated for children ever born to women age 40-49) can be interpreted
as follows: the overall average number of children ever born to women age 40-49 from the national sample
is 4.618 and its standard error is 0.050. Therefore, to obtain the 95% confidence limits, one adds and
subtracts twice the standard error to the sample estimate, i.e., 4.618±2×0.050. There is a high probability
(95%) that the true average number of children ever born to all women age 40 to 49 is between 4.518 and
4.717.

154 • Appendix B
 For the total sample, the value of the DEFT, averaged over all variables, is 1.602. This means that, due to
multi-stage clustering of the sample, the average standard error is increased by a factor o1.602 over that in
an equivalent simple random sample.

Table B.1 List of selected variables for sampling errors, Ghana MHS 2017
Variable Estimate Base population
WOMEN

Urban residence Proportion Women 15-49

Literacy Proportion Women 15-49
No education Proportion Women 15-49
Secondary education or higher Proportion Women 15-49
Never married/never in union Proportion Women 15-49
Currently married/in union Proportion Women 15-49
Married before age 18 Proportion Women 20-49
Had sexual intercourse before age 18 Proportion Women 20-49
Currently pregnant Proportion Women 15-49
Children ever born Mean Women 15-49
Children surviving Mean Women 15-49
Children ever born to women 40-49 Mean Women 40-49
Know any contraceptive method Proportion Currently married women 15-49
Know a modern method Proportion Currently married women 15-49
Currently using any method Proportion Currently married women 15-49
Currently using a modern method Proportion Currently married women 15-49
Currently using pill Proportion Currently married women 15-49
Currently using male condoms Proportion Currently married women 15-49
Currently using injectables Proportion Currently married women 15-49
Currently using implants Proportion Currently married women 15-49
Currently using female sterilization Proportion Currently married women 15-49
Currently using withdrawal Proportion Currently married women 15-49
Currently using rhythm Proportion Currently married women 15-49
Currently using withdrawal Proportion Currently married women 15-49
Mothers received antenatal care for last birth/stillbirth Proportion Women with a live birth/stillbirth in last 5 years
Mothers protected against tetanus for last birth/stillbirth Proportion Women with a live birth/stillbirth in last 5 years
Births/stillbirths with skilled attendant at delivery Proportion Births/stillbirths occurring 1-59 months before survey
Induced abortion in the 5 years before the survey Proportion Women with an induced abortion in the 5 years before the survey
Miscarriage in the 5 years before the survey Proportion Women with a miscarriage in the 5 years before the survey
Ever had an induced abortion Proportion Women who have ever had an induced abortion
No induced abortion but have heard of induced abortion Proportion Women who have not had an induced abortion but have heard of induced
abortion
Believe induced abortion is legal in Ghana Proportion Women who believe induced abortion is legal in Ghana
Total fertility rate (3 years) Rate Women-years of exposure to childbearing
Neonatal mortality rate¹ Rate Children exposed to the risk of mortality
Post-neonatal mortality rate¹ Rate Children exposed to the risk of mortality
Infant mortality rate¹ Rate Children exposed to the risk of mortality
Child mortality rate¹ Rate Children exposed to the risk of mortality
Under-5 mortality rate¹ Rate Children exposed to the risk of mortality

1
The mortality rates are calculated for 5 years before the survey for national sample and by residence type, and 10 years for regional samples.

Appendix B • 155
 Table B.2 Sampling errors: Total sample, Ghana MHS 2017
Number of Cases Confidence Limits
Standard Un- Design Relative
Value error weighted Weighted effect error Lower Upper
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) (R-2SE) (R+2SE)
WOMEN

Urban residence 0.549 0.010 25062 25062 3.157 0.018 0.529 0.569
Literacy 0.538 0.007 25062 25062 2.076 0.012 0.525 0.551
No education 0.183 0.005 25062 25062 2.192 0.029 0.172 0.194
Secondary or higher education 0.660 0.007 25062 25062 2.375 0.011 0.646 0.674
Never married/never in union 0.335 0.004 25062 25062 1.417 0.013 0.327 0.343
Currently married/in union 0.573 0.005 25062 25062 1.517 0.008 0.564 0.582
Married before age 18 0.247 0.005 20174 20277 1.658 0.020 0.237 0.257
Had sexual intercourse before age 18 0.486 0.006 20174 20277 1.825 0.013 0.473 0.499
Currently pregnant 0.064 0.002 25062 25062 1.312 0.032 0.060 0.068
Children ever born 2.239 0.023 25062 25062 1.556 0.010 2.194 2.284
Children surviving 2.058 0.020 25062 25062 1.527 0.010 2.017 2.098
Children ever born to women age 40-49 4.618 0.050 4846 4818 1.448 0.011 4.518 4.717
Know any contraceptive method 0.994 0.001 15052 14361 1.317 0.001 0.992 0.996
Know a modern method 0.994 0.001 15052 14361 1.302 0.001 0.992 0.995
Currently using any method 0.308 0.006 15052 14361 1.513 0.018 0.297 0.319
Currently using a modern method 0.250 0.005 15052 14361 1.491 0.021 0.240 0.261
Currently using pill 0.043 0.002 15052 14361 1.395 0.054 0.038 0.047
Currently using IUD 0.008 0.001 15052 14361 1.489 0.134 0.006 0.010
Currently using condoms 0.011 0.001 15052 14361 1.325 0.104 0.008 0.013
Currently using injectables 0.082 0.003 15052 14361 1.425 0.039 0.076 0.089
Currently using implants 0.074 0.003 15052 14361 1.487 0.043 0.067 0.080
Currently using female sterilization 0.019 0.002 15052 14361 1.548 0.092 0.015 0.022
Currently using rhythm 0.042 0.003 15052 14361 1.604 0.062 0.037 0.048
Currently using withdrawal 0.013 0.001 15052 14361 1.465 0.106 0.010 0.015
Mothers received antenatal care for last birth/stillbirth 0.976 0.002 11492 10940 1.525 0.002 0.971 0.980
Mothers protected against tetanus for last birth/stillbirth 0.767 0.006 11492 10940 1.498 0.008 0.755 0.780
Births/stillbirths with skilled attendant at delivery 0.794 0.009 11492 10940 2.266 0.011 0.776 0.811
Induced abortion in the 5 years before the survey 0.067 0.002 25062 25062 1.465 0.035 0.062 0.072
Miscarriage in the 5 years before the survey 0.071 0.002 25062 25062 1.322 0.030 0.067 0.076
Ever had an induced abortion 0.196 0.005 25062 25062 1.837 0.023 0.187 0.205
No induced abortion but have heard of induced abortion 0.753 0.005 25062 25062 1.961 0.007 0.743 0.764
Believe induced abortion is legal in Ghana 0.114 0.004 23160 23801 1.924 0.035 0.106 0.122
Total fertility rate (last 3 years) 3.923 0.062 69994 70346 1.440 0.016 3.798 4.048
Neonatal mortality (last 0-4 years) 24.805 1.658 15375 14616 1.230 0.067 21.489 28.120
Post-neonatal mortality (last 0-4 years) 12.052 1.243 15351 14628 1.370 0.103 9.566 14.538
Infant mortality (last 0-4 years) 36.857 2.029 15393 14635 1.231 0.055 32.799 40.915
Child mortality (last 0-4 years) 15.647 1.208 15108 14337 1.150 0.077 13.232 18.063
Under-5 mortality (last 0-4 years) 51.927 2.341 15513 14727 1.217 0.045 47.244 56.610

156 • Appendix B
Table B.3 Sampling errors: Urban sample, Ghana MHS 2017
Number of Cases Confidence Limits
Standard Un- Design Relative
Value error weighted Weighted effect error Lower Upper
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) (R-2SE) (R+2SE)
WOMEN

Urban residence 1.000 0.000 12544 13752 na 0.000 1.000 1.000

Literacy 0.648 0.008 12544 13752 1.900 0.012 0.632 0.665
No education 0.112 0.005 12544 13752 1.932 0.049 0.101 0.122
Secondary or higher education 0.760 0.008 12544 13752 2.045 0.010 0.744 0.775
Never married/never in union 0.378 0.006 12544 13752 1.360 0.016 0.366 0.389
Currently married/in union 0.525 0.007 12544 13752 1.464 0.012 0.512 0.539
Married before age 18 0.185 0.006 10304 11341 1.637 0.034 0.173 0.198
Had sexual intercourse before age 18 0.413 0.009 10304 11341 1.758 0.021 0.396 0.430
Currently pregnant 0.055 0.002 12544 13752 1.203 0.044 0.050 0.060
Children ever born 1.845 0.025 12544 13752 1.389 0.013 1.796 1.894
Children surviving 1.716 0.023 12544 13752 1.403 0.013 1.670 1.762
Children ever born to women age 40-49 3.820 0.062 2325 2559 1.389 0.016 3.696 3.944
Know any contraceptive method 0.998 0.000 6730 7226 1.016 0.000 0.997 0.999
Know a modern method 0.998 0.000 6730 7226 0.995 0.000 0.997 0.999
Currently using any method 0.302 0.008 6730 7226 1.385 0.026 0.287 0.318
Currently using a modern method 0.226 0.007 6730 7226 1.314 0.030 0.213 0.240
Currently using pill 0.039 0.003 6730 7226 1.213 0.073 0.034 0.045
Currently using IUD 0.011 0.002 6730 7226 1.458 0.169 0.007 0.015
Currently using condoms 0.016 0.002 6730 7226 1.257 0.119 0.013 0.020
Currently using injectables 0.066 0.004 6730 7226 1.364 0.063 0.058 0.074
Currently using implants 0.060 0.004 6730 7226 1.357 0.065 0.052 0.068
Currently using female sterilization 0.018 0.002 6730 7226 1.272 0.115 0.014 0.022
Currently using rhythm 0.057 0.004 6730 7226 1.485 0.074 0.048 0.065
Currently using withdrawal 0.015 0.002 6730 7226 1.354 0.132 0.011 0.019
Mothers received antenatal care for last birth/stillbirth 0.983 0.003 4940 5286 1.565 0.003 0.977 0.989
Mothers protected against tetanus for last birth/stillbirth 0.803 0.008 4940 5286 1.469 0.010 0.786 0.820
Births/stillbirths with skilled attendant at delivery 0.906 0.009 4940 5286 2.031 0.009 0.889 0.923
Induced abortion in the 5 years before the survey 0.081 0.003 12544 13752 1.373 0.041 0.074 0.087
Miscarriage in the 5 years before the survey 0.071 0.003 12544 13752 1.247 0.040 0.065 0.076
Ever had an induced abortion 0.236 0.007 12544 13752 1.730 0.028 0.223 0.249
No induced abortion but have heard of induced abortion 0.731 0.008 12544 13752 1.916 0.010 0.716 0.746
Believe induced abortion is legal in Ghana 0.142 0.006 12008 13298 1.832 0.041 0.130 0.154
Total fertility rate (last 3 years) 3.334 0.075 35356 38943 1.391 0.022 3.184 3.484
Neonatal mortality (last 0-4 years) 25.468 2.663 6405 6925 1.252 0.105 20.141 30.794
Post-neonatal mortality (last 0-4 years) 10.192 1.843 6398 6934 1.394 0.181 6.506 13.877
Infant mortality (last 0-4 years) 35.659 3.196 6412 6934 1.242 0.090 29.267 42.051
Child mortality (last 0-4 years) 12.436 1.660 6286 6758 1.165 0.133 9.115 15.756
Under-5 mortality (last 0-4 years) 47.651 3.542 6444 6968 1.203 0.074 40.567 54.736

Appendix B • 157
 Table B.4 Sampling errors: Rural sample, Ghana MHS 2017
Number of Cases Confidence Limits
Standard Un- Design Relative
Value error weighted Weighted effect error Lower Upper
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) (R-2SE) (R+2SE)
WOMEN

Urban residence 0.000 0.000 12518 11310 na na 0.000 0.000

Literacy 0.405 0.009 12518 11310 2.086 0.023 0.386 0.423
No education 0.270 0.009 12518 11310 2.367 0.035 0.251 0.289
Secondary or higher education 0.539 0.012 12518 11310 2.587 0.021 0.516 0.562
Never married/never in union 0.283 0.006 12518 11310 1.488 0.021 0.271 0.295
Currently married/in union 0.631 0.007 12518 11310 1.629 0.011 0.617 0.645
Married before age 18 0.326 0.007 9870 8936 1.560 0.023 0.311 0.340
Had sexual intercourse before age 18 0.578 0.008 9870 8936 1.645 0.014 0.562 0.595
Currently pregnant 0.074 0.003 12518 11310 1.430 0.045 0.067 0.081
Children ever born 2.718 0.036 12518 11310 1.578 0.013 2.646 2.790
Children surviving 2.473 0.032 12518 11310 1.549 0.013 2.410 2.537
Children ever born to women age 40-49 5.521 0.070 2521 2259 1.502 0.013 5.381 5.661
Know any contraceptive method 0.989 0.002 8322 7135 1.423 0.002 0.986 0.993
Know a modern method 0.989 0.002 8322 7135 1.411 0.002 0.986 0.992
Currently using any method 0.314 0.008 8322 7135 1.633 0.026 0.297 0.331
Currently using a modern method 0.274 0.008 8322 7135 1.601 0.029 0.259 0.290
Currently using pill 0.047 0.004 8322 7135 1.558 0.077 0.039 0.054
Currently using IUD 0.005 0.001 8322 7135 1.439 0.216 0.003 0.008
Currently using condoms 0.005 0.001 8322 7135 1.336 0.213 0.003 0.007
Currently using injectables 0.099 0.005 8322 7135 1.452 0.048 0.089 0.108
Currently using implants 0.088 0.005 8322 7135 1.577 0.056 0.078 0.097
Currently using female sterilization 0.019 0.003 8322 7135 1.803 0.141 0.014 0.025
Currently using rhythm 0.028 0.003 8322 7135 1.662 0.108 0.022 0.034
Currently using withdrawal 0.010 0.002 8322 7135 1.589 0.177 0.006 0.013
Mothers received antenatal care for last birth/stillbirth 0.969 0.003 6552 5655 1.543 0.004 0.962 0.975
Mothers protected against tetanus for last birth/stillbirth 0.734 0.009 6552 5655 1.523 0.012 0.717 0.751
Births/stillbirths with skilled attendant at delivery 0.689 0.014 6552 5655 2.391 0.020 0.661 0.717
Induced abortion in the 5 years before the survey 0.050 0.003 12518 11310 1.522 0.059 0.044 0.056
Miscarriage in the 5 years before the survey 0.072 0.003 12518 11310 1.411 0.045 0.066 0.079
Ever had an induced abortion 0.148 0.006 12518 11310 1.858 0.040 0.136 0.160
No induced abortion but have heard of induced abortion 0.781 0.007 12518 11310 1.950 0.009 0.766 0.795
Believe induced abortion is legal in Ghana 0.078 0.005 11152 10503 2.070 0.067 0.068 0.089
Total fertility rate (last 3 years) 4.667 0.089 34639 31403 1.521 0.019 4.489 4.845
Neonatal mortality (last 0-4 years) 24.207 2.055 8970 7691 1.199 0.085 20.097 28.318
Post-neonatal mortality (last 0-4 years) 13.725 1.666 8953 7694 1.356 0.121 10.394 17.056
Infant mortality (last 0-4 years) 37.933 2.567 8981 7702 1.214 0.068 32.799 43.067
Child mortality (last 0-4 years) 18.415 1.722 8822 7579 1.165 0.094 14.970 21.859
Under-5 mortality (last 0-4 years) 55.649 3.063 9069 7759 1.227 0.055 49.523 61.775

158 • Appendix B
Table B.5 Sampling errors: Coastal zone sample, Ghana MHS 2017
Number of Cases Confidence Limits
Standard Un- Design Relative
Value error weighted Weighted effect error Lower Upper
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) (R-2SE) (R+2SE)
WOMEN

Urban residence 0.626 0.016 7938 12121 2.989 0.026 0.593 0.658
Literacy 0.605 0.011 7938 12121 2.033 0.018 0.583 0.627
No education 0.136 0.008 7938 12121 2.191 0.062 0.119 0.153
Secondary or higher education 0.708 0.012 7938 12121 2.286 0.016 0.684 0.731
Never married/never in union 0.357 0.007 7938 12121 1.215 0.018 0.344 0.371
Currently married/in union 0.546 0.007 7938 12121 1.339 0.014 0.531 0.561
Married before age 18 0.223 0.008 6494 9915 1.538 0.036 0.207 0.239
Had sexual intercourse before age 18 0.455 0.010 6494 9915 1.634 0.022 0.435 0.475
Currently pregnant 0.058 0.003 7938 12121 1.133 0.051 0.052 0.063
Children ever born 2.081 0.037 7938 12121 1.509 0.018 2.007 2.155
Children surviving 1.918 0.032 7938 12121 1.446 0.017 1.853 1.982
Children ever born to women age 40-49 4.251 0.077 1565 2351 1.274 0.018 4.098 4.404
Know any contraceptive method 0.998 0.001 4323 6622 1.610 0.001 0.996 1.000
Know a modern method 0.998 0.001 4323 6622 1.579 0.001 0.996 1.000
Currently using any method 0.293 0.009 4323 6622 1.269 0.030 0.276 0.311
Currently using a modern method 0.235 0.008 4323 6622 1.293 0.036 0.218 0.251
Currently using pill 0.040 0.004 4323 6622 1.328 0.099 0.032 0.048
Currently using IUD 0.009 0.002 4323 6622 1.297 0.208 0.005 0.013
Currently using condoms 0.011 0.002 4323 6622 1.110 0.159 0.008 0.015
Currently using injectables 0.069 0.005 4323 6622 1.294 0.072 0.059 0.079
Currently using implants 0.072 0.005 4323 6622 1.228 0.067 0.062 0.082
Currently using female sterilization 0.022 0.003 4323 6622 1.311 0.133 0.016 0.028
Currently using rhythm 0.038 0.003 4323 6622 1.144 0.087 0.032 0.045
Currently using withdrawal 0.017 0.002 4323 6622 1.254 0.145 0.012 0.022
Mothers received antenatal care for last birth/stillbirth 0.969 0.004 3217 4916 1.325 0.004 0.961 0.977
Mothers protected against tetanus for last birth/stillbirth 0.795 0.009 3217 4916 1.312 0.012 0.776 0.813
Births/stillbirths with skilled attendant at delivery 0.799 0.015 3217 4916 2.150 0.019 0.769 0.829
Induced abortion in the 5 years before the survey 0.075 0.003 7938 12121 1.159 0.046 0.068 0.082
Miscarriage in the 5 years before the survey 0.070 0.003 7938 12121 1.129 0.046 0.064 0.077
Ever had an induced abortion 0.218 0.007 7938 12121 1.545 0.033 0.203 0.232
No induced abortion but have heard of induced abortion 0.747 0.009 7938 12121 1.743 0.011 0.730 0.764
Believe induced abortion is legal in Ghana 0.113 0.006 7702 11689 1.644 0.052 0.102 0.125
Total fertility rate (last 3 years) 3.634 0.101 22351 34123 1.360 0.028 3.433 3.835
Neonatal mortality (last 0-4 years) 27.663 2.310 8150 12515 1.139 0.084 23.043 32.283
Post-neonatal mortality (last 0-4 years) 14.967 1.765 8154 12529 1.265 0.118 11.437 18.496
Infant mortality (last 0-4 years) 42.629 2.913 8157 12525 1.201 0.068 36.803 48.456
Child mortality (last 0-4 years) 16.922 1.676 7963 12230 1.099 0.099 13.569 20.274
Under-5 mortality (last 0-4 years) 58.830 3.424 8195 12588 1.226 0.058 51.981 65.678

Appendix B • 159
 Table B.6 Sampling errors: Middle zone sample, Ghana MHS 2017
Number of Cases Confidence Limits
Standard Un- Design Relative
Value error weighted Weighted effect error Lower Upper
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) (R-2SE) (R+2SE)
WOMEN

Urban residence 0.548 0.015 7610 9674 2.570 0.027 0.518 0.577
Literacy 0.526 0.009 7610 9674 1.498 0.016 0.509 0.543
No education 0.135 0.007 7610 9674 1.811 0.052 0.121 0.149
Secondary or higher education 0.705 0.010 7610 9674 1.883 0.014 0.686 0.725
Never married/never in union 0.336 0.007 7610 9674 1.255 0.020 0.323 0.350
Currently married/in union 0.564 0.007 7610 9674 1.305 0.013 0.549 0.578
Married before age 18 0.251 0.008 6104 7758 1.437 0.032 0.236 0.267
Had sexual intercourse before age 18 0.523 0.010 6104 7758 1.586 0.019 0.503 0.543
Currently pregnant 0.062 0.003 7610 9674 1.248 0.056 0.055 0.069
Children ever born 2.245 0.033 7610 9674 1.254 0.015 2.179 2.310
Children surviving 2.081 0.031 7610 9674 1.273 0.015 2.019 2.142
Children ever born to women age 40-49 4.617 0.077 1454 1846 1.279 0.017 4.462 4.772
Know any contraceptive method 0.997 0.001 4256 5452 0.948 0.001 0.996 0.999
Know a modern method 0.997 0.001 4256 5452 0.948 0.001 0.996 0.999
Currently using any method 0.352 0.009 4256 5452 1.292 0.027 0.333 0.371
Currently using a modern method 0.277 0.009 4256 5452 1.240 0.031 0.260 0.294
Currently using pill 0.051 0.003 4256 5452 1.027 0.068 0.044 0.058
Currently using IUD 0.009 0.002 4256 5452 1.174 0.186 0.006 0.013
Currently using condoms 0.013 0.002 4256 5452 1.117 0.151 0.009 0.016
Currently using injectables 0.083 0.005 4256 5452 1.219 0.062 0.073 0.094
Currently using implants 0.080 0.006 4256 5452 1.349 0.070 0.069 0.091
Currently using female sterilization 0.021 0.003 4256 5452 1.227 0.130 0.015 0.026
Currently using rhythm 0.060 0.005 4256 5452 1.494 0.091 0.049 0.071
Currently using withdrawal 0.011 0.002 4256 5452 1.085 0.157 0.008 0.015
Mothers received antenatal care for last birth/stillbirth 0.980 0.003 3294 4243 1.248 0.003 0.974 0.986
Mothers protected against tetanus for last birth/stillbirth 0.781 0.010 3294 4243 1.389 0.013 0.761 0.801
Births/stillbirths with skilled attendant at delivery 0.824 0.012 3294 4243 1.857 0.015 0.799 0.848
Induced abortion in the 5 years before the survey 0.075 0.004 7610 9674 1.342 0.054 0.067 0.083
Miscarriage in the 5 years before the survey 0.078 0.004 7610 9674 1.202 0.047 0.071 0.086
Ever had an induced abortion 0.224 0.007 7610 9674 1.541 0.033 0.210 0.239
No induced abortion but have heard of induced abortion 0.747 0.007 7610 9674 1.505 0.010 0.732 0.762
Believe induced abortion is legal in Ghana 0.112 0.007 7360 9401 1.832 0.060 0.099 0.126
Total fertility rate (last 3 years) 3.842 0.086 21355 27177 1.140 0.022 3.671 4.014
Neonatal mortality (last 0-4 years) 25.503 2.083 8337 10751 1.090 0.082 21.337 29.669
Post-neonatal mortality (last 0-4 years) 11.795 1.367 8333 10757 1.145 0.116 9.061 14.528
Infant mortality (last 0-4 years) 37.298 2.547 8346 10762 1.130 0.068 32.203 42.392
Child mortality (last 0-4 years) 16.126 1.594 8211 10580 1.101 0.099 12.939 19.313
Under-5 mortality (last 0-4 years) 52.822 2.950 8370 10791 1.104 0.056 46.923 58.721

160 • Appendix B
Table B.7 Sampling errors: Northern zone sample, Ghana MHS 2017
Number of Cases Confidence Limits
Standard Un- Design Relative
Value error weighted Weighted effect error Lower Upper
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) (R-2SE) (R+2SE)
WOMEN

Urban residence 0.267 0.011 9514 3267 2.469 0.042 0.244 0.289
Literacy 0.328 0.011 9514 3267 2.194 0.032 0.307 0.349
No education 0.499 0.011 9514 3267 2.166 0.022 0.477 0.521
Secondary or higher education 0.349 0.011 9514 3267 2.230 0.031 0.328 0.371
Never married/never in union 0.248 0.006 9514 3267 1.336 0.024 0.236 0.260
Currently married/in union 0.700 0.007 9514 3267 1.504 0.010 0.686 0.714
Married before age 18 0.325 0.007 7576 2604 1.291 0.021 0.311 0.339
Had sexual intercourse before age 18 0.494 0.009 7576 2604 1.510 0.018 0.477 0.512
Currently pregnant 0.092 0.004 9514 3267 1.273 0.041 0.084 0.099
Children ever born 2.807 0.038 9514 3267 1.417 0.014 2.731 2.884
Children surviving 2.508 0.032 9514 3267 1.358 0.013 2.444 2.572
Children ever born to women age 40-49 6.006 0.076 1827 621 1.469 0.013 5.854 6.158
Know any contraceptive method 0.975 0.004 6473 2287 1.832 0.004 0.968 0.982
Know a modern method 0.974 0.004 6473 2287 1.811 0.004 0.967 0.981
Currently using any method 0.245 0.010 6473 2287 1.885 0.041 0.225 0.265
Currently using a modern method 0.230 0.010 6473 2287 1.873 0.043 0.210 0.249
Currently using pill 0.032 0.003 6473 2287 1.372 0.094 0.026 0.038
Currently using IUD 0.003 0.001 6473 2287 1.395 0.316 0.001 0.005
Currently using condoms 0.004 0.001 6473 2287 1.265 0.244 0.002 0.006
Currently using injectables 0.119 0.006 6473 2287 1.481 0.050 0.107 0.131
Currently using implants 0.064 0.005 6473 2287 1.548 0.074 0.055 0.073
Currently using female sterilization 0.003 0.001 6473 2287 1.163 0.253 0.002 0.005
Currently using rhythm 0.012 0.002 6473 2287 1.274 0.144 0.008 0.015
Currently using withdrawal 0.003 0.001 6473 2287 1.145 0.255 0.002 0.005
Mothers received antenatal care for last birth/stillbirth 0.983 0.003 4981 1782 1.712 0.003 0.977 0.990
Mothers protected against tetanus for last birth/stillbirth 0.661 0.011 4981 1782 1.644 0.016 0.639 0.682
Births/stillbirths with skilled attendant at delivery 0.708 0.016 4981 1782 2.608 0.023 0.675 0.741
Induced abortion in the 5 years before the survey 0.015 0.001 9514 3267 1.104 0.093 0.012 0.017
Miscarriage in the 5 years before the survey 0.057 0.003 9514 3267 1.121 0.047 0.052 0.062
Ever had an induced abortion 0.034 0.003 9514 3267 1.376 0.076 0.029 0.039
No induced abortion but have heard of induced abortion 0.796 0.013 9514 3267 3.245 0.017 0.769 0.823
Believe induced abortion is legal in Ghana 0.121 0.006 8098 2710 1.770 0.053 0.108 0.134
Total fertility rate (last 3 years) 5.267 0.109 26288 9046 1.528 0.021 5.048 5.485
Neonatal mortality (last 0-4 years) 25.033 1.620 12919 4678 1.123 0.065 21.792 28.274
Post-neonatal mortality (last 0-4 years) 14.903 1.248 12917 4683 1.219 0.084 12.408 17.398
Infant mortality (last 0-4 years) 39.936 2.049 12928 4683 1.145 0.051 35.837 44.034
Child mortality (last 0-4 years) 32.310 2.231 12616 4577 1.346 0.069 27.847 36.773
Under-5 mortality (last 0-4 years) 70.955 3.087 13023 4716 1.288 0.044 64.782 77.129

Appendix B • 161
 Table B.8 Sampling errors: Western region sample, Ghana MHS 2017
Number of Cases Confidence Limits
Standard Un- Design Relative
Value error weighted Weighted effect error Lower Upper
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) (R-2SE) (R+2SE)
WOMEN

Urban residence 0.452 0.031 2334 3230 2.986 0.068 0.390 0.513
Literacy 0.524 0.021 2334 3230 1.997 0.039 0.483 0.565
No education 0.176 0.014 2334 3230 1.824 0.082 0.147 0.205
Secondary or higher education 0.685 0.020 2334 3230 2.121 0.030 0.644 0.726
Never married/never in union 0.357 0.014 2334 3230 1.452 0.040 0.328 0.386
Currently married/in union 0.557 0.016 2334 3230 1.507 0.028 0.526 0.588
Married before age 18 0.271 0.016 1871 2580 1.580 0.060 0.239 0.304
Had sexual intercourse before age 18 0.528 0.019 1871 2580 1.602 0.035 0.491 0.565
Currently pregnant 0.064 0.006 2334 3230 1.100 0.087 0.053 0.076
Children ever born 2.272 0.074 2334 3230 1.561 0.033 2.124 2.420
Children surviving 2.086 0.068 2334 3230 1.571 0.033 1.950 2.222
Children ever born to women age 40-49 4.821 0.131 424 579 1.182 0.027 4.560 5.083
Know any contraceptive method 0.994 0.004 1293 1799 1.815 0.004 0.987 1.002
Know a modern method 0.994 0.004 1293 1799 1.815 0.004 0.987 1.002
Currently using any method 0.323 0.016 1293 1799 1.249 0.050 0.290 0.355
Currently using a modern method 0.270 0.016 1293 1799 1.326 0.061 0.238 0.303
Currently using pill 0.058 0.010 1293 1799 1.599 0.179 0.038 0.079
Currently using IUD 0.000 0.000 1293 1799 na na 0.000 0.000
Currently using condoms 0.010 0.003 1293 1799 1.189 0.323 0.004 0.017
Currently using injectables 0.089 0.010 1293 1799 1.267 0.113 0.069 0.109
Currently using implants 0.071 0.006 1293 1799 0.905 0.091 0.058 0.084
Currently using female sterilization 0.029 0.006 1293 1799 1.379 0.220 0.017 0.042
Currently using rhythm 0.038 0.007 1293 1799 1.245 0.173 0.025 0.052
Currently using withdrawal 0.011 0.003 1293 1799 1.014 0.271 0.005 0.017
Mothers received antenatal care for last birth/stillbirth 0.966 0.009 1008 1415 1.540 0.009 0.949 0.984
Mothers protected against tetanus for last birth/stillbirth 0.762 0.019 1008 1415 1.416 0.025 0.724 0.799
Births/stillbirths with skilled attendant at delivery 0.783 0.026 1008 1415 2.014 0.033 0.732 0.835
Induced abortion in the 5 years before the survey 0.089 0.007 2334 3230 1.130 0.075 0.076 0.103
Miscarriage in the 5 years before the survey 0.074 0.006 2334 3230 1.015 0.074 0.063 0.085
Ever had an induced abortion 0.208 0.011 2334 3230 1.259 0.051 0.187 0.230
No induced abortion but have heard of induced abortion 0.749 0.013 2334 3230 1.401 0.017 0.724 0.774
Believe induced abortion is legal in Ghana 0.068 0.007 2259 3092 1.341 0.104 0.054 0.082
Total fertility rate (last 3 years) 4.138 0.215 6502 9017 1.513 0.052 3.708 4.569
Neonatal mortality (last 0-9 years) 30.254 4.252 2568 3675 1.124 0.141 21.751 38.757
Post-neonatal mortality (last 0-9 years) 16.722 3.775 2569 3679 1.444 0.226 9.171 24.272
Infant mortality (last 0-9 years) 46.976 5.490 2572 3682 1.228 0.117 35.997 57.956
Child mortality (last 0-9 years) 23.038 3.678 2485 3579 1.174 0.160 15.683 30.394
Under-5 mortality (last 0-9 years) 68.932 6.256 2585 3705 1.198 0.091 56.421 81.443

162 • Appendix B
Table B.9 Sampling errors: Central region sample, Ghana MHS 2017
Number of Cases Confidence Limits
Standard Un- Design Relative
Value error weighted Weighted effect error Lower Upper
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) (R-2SE) (R+2SE)
WOMEN

Urban residence 0.515 0.031 1603 2218 2.483 0.060 0.453 0.577
Literacy 0.527 0.021 1603 2218 1.716 0.041 0.484 0.570
No education 0.132 0.011 1603 2218 1.264 0.081 0.110 0.153
Secondary or higher education 0.695 0.021 1603 2218 1.783 0.030 0.654 0.736
Never married/never in union 0.311 0.013 1603 2218 1.113 0.041 0.285 0.336
Currently married/in union 0.579 0.015 1603 2218 1.212 0.026 0.549 0.609
Married before age 18 0.246 0.015 1313 1805 1.283 0.062 0.216 0.277
Had sexual intercourse before age 18 0.489 0.016 1313 1805 1.188 0.034 0.456 0.522
Currently pregnant 0.061 0.007 1603 2218 1.135 0.111 0.048 0.075
Children ever born 2.457 0.070 1603 2218 1.146 0.028 2.318 2.596
Children surviving 2.223 0.062 1603 2218 1.151 0.028 2.099 2.348
Children ever born to women age 40-49 5.149 0.157 327 447 1.168 0.031 4.834 5.464
Know any contraceptive method 0.999 0.001 913 1285 0.895 0.001 0.997 1.001
Know a modern method 0.999 0.001 913 1285 0.895 0.001 0.997 1.001
Currently using any method 0.281 0.021 913 1285 1.404 0.074 0.239 0.323
Currently using a modern method 0.246 0.019 913 1285 1.365 0.079 0.207 0.285
Currently using pill 0.039 0.006 913 1285 0.924 0.153 0.027 0.050
Currently using IUD 0.007 0.003 913 1285 1.192 0.468 0.000 0.014
Currently using condoms 0.004 0.002 913 1285 0.837 0.446 0.000 0.007
Currently using injectables 0.061 0.009 913 1285 1.125 0.146 0.043 0.079
Currently using implants 0.104 0.015 913 1285 1.492 0.145 0.074 0.134
Currently using female sterilization 0.028 0.007 913 1285 1.233 0.238 0.015 0.042
Currently using rhythm 0.024 0.006 913 1285 1.260 0.268 0.011 0.036
Currently using withdrawal 0.007 0.003 913 1285 1.035 0.401 0.001 0.013
Mothers received antenatal care for last birth/stillbirth 0.975 0.007 702 986 1.112 0.007 0.962 0.988
Mothers protected against tetanus for last birth/stillbirth 0.823 0.015 702 986 1.017 0.018 0.794 0.852
Births/stillbirths with skilled attendant at delivery 0.782 0.033 702 986 2.129 0.042 0.716 0.848
Induced abortion in the 5 years before the survey 0.060 0.006 1603 2218 1.094 0.108 0.047 0.073
Miscarriage in the 5 years before the survey 0.075 0.008 1603 2218 1.239 0.109 0.059 0.092
Ever had an induced abortion 0.184 0.009 1603 2218 0.972 0.051 0.165 0.203
No induced abortion but have heard of induced abortion 0.784 0.009 1603 2218 0.913 0.012 0.765 0.803
Believe induced abortion is legal in Ghana 0.094 0.012 1555 2148 1.577 0.124 0.071 0.118
Total fertility rate (last 3 years) 4.331 0.199 4514 6226 1.209 0.046 3.932 4.730
Neonatal mortality (last 0-9 years) 31.324 4.444 1844 2616 0.980 0.142 22.436 40.212
Post-neonatal mortality (last 0-9 years) 17.724 4.037 1829 2594 1.258 0.228 9.650 25.799
Infant mortality (last 0-9 years) 49.048 6.096 1846 2618 1.131 0.124 36.856 61.240
Child mortality (last 0-9 years) 15.383 2.813 1800 2563 0.932 0.183 9.757 21.008
Under-5 mortality (last 0-9 years) 63.676 6.034 1851 2626 1.015 0.095 51.608 75.745

Appendix B • 163
 Table B.10 Sampling errors: Greater Accra region sample, Ghana MHS 2017
Number of Cases Confidence Limits
Standard Un- Design Relative
Value error weighted Weighted effect error Lower Upper
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) (R-2SE) (R+2SE)
WOMEN

Urban residence 0.915 0.013 2535 4673 2.262 0.014 0.890 0.940
Literacy 0.737 0.014 2535 4673 1.598 0.019 0.709 0.765
No education 0.073 0.008 2535 4673 1.499 0.106 0.057 0.088
Secondary or higher education 0.791 0.014 2535 4673 1.773 0.018 0.763 0.820
Never married/never in union 0.398 0.010 2535 4673 1.058 0.026 0.377 0.418
Currently married/in union 0.504 0.012 2535 4673 1.237 0.024 0.479 0.528
Married before age 18 0.152 0.012 2130 3926 1.496 0.077 0.128 0.175
Had sexual intercourse before age 18 0.342 0.014 2130 3926 1.385 0.042 0.314 0.371
Currently pregnant 0.050 0.005 2535 4673 1.094 0.095 0.040 0.059
Children ever born 1.609 0.037 2535 4673 1.038 0.023 1.535 1.682
Children surviving 1.516 0.033 2535 4673 1.008 0.022 1.450 1.583
Children ever born to women age 40-49 3.274 0.110 493 897 1.186 0.034 3.053 3.494
Know any contraceptive method 0.999 0.001 1266 2354 1.120 0.001 0.997 1.001
Know a modern method 0.999 0.001 1266 2354 1.026 0.001 0.997 1.001
Currently using any method 0.284 0.014 1266 2354 1.140 0.051 0.255 0.313
Currently using a modern method 0.208 0.013 1266 2354 1.117 0.061 0.182 0.233
Currently using pill 0.030 0.006 1266 2354 1.165 0.185 0.019 0.042
Currently using IUD 0.019 0.005 1266 2354 1.220 0.244 0.010 0.029
Currently using condoms 0.017 0.004 1266 2354 1.063 0.227 0.009 0.025
Currently using injectables 0.053 0.008 1266 2354 1.327 0.158 0.036 0.070
Currently using implants 0.055 0.008 1266 2354 1.243 0.144 0.039 0.071
Currently using female sterilization 0.016 0.005 1266 2354 1.307 0.292 0.007 0.025
Currently using rhythm 0.051 0.006 1266 2354 0.997 0.121 0.039 0.064
Currently using withdrawal 0.022 0.005 1266 2354 1.240 0.232 0.012 0.032
Mothers received antenatal care for last birth/stillbirth 0.975 0.008 865 1613 1.435 0.008 0.959 0.990
Mothers protected against tetanus for last birth/stillbirth 0.816 0.017 865 1613 1.320 0.021 0.781 0.850
Births/stillbirths with skilled attendant at delivery 0.921 0.013 865 1613 1.441 0.014 0.895 0.948
Induced abortion in the 5 years before the survey 0.080 0.006 2535 4673 1.132 0.076 0.068 0.093
Miscarriage in the 5 years before the survey 0.067 0.006 2535 4673 1.159 0.086 0.055 0.078
Ever had an induced abortion 0.264 0.014 2535 4673 1.541 0.051 0.237 0.292
No induced abortion but have heard of induced abortion 0.699 0.017 2535 4673 1.861 0.024 0.665 0.733
Believe induced abortion is legal in Ghana 0.166 0.011 2461 4501 1.511 0.068 0.143 0.189
Total fertility rate (last 3 years) 2.798 0.133 7230 13301 1.265 0.048 2.532 3.064
Neonatal mortality (last 0-9 years) 19.384 3.995 2049 3800 1.221 0.206 11.393 27.375
Post-neonatal mortality (last 0-9 years) 13.002 3.160 2065 3829 1.226 0.243 6.682 19.321
Infant mortality (last 0-9 years) 32.386 4.918 2050 3802 1.145 0.152 22.549 42.223
Child mortality (last 0-9 years) 9.562 2.149 2023 3705 0.987 0.225 5.265 13.860
Under-5 mortality (last 0-9 years) 41.639 5.102 2060 3818 1.076 0.123 31.434 51.843

164 • Appendix B
Table B.11 Sampling errors: Volta region sample, Ghana MHS 2017
Number of Cases Confidence Limits
Standard Un- Design Relative
Value error weighted Weighted effect error Lower Upper
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) (R-2SE) (R+2SE)
WOMEN

Urban residence 0.353 0.037 1466 2000 2.916 0.103 0.280 0.426
Literacy 0.513 0.029 1466 2000 2.211 0.056 0.455 0.571
No education 0.222 0.034 1466 2000 3.117 0.153 0.154 0.290
Secondary or higher education 0.564 0.037 1466 2000 2.864 0.066 0.490 0.639
Never married/never in union 0.315 0.013 1466 2000 1.096 0.042 0.289 0.342
Currently married/in union 0.592 0.017 1466 2000 1.295 0.028 0.558 0.625
Married before age 18 0.293 0.017 1180 1604 1.285 0.058 0.259 0.327
Had sexual intercourse before age 18 0.575 0.022 1180 1604 1.494 0.037 0.531 0.618
Currently pregnant 0.060 0.008 1466 2000 1.218 0.126 0.045 0.075
Children ever born 2.460 0.115 1466 2000 1.852 0.047 2.231 2.690
Children surviving 2.246 0.093 1466 2000 1.638 0.041 2.060 2.431
Children ever born to women age 40-49 4.590 0.184 321 427 1.385 0.040 4.222 4.957
Know any contraceptive method 1.000 0.000 851 1183 na 0.000 1.000 1.000
Know a modern method 1.000 0.000 851 1183 na 0.000 1.000 1.000
Currently using any method 0.279 0.019 851 1183 1.260 0.069 0.241 0.318
Currently using a modern method 0.222 0.017 851 1183 1.183 0.076 0.189 0.256
Currently using pill 0.034 0.007 851 1183 1.118 0.205 0.020 0.048
Currently using IUD 0.004 0.002 851 1183 1.039 0.570 0.000 0.008
Currently using condoms 0.009 0.003 851 1183 0.978 0.357 0.003 0.015
Currently using injectables 0.078 0.012 851 1183 1.264 0.149 0.054 0.101
Currently using implants 0.073 0.010 851 1183 1.081 0.132 0.054 0.092
Currently using female sterilization 0.017 0.005 851 1183 1.057 0.279 0.007 0.026
Currently using rhythm 0.028 0.006 851 1183 1.084 0.218 0.016 0.040
Currently using withdrawal 0.027 0.007 851 1183 1.280 0.266 0.012 0.041
Mothers received antenatal care for last birth/stillbirth 0.956 0.008 642 902 0.950 0.008 0.941 0.971
Mothers protected against tetanus for last birth/stillbirth 0.777 0.021 642 902 1.320 0.027 0.735 0.820
Births/stillbirths with skilled attendant at delivery 0.624 0.040 642 902 2.144 0.065 0.543 0.704
Induced abortion in the 5 years before the survey 0.054 0.006 1466 2000 1.050 0.115 0.042 0.067
Miscarriage in the 5 years before the survey 0.065 0.006 1466 2000 0.976 0.097 0.052 0.077
Ever had an induced abortion 0.159 0.015 1466 2000 1.603 0.096 0.129 0.190
No induced abortion but have heard of induced abortion 0.815 0.015 1466 2000 1.485 0.019 0.784 0.845
Believe induced abortion is legal in Ghana 0.085 0.012 1427 1948 1.640 0.143 0.060 0.109
Total fertility rate (last 3 years) 4.075 0.221 4105 5579 1.538 0.054 3.633 4.516
Neonatal mortality (last 0-9 years) 32.827 6.207 1689 2423 1.247 0.189 20.412 45.241
Post-neonatal mortality (last 0-9 years) 12.410 2.924 1691 2427 1.046 0.236 6.561 18.259
Infant mortality (last 0-9 years) 45.237 7.554 1689 2423 1.346 0.167 30.129 60.345
Child mortality (last 0-9 years) 20.998 3.921 1655 2383 1.094 0.187 13.156 28.840
Under-5 mortality (last 0-9 years) 65.285 9.999 1699 2440 1.587 0.153 45.287 85.283

Appendix B • 165
 Table B.12 Sampling errors: Eastern region sample, Ghana MHS 2017
Number of Cases Confidence Limits
Standard Un- Design Relative
Value error weighted Weighted effect error Lower Upper
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) (R-2SE) (R+2SE)
WOMEN

Urban residence 0.463 0.026 2172 2517 2.400 0.056 0.412 0.514
Literacy 0.605 0.017 2172 2517 1.603 0.028 0.572 0.639
No education 0.110 0.012 2172 2517 1.743 0.106 0.087 0.134
Secondary or higher education 0.697 0.021 2172 2517 2.092 0.030 0.656 0.739
Never married/never in union 0.328 0.011 2172 2517 1.139 0.035 0.305 0.351
Currently married/in union 0.562 0.014 2172 2517 1.299 0.025 0.534 0.589
Married before age 18 0.273 0.017 1751 2027 1.583 0.062 0.239 0.307
Had sexual intercourse before age 18 0.569 0.021 1751 2027 1.814 0.038 0.526 0.612
Currently pregnant 0.059 0.006 2172 2517 1.193 0.102 0.047 0.071
Children ever born 2.305 0.060 2172 2517 1.214 0.026 2.185 2.425
Children surviving 2.146 0.056 2172 2517 1.219 0.026 2.034 2.258
Children ever born to women age 40-49 4.553 0.144 448 521 1.306 0.032 4.264 4.841
Know any contraceptive method 0.998 0.001 1211 1414 0.945 0.001 0.995 1.000
Know a modern method 0.998 0.001 1211 1414 0.945 0.001 0.995 1.000
Currently using any method 0.356 0.016 1211 1414 1.159 0.045 0.324 0.388
Currently using a modern method 0.277 0.015 1211 1414 1.197 0.056 0.246 0.308
Currently using pill 0.031 0.005 1211 1414 1.061 0.170 0.021 0.042
Currently using IUD 0.016 0.004 1211 1414 1.234 0.281 0.007 0.025
Currently using condoms 0.017 0.004 1211 1414 1.127 0.246 0.009 0.025
Currently using injectables 0.079 0.010 1211 1414 1.287 0.126 0.059 0.099
Currently using implants 0.105 0.012 1211 1414 1.387 0.116 0.081 0.130
Currently using female sterilization 0.016 0.004 1211 1414 0.999 0.227 0.009 0.023
Currently using rhythm 0.058 0.008 1211 1414 1.194 0.138 0.042 0.075
Currently using withdrawal 0.017 0.004 1211 1414 1.000 0.220 0.009 0.024
Mothers received antenatal care for last birth/stillbirth 0.970 0.006 930 1086 1.100 0.006 0.958 0.982
Mothers protected against tetanus for last birth/stillbirth 0.798 0.013 930 1086 1.000 0.016 0.772 0.824
Births/stillbirths with skilled attendant at delivery 0.783 0.026 930 1086 1.901 0.033 0.732 0.835
Induced abortion in the 5 years before the survey 0.059 0.007 2172 2517 1.447 0.124 0.044 0.074
Miscarriage in the 5 years before the survey 0.066 0.005 2172 2517 1.031 0.083 0.055 0.077
Ever had an induced abortion 0.199 0.013 2172 2517 1.535 0.066 0.173 0.225
No induced abortion but have heard of induced abortion 0.765 0.014 2172 2517 1.494 0.018 0.738 0.792
Believe induced abortion is legal in Ghana 0.178 0.016 2078 2426 1.860 0.088 0.147 0.209
Total fertility rate (last 3 years) 3.802 0.151 6080 7055 1.103 0.040 3.501 4.104
Neonatal mortality (last 0-9 years) 27.722 4.323 2384 2836 1.027 0.156 19.077 36.368
Post-neonatal mortality (last 0-9 years) 9.659 2.456 2386 2846 1.240 0.254 4.746 14.572
Infant mortality (last 0-9 years) 37.381 4.383 2387 2839 0.939 0.117 28.616 46.147
Child mortality (last 0-9 years) 14.742 2.657 2337 2789 0.985 0.180 9.428 20.055
Under-5 mortality (last 0-9 years) 51.572 4.820 2397 2851 0.888 0.093 41.933 61.211

166 • Appendix B
Table B.13 Sampling errors: Ashanti region sample, Ghana MHS 2017
Number of Cases Confidence Limits
Standard Un- Design Relative
Value error weighted Weighted effect error Lower Upper
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) (R-2SE) (R+2SE)
WOMEN

Urban residence 0.631 0.022 3136 4790 2.539 0.035 0.588 0.675
Literacy 0.540 0.011 3136 4790 1.271 0.021 0.517 0.562
No education 0.108 0.009 3136 4790 1.565 0.080 0.090 0.125
Secondary or higher education 0.752 0.011 3136 4790 1.483 0.015 0.729 0.775
Never married/never in union 0.347 0.011 3136 4790 1.252 0.031 0.325 0.368
Currently married/in union 0.554 0.011 3136 4790 1.288 0.021 0.531 0.577
Married before age 18 0.216 0.011 2530 3854 1.337 0.051 0.194 0.238
Had sexual intercourse before age 18 0.489 0.015 2530 3854 1.458 0.030 0.460 0.518
Currently pregnant 0.060 0.006 3136 4790 1.301 0.092 0.049 0.071
Children ever born 2.151 0.044 3136 4790 1.117 0.021 2.062 2.240
Children surviving 1.999 0.043 3136 4790 1.179 0.022 1.913 2.086
Children ever born to women age 40-49 4.497 0.109 619 931 1.200 0.024 4.279 4.715
Know any contraceptive method 0.997 0.001 1698 2655 0.904 0.001 0.995 0.999
Know a modern method 0.997 0.001 1698 2655 0.904 0.001 0.995 0.999
Currently using any method 0.350 0.015 1698 2655 1.270 0.042 0.321 0.379
Currently using a modern method 0.260 0.013 1698 2655 1.183 0.048 0.235 0.285
Currently using pill 0.052 0.005 1698 2655 0.984 0.102 0.042 0.063
Currently using IUD 0.008 0.002 1698 2655 1.071 0.288 0.003 0.013
Currently using condoms 0.014 0.003 1698 2655 1.057 0.214 0.008 0.020
Currently using injectables 0.066 0.007 1698 2655 1.229 0.112 0.051 0.081
Currently using implants 0.062 0.008 1698 2655 1.326 0.126 0.046 0.077
Currently using female sterilization 0.026 0.005 1698 2655 1.241 0.184 0.016 0.036
Currently using rhythm 0.074 0.009 1698 2655 1.480 0.127 0.055 0.093
Currently using withdrawal 0.011 0.003 1698 2655 1.062 0.250 0.005 0.016
Mothers received antenatal care for last birth/stillbirth 0.979 0.005 1266 2017 1.308 0.005 0.969 0.990
Mothers protected against tetanus for last birth/stillbirth 0.813 0.016 1266 2017 1.469 0.019 0.781 0.844
Births/stillbirths with skilled attendant at delivery 0.859 0.016 1266 2017 1.616 0.018 0.828 0.890
Induced abortion in the 5 years before the survey 0.086 0.006 3136 4790 1.290 0.075 0.073 0.099
Miscarriage in the 5 years before the survey 0.088 0.006 3136 4790 1.245 0.072 0.075 0.100
Ever had an induced abortion 0.249 0.011 3136 4790 1.474 0.046 0.227 0.272
No induced abortion but have heard of induced abortion 0.731 0.012 3136 4790 1.467 0.016 0.707 0.754
Believe induced abortion is legal in Ghana 0.099 0.009 3066 4693 1.621 0.088 0.082 0.117
Total fertility rate (last 3 years) 3.812 0.130 8812 13475 1.095 0.034 3.551 4.072
Neonatal mortality (last 0-9 years) 26.148 3.222 3206 5052 1.124 0.123 19.704 32.593
Post-neonatal mortality (last 0-9 years) 9.916 2.163 3212 5054 1.227 0.218 5.589 14.243
Infant mortality (last 0-9 years) 36.065 4.366 3210 5058 1.255 0.121 27.333 44.796
Child mortality (last 0-9 years) 13.467 2.252 3141 4932 1.070 0.167 8.964 17.971
Under-5 mortality (last 0-9 years) 49.046 4.613 3216 5068 1.129 0.094 39.820 58.273

Appendix B • 167
 Table B.14 Sampling errors: Brong Ahafo region sample, Ghana MHS 2017
Number of Cases Confidence Limits
Standard Un- Design Relative
Value error weighted Weighted effect error Lower Upper
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) (R-2SE) (R+2SE)
WOMEN

Urban residence 0.468 0.024 2302 2367 2.259 0.050 0.421 0.515
Literacy 0.414 0.017 2302 2367 1.635 0.041 0.380 0.447
No education 0.218 0.018 2302 2367 2.072 0.082 0.182 0.253
Secondary or higher education 0.620 0.022 2302 2367 2.184 0.036 0.576 0.664
Never married/never in union 0.324 0.013 2302 2367 1.303 0.039 0.298 0.349
Currently married/in union 0.584 0.013 2302 2367 1.277 0.022 0.558 0.611
Married before age 18 0.301 0.015 1823 1878 1.356 0.048 0.272 0.331
Had sexual intercourse before age 18 0.544 0.017 1823 1878 1.451 0.031 0.510 0.578
Currently pregnant 0.068 0.006 2302 2367 1.059 0.082 0.057 0.079
Children ever born 2.370 0.075 2302 2367 1.529 0.032 2.220 2.520
Children surviving 2.175 0.066 2302 2367 1.477 0.030 2.044 2.307
Children ever born to women age 40-49 4.987 0.168 387 394 1.402 0.034 4.651 5.322
Know any contraceptive method 0.997 0.001 1347 1384 0.989 0.001 0.994 1.000
Know a modern method 0.997 0.001 1347 1384 0.989 0.001 0.994 1.000
Currently using any method 0.353 0.018 1347 1384 1.387 0.051 0.317 0.389
Currently using a modern method 0.311 0.016 1347 1384 1.288 0.052 0.279 0.344
Currently using pill 0.068 0.007 1347 1384 1.026 0.104 0.054 0.082
Currently using IUD 0.005 0.002 1347 1384 1.046 0.400 0.001 0.009
Currently using condoms 0.005 0.002 1347 1384 0.993 0.376 0.001 0.009
Currently using injectables 0.120 0.010 1347 1384 1.109 0.082 0.101 0.140
Currently using implants 0.089 0.009 1347 1384 1.190 0.104 0.071 0.108
Currently using female sterilization 0.015 0.004 1347 1384 1.084 0.237 0.008 0.023
Currently using rhythm 0.035 0.007 1347 1384 1.410 0.201 0.021 0.050
Currently using withdrawal 0.006 0.003 1347 1384 1.280 0.433 0.001 0.012
Mothers received antenatal care for last birth/stillbirth 0.992 0.003 1098 1140 0.958 0.003 0.987 0.997
Mothers protected against tetanus for last birth/stillbirth 0.708 0.019 1098 1140 1.408 0.027 0.670 0.747
Births/stillbirths with skilled attendant at delivery 0.800 0.026 1098 1140 2.161 0.032 0.748 0.852
Induced abortion in the 5 years before the survey 0.070 0.006 2302 2367 1.079 0.082 0.058 0.081
Miscarriage in the 5 years before the survey 0.071 0.005 2302 2367 0.995 0.075 0.061 0.082
Ever had an induced abortion 0.201 0.012 2302 2367 1.449 0.060 0.177 0.225
No induced abortion but have heard of induced abortion 0.763 0.012 2302 2367 1.406 0.016 0.738 0.788
Believe induced abortion is legal in Ghana 0.069 0.010 2216 2281 1.872 0.146 0.049 0.090
Total fertility rate (last 3 years) 3.970 0.175 6463 6647 1.233 0.044 3.620 4.320
Neonatal mortality (last 0-9 years) 22.157 3.396 2747 2863 1.110 0.153 15.365 28.949
Post-neonatal mortality (last 0-9 years) 17.175 2.281 2735 2856 0.907 0.133 12.614 21.736
Infant mortality (last 0-9 years) 39.332 3.753 2749 2865 1.004 0.095 31.827 46.838
Child mortality (last 0-9 years) 22.062 3.493 2733 2859 1.201 0.158 15.075 29.048
Under-5 mortality (last 0-9 years) 60.526 5.635 2757 2873 1.221 0.093 49.256 71.796

168 • Appendix B
Table B.15 Sampling errors: Northern region sample, Ghana MHS 2017
Number of Cases Confidence Limits
Standard Un- Design Relative
Value error weighted Weighted effect error Lower Upper
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) (R-2SE) (R+2SE)
WOMEN

Urban residence 0.307 0.015 4202 1786 2.124 0.049 0.277 0.337
Literacy 0.291 0.015 4202 1786 2.189 0.053 0.260 0.322
No education 0.583 0.017 4202 1786 2.198 0.029 0.550 0.617
Secondary or higher education 0.298 0.016 4202 1786 2.286 0.054 0.266 0.331
Never married/never in union 0.233 0.009 4202 1786 1.364 0.038 0.215 0.250
Currently married/in union 0.733 0.011 4202 1786 1.586 0.015 0.712 0.755
Married before age 18 0.305 0.010 3385 1434 1.250 0.032 0.286 0.325
Had sexual intercourse before age 18 0.496 0.012 3385 1434 1.420 0.025 0.471 0.520
Currently pregnant 0.101 0.005 4202 1786 1.082 0.050 0.091 0.111
Children ever born 2.997 0.055 4202 1786 1.310 0.018 2.887 3.107
Children surviving 2.675 0.046 4202 1786 1.243 0.017 2.584 2.767
Children ever born to women age 40-49 6.340 0.114 762 321 1.396 0.018 6.113 6.567
Know any contraceptive method 0.960 0.006 3038 1309 1.684 0.006 0.948 0.972
Know a modern method 0.960 0.006 3038 1309 1.674 0.006 0.948 0.972
Currently using any method 0.185 0.014 3038 1309 1.918 0.073 0.158 0.212
Currently using a modern method 0.168 0.013 3038 1309 1.896 0.077 0.142 0.194
Currently using pill 0.036 0.005 3038 1309 1.399 0.131 0.027 0.046
Currently using IUD 0.003 0.001 3038 1309 1.291 0.415 0.001 0.006
Currently using condoms 0.004 0.002 3038 1309 1.334 0.374 0.001 0.007
Currently using injectables 0.093 0.009 3038 1309 1.632 0.092 0.076 0.111
Currently using implants 0.023 0.004 3038 1309 1.464 0.174 0.015 0.031
Currently using female sterilization 0.002 0.001 3038 1309 0.967 0.431 0.000 0.003
Currently using rhythm 0.013 0.003 3038 1309 1.254 0.200 0.008 0.018
Currently using withdrawal 0.004 0.001 3038 1309 1.138 0.333 0.001 0.006
Mothers received antenatal care for last birth/stillbirth 0.977 0.005 2442 1056 1.634 0.005 0.967 0.987
Mothers protected against tetanus for last birth/stillbirth 0.658 0.016 2442 1056 1.683 0.024 0.626 0.690
Births/stillbirths with skilled attendant at delivery 0.593 0.026 2442 1056 2.630 0.044 0.541 0.645
Induced abortion in the 5 years before the survey 0.010 0.002 4202 1786 1.114 0.168 0.007 0.014
Miscarriage in the 5 years before the survey 0.054 0.004 4202 1786 1.119 0.072 0.046 0.062
Ever had an induced abortion 0.028 0.004 4202 1786 1.522 0.138 0.020 0.036
No induced abortion but have heard of induced abortion 0.769 0.023 4202 1786 3.566 0.030 0.723 0.815
Believe induced abortion is legal in Ghana 0.117 0.010 3425 1423 1.872 0.088 0.097 0.138
Total fertility rate (last 3 years) 5.786 0.156 11683 4966 1.481 0.027 5.473 6.099
Neonatal mortality (last 0-9 years) 26.071 2.294 6588 2864 1.137 0.088 21.483 30.658
Post-neonatal mortality (last 0-9 years) 16.031 1.537 6597 2868 0.984 0.096 12.958 19.104
Infant mortality (last 0-9 years) 42.102 2.705 6593 2866 1.050 0.064 36.691 47.512
Child mortality (last 0-9 years) 36.627 3.112 6472 2821 1.254 0.085 30.403 42.850
Under-5 mortality (last 0-9 years) 77.186 4.224 6643 2888 1.221 0.055 68.739 85.633

Appendix B • 169
 Table B.16 Sampling errors: Upper East region sample, Ghana MHS 2017
Number of Cases Confidence Limits
Standard Un- Design Relative
Value error weighted Weighted effect error Lower Upper
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) (R-2SE) (R+2SE)
WOMEN

Urban residence 0.232 0.021 2709 854 2.612 0.091 0.190 0.275
Literacy 0.386 0.019 2709 854 1.996 0.048 0.349 0.423
No education 0.382 0.017 2709 854 1.822 0.045 0.348 0.416
Secondary or higher education 0.425 0.018 2709 854 1.885 0.042 0.390 0.461
Never married/never in union 0.254 0.010 2709 854 1.142 0.038 0.235 0.273
Currently married/in union 0.666 0.010 2709 854 1.078 0.015 0.647 0.686
Married before age 18 0.357 0.013 2153 678 1.261 0.036 0.331 0.384
Had sexual intercourse before age 18 0.504 0.018 2153 678 1.633 0.035 0.469 0.540
Currently pregnant 0.085 0.006 2709 854 1.198 0.076 0.072 0.098
Children ever born 2.506 0.064 2709 854 1.418 0.026 2.377 2.635
Children surviving 2.280 0.056 2709 854 1.377 0.024 2.168 2.391
Children ever born to women age 40-49 5.439 0.143 526 169 1.637 0.026 5.154 5.724
Know any contraceptive method 0.996 0.002 1765 569 1.263 0.002 0.993 1.000
Know a modern method 0.995 0.002 1765 569 1.190 0.002 0.990 0.999
Currently using any method 0.324 0.018 1765 569 1.635 0.056 0.288 0.361
Currently using a modern method 0.316 0.018 1765 569 1.633 0.057 0.280 0.353
Currently using pill 0.022 0.004 1765 569 1.109 0.178 0.014 0.029
Currently using IUD 0.003 0.001 1765 569 0.967 0.444 0.000 0.005
Currently using condoms 0.003 0.001 1765 569 0.970 0.418 0.000 0.006
Currently using injectables 0.153 0.011 1765 569 1.274 0.071 0.131 0.174
Currently using implants 0.132 0.011 1765 569 1.313 0.080 0.111 0.154
Currently using female sterilization 0.003 0.002 1765 569 1.179 0.519 0.000 0.006
Currently using rhythm 0.006 0.002 1765 569 1.062 0.317 0.002 0.010
Currently using withdrawal 0.002 0.001 1765 569 0.976 0.590 0.000 0.003
Mothers received antenatal care for last birth/stillbirth 0.996 0.002 1321 424 1.162 0.002 0.993 1.000
Mothers protected against tetanus for last birth/stillbirth 0.619 0.017 1321 424 1.315 0.028 0.584 0.653
Births/stillbirths with skilled attendant at delivery 0.918 0.012 1321 424 1.555 0.013 0.895 0.941
Induced abortion in the 5 years before the survey 0.014 0.002 2709 854 0.963 0.157 0.009 0.018
Miscarriage in the 5 years before the survey 0.057 0.005 2709 854 1.112 0.087 0.047 0.067
Ever had an induced abortion 0.035 0.004 2709 854 1.183 0.120 0.026 0.043
No induced abortion but have heard of induced abortion 0.825 0.010 2709 854 1.426 0.013 0.804 0.846
Believe induced abortion is legal in Ghana 0.133 0.010 2345 734 1.432 0.075 0.113 0.153
Total fertility rate (last 3 years) 4.662 0.194 7513 2370 1.505 0.042 4.275 5.049
Neonatal mortality (last 0-9 years) 19.910 2.763 3192 1023 0.949 0.139 14.384 25.436
Post-neonatal mortality (last 0-9 years) 8.556 1.781 3181 1020 1.096 0.208 4.993 12.119
Infant mortality (last 0-9 years) 28.466 3.402 3192 1023 1.035 0.120 21.662 35.270
Child mortality (last 0-9 years) 19.642 3.104 3060 975 1.132 0.158 13.434 25.849
Under-5 mortality (last 0-9 years) 47.549 4.790 3207 1027 1.176 0.101 37.968 57.129

170 • Appendix B
Table B.17 Sampling errors: Upper West region sample, Ghana MHS 2017
Number of Cases Confidence Limits
Standard Un- Design Relative
Value error weighted Weighted effect error Lower Upper
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) (R-2SE) (R+2SE)
WOMEN

Urban residence 0.198 0.027 2603 628 3.502 0.138 0.144 0.253
Literacy 0.355 0.022 2603 628 2.362 0.063 0.310 0.399
No education 0.418 0.018 2603 628 1.824 0.042 0.383 0.454
Secondary or higher education 0.391 0.021 2603 628 2.203 0.054 0.349 0.433
Never married/never in union 0.285 0.011 2603 628 1.295 0.040 0.262 0.308
Currently married/in union 0.651 0.013 2603 628 1.434 0.021 0.625 0.678
Married before age 18 0.338 0.014 2038 492 1.361 0.042 0.310 0.367
Had sexual intercourse before age 18 0.476 0.016 2038 492 1.423 0.033 0.445 0.508
Currently pregnant 0.074 0.010 2603 628 1.901 0.131 0.055 0.094
Children ever born 2.678 0.072 2603 628 1.363 0.027 2.534 2.822
Children surviving 2.343 0.061 2603 628 1.349 0.026 2.221 2.464
Children ever born to women age 40-49 5.920 0.102 539 131 1.069 0.017 5.716 6.124
Know any contraceptive method 0.994 0.003 1670 409 1.472 0.003 0.988 0.999
Know a modern method 0.992 0.004 1670 409 1.680 0.004 0.985 0.999
Currently using any method 0.326 0.019 1670 409 1.618 0.057 0.289 0.363
Currently using a modern method 0.307 0.018 1670 409 1.624 0.060 0.270 0.343
Currently using pill 0.031 0.005 1670 409 1.204 0.164 0.021 0.042
Currently using IUD 0.003 0.003 1670 409 2.095 0.952 0.000 0.008
Currently using condoms 0.006 0.002 1670 409 1.059 0.349 0.002 0.009
Currently using injectables 0.153 0.010 1670 409 1.113 0.064 0.133 0.172
Currently using implants 0.101 0.013 1670 409 1.810 0.132 0.074 0.128
Currently using female sterilization 0.009 0.003 1670 409 1.383 0.359 0.002 0.015
Currently using rhythm 0.017 0.004 1670 409 1.324 0.249 0.008 0.025
Currently using withdrawal 0.003 0.001 1670 409 0.826 0.369 0.001 0.005
Mothers received antenatal care for last birth/stillbirth 0.988 0.004 1218 301 1.389 0.004 0.979 0.996
Mothers protected against tetanus for last birth/stillbirth 0.730 0.014 1218 301 1.120 0.019 0.702 0.758
Births/stillbirths with skilled attendant at delivery 0.813 0.021 1218 301 1.882 0.026 0.771 0.854
Induced abortion in the 5 years before the survey 0.027 0.003 2603 628 1.091 0.127 0.020 0.034
Miscarriage in the 5 years before the survey 0.066 0.005 2603 628 0.988 0.073 0.056 0.075
Ever had an induced abortion 0.048 0.004 2603 628 0.959 0.084 0.040 0.056
No induced abortion but have heard of induced abortion 0.832 0.013 2603 628 1.811 0.016 0.806 0.859
Believe induced abortion is legal in Ghana 0.115 0.010 2328 553 1.550 0.089 0.094 0.135
Total fertility rate (last 3 years) 4.577 0.160 7092 1710 1.363 0.035 4.256 4.898
Neonatal mortality (last 0-9 years) 27.887 3.106 3139 792 0.992 0.111 21.674 34.100
Post-neonatal mortality (last 0-9 years) 18.868 3.979 3139 794 1.798 0.211 10.910 26.827
Infant mortality (last 0-9 years) 46.755 4.991 3143 794 1.318 0.107 36.773 56.738
Child mortality (last 0-9 years) 33.006 4.906 3084 781 1.470 0.149 23.194 42.818
Under-5 mortality (last 0-9 years) 78.218 5.766 3173 801 1.150 0.074 66.686 89.749

Appendix B • 171
 Table B.18 Sampling errors for adult and maternal mortality rates, Ghana 2017
Number of cases Confidence limits
Standard Un- Design Relative
Value Error weighted Weighted Effect Error Lower Upper
Variable (R) (SE) (N) (WN) (DEFT) (SE/R) (R-2SE) (R+2SE)
WOMEN

Adult mortality rates

Age
15-19 1.543 0.243 47751 46486 1.334 0.157 1.058 2.029
20-24 1.151 0.162 55437 54463 1.108 0.141 0.827 1.474
25-29 2.710 0.315 54566 54462 1.382 0.116 2.081 3.340
30-34 4.180 0.424 47456 48003 1.425 0.102 3.331 5.029
35-39 5.040 0.528 37864 38515 1.447 0.105 3.985 6.095
40-44 5.679 0.587 26159 27269 1.288 0.103 4.506 6.852
45-49 8.345 0.934 17432 18476 1.375 0.112 6.476 10.214
Total 15-49 (Age adjusted) 3.570 0.163 286666 287673 1.369 0.046 3.245 3.896
Zone
Coastal (Age adjusted) 3.622 0.271 88377 135354 1.231 0.075 3.080 4.164
Middle (Age adjusted) 3.737 0.243 88166 113855 1.162 0.065 3.251 4.223
Northern (Age adjusted) 2.882 0.228 110122 38464 1.095 0.079 2.426 3.338
Adult mortality probabilities 35q15
Total 15-49 134 6 286666 287673 1.776 0.045 121 146
Coastal 134 10 88377 135354 1.444 0.073 114 153
Middle 142 9 88166 113855 1.288 0.065 123 160
Northern 106 9 110122 38464 1.199 0.081 88 123
Total 15-49 [2007] 148 8 119415 120656 1.412 0.057 131 165
Maternal mortality rates
Age
15-19 0.112 0.068 47751 46486 1.383 0.605 0.000 0.249
20-24 0.179 0.070 55437 54463 1.224 0.392 0.039 0.320
25-29 0.403 0.113 54566 54462 1.311 0.280 0.177 0.628
30-34 0.896 0.239 47456 48003 1.749 0.267 0.418 1.374
35-39 0.644 0.176 37864 38515 1.361 0.273 0.292 0.995
40-44 0.443 0.144 26159 27269 1.128 0.325 0.155 0.731
45-49 0.058 0.047 17432 18476 0.842 0.810 0.000 0.153
Total 15-49 (Age adjusted) 0.387 0.058 286666 287673 1.448 0.149 0.271 0.502
Zone
Coastal (Age adjusted) 0.385 0.107 88377 135354 1.390 0.277 0.172 0.598
Middle (Age adjusted) 0.368 0.073 88166 113855 1.213 0.199 0.222 0.514
Northern (Age adjusted) 0.454 0.073 110122 38464 1.051 0.161 0.308 0.600
Maternal Mortality Ratio (MMR)
Total 15-49 (Age adjusted) 310 46 286666 287673 1.448 0.149 217 402
Coastal (Age adjusted) 336 93 88377 135354 1.390 0.276 151 521
Middle (Age adjusted) 296 59 88166 113855 1.213 0.200 177 414
Northern (Age adjusted) 276 45 110122 38464 1.051 0.162 186 365
Pregnancy Related Mortality
Ratio (PRMR)
Total 15-49 343 51 286666 287673 1.465 0.150 240 446
Coastal 379 107 88377 135354 1.431 0.282 165 593
Middle 314 60 88166 113855 1.195 0.191 194 433
Northern 326 48 110122 38464 1.049 0.147 230 422
Total 15-49 [2007] 451 63 119415 120656 1.164 0.141 324 577

MEN

Adult mortality rates

Age
15-19 2.342 0.312 47457 46301 1.334 0.133 1.719 2.965
20-24 2.343 0.273 56907 55325 1.325 0.116 1.798 2.889
25-29 3.189 0.304 55769 54601 1.257 0.095 2.580 3.797
30-34 4.486 0.439 48399 48854 1.386 0.098 3.607 5.364
35-39 5.921 0.494 38425 39354 1.241 0.083 4.933 6.909
40-44 9.261 0.802 26553 27701 1.370 0.087 7.656 10.865
45-49 12.244 1.190 16944 18351 1.386 0.097 9.864 14.624
Total 15-49 (Age adjusted) 4.884 0.201 290452 290486 1.344 0.041 4.482 5.286
Zone
Coastal (Age adjusted) 4.658 0.289 90401 138408 1.173 0.062 4.080 5.236
Middle (Age adjusted) 5.116 0.349 88635 112932 1.200 0.068 4.417 5.815
Northern (Age adjusted) 4.879 0.308 111417 39147 1.146 0.063 4.262 5.496
Adult mortality probabilities 35q15
Total 15-49 181 7 290452 290486 1.762 0.040 166 195
Coastal 174 10 90401 138408 1.416 0.060 154 195
Middle 188 12 88635 112932 1.357 0.066 164 213
Northern 177 10 111417 39147 1.325 0.059 156 198
Total 15-49 [2007] 172 10 122353 123943 1.341 0.059 152 192

172 • Appendix B
DATA QUALITY TABLES Appendix C
Table C.1 Household age distribution

Single-year age distribution of the de facto household population by sex (weighted), Ghana MHS 2017
Female Male Female Male
Age Number Percent Number Percent Age Number Percent Number Percent

0 1,296 2.5 1,422 3.0 37 571 1.1 436 0.9

1 1,302 2.5 1,263 2.7 38 655 1.3 552 1.2
2 1,295 2.5 1,315 2.8 39 489 1.0 330 0.7
3 1,322 2.6 1,389 2.9 40 696 1.4 848 1.8
4 1,419 2.8 1,475 3.1 41 368 0.7 264 0.6
5 1,346 2.6 1,367 2.9 42 570 1.1 505 1.1
6 1,342 2.6 1,421 3.0 43 417 0.8 414 0.9
7 1,322 2.6 1,493 3.2 44 360 0.7 284 0.6
8 1,209 2.4 1,337 2.8 45 639 1.2 708 1.5
9 1,239 2.4 1,345 2.9 46 350 0.7 287 0.6
10 1,326 2.6 1,350 2.9 47 409 0.8 312 0.7
11 1,139 2.2 1,111 2.4 48 410 0.8 380 0.8
12 1,255 2.4 1,256 2.7 49 407 0.8 259 0.5
13 1,283 2.5 1,296 2.7 50 362 0.7 517 1.1
14 1,004 2.0 1,123 2.4 51 306 0.6 193 0.4
15 998 1.9 1,118 2.4 52 525 1.0 332 0.7
16 952 1.9 875 1.9 53 420 0.8 220 0.5
17 1,058 2.1 1,034 2.2 54 420 0.8 286 0.6
18 961 1.9 936 2.0 55 479 0.9 383 0.8
19 721 1.4 764 1.6 56 338 0.7 225 0.5
20 902 1.8 932 2.0 57 307 0.6 248 0.5
21 721 1.4 515 1.1 58 332 0.6 210 0.4
22 814 1.6 743 1.6 59 203 0.4 165 0.3
23 776 1.5 672 1.4 60 558 1.1 453 1.0
24 854 1.7 652 1.4 61 129 0.3 121 0.3
25 951 1.9 748 1.6 62 247 0.5 224 0.5
26 746 1.5 575 1.2 63 214 0.4 152 0.3
27 937 1.8 664 1.4 64 195 0.4 159 0.3
28 817 1.6 666 1.4 65 374 0.7 308 0.7
29 683 1.3 553 1.2 66 118 0.2 97 0.2
30 933 1.8 838 1.8 67 144 0.3 135 0.3
31 606 1.2 441 0.9 68 130 0.3 120 0.3
32 803 1.6 756 1.6 69 93 0.2 89 0.2
33 560 1.1 405 0.9 70+ 2,081 4.0 1,405 3.0
34 674 1.3 480 1.0 37 571 1.1 436 0.9
35 856 1.7 802 1.7 38 655 1.3 552 1.2
36 636 1.2 396 0.8 39 489 1.0 330 0.7
Don’t know/
missing 13 0.0 23 0.0
Total 51,391 100.0 47,173 100.0

Note: The de facto population includes all residents and nonresidents who stayed in the household the night before the interview.

Appendix C • 173
 Table C.2 Age distribution of eligible and interviewed women

De facto household population of women age 10-54, number and percent distribution of interviewed
women age 15-49, and percentage of eligible women who were interviewed (weighted), by 5-year age
groups, Ghana MHS 2017
Household Interviewed women age 15-49 Percentage of
population of eligible women
Age group women age 10-54 Number Percentage interviewed
10-14 6,008 na na na
15-19 4,690 4,636 19.3 98.8
20-24 4,067 4,028 16.7 99.1
25-29 4,135 4,101 17.0 99.2
30-34 3,576 3,542 14.7 99.0
35-39 3,206 3,169 13.2 98.8
40-44 2,411 2,387 9.9 99.0
45-49 2,216 2,197 9.1 99.1
50-54 2,034 na na na
15-49 24,302 24,059 100.0 99.0

Note: The de facto population includes all residents and nonresidents who stayed in the household the
night before the interview. Weights for both household population of women and interviewed women are
household weights. Age is based on the Household Questionnaire.
na = Not applicable

Table C.3 Completeness of reporting

Percentage of observations missing information for selected demographic and health questions (weighted), Ghana MHS 2017
Percentage with
information Number
Subject Reference group missing of cases
Birth date Births in the 15 years preceding the survey
Day Only 4.25 38,962
Month Only 2.33 38,962
Month and Year 0.16 38,962
Age at Death Deceased children born in the 15 years preceding the survey 0.00 2,360
Age/date at first union1 Ever married women age 15-49 0.83 16,665
Respondent’s education Women age 15-49 0.00 25,062

1
Both year and age missing

Table C.4 Births by calendar years

Number of births, percentage with complete birth date, sex ratio at birth, and calendar year ratio by calendar year, according to living, dead, and total
children (weighted), Ghana MHS 2017
Percentage with year and
Number of births month of birth given Sex ratio at birth2 Calendar year ratio3
Calendar year Living Dead Total Living Dead Total Living Dead Total Living Dead Total
2017 1,958 71 2,029 99.8 99.4 99.8 107.9 98.7 107.5 na na na
2016 2,908 108 3,016 99.5 98.9 99.5 100.6 153.6 102.1 na na na
2015 2,622 121 2,743 99.4 98.3 99.4 101.7 129.0 102.8 91.4 101.4 91.8
2014 2,830 131 2,961 99.2 94.2 99.0 99.6 81.9 98.7 106.6 102.5 106.4
2013 2,687 134 2,821 99.2 91.0 98.8 101.7 132.6 103.0 97.0 96.1 96.9
2012 2,713 148 2,861 98.7 88.5 98.2 98.6 123.5 99.7 102.2 96.8 101.9
2011 2,620 172 2,792 98.0 92.4 97.6 102.6 152.3 105.1 99.1 108.5 99.6
2010 2,573 169 2,742 97.4 89.9 96.9 111.4 125.9 112.2 102.0 104.6 102.2
2009 2,424 151 2,574 97.1 88.3 96.6 107.2 113.7 107.6 98.2 82.7 97.1
2008 2,362 196 2,558 97.5 87.8 96.8 106.1 135.7 108.1 96.9 101.6 97.3
2013 - 2017 13,005 565 13,570 99.4 95.9 99.3 101.9 116.7 102.5 na na na
2008 - 2012 12,692 836 13,528 97.8 89.4 97.3 105.0 130.3 106.4 na na na
2003 - 2007 10,394 913 11,308 96.8 83.8 95.8 102.2 133.6 104.5 na na na
1998 - 2002 7,748 884 8,633 95.0 84.6 94.0 99.8 125.6 102.2 na na na
<1998 7,729 1,346 9,075 92.2 82.3 90.7 101.9 123.1 104.8 na na na
All 51,568 4,545 56,113 96.7 86.1 95.9 102.4 126.1 104.1 na na na

NA = Not applicable
1
(Bm/Bf)x100, where Bm and Bf are the numbers of male and female births, respectively
2
[2Bx/(Bx-1+Bx+1)]x100, where Bx is the number of births in calendar year x

174 • Appendix C
Table C.5 Reporting of age at death in days

Distribution of reported deaths under age 1 month by age at death in days and
the percentage of neonatal deaths reported to occur at ages 0-6 days, for 5-year
periods preceding the survey (weighted), Ghana MHS 2017
Number of years preceding the survey Total
Age at death (days) 0-4 5-9 10-14 15-19 0-19
<1 176 175 157 87 595
1 62 68 48 43 221
2 12 6 15 18 51
3 28 43 34 24 130
4 6 16 12 13 47
5 6 5 9 7 27
6 6 5 2 6 19
7 22 17 34 23 96
8 3 1 1 2 7
9 4 1 1 1 8
10 5 3 2 0 10
11 3 1 2 0 5
12 0 1 0 0 1
13 0 0 0 0 0
14 16 17 17 25 75
15 1 3 0 0 4
16 0 1 0 0 1
17 2 0 0 0 2
18 0 0 0 0 0
19 0 0 0 0 0
20 0 1 4 1 6
21 2 10 9 11 33
23 0 1 0 0 2
24 0 1 0 0 1
27 0 1 0 0 2
28 1 0 0 1 3
29 0 0 1 0 1
30 1 1 1 3 6
Percentage early neonatal1 82.3 84.4 78.9 74.6 80.5

1
≤ 6 days / ≤ 30 days

Table C.6 Reporting of age at death in months

Distribution of reported deaths under age 2 years by age at death in months and
the percentage of infant deaths reported to occur at age under 1 month, for
5-year periods preceding the survey (weighted), Ghana MHS 2017
Number of years preceding the survey Total
Age at death (months) 0-4 5-9 10-14 15-19 0-19
<1a 361 377 351 265 1,355
1 31 28 30 40 129
2 24 22 20 18 84
3 28 28 28 19 103
4 12 21 11 11 55
5 7 14 8 13 42
6 8 18 20 30 76
7 11 11 19 9 49
8 4 21 20 22 67
9 10 11 22 15 59
10 2 9 10 4 25
11 14 9 21 12 55
12 14 33 40 59 146
13 3 6 4 13 26
14 3 6 6 8 24
15 8 6 5 6 25
16 2 6 5 4 16
17 1 4 2 2 10
18 10 13 20 18 61
19 1 3 3 0 8
20 2 1 3 0 5
21 3 5 0 0 9
22 0 1 0 0 1
23 0 1 2 0 4
Percentage neonatal1 70.4 66.3 62.7 57.9 64.5

a
Includes deaths under one month reported in days
1
Under one month / under one year

Appendix C • 175
 Table C.7 Completeness of information on siblings

Completeness of data on survival status of sisters and brothers reported by interviewed women, age of living
siblings and age at death (AD) and years since death (YSD) of dead siblings (unweighted), Ghana MHS 2017
Sisters Brothers All siblings
Number Percent Number Percent Number Percent
All siblings 60,630 100.0 62,577 100.0 123,207 100.0
Living 53,760 88.7 54,281 86.7 108,041 87.7
Dead 6,865 11.3 8,288 13.2 15,153 12.3
Survival status unknown 5 0.0 8 0.0 13 0.0
Living siblings 53,760 100.0 54,281 100.0 108,041 100.0
Age reported 53,760 100.0 54,281 100.0 108,041 100.0
Dead siblings 6,865 100.0 8,288 100.0 15,153 100.0
AD and YSD reported 6,865 100.0 8,288 100.0 15,153 100.0

Table C.8 Sibship size and sex ratio of siblings

Mean sibship size and sex ratio of siblings at birth, Ghana MHS 2017

Sex ratio of
Background Mean sibship siblings at
characteristic size1 birth2
Age of respondents
15-19 5.3 107.0
20-24 5.6 102.1
25-29 5.8 103.5
30-34 6.0 98.9
35-39 6.2 101.6
40-44 6.3 101.5
45-49 6.5 104.0
Zone
Coastal 5.7 103.5
Middle 5.9 101.2
Northern 6.2 104.1
Total 5.9 102.7

1
Includes the respondent
2
Excludes the respondent

Table C.9 Pregnancy-related mortality trends

Direct estimates of pregnancy-related mortality rates for the 7 years preceding each
survey, by 5-year age groups, Ghana MHS 2017
Pregnancy-related mortality rates1,2
Age 2010-2017 2000-2007
15-19 0.12 0.26
20-24 0.18 0.41
25-29 0.50 0.53
30-34 0.99 0.66
35-39 0.69 1.41
40-44 0.46 1.40
45-49 0.07 0.13
Total 15-49 a 0.43 0.64
Total fertility rate (TFR) 4.0 4.7
General fertility rate (GFR)3 125 142
Pregnancy-related mortality ratio (PRMR)4 343 451
Confidence interval (240-446) (324-577)
Lifetime risk of pregnancy-related death5 0.014 0.021

1
Pregnancy-related mortality is defined as the death of a woman while pregnant or within
2 months of termination of pregnancy, from any cause including accident or violence
2
Expressed per 1,000 woman-years of exposure
3
Age-adjusted rate expressed per 1,000 women age 15-49
4
Expressed per 100,000 live births; calculated as the age-adjusted pregnancy-related
mortality rate times 100 divided by the age-adjusted general fertility rate
5
Calculated as 1-(1-PRMR)TFR where TFR represents the total fertility rate for the 7 years
preceding the survey
a
Age-adjusted rate

176 • Appendix C
PARTICIPANTS IN THE 2017 GHANA
MATERNAL HEALTH SURVEY Appendix D
PROJECT IMPLEMENTATION TEAM
Senior Project Management
Baah Wadieh Acting Government Statistician & Project Director
Anthony Amuzu Deputy Government Statistician & Deputy Project Director
Abena Asamoabea Osei-Akoto Project Manager
Peter Takyi Peprah Project Coordinator
Dr. Patrick Aboagye (GHS) Instrument Review
Godwin Odei Gyebi Trainer & Field Coordinator
Emmanuel George Ossei Trainer & Field Coordinator
Emmanuel Boateng Trainer & Field Coordinator
Michael Opoku Acheampong Trainer & Field Coordinator
Andani Iddrisu Abdulai Trainer & Field Coordinator
Rochester Appiah-Kusi CAPI Trainer & Field Coordinator
Leo Kwamena Arkafra CAPI Trainer & Field Coordinator
Jacqueline Anum Head of Data Processing
Ephraim Kakpor Project Accountant
Robert Theophilus Kwami Director of Finance
Timothy Afful Deputy Director of Finance
Titus Quartey Director of Transport
Betty-Love Cobbinah Hermann Head of Audit
Asante Ansah Asare Audit
Emmanuel Amonu Cobbinah Head, Procurement Unit
Alberta Eshun Administrative Support
Hannah Konadu Frempong Administrative Support
Bernice Adjetey-Mensah Administrative Support
Mary Nyarko Administrative Support
Simon Kofi Kasakwa Administrative Support, Driver

Regional Statisticians
Ernest Nyarku Field Monitor
Isaac Addae Field Monitor
Chris Assem Field Monitor
Chris Amewu Field Monitor
Ernestina Hope-Turkson Field Monitor
Kobina Abaka Ansah Field Monitor
Amatus S. Nababuma Field Monitor
Abdul-Kadir Bawa Field Monitor
Felix Geli Field Monitor
Sixtus Jerimiah Dery Field Monitor

Appendix D • 177
 DATA PROCESSING
Secondary Editors
Albert Riis Wilson James Christian Adu

Data Entry Clerks

Margaret Andam Marilyn Tamakloe
Vera Blankson Getrude Owusu-Asamoah

IT Support
Paa Kwesi Eshun

LISTING EXERCISE
Supervisors
Orlando Ackumey Isaac Frank Arhin Patrick Ziddah
Charles Okyere-Larbi William Adofo Tweneboah Benjamin Narh Siameh
Daniel Ansah Bright Neku Worlanyo Jacob Osward Andoh
Noah Kwesi Acquandoh Charles Boateng Bisilin Alhassan
Shiek Borquaye Abdel-Salaam Stephen Gbesemete Robert Kwamena Mensah
Emmanuel Okpoti Mensah Alabira Mohammed Awal Dennis Asanga
Bekui Mawulikem Gabriel Opare Mintah

Listers
Justice Lawson Mansfield Fredrick Edem Apaloo Fredrick Amartey Laryea
Eric Kunutsor Benedict Laryea Philip Kofi Akpabli
Henry Mensah Stephen Daamah Mercy Naa Quarshie
Daniel Osei Boamah Arnold Gbatey John Osei
Mac-Arthur Darlington Charity Frempong Paul Nii Amartey
Angelina Okoto Albert Riis Wilson Vivian Nkansah
Paul Seneadza Gertrude Andorful Elvis Peprah
Benson Akpah Michael Otibu Robert Kabutey
Patrick Gbolonyo Eric Amponsah Doris Osabutey
Richard Oduro Michael Joy-Smith Dickson Alordeh
Anai Nyarku George Midley Isaac Asante Mensah
Christian Dohu Isaac Yao Nornyibey Winston Roland Nortey
Samuel Kofi Baffoe Thinkler Daniel Owusu Appiah Gilbert Tetteh
Isaac Cudjoe Akua Osei Ababio Ahmed Mohammed
Adamu Issaka Abubakari Issah Kofi Binditi
Yussif Anass Abdallah Mogtar Cynthia Agumah
Haruna Mahama Alexander Kankpe Edward Tabiasinaa
Atibilla Rukaya Mangotiba Ebenezer Ankomah Albert Ansah
Fatai Bashiru Kwaku Atta Agyeman-Badu Yinbil Gilbert
Aba-Am Abdur-Razak Aduko Vida Ayangba

178 • Appendix D
 Drivers
Emmanuel Acquah Alex Anni Jacob Jabotir
Daniel Mensah Isaac Fosu Wisdom Kuagbelah
Charles Adu Gyamfi Samuel Nyamekye George Ansah
Ernest Annang Isaac Odoom Kennedy Awli
Achibold Cobblah Acheampong Sampson Joseph Ampomah
Nii Laryea Ebenezer Dinsey Ronald Akrong
Stephen Otoo Felix Osei

FIELDWORK
Supervisors
Richard Sackey Comfort Ashitey Patrick Ziddah
Victor Owusu Boateng Joyce Date Anthony Oduro Denkyira
Angela McDodoo Faustine Adzroe Kweku Dzanie
Sarah Woode Judith Attipoe Eric Nii Amoo
Dieudonne Ankamah Ernest Nutakoh Gabriel Opoku Nyarko
Gershon Doe Tekpli Emmanuel Baidoo Robert Kwamena Mensah
Bright Worlanyo Neku Umuhera Briamah Philip Adosinaba
Charles K. Agbenu John Gambo Robert Lawson
Alabira Mohammed Awal

Interviewers
Linda Atiayaw Felicity Kuwornu Everlove Rashie Acquah
Kate Asamoah Rosemary Tedeku-Quarcoo Sandra Ami Yevunoo
Loretta Valentina Amoah Nana Efua Akyeampong Dorothy Naa Dedie Quaye
Ruby Awortwe Shirley Yaa Brago Rita Acheampong
Rebecca Aryeetey Winifred Tawiah Kyereko Judith Addo
Shirley Agyeman Yeboah Benedicta Allotey Mercy Naa Quarshie
Pamela Aninagyei-Bonsu Christiana Annan-Tofah Monica Lamptey
Elizabeth Adjei-Bempong Darling Anita Eshun Salomey Apanfo
Rose Addy Silvia Ovulley Kas Damba
Mercy Amartey Silvia Klu Mavis Yeboah
Vera Agyeiwaa Ntow Elizabeth Abgenyagah Lisa Agyinor A. Forson
Cybil A. Odamtten Theresa Yebgey Evelyn Amoaba Owusu
Naa Lengoi Nyarko Getrude Owusu-Asamoah Hagar Kumi
Sena Lucy Pewu Sarah Afriyie Agyeman Lydia Forson
Anita Afu Elorm Priscilla Nkansah Vida Marfo
Peace Adza-Krakani Nyuiemedi Christiana Gadasu Jessica Emelia Zor
Bernice Nyarko Mensah Priscilla Kyei Deborah Arhin
Eunice Pomaa Odoom Priscilla Cleland Afsatu Dawud
Achiaa Yaa Agyeman-Badu Comfort Addai Bernice Peprah
Rita Osei-Owusu Millicent Sitsofe Dzoboku Shafiya Ali
Amanda Sarpong Beatrice Nornyibey Hellen Gyan
Franklina Afriyie Amoah Barbara Effah Lady Talata Bawa
Constance Serwaa Twumasi Caroline Anipah Regina Kwakye
Bernice Eugenia Osei Hannah Ankrah Zakari Fatima
Bernice Nyarko Mensah Priscilla Kyei Deborah Arhin
Susana Achiaa Marfo Rabi Kanton Afra Adomako Kwabiah
Nana Yaa Asabea Owiredu Sherifa Abass Charlotte Tengan
Tahiru Khadijah Eunice Obboh-Rockson Sofia Dinmah Bukari
Hannah Ampomah Rubina Ngmapigre Mary Larbi
Denteh Patience Pearl Mensah Audrey Maame Esi Russel

Appendix D • 179
 Ruth Ngmenirima Koyiri Suweba Jibrine Kubura Issaka Imoro
Abubakari Sadick Rafatu Yvonne Atsutse Liticia Nyaaba
Elsie Osei Owusu Fole Justina Peggy Enyonam Akabuah
Juliana Aninteriga Anyinbila Winnie Getty Obeng Mary Yaa Serwaa
Shirley Adombiri Naba Dorcas Anarfi

Drivers
James Nii Laryea Ronald Akrong Emmanuel Acquah
Tweneboah Gyasi A. Kennedy Awli Emmaneul Badasu
Isaac Fosu Gershon Nornyibey Alex Anni
Ernest Annang Jacob Anum Anang Charles Adu Gyamfi
Isaac Addai Daniel Mensah Emmanuel Chartey
Archibold Cobblah George Karikari Joseph Ampomah
Victor Mensah Ebenezer Dinsey George Ansah
Felix Osei Jacob Jabotir Wisdom Kuagbelah
William Akamaboro

VERBAL AUTOPSY CAUSE OF DEATH DETERMINATION AND ICD-10 CODING

Physicians
John Kanyiri Yambah Margaret Maame Yaa Mprengo Abua Forson
Edgar Sopiimeh John Ekow Otoo
Steve Ogbordjor Nana Mireku-Gyimah

REPORT WRITING
Peter Takyi Peprah Ghana Statistical Service
Emmanuel George Ossei Ghana Statistical Service
Comfort Ashitey Ghana Statistical Service
Emmanuel Boateng Ghana Statistical Service
Michael Opoku Acheampong Ghana Statistical Service
Yaa Asante Ghana Health Service
Umuhera Briamah Ghana Statistical Service
Thelma Jennifer Jakalia Ministry of Health
Victor Boateng Owusu Ghana Statistical Service
Vivian Ofori-Dankwah Ghana Health Service
Godwin Odei Gyebi Ghana Statistical Service
Sarah Woode Ghana Statistical Service
John Kanyiri Yambah University of Education, Mampong
Steve Ogbordjor Private Health Practitioner
Anthony Amuzu Technical Reviewer

180 • Appendix D
 TECHNICAL SUPPORT: ICF
Julia Fleuret Survey Manager
Jeremy Taglieri Survey Specialist
Rubén Hume Data Processing Specialist
Ruilin Ren Sampling Specialist
Dr. Gulnara Semenov Regional Coordinator
Dr. Yusuf Hemed ICD-10 and Verbal Autopsy Expert (Consultant)
Elizabeth Britton Data Processing Logistics Support
Courtney Allen Technical Reviewer
Trevor Croft Technical Reviewer
Joy Fishel Technical Reviewer
Lindsay Mallick Technical Reviewer
Debra Prosnitz Technical Reviewer
Anne Siegle Technical Reviewer
Chris Gramer Report Production Specialist
Natalie Shattuck Report Production Specialist
Greg Edmondson Editor
Tom Fish GIS Specialist
Megan Gottfried GIS Specialist
Sarah Balian Dissemination Specialist
Sally Zweimueller Dissemination Specialist

Appendix D • 181
 TABULATION OF INTERNATIONAL
CLASSIFICATION OF DISEASE (ICD) 10
OBSTETRIC CODES Appendix E
This key shows how obstetric codes were tabulated in the cause-of-death tables in Chapter 9.

Table 9.4.1 Table 9.4.2 Table 9.5

(ICD-MM (2007 GMHS (Onset period of
Code Description Table 9.3.1 Table 9.3.2 Tabulation) Tabulation) cause of death)

O00.0 Abdominal pregnancy Maternal Maternal Pregnancy with Spontaneous Pregnancy

(direct) abortive outcome abortion/miscarriage
O00.9 Ectopic pregnancy, unspecified Maternal Maternal Pregnancy with Spontaneous Pregnancy
(direct) abortive outcome abortion/miscarriage
O03.0 Spontaneous abortion : incomplete, Maternal Maternal Pregnancy with Spontaneous Pregnancy
complicated by genital tract and pelvic (direct) abortive outcome abortion/miscarriage
infection
O03.1 Spontaneous abortion : incomplete, Maternal Maternal Pregnancy with Spontaneous Pregnancy
complicated by delayed or excessive (direct) abortive outcome abortion/miscarriage
haemorrhage
O03.6 Spontaneous abortion : complete or Maternal Maternal Pregnancy with Spontaneous Pregnancy
unspecified, complicated by delayed or (direct) abortive outcome abortion/miscarriage
excessive haemorrhage
O04.1 Medical abortion : incomplete, Maternal Maternal Pregnancy with Abortion (medical, Pregnancy
complicated by delayed or excessive (direct) abortive outcome attempted, failed, other
haemorrhage unspecified)
O05 Complications following abortion and Maternal Maternal Pregnancy with Abortion (medical, Pregnancy
ectopic and molar pregnancy (direct) abortive outcome attempted, failed, other
unspecified)
O06 Unspecified abortion Maternal Maternal Pregnancy with Abortion (medical, Pregnancy
(direct) abortive outcome attempted, failed, other
unspecified)
O06.8 Unspecified abortion : complete or Maternal Maternal Pregnancy with Abortion (medical, Pregnancy
unspecified, with other and unspecified (direct) abortive outcome attempted, failed, other
complications unspecified)
O07.5 Other and unspecified failed attempted Maternal Maternal Pregnancy with Abortion (medical, Pregnancy
abortion, complicated by genital tract (direct) abortive outcome attempted, failed, other
and pelvic infection unspecified)
O07.6 Other and unspecified failed attempted Maternal Maternal Pregnancy with Abortion (medical, Pregnancy
abortion, complicated by delayed or (direct) abortive outcome attempted, failed, other
excessive haemorrhage unspecified)
O07.8 Other and unspecified failed attempted Maternal Maternal Pregnancy with Abortion (medical, Pregnancy
abortion, with other and unspecified (direct) abortive outcome attempted, failed, other
complications unspecified)
O10.0 Pre-existing essential hypertension Maternal Maternal Non-obstetric Other not elsewhere Before pregnancy
complicating pregnancy, childbirth and (indirect) complications classified: non-
the puerperium infectious
O14 Pre-eclampsia Maternal Maternal Hypertensive disorders Hypertensive disorders Pregnancy
(direct) in pregnancy, (including eclampsia)
childbirth, and the
puerperium
O14.1 Severe pre-eclampsia Maternal Maternal Hypertensive disorders Hypertensive disorders Pregnancy
(direct) in pregnancy, (including eclampsia)
childbirth, and the
puerperium
O14.2 HELLP syndrome Maternal Maternal Hypertensive disorders Hypertensive disorders Pregnancy or
(direct) in pregnancy, (including eclampsia) childbirth
childbirth, and the
puerperium
O14.9 Pre-eclampsia, unspecified Maternal Maternal Hypertensive disorders Hypertensive disorders Pregnancy
(direct) in pregnancy, (including eclampsia)
childbirth, and the
puerperium

Continued

Appendix E • 183
 Table 9.4.1 Table 9.4.2 Table 9.5
(ICD-MM (2007 GMHS (Onset period of
Code Description Table 9.3.1 Table 9.3.2 Tabulation) Tabulation) cause of death)

O15.0 Eclampsia in pregnancy Maternal Maternal Hypertensive disorders Hypertensive disorders Pregnancy
(direct) in pregnancy, (including eclampsia)
childbirth, and the
puerperium
O15.1 Eclampsia in labour Maternal Maternal Hypertensive disorders Hypertensive disorders Childbirth
(direct) in pregnancy, (including eclampsia)
childbirth, and the
puerperium
O15.2 Eclampsia in the puerperium Maternal Maternal Hypertensive disorders Hypertensive disorders Puerperium
(direct) in pregnancy, (including eclampsia)
childbirth, and the
puerperium
O15.9 Eclampsia, unspecified as to time Maternal Maternal Hypertensive disorders Hypertensive disorders Any
period (direct) in pregnancy, (including eclampsia)
childbirth, and the
puerperium
O16 Unspecified maternal hypertension Maternal Maternal Hypertensive disorders Hypertensive disorders Any
(direct) in pregnancy, (including eclampsia)
childbirth, and the
puerperium
O21.2 Late vomiting of pregnancy Maternal Maternal Other obstetric Other, miscellaneous Pregnancy
(direct) complications
O24.4 Diabetes mellitus arising in pregnancy Maternal Maternal Other obstetric Other, miscellaneous Pregnancy
(direct) complications
O43.2 Morbidly adherent placenta Maternal Maternal Obstetric haemorrhage Haemorrhage (ante- Childbirth
(direct) and post-partum)
O46.9 Antepartum haemorrhage, unspecified Maternal Maternal Obstetric haemorrhage Haemorrhage (ante- Pregnancy
(direct) and post-partum)
O67 Labour and delivery complicated by Maternal Maternal Obstetric haemorrhage Haemorrhage (ante- Childbirth
intrapartum haemorrhage, not (direct) and post-partum)
elsewhere classified
O67.0 Intrapartum haemorrhage with Maternal Maternal Obstetric haemorrhage Haemorrhage (ante- Childbirth
coagulation defect (direct) and post-partum)
O67.8 Other intrapartum haemorrhage Maternal Maternal Obstetric haemorrhage Haemorrhage (ante- Childbirth
(direct) and post-partum)
O67.9 Intrapartum haemorrhage, unspecified Maternal Maternal Obstetric haemorrhage Haemorrhage (ante- Childbirth
(direct) and post-partum)
O71.1 Rupture of uterus during labour Maternal Maternal Obstetric haemorrhage Haemorrhage (ante- Childbirth
(direct) and post-partum)
O72 Postpartum haemorrhage Maternal Maternal Obstetric haemorrhage Haemorrhage (ante- Puerperium
(direct) and post-partum)
O72.0 Third-stage haemorrhage Maternal Maternal Obstetric haemorrhage Haemorrhage (ante- Childbirth
(direct) and post-partum)
O72.1 Other immediate postpartum Maternal Maternal Obstetric haemorrhage Haemorrhage (ante- Puerperium
haemorrhage (direct) and post-partum)
O72.2 Delayed and secondary postpartum Maternal Maternal Obstetric haemorrhage Haemorrhage (ante- Puerperium
haemorrhage (direct) and post-partum)
O73.0 Retained placenta without Maternal Maternal Other obstetric Other, miscellaneous Childbirth
haemorrhage (direct) complications
O75.4 Other complications of obstetric Maternal Maternal Other obstetric Other, miscellaneous Childbirth
surgery and procedures (direct) complications
O75.8 Haemorrhage (ante- and post-partum) Maternal Maternal Other obstetric Other, miscellaneous Pregnancy or
(direct) complications childbirth
O75.9 Complication of labour and delivery, Maternal Maternal Other obstetric Other, miscellaneous Childbirth
unspecified (direct) complications
O85 Puerperal sepsis Maternal Maternal Pregnancy-related Sepsis Puerperium
(direct) infection
O89.2 Central nervous system complications Maternal Maternal Unanticipated Other, miscellaneous Puerperium
of anaesthesia during the puerperium (direct) complications of
management
O90.3 Cardiomyopathy in the puerperium Maternal Maternal Other obstetric Other, miscellaneous Puerperium
(direct) complications
O95 Obstetric death of unspecified cause Maternal Maternal Unknown/ Other, miscellaneous Any
(direct) undetermined

Continued

184 • Appendix E
 Table 9.4.1 Table 9.4.2 Table 9.5
(ICD-MM (2007 GMHS (Onset period of
Code Description Table 9.3.1 Table 9.3.2 Tabulation) Tabulation) cause of death)

O98.8 Other maternal infectious and parasitic Maternal Maternal Non-obstetric Other not elsewhere Any
diseases complicating pregnancy, (indirect) complications classified: infectious
childbirth and the puerperium
O99.0 Anaemia complicating pregnancy, Maternal Maternal Non-obstetric Other not elsewhere Any
childbirth and the puerperium (indirect) complications classified: non-
infectious
O99.6 Diseases of the digestive system Maternal Maternal Non-obstetric Other not elsewhere Any
complicating pregnancy, childbirth and (indirect) complications classified: non-
the puerperium infectious
O99.8 Other specified diseases and Maternal Maternal Non-obstetric Other not elsewhere Any
conditions complicating pregnancy, (indirect) complications classified: non-
childbirth and the puerperium infectious

Appendix E • 185
QUESTIONNAIRES Appendix F

Appendix F • 187
 FORMATTING DATE: 30 May 2017
ENGLISH LANGUAGE: 17 Mar. 2017
2017 GHANA MATERNAL HEALTH SURVEY
HOUSEHOLD QUESTIONNAIRE
MINISTRY OF HEALTH GHANA STATISTICAL SERVICES

IDENTIFICATION

LOCALITY NAME

NAME OF HOUSEHOLD HEAD

REGION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DISTRICT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CLUSTER NUMBER ...................................................................... 0

HOUSEHOLD NUMBER ...................................................................

INTERVIEWER VISITS

1 2 3 FINAL VISIT

DATE DAY

MONTH

YEAR 2 0 1 7
INTERVIEWER'S
NAME INT. NO.

RESULT* RESULT*

NEXT VISIT: DATE

TOTAL NUMBER
TIME OF VISITS

*RESULT CODES: TOTAL PERSONS

IN HOUSEHOLD
1 COMPLETED
2 NO HOUSEHOLD MEMBER AT HOME OR NO COMPETENT RESPONDENT
AT HOME AT TIME OF VISIT TOTAL ELIGIBLE
3 ENTIRE HOUSEHOLD ABSENT FOR EXTENDED PERIOD OF TIME WOMEN
4 POSTPONED
5 REFUSED
6 DWELLING VACANT OR ADDRESS NOT A DWELLING
7 DWELLING DESTROYED
8 DWELLING NOT FOUND
9 OTHER LINE NO. OF
(SPECIFY) RESPONDENT
TO HOUSEHOLD
QUESTIONNAIRE

LANGUAGE OF
QUESTIONNAIRE** 0 0 LANGUAGE OF
INTERVIEW**
NATIVE LANGUAGE
OF RESPONDENT**
TRANSLATOR USED
(YES = 1, NO = 2)

LANGUAGE OF
QUESTIONNAIRE** ENGLISH **LANGUAGE CODES:
00 ENGLISH 05 MOLE-DAGBANI
01 AKAN 06 GRUSI
02 GA 07 GURMA
03 EWE 08 MANDE
04 GUAN 96 OTHER
(SPECIFY)

SUPERVISOR

NAME NUMBER

Appendix F • 189
 THIS PAGE IS INTENTIONALLY BLANK

190 • Appendix F
 INTRODUCTION AND CONSENT

Hello. My name is _______________________________________. I am working with Ghana Statistical Service and the
Ministry of Health. We are conducting a national survey that asks about maternal health issues. The information we collect
will help the government to plan health services for women. Your household was selected for the survey. I would like to ask
you some questions about your household. The questions usually take about 15 to 20 minutes. All of the answers you give
will be confidential and will not be shared with anyone other than members of our survey team. You don't have to be in the
survey, but we hope you will agree to answer the questions since your views are important. If I ask you any question you don't
want to answer, just let me know and I will go on to the next question or you can stop the interview at any time. In case you
need more information about the survey, you may contact the person listed on this card.

GIVE CARD WITH CONTACT INFORMATION

Do you have any questions?

May I begin the interview now?

SIGNATURE OF INTERVIEWER DATE

RESPONDENT AGREES RESPONDENT DOES NOT AGREE

TO BE INTERVIEWED . . 1 TO BE INTERVIEWED . . 2 END

100 RECORD THE TIME INTERVIEW STARTS.

HOURS ........................

MINUTES . . . . . . . . . . . . . . . . . . . . . . . .

Appendix F • 191
 HOUSEHOLD SCHEDULE

IF AGE 3 YEARS OR OLDER

LINE USUAL RESIDENTS RELATIONSHIP SEX RESIDENCE AGE EVER ATTENDED SCHOOL ELIGI-
NO. AND VISITORS TO HEAD OF BILITY
HOUSEHOLD

1 2 3 4 5 6 7 8 9 10

Please give me the names of What is the Is Does Did How old is Has What is the highest CIRCLE
the persons who usually live relationship of (NAME) (NAME) (NAM (NAME)? (NAME) level of school (NAME) LINE
in your household and (NAME) to the male usually E) ever has attended? NUMBER
guests of the household who head of the or live stay attended OF ALL
stayed here last night, household? female? here? here school? SEE CODES BELOW WOMEN
starting with the head of the last AGE
household. night? What is the highest 15-49
grade (NAME)
completed at that level?

AFTER LISTING THE SEE CODES BELOW

NAMES AND RECORDING RECORD
THE RELATIONSHIP IN COMP-
AND SEX FOR EACH LETED
PERSON, ASK YEARS
QUESTIONS 2A-2C
TO BE SURE THAT THE
LISTING IS COMPLETE.
IF 95
THEN ASK APPROPRIATE OR MORE,
QUESTIONS IN COLUMNS SEE CODES RECORD
5-9 FOR EACH PERSON. BELOW. '95'.

M F Y N Y N IN YEARS Y N LEVEL GRADE

01 1 2 1 2 1 2 1 2 01

GO TO 10

1 2 1 2 1 2 1 2
02 02
GO TO 10

1 2 1 2 1 2 1 2
03 03
GO TO 10

1 2 1 2 1 2 1 2
04 04
GO TO 10

1 2 1 2 1 2 1 2
05 05
GO TO 10

1 2 1 2 1 2 1 2
06 06
GO TO 10

1 2 1 2 1 2 1 2
07 07
GO TO 10

1 2 1 2 1 2 1 2
08 08
GO TO 10

1 2 1 2 1 2 1 2
09 09
GO TO 10

1 2 1 2 1 2 1 2
10 10
GO TO 10

2A) Just to make sure that I have a complete listing: are there
any other people such as small children or infants that we ADD TO
YES NO
have not listed? TABLE
2B) Are there any other people who may not be members of
your family, such as domestic servants, lodgers, or friends ADD TO
YES NO
who usually live here? TABLE
2C) Are there any guests or temporary visitors staying here, or
anyone else who stayed here last night, who have not been ADD TO
YES NO
listed? TABLE

CODES FOR Q. 3: RELATIONSHIP TO HEAD OF HOUSEHOLD CODES FOR Q. 9: EDUCATION

01 = HEAD 07 = PARENT-IN-LAW LEVEL GRADE

02 = WIFE OR HUSBAND 08 = BROTHER OR SISTER 0 = PRE-PRIMARY 00 = LESS THAN 1 YEAR COMPLETED
03 = SON OR DAUGHTER 09 = OTHER RELATIVE 1 = PRIMARY 98 = DON'T KNOW
04 = SON-IN-LAW OR 10 = ADOPTED/FOSTER/ 2 = MIDDLE
DAUGHTER-IN-LAW STEPCHILD 3 = JSS/JHS
05 = GRANDCHILD 11 = NOT RELATED 4 = SECONDARY / TECH / VOC / COMM
06 = PARENT 98 = DON'T KNOW 5 = SSS/SHS / TECH / VOC / COMM
6 = HIGHER
8 = DON'T KNOW

192 • Appendix F
 HOUSEHOLD SCHEDULE

IF AGE 3 YEARS OR OLDER

LINE USUAL RESIDENTS RELATIONSHIP SEX RESIDENCE AGE EVER ATTENDED SCHOOL ELIGI-
NO. AND VISITORS TO HEAD OF BILITY
HOUSEHOLD

1 2 3 4 5 6 7 8 9 10

Please give me the names of What is the Is Does Did How old is Has What is the highest CIRCLE
the persons who usually live relationship of (NAME) (NAME) (NAM (NAME)? (NAME) level of school (NAME) LINE
in your household and (NAME) to the male usually E) ever has attended? NUMBER
guests of the household who head of the or live stay attended OF ALL
stayed here last night, household? female? here? here school? SEE CODES BELOW WOMEN
starting with the head of the last AGE
household. night? What is the highest 15-49
grade (NAME)
completed at that level?

AFTER LISTING THE SEE CODES BELOW

NAMES AND RECORDING RECORD
THE RELATIONSHIP IN COMP-
AND SEX FOR EACH LETED
PERSON, ASK YEARS
QUESTIONS 2A-2C
TO BE SURE THAT THE
LISTING IS COMPLETE.
IF 95
THEN ASK APPROPRIATE OR MORE,
QUESTIONS IN COLUMNS SEE CODES RECORD
5-9 FOR EACH PERSON. BELOW. '95'.

M F Y N Y N IN YEARS Y N LEVEL GRADE

11 1 2 1 2 1 2 1 2 11

GO TO 10

1 2 1 2 1 2 1 2
12 12
GO TO 10

1 2 1 2 1 2 1 2
13 13
GO TO 10

1 2 1 2 1 2 1 2
14 14
GO TO 10

1 2 1 2 1 2 1 2
15 15
GO TO 10

1 2 1 2 1 2 1 2
16 16
GO TO 10

1 2 1 2 1 2 1 2
17 17
GO TO 10

1 2 1 2 1 2 1 2
18 18
GO TO 10

1 2 1 2 1 2 1 2
19 19
GO TO 10

1 2 1 2 1 2 1 2
20 20
GO TO 10

TICK HERE IF CONTINUATION SHEET USED

CODES FOR Q. 3: RELATIONSHIP TO HEAD OF HOUSEHOLD CODES FOR Q. 9: EDUCATION

01 = HEAD 07 = PARENT-IN-LAW LEVEL GRADE

02 = WIFE OR HUSBAND 08 = BROTHER OR SISTER 0 = PRE-PRIMARY 00 = LESS THAN 1 YEAR COMPLETED
03 = SON OR DAUGHTER 09 = OTHER RELATIVE 1 = PRIMARY 98 = DON'T KNOW
04 = SON-IN-LAW OR 10 = ADOPTED/FOSTER/ 2 = MIDDLE
DAUGHTER-IN-LAW STEPCHILD 3 = JSS/JHS
05 = GRANDCHILD 11 = NOT RELATED 4 = SECONDARY / TECH / VOC / COMM
06 = PARENT 98 = DON'T KNOW 5 = SSS/SHS / TECH / VOC / COMM
6 = HIGHER
8 = DON'T KNOW

Appendix F • 193
 HOUSEHOLD CHARACTERISTICS
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP
101 What is the main source of drinking water for members PIPED WATER
of your household? PIPED INTO DWELLING . . . . . . . . . . . . . . . . 11
PIPED TO YARD/PLOT . . . . . . . . . . . . . . . . . . 12 105
PIPED TO NEIGHBOR . . . . . . . . . . . . . . . . . . 13
PUBLIC TAP/STANDPIPE . . . . . . . . . . . . . . . . 14

TUBE WELL OR BOREHOLE . . . . . . . . . . . . . . . . 21

DUG WELL
PROTECTED WELL . . . . . . . . . . . . . . . . . . . . . 31
UNPROTECTED WELL . . . . . . . . . . . . . . . . . . 32
WATER FROM SPRING
PROTECTED SPRING . . . . . . . . . . . . . . . . . . 41 103
UNPROTECTED SPRING . . . . . . . . . . . . . . . . 42

RAINWATER ........................... 51
TANKER TRUCK ........................ 61
CART WITH SMALL TANK . . . . . . . . . . . . . . . . . . 71
SURFACE WATER (RIVER/DAM/
LAKE/POND/STREAM/CANAL/
IRRIGATION CHANNEL) . . . . . . . . . . . . . . . . 81
BOTTLED WATER . . . . . . . . . . . . . . . . . . . . . . . . 91
SACHET WATER . . . . . . . . . . . . . . . . . . . . . . . . 92

OTHER 96 103
(SPECIFY)

102 What is the main source of water used by your PIPED WATER
household for other purposes such as cooking and PIPED INTO DWELLING . . . . . . . . . . . . . . . . 11
handwashing? PIPED TO YARD/PLOT . . . . . . . . . . . . . . . . . . 12 105
PIPED TO NEIGHBOR . . . . . . . . . . . . . . . . . . 13
PUBLIC TAP/STANDPIPE . . . . . . . . . . . . . . . . 14

TUBE WELL OR BOREHOLE . . . . . . . . . . . . . . . . 21

DUG WELL
PROTECTED WELL . . . . . . . . . . . . . . . . . . . . . 31
UNPROTECTED WELL . . . . . . . . . . . . . . . . . . 32
WATER FROM SPRING
PROTECTED SPRING . . . . . . . . . . . . . . . . . . 41
UNPROTECTED SPRING . . . . . . . . . . . . . . . . 42

RAINWATER ........................... 51
TANKER TRUCK ........................ 61
CART WITH SMALL TANK . . . . . . . . . . . . . . . . . . 71
SURFACE WATER (RIVER/DAM/
LAKE/POND/STREAM/CANAL/
IRRIGATION CHANNEL) . . . . . . . . . . . . . . . . 81

OTHER 96
(SPECIFY)

103 Where is that water source located? IN OWN DWELLING ..................... 1

105
IN OWN YARD/PLOT . . . . . . . . . . . . . . . . . . . . . 2
ELSEWHERE ........................... 3

104 How long does it take to go there, get water, and come
back? MINUTES . . . . . . . . . . . . . . . . . .

DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 998

194 • Appendix F
 HOUSEHOLD CHARACTERISTICS
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

105 What kind of toilet facility do members of your FLUSH OR POUR FLUSH TOILET
household usually use? FLUSH TO PIPED SEWER SYSTEM . . . . . . . 11
FLUSH TO MANHOLE/SEPTIC TANK . . . . . . . 12
IF NOT POSSIBLE TO DETERMINE, ASK FLUSH TO PIT LATRINE . . . . . . . . . . . . . . . . 13
PERMISSION TO OBSERVE THE FACILITY. FLUSH TO SOMEWHERE ELSE . . . . . . . . . . 14
FLUSH, DON'T KNOW WHERE . . . . . . . . . . 15
PIT LATRINE
VENTILATED IMPROVED PIT LATRINE . . . . . 21
PIT LATRINE WITH SLAB . . . . . . . . . . . . . . . . 22
PIT LATRINE WITHOUT SLAB/OPEN PIT . . 23

COMPOSTING TOILET . . . . . . . . . . . . . . . . . . . . . 31
BUCKET TOILET ........................ 41
HANGING TOILET/HANGING LATRINE . . . . . . . 51
NO FACILITY/BUSH/FIELD ................ 61 108

OTHER 96
(SPECIFY)

106 Do you share this toilet facility with other households? YES ................................... 1
NO ................................... 2 108

107 Including your own household, how many households

use this toilet facility?
NO. OF HOUSEHOLDS
IF LESS THAN 10 . . . . . . . . . . . . . 0
10 OR MORE HOUSEHOLDS . . . . . . . . . . . . . . . . 95
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 98

108 What type of fuel does your household mainly use for ELECTRICITY . . . . . . . . . . . . . . . . . . . . . . . . . . . 01
cooking? LPG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 02
NATURAL GAS . . . . . . . . . . . . . . . . . . . . . . . . . . . 03
BIOGAS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 04
KEROSENE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 05
COAL, LIGNITE . . . . . . . . . . . . . . . . . . . . . . . . . . . 06
CHARCOAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 07
WOOD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 08
STRAW/SHRUBS/GRASS . . . . . . . . . . . . . . . . . . 09
AGRICULTURAL CROP RESIDUE. . . . . . . . . . . . . 10
ANIMAL DUNG . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

NO FOOD COOKED IN HOUSEHOLD. . . . . . . . . . 95

OTHER 96
(SPECIFY)

109 How many rooms in this household are used for

sleeping? ROOMS . . . . . . . . . . . . . . . . . . . . . . . .

110 Does this household own any livestock, herds, other YES ................................... 1
farm animals, or poultry? NO ................................... 2 112

111 How many of the following animals does this household

own?
IF NONE, RECORD '00'.
IF 95 OR MORE, RECORD '95'.
IF UNKNOWN, RECORD '98'.

a) Milk cows? a) MILK COWS . . . . . . . . . . . . . . . . . .

b) Other cattle? b) OTHER CATTLE . . . . . . . . . . . . . . . .

c) Horses, donkeys, or mules? c) HORSES/DONKEYS/MULES .....

d) Goats? d) GOATS .....................

e) Sheep? e) SHEEP .....................

f) Chickens or other poultry? f) CHICKENS/POULTRY . . . . . . . . . .

g) Pigs? g) PIGS . . . . . . . . . . . . . . . . . . . . . . . .

h) Rabbits? h) RABBITS . . . . . . . . . . . . . . . . . . . . .

i) Grasscutter? i) GRASSCUTTER .............

Appendix F • 195
 HOUSEHOLD CHARACTERISTICS
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

112 Does any member of your household own any YES ................................... 1
agricultural land? NO ................................... 2 114

113 How many hectares or acres or plots of agricultural

land do members of this household own? HECTARES . . . . . . . . . . 1 .

ACRES ............. 2 .

PLOTS ............. 3 .
IF 95 OR MORE HECTARES, CIRCLE '950'
IF 95 OR MORE ACRES, RECORD IN HECTARES POLES ............. 4 .
IF 95 OR MORE PLOTS, RECORD IN ACRES
IF 95 OR MORE POLES, RECORD IN PLOTS 95 OR MORE HECTARES . . . . . . . . . . . . . . . . 950
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . 998

114 Does your household have: YES NO

a) Electricity? a) ELECTRICITY . . . . . . . . . . . . . 1 2
b) A radio? b) RADIO .................. 1 2
c) A television? c) TELEVISION . . . . . . . . . . . . . . . . 1 2
d) A non-mobile telephone (landline)? d) NON-MOBILE TELEPHONE. . . . . 1 2
e) A computer/Tablet computer? e) COMPUTER . . . . . . . . . . . . . . . . 1 2
f) A refrigerator? f) REFRIGERATOR. . . . . . . . . . . . . 1 2
g) A freezer g) FREEZER. . . . . . . . . . . . . . . . . . 1 2
h) An electric generator/Invertor? h) GENERATOR. . . . . . . . . . . . . . . . 1 2
i) A washing machine? i) WASHING MACHINE . . . . . . . 1 2
j) A photo camera? (NOT ON PHONE) j) CAMERA . . . . . . . . . . . . . . . . . . 1 2
k) A video deck/DVD/VCD? k) VIDEO/DVD/VCD .......... 1 2
l) A sewing machine? l) SEWING MACHINE . . . . . . . . . . 1 2
m) A bed? m) BED . . . . . . . . . . . . . . . . . . . . . 1 2
n) A table? n) TABLE .................. 1 2
o) A chair? o) CHAIR .................. 1 2
p) A cabinet/cupboard? p) CABINET . . . . . . . . . . . . . . . . . . 1 2

115 Does any member of this household own: YES NO

a) A wrist watch? a) WRIST WATCH . . . . . . . . . . . . . 1 2
b) A mobile phone? b) MOBILE PHONE .......... 1 2
c) A bicycle? c) BICYCLE . . . . . . . . . . . . . . . . . . 1 2
d) A motorcycle or motor scooter? d) MOTORCYCLE/SCOOTER . . . . . 1 2
e) An animal-drawn cart? e) ANIMAL-DRAWN CART ..... 1 2
f) A car, bus or truck? f) CAR/TRUCK . . . . . . . . . . . . . . . . 1 2
g) A boat with a motor? g) BOAT WITH MOTOR . . . . . . . 1 2
h) A boat without a motor? h) BOAT WITHOUT MOTOR . . . . . 1 2

116 Does any member of this household have a bank YES ................................... 1
account? NO ................................... 2

196 • Appendix F
 ADDITIONAL HOUSEHOLD CHARACTERISTICS
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP
117 OBSERVE MAIN MATERIAL OF THE FLOOR OF NATURAL FLOOR
THE DWELLING. EARTH/SAND . . . . . . . . . . . . . . . . . . . . . . . . 11
DUNG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
RECORD OBSERVATION. RUDIMENTARY FLOOR
WOOD PLANKS . . . . . . . . . . . . . . . . . . . . . . . . 21
PALM/BAMBOO . . . . . . . . . . . . . . . . . . . . . . . . 22
FINISHED FLOOR
PARQUET OR POLISHED WOOD ....... 31
VINYL OR ASPHALT STRIPS . . . . . . . . . . . . . 32
CERAMIC/MARBLE/PORCELAIN
TILES/TERRAZO .................. 33
CEMENT ........................... 34
WOOLEN CARPET/SYNTHETIC CARPET . . 35
LINOLEUM/RUBBER CARPET . . . . . . . . . . . . . 36

OTHER 96
(SPECIFY)

118 OBSERVE MAIN MATERIAL OF THE ROOF OF THE NATURAL ROOFING

DWELLING. THATCH/PALM LEAF . . . . . . . . . . . . . . . . . . 11
MUD/SOD ........................... 12
RECORD OBSERVATION. RUDIMENTARY ROOFING
RUSTIC MAT ........................ 21
PALM/BAMBOO . . . . . . . . . . . . . . . . . . . . . . . . 22
WOOD PLANKS . . . . . . . . . . . . . . . . . . . . . . . . 23
CARDBOARD . . . . . . . . . . . . . . . . . . . . . . . . 24
FINISHED ROOFING
ZINC/ALUMINIUM .................. 31
WOOD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32
CALAMINE/CEMENT FIBER . . . . . . . . . . . . . 33
CERAMIC/BRICK TILES ............. 34
CEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
ROOFING SHINGLES . . . . . . . . . . . . . . . . . . 36
ASBESTOS/SLATE ROOFING SHEETS .. 37

OTHER 96
(SPECIFY)

119 OBSERVE MAIN MATERIAL OF THE EXTERIOR NATURAL WALLS

WALLS OF THE DWELLING. CANE/PALM/TRUNKS . . . . . . . . . . . . . . . . . . 11
MUD/LANDCRETE .................. 12
RECORD OBSERVATION. RUDIMENTARY WALLS
BAMBOO WITH MUD . . . . . . . . . . . . . . . . . . 21
STONE WITH MUD . . . . . . . . . . . . . . . . . . . . . 22
UNCOVERED ADOBE . . . . . . . . . . . . . . . . . . 23
PLYWOOD . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
CARDBOARD . . . . . . . . . . . . . . . . . . . . . . . . 25
REUSED WOOD ..................... 26
FINISHED WALLS
CEMENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
STONE WITH LIME/CEMENT . . . . . . . . . . . . . 32
BRICKS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
CEMENT BLOCKS . . . . . . . . . . . . . . . . . . . . . 34
COVERED ADOBE . . . . . . . . . . . . . . . . . . . . . 35
WOOD PLANKS/SHINGLES . . . . . . . . . . . . . 36

OTHER 96
(SPECIFY)

120 RECORD THE TIME INTERVIEW ENDED.

HOURS ........................

MINUTES . . . . . . . . . . . . . . . . . . . . . . . .

Appendix F • 197
 INTERVIEWER'S OBSERVATIONS
TO BE FILLED IN AFTER COMPLETING INTERVIEW

COMMENTS ABOUT INTERVIEW:

COMMENTS ON SPECIFIC QUESTIONS:

ANY OTHER COMMENTS:

SUPERVISOR'S OBSERVATIONS

198 • Appendix F
 FORMATTING DATE: 1 June 2017
ENGLISH LANGUAGE: 2 June 2017
2017 GHANA MATERNAL HEALTH SURVEY
PHASE 2 WOMAN'S QUESTIONNAIRE
GHANA STATISTICAL SERVICE

IDENTIFICATION

LOCALITY NAME

NAME OF HOUSEHOLD HEAD

REGION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DISTRICT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CLUSTER NUMBER 0
HOUSEHOLD NUMBER ...................................................................

NAME AND LINE NUMBER OF WOMAN ................................................................

INTERVIEWER VISITS

1 2 3 FINAL VISIT

DATE DAY

MONTH

YEAR 2 0 1 7
INTERVIEWER'S
NAME INT. NO.

RESULT* RESULT*

NEXT VISIT: DATE

TOTAL NUMBER
TIME OF VISITS

*RESULT CODES: 1 COMPLETED 4 REFUSED

2 NOT AT HOME 5 PARTLY COMPLETED 7 OTHER
3 POSTPONED 6 INCAPACITATED SPECIFY

LANGUAGE OF
QUESTIONNAIRE** 0 0 LANGUAGE OF
INTERVIEW**
NATIVE LANGUAGE
OF RESPONDENT**
TRANSLATOR USED
(YES = 1, NO = 2)

LANGUAGE OF
QUESTIONNAIRE** ENGLISH **LANGUAGE CODES:
00 ENGLISH 05 MOLE-DAGBANI
01 AKAN 06 GRUSI
02 GA 07 GURMA
03 EWE 08 MANDE
04 GUAN 96 OTHER
(SPECIFY)

SUPERVISOR

NAME NUMBER

Appendix F • 199
 INTRODUCTION AND CONSENT

Hello. My name is _______________________________________. I am working with the Ghana Statistical Service. We are conducting a
survey about women's health issues all over Ghana. The information we collect will help the government to plan health services. Your
household was selected for the survey. The questions usually take about 30 to 60 minutes. All of the answers you give will be confidential and
will not be shared with anyone other than members of our survey team. You don't have to be in the survey, but we hope you will agree to
answer the questions since your views are important. If I ask you any question you don't want to answer, just let me know and I will go on to
the next question or you can stop the interview at any time.

In case you need more information about the survey, you may contact the person listed on the card that has already been given to your
household.

Do you have any questions?

May I begin the interview now?

SIGNATURE OF INTERVIEWER DATE

RESPONDENT AGREES RESPONDENT DOES NOT AGREE

TO BE INTERVIEWED . . 1 TO BE INTERVIEWED . . 2 END

SECTION 1. RESPONDENT'S BACKGROUND

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

101 RECORD THE TIME INTERVIEW STARTED.

HOURS .........................

MINUTES . . . . . . . . . . . . . . . . . . . . . . . . .

102 How long have you been living continuously in (NAME

OF CURRENT CITY, TOWN OR VILLAGE OF YEARS .........................
RESIDENCE)?
ALWAYS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
105
IF LESS THAN ONE YEAR, RECORD ‘00’ YEARS. VISITOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96

103 Just before you moved here, did you live in a city, in a CITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
town, or in a rural area? TOWN .................................. 2
RURAL AREA ............................ 3

104 Before you moved here, which region did you live in? WESTERN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 01
CENTRAL ............................... 02
GREATER ACCRA . . . . . . . . . . . . . . . . . . . . . . . . . 03
VOLTA .................................. 04
EASTERN ............................... 05
ASHANTI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 06
BRONG AHAFO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 07
NORTHERN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 08
UPPER EAST ............................ 09
UPPER WEST . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
OUTSIDE OF GHANA . . . . . . . . . . . . . . . . . . . . . . . 96

105 In what month and year were you born?

MONTH .........................

DON'T KNOW MONTH . . . . . . . . . . . . . . . . . . . . . . . 98

YEAR . . . . . . . . . . . . . . . . .

DON'T KNOW YEAR . . . . . . . . . . . . . . . . . . . . . .9998

.

106 How old were you at your last birthday?

AGE IN COMPLETED YEARS . . . . . . . .
COMPARE AND CORRECT 105 AND/OR 106
IF INCONSISTENT.

107 Have you ever attended school? YES ..................................... 1

NO ..................................... 2 111

108 What is the highest level of school you attended: PRIMARY ............................... 1
primary, middle, JSS/JHS, SSS/SHS, secondary, or MIDDLE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
higher? JSS/JHS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
SECONDARY / TECH / VOC / COMM ........ 4
SSS/SHS / TECH / VOC / COMM . . . . . . . . . . . . . . 5
HIGHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

109 What is the highest grade you completed at that level?

GRADE .........................
IF COMPLETED LESS THAN ONE YEAR AT THAT
LEVEL, RECORD '00'.

200 • Appendix F
 SECTION 1. RESPONDENT'S BACKGROUND

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

110 CHECK 108:

PRIMARY, MIDDLE, JSS/JHS HIGHER
113
SSS/SHS OR SECONDARY

111 Now I would like you to read this sentence to me. CANNOT READ AT ALL . . . . . . . . . . . . . . . . . . . . . . . 1
ABLE TO READ ONLY PART OF
SHOW CARD TO RESPONDENT. THE SENTENCE . . . . . . . . . . . . . . . . . . . . . . . . . 2
ABLE TO READ WHOLE SENTENCE . . . . . . . . . . . 3
IF RESPONDENT CANNOT READ WHOLE NO CARD WITH REQUIRED
SENTENCE, LANGUAGE 4
PROBE: Can you read any part of the sentence to me? (SPECIFY LANGUAGE)
BLIND/VISUALLY IMPAIRED . . . . . . . . . . . . . . . . . 5

112 CHECK 111:

CODE '2', '3' CODE '1' OR '5'
OR '4' CIRCLED 114
CIRCLED

113 Do you read a newspaper or magazine at least once a AT LEAST ONCE A WEEK . . . . . . . . . . . . . . . . . . . . 1
week, less than once a week or not at all? LESS THAN ONCE A WEEK . . . . . . . . . . . . . . . . . 2
NOT AT ALL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

114 Do you listen to the radio at least once a week, less AT LEAST ONCE A WEEK . . . . . . . . . . . . . . . . . . . . 1
than once a week or not at all? LESS THAN ONCE A WEEK . . . . . . . . . . . . . . . . . 2
NOT AT ALL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

115 Do you watch television at least once a week, less than AT LEAST ONCE A WEEK . . . . . . . . . . . . . . . . . . . . 1
once a week or not at all? LESS THAN ONCE A WEEK . . . . . . . . . . . . . . . . . 2
NOT AT ALL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

116 Do you own a mobile telephone? YES ..................................... 1

NO ..................................... 2 118

117 Do you use your mobile phone for any financial YES ..................................... 1
transactions? NO ..................................... 2

118 Do you have an account in a bank or other financial YES ..................................... 1

institution that you yourself use? NO ..................................... 2

119 Have you ever used the internet? YES ..................................... 1

NO ..................................... 2 122

120 In the last 12 months, have you used the internet?

YES ..................................... 1
IF NECESSARY, PROBE FOR USE FROM ANY NO ..................................... 2 122
LOCATION, WITH ANY DEVICE.

121 During the last one month, how often did you use the ALMOST EVERY DAY . . . . . . . . . . . . . . . . . . . . . . . 1
internet: almost every day, at least once a week, less AT LEAST ONCE A WEEK . . . . . . . . . . . . . . . . . . . . 2
than once a week, or not at all? LESS THAN ONCE A WEEK . . . . . . . . . . . . . . . . . 3
NOT AT ALL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

122 What is your religion? CATHOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 01

ANGLICAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 02
METHODIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 03
PRESBYTERIAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . 04
PENTECOSTAL/CHARISMATIC . . . . . . . . . . . . . . 05
OTHER CHRISTIAN . . . . . . . . . . . . . . . . . . . . . . . . . 06
ISLAM .................................. 07
TRADITIONAL/SPIRITUALIST . . . . . . . . . . . . . . . . . 08
NO RELIGION . . . . . . . . . . . . . . . . . . . . . . . . . . . . 09
OTHER 96
(SPECIFY)

123 To which ethnic group do you belong? AKAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 01

GA/DANGME . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 02
EWE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 03
GUAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 04
MOLE-DAGBANI . . . . . . . . . . . . . . . . . . . . . . . . . . . . 05
GRUSI .................................. 06
GURMA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 07
MANDE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 08
OTHER 96
(SPECIFY)

Appendix F • 201
 SECTION 2. REPRODUCTION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

201 Now I would like to ask you about all the pregnancies YES .................................... 1
that you have had during your life. By this I mean all NO .................................... 2 206
the children born to you whether they were born alive
or dead, whether they are still living or not, whether
they live with you or somewhere else, and all the
pregnancies that you have had that did not result in a
live birth. I will ask about pregnancies that resulted in a
stillbirth, or that ended spontaneously in miscarriage, or
that you may have had to end early in abortion. I
understand that it is not easy to talk about children who
have died, or pregnancies that ended before full term,
but it is important that you tell us about all of them, so
that the government can develop programs to improve
maternal health.

Now I would like to ask about all the births you have
had during your life. Have you ever given birth?

202 Do you have any sons or daughters to whom you have YES .................................... 1
given birth who are now living with you? NO .................................... 2 204

203 a) How many sons live with you?

a) SONS AT HOME . . . . . . . . . . . . . . . .
b) And how many daughters live with you?
b) DAUGHTERS AT HOME ........
IF NONE, RECORD '00'.

204 Do you have any sons or daughters to whom you have YES .................................... 1
given birth who are alive but do not live with you? NO .................................... 2 206

205 a) How many sons are alive but do not live with you?
a) SONS ELSEWHERE ..........
b) And how many daughters are alive but do not live
with you? b) DAUGHTERS ELSEWHERE .....
IF NONE, RECORD '00'.

206 Have you ever given birth to a boy or girl who was born
alive but later died?
YES .................................... 1
IF NO, PROBE: Any baby who cried, who made any NO .................................... 2 207A
movement, sound, or effort to breathe, or who showed
any other signs of life even if for a very short time?

206A a) How many boys have died?

a) BOYS DEAD ................
b) And how many girls have died?
b) GIRLS DEAD ................
IF NONE, RECORD '00'.

207A Some women lose their pregnancy spontaneously, that

is they have a miscarriage.
YES .................................... 1
Have you ever had a miscarriage? That is, have you NO .................................... 2 207C
ever lost a pregnancy spontaneously?

207B How many miscarriages have you had in your lifetime?

MISCARRIAGES ................

202 • Appendix F
 SECTION 2. REPRODUCTION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

207C Women sometimes take steps to end their pregnancy,

because they find themselves pregnant when they do
not want to be, or when it is difficult for them to YES .................................... 1
continue with their pregnancy because of opposition NO .................................... 2 207E
from their husband, partner, relatives or others.

Have you ever been in a situation when you or

someone else have had to do something to end your
pregnancy?

207D How many pregnancies have ended this way in your

lifetime? ABORTIONS . . . . . . . . . . . . . . . . . . . . . .

207E Some women have stillbirths, that is, they give birth in
late pregnancy to a dead child.
YES .................................... 1
Have you ever had a still birth? NO .................................... 2 208A

207F How many stillbirths have you had in your lifetime?

STILLBIRTHS ...................

208A SUM ANSWERS TO 203, 205, AND 206A AND

ENTER TOTAL. IF NONE, RECORD '00'. TOTAL LIVE BIRTHS .............

208B SUM ANSWERS TO 203, 205, 206A, 207B, 207D, TOTAL PREGNANCY
AND 207F AND ENTER TOTAL. IF NONE, RECORD OUTCOMES . . . . . . . . . . . . . . . . . . . . . .

208C SUM ANSWERS TO 207B, 207D, AND 207F AND TOTAL PREGNANCIES
ENTER TOTAL. IF NONE, RECORD '00'. WITH NO LIVE BIRTH . . . . . . . . . . . . .

209 CHECK 208A AND 208C:

Just to make sure that I have this right: you have had in TOTAL _____ births and _____ other pregnancies during
your life. Is that correct?

YES NO

PROBE AND CORRECT

201-208C AS
NECESSARY.

210 CHECK 208B:

ONE OR MORE NO PREGNANCIES 226
PREGNANCIES

Appendix F • 203
 SECTION 2. REPRODUCTION

211 Now I would like to record all your pregnancies, whether born alive, born dead, or lost before full term, starting with the first one
you had.
RECORD ALL PREGNANCIES IN 212-221. RECORD TWINS AND TRIPLETS ON SEPARATE LINES.
IF THERE ARE MORE THAN 10 PREGNANCIES, USE AN ADDITIONAL QUESTIONNAIRE, STARTING WITH THE
SECOND ROW.

212 212A 212B 212C 212D 213 215 216

PREG- Think back Was that a Was the baby born Did that Is (NAME) On what day, Is (NAME)
NANCY to your single or alive, born dead, or baby cry, a boy or a month, and year still alive?
HISTORY (first/next) multiple did you have a move, or girl? was (NAME)
LINE pregnancy. pregnancy? miscarriage or breathe born?
NUMBER abortion? when it was
What name born? PROBE: When
was given is his/her
to the child? birthday?

RECORD
NAME

01 BORN ALIVE 1
DAY
SING 1 (SKIP TO 213) YES 1 BOY 1 YES 1
BORN DEAD 2
MONTH
MULT 2 NO 2 GIRL 2 NO 2
NAME MISCARR. 3
(SKIP TO 220AB) (SKIP TO (SKIP TO
ABORTION 4 220AB) YEAR 220)

02 BORN ALIVE 1
DAY
SING 1 (SKIP TO 213) YES 1 BOY 1 YES 1

MONTH
MULT 2 BORN DEAD 2 NO 2 GIRL 2 NO 2
NAME MISCARR. 3
(SKIP TO 220AB) (SKIP TO (SKIP TO
ABORTION 4 220AB) YEAR 220)

03 BORN ALIVE 1
DAY
SING 1 (SKIP TO 213) YES 1 BOY 1 YES 1

MONTH
MULT 2 BORN DEAD 2 NO 2 GIRL 2 NO 2
NAME MISCARR. 3
(SKIP TO 220AB) (SKIP TO (SKIP TO
ABORTION 4 220AB) YEAR 220)

04 BORN ALIVE 1
DAY
SING 1 (SKIP TO 213) YES 1 BOY 1 YES 1

MONTH
MULT 2 BORN DEAD 2 NO 2 GIRL 2 NO 2
NAME MISCARR. 3
(SKIP TO 220AB) (SKIP TO (SKIP TO
ABORTION 4 220AB) YEAR 220)

05 BORN ALIVE 1
DAY
SING 1 (SKIP TO 213) YES 1 BOY 1 YES 1

MONTH
MULT 2 BORN DEAD 2 NO 2 GIRL 2 NO 2
NAME MISCARR. 3
(SKIP TO 220AB) (SKIP TO (SKIP TO
ABORTION 4 220AB) YEAR 220)

204 • Appendix F
 217 220 220AA 220AB 220AC 220AD 221
STILL ALIVE IF BORN ALIVE AND NOW DEAD: IF BORN DEAD OR LOST BEFORE BIRTH

How old was How old was (NAME) when On what day, On what day, How many Did you Were there
(NAME) at (he/she) died? month, and year month, and year months did or any other
(NAME)'s last did (NAME) die? did this pregnancy this someone pregnancies
birthday? IF '12 MONTHS' OR '1 YR', end? pregnancy else do between
ASK: Did (NAME) have last? something the
(his/her) first birthday? to end previous
this preg- pregnancy
THEN ASK: Exactly how nancy? and this
many months old was (NAME) pregnancy?
when (he/she) died?

RECORD AGE IN RECORD DAYS IF LESS RECORD

COMPLETED THAN 1 MONTH; MONTHS IF IN COMP-
YEARS LESS THAN TWO YEARS; LETED
OR YEARS. MONTHS.

AGE IN
DAYS 1 DAY DAY
YEARS MONTHS YES 1

MONTHS 2 MONTH MONTH

NO 2

YEARS 3
(NEXT
PREGNANCY) (NEXT PREGNANCY) YEAR

AGE IN YES 1
DAYS 1 DAY DAY
YEARS MONTHS YES 1
(ADD
PREGNANCY)
MONTHS 2 MONTH MONTH
NO 2
NO 2
YEARS 3
(NEXT
(SKIP TO 221)
(GO TO 221) YEAR PREGNANCY)

AGE IN YES 1
DAYS 1 DAY DAY
YEARS MONTHS YES 1
(ADD
PREGNANCY)
MONTHS 2 MONTH MONTH
NO 2
NO 2
YEARS 3
(NEXT
(SKIP TO 221)
(GO TO 221) YEAR PREGNANCY)

AGE IN YES 1
DAYS 1 DAY DAY
YEARS MONTHS YES 1
(ADD
PREGNANCY)
MONTHS 2 MONTH MONTH
NO 2
NO 2
YEARS 3
(NEXT
(SKIP TO 221)
(GO TO 221) YEAR PREGNANCY)

AGE IN YES 1
DAYS 1 DAY DAY
YEARS MONTHS YES 1
(ADD
PREGNANCY)
MONTHS 2 MONTH MONTH
NO 2
NO 2
YEARS 3
(NEXT
(SKIP TO 221)
(GO TO 221) YEAR PREGNANCY)

Appendix F • 205
 SECTION 2. REPRODUCTION

211 Now I would like to record all your pregnancies, whether born alive, born dead, or lost before full term, starting with the first one
you had.
RECORD ALL PREGNANCIES IN 212-221. RECORD TWINS AND TRIPLETS ON SEPARATE LINES.
IF THERE ARE MORE THAN 10 PREGNANCIES, USE AN ADDITIONAL QUESTIONNAIRE, STARTING WITH THE
SECOND ROW.

212 212A 212B 212C 212D 213 215 216

PREG- Think back Was that a Was the baby born Did that Is (NAME) On what day, Is (NAME)
NANCY to your single or alive, born dead, or baby cry, a boy or a month, and year still alive?
HISTORY (first/next) multiple did you have a move, or girl? was (NAME)
LINE pregnancy. pregnancy? miscarriage or breathe born?
NUMBER abortion? when it was
What name born? PROBE: When
was given is his/her
to the child? birthday?

RECORD
NAME

06 BORN ALIVE 1
DAY
SING 1 (SKIP TO 213) YES 1 BOY 1 YES 1

MONTH
MULT 2 BORN DEAD 2 NO 2 GIRL 2 NO 2
NAME MISCARR. 3
(SKIP TO 220AB) (SKIP TO (SKIP TO
ABORTION 4 220AB) YEAR 220)

07 BORN ALIVE 1
DAY
SING 1 (SKIP TO 213) YES 1 BOY 1 YES 1

MONTH
MULT 2 BORN DEAD 2 NO 2 GIRL 2 NO 2
NAME MISCARR. 3
(SKIP TO 220AB) (SKIP TO (SKIP TO
ABORTION 4 220AB) YEAR 220)

08 BORN ALIVE 1
DAY
SING 1 (SKIP TO 213) YES 1 BOY 1 YES 1

MONTH
MULT 2 BORN DEAD 2 NO 2 GIRL 2 NO 2
NAME MISCARR. 3
(SKIP TO 220AB) (SKIP TO (SKIP TO
ABORTION 4 220AB) YEAR 220)

09 BORN ALIVE 1
DAY
SING 1 (SKIP TO 213) YES 1 BOY 1 YES 1

MONTH
MULT 2 BORN DEAD 2 NO 2 GIRL 2 NO 2
NAME MISCARR. 3
(SKIP TO 220AB) (SKIP TO (SKIP TO
ABORTION 4 220AB) YEAR 220)

10 BORN ALIVE 1
DAY
SING 1 (SKIP TO 213) YES 1 BOY 1 YES 1

MONTH
MULT 2 BORN DEAD 2 NO 2 GIRL 2 NO 2
NAME MISCARR. 3
(SKIP TO 220AB) (SKIP TO (SKIP TO
ABORTION 4 220AB) YEAR 220)

206 • Appendix F
 217 220 220AA 220AB 220AC 220AD 221
STILL ALIVE IF BORN ALIVE AND NOW DEAD: IF BORN DEAD OR LOST BEFORE BIRTH

How old was How old was (NAME) when On what day, On what day, How many Did you Were there
(NAME) at (he/she) died? month, and year month, and year months did or any other
(NAME)'s last did (NAME) die? did this pregnancy this someone pregnancies
birthday? IF '12 MONTHS' OR '1 YR', end? pregnancy else do between
ASK: Did (NAME) have last? something the
(his/her) first birthday? to end previous
this preg- pregnancy
THEN ASK: Exactly how nancy? and this
many months old was (NAME) pregnancy?
when (he/she) died?

RECORD AGE IN RECORD DAYS IF LESS RECORD

COMPLETED THAN 1 MONTH; MONTHS IF IN COMP-
YEARS LESS THAN TWO YEARS; LETED
OR YEARS. MONTHS.

AGE IN YES 1
DAYS 1 DAY DAY
YEARS MONTHS YES 1
(ADD
PREGNANCY)
MONTHS 2 MONTH MONTH
NO 2
NO 2
YEARS 3
(NEXT
(SKIP TO 221)
(GO TO 221) YEAR PREGNANCY)

AGE IN YES 1
DAYS 1 DAY DAY
YEARS MONTHS YES 1
(ADD
PREGNANCY)
MONTHS 2 MONTH MONTH
NO 2
NO 2
YEARS 3
(NEXT
(SKIP TO 221)
(GO TO 221) YEAR PREGNANCY)

AGE IN YES 1
DAYS 1 DAY DAY
YEARS MONTHS YES 1
(ADD
PREGNANCY)
MONTHS 2 MONTH MONTH
NO 2
NO 2
YEARS 3
(NEXT
(SKIP TO 221)
(GO TO 221) YEAR PREGNANCY)

AGE IN YES 1
DAYS 1 DAY DAY
YEARS MONTHS YES 1
(ADD
PREGNANCY)
MONTHS 2 MONTH MONTH
NO 2
NO 2
YEARS 3
(NEXT
(SKIP TO 221)
(GO TO 221) YEAR PREGNANCY)

AGE IN YES 1
DAYS 1 DAY DAY
YEARS MONTHS YES 1
(ADD
PREGNANCY)
MONTHS 2 MONTH MONTH
NO 2
NO 2
YEARS 3
(NEXT
(SKIP TO 221)
(GO TO 221) YEAR PREGNANCY)

Appendix F • 207
 SECTION 2. REPRODUCTION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

222 Have you had any pregnancies since the last YES .................................... 1
pregnancy mentioned? (RECORD PREGNANCY(IES) IN TABLE)
NO .................................... 2

223 COMPARE 208B WITH NUMBER OF PREGNANCIES IN PREGNANCY HISTORY

NUMBERS NUMBERS ARE
ARE SAME DIFFERENT

(PROBE AND RECONCILE)

224A CHECK 220AB AND 220AD: ENTER THE NUMBER NUMBER OF ABORTIONS
OF PREGNANCIES THAT RESPONDENT OR IN 2012-2017 .........................
SOMEONE ELSE DID SOMETHING TO END (220AD
= 1) IN 2012-2017 AND ENTER THE YEAR OF MOST NONE IN 2012-2017 ...................... 0
RECENT ABORTION BETWEEN 2012-2017
YEAR OF MOST RECENT
ABORTION . . . . . . . . . .

NONE IN 2012-2017 ...................... 0

224B CHECK 220AB, 220AC, AND 220AD: ENTER THE NUMBER OF MISCARRIAGES
NUMBER OF PREGNANCIES ENDED BEFORE FULL IN 2012-2017 .........................
TERM THAT LASTED 6 MONTHS OR LESS (220AC
<7), AND THAT RESPONDENT OR SOMEONE ELSE NONE IN 2012-2017 ...................... 0
DID NOT DO SOMETHING TO END (220AD = 2) IN
2012-2017 AND ENTER THE YEAR OF MOST YEAR OF MOST RECENT
RECENT MISCARRIAGE BETWEEN 2012-2017 MISCARRIAGE . . . . . . . .

NONE IN 2012-2017 ...................... 0

224C CHECK 215: ENTER THE NUMBER OF BIRTHS IN

2012-2017 NUMBER OF BIRTHS ...................

NONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0

224D CHECK 220AB, 220AC, AND 220AD: ENTER THE

NUMBER OF PREGNANCIES ENDED BEFORE FULL NUMBER OF STILLBIRTHS .............
TERM THAT LASTED 7 MONTHS OR MORE (220AC
>=7), AND THAT RESPONDENT OR SOMEONE
ELSE DID NOT DO SOMETHING TO END (220AD =
2) IN 2012-2017 NONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0

226 Are you pregnant now? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
230
UNSURE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

227 How many months pregnant are you?

MONTHS . . . . . . . . . . . . . . . . . . . . . . . . .
RECORD NUMBER OF COMPLETED MONTHS.

228 When you got pregnant, did you want to get pregnant YES .................................... 1 230
at that time? NO .................................... 2

229 CHECK 208A: TOTAL NUMBER OF BIRTHS

ONE OR MORE NONE
a) Did you want to have a b) Did you want to have a
baby later on or did baby later on or did LATER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
you not want any more you not want any NO MORE/NONE . . . . . . . . . . . . . . . . . . . . . . . . . 2
children? children?

208 • Appendix F
 SECTION 2. REPRODUCTION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

230 When did your last menstrual period start?

DAYS AGO ............. 1

WEEKS AGO ............. 2

MONTHS AGO ............. 3

(DATE, IF GIVEN) YEARS AGO ............. 4

IN MENOPAUSE/
HAS HAD HYSTERECTOMY .......... 994

BEFORE LAST BIRTH . . . . . . . . . . . . . . . . . . . 995

NEVER MENSTRUATED ................ 996

231 From one menstrual period to the next, are there YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
certain days when a woman is more likely to become NO .................................... 2
233
pregnant? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

232 Is this time just before her period begins, during her JUST BEFORE HER PERIOD BEGINS . . . . . . . . 1
period, right after her period has ended, or halfway DURING HER PERIOD . . . . . . . . . . . . . . . . . . . . . . 2
between two periods? RIGHT AFTER HER PERIOD HAS ENDED . . . . . 3
HALFWAY BETWEEN TWO PERIODS . . . . . . . . 4

OTHER 6
(SPECIFY)
DON'T KNOW ........................... 8

233 After the birth of a child, can a woman become YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

pregnant before her menstrual period has returned? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Appendix F • 209
 SECTION 3. CONTRACEPTION

301

01 Now I would like to talk about family planning - the various ways or YES ................................ 1
methods that a couple can use to delay or avoid a pregnancy. Have NO ................................ 2
you ever heard of (METHOD)?

Female Sterilization.
PROBE: Women can have an operation to avoid having any more
children.

02 Male Sterilization. YES ................................ 1

PROBE: Men can have an operation to avoid having any more NO ................................ 2
children.

03 IUD. YES ................................ 1

PROBE: Women can have a loop or coil placed inside them by a NO ................................ 2
doctor or a nurse which can prevent pregnancy for one or more years.

04 Injectables. YES ................................ 1

PROBE: Women can have an injection by a health provider that NO ................................ 2
stops them from becoming pregnant for one or more months.

05 Implants. YES ................................ 1

PROBE: Women can have one or more small rods placed in their NO ................................ 2
upper arm by a doctor or nurse which can prevent pregnancy for one
or more years.

06 Pill. YES ................................ 1

PROBE: Women can take a pill every day to avoid becoming NO ................................ 2
pregnant.

07 Condom. YES ................................ 1

PROBE: Men can put a rubber sheath on their penis before sexual NO ................................ 2
intercourse.

08 Female Condom. YES ................................ 1

PROBE: Women can place a sheath in their vagina before sexual NO ................................ 2
intercourse.

09 Emergency Contraception. YES ................................ 1

PROBE: As an emergency measure, within three to five days after NO ................................ 2
they have unprotected sexual intercourse, women can take special
pills to prevent pregnancy.

10 Lactational Amenorrhea Method (LAM).

PROBE: Up to six months after childbirth, before the menstrual YES ................................ 1
period has returned, women use a method requiring frequent NO ................................ 2
breastfeeding day and night.

11 Rhythm Method. YES ................................ 1

PROBE: To avoid pregnancy, women do not have sexual intercourse NO ................................ 2
on the days of the month they think they can get pregnant.

12 Withdrawal. YES ................................ 1

PROBE: Men can be careful and pull out before climax. NO ................................ 2

13 Have you heard of any other ways or methods that women or men YES, MODERN METHOD
can use to avoid pregnancy?
A
(SPECIFY)
YES, TRADITIONAL METHOD

B
(SPECIFY)
NO ................................ Y

210 • Appendix F
 SECTION 3. CONTRACEPTION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

302 CHECK 226:

NOT PREGNANT PREGNANT
305
OR UNSURE

303 Are you or your partner currently doing something or YES .................................... 1
using any method to delay or avoid getting pregnant? NO .................................... 2 305

304 Which method are you using? FEMALE STERILIZATION . . . . . . . . . . . . . . . . . . . A

MALE STERILIZATION . . . . . . . . . . . . . . . . . . . . . . B
IUD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C
RECORD ALL MENTIONED. INJECTABLES . . . . . . . . . . . . . . . . . . . . . . . . . . . D
IMPLANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E
PILL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F 401
CONDOM .............................. G
FEMALE CONDOM . . . . . . . . . . . . . . . . . . . . . . . . . H
DIAPHRAGM ........................... I
FOAM/JELLY ........................... J
EMERGENCY CONTRACEPTION . . . . . . . . . . . . . K
LACTATIONAL AMENORRHEA METHOD ..... L
RHYTHM METHOD . . . . . . . . . . . . . . . . . . . . . . . . . M
WITHDRAWAL . . . . . . . . . . . . . . . . . . . . . . . . . . . N
OTHER MODERN METHOD . . . . . . . . . . . . . . . . X 401
OTHER TRADITIONAL METHOD . . . . . . . . . . . . . Y

305 Do you know of a place where you can obtain a YES .................................... 1
method of family planning? NO .................................... 2 401

306 Where is that? PUBLIC SECTOR

GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . A
Any other place? GOVT HEALTH CENTER/CLINIC . . . . . . . . . . B
GOVT HEALTH POST/CHPS . . . . . . . . . . . . . C
PROBE TO IDENTIFY EACH TYPE OF SOURCE MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . D
AND CIRCLE THE APPROPRIATE CODE(S). FAMILY PLANNING CLINIC ............. E
FIELDWORKER . . . . . . . . . . . . . . . . . . . . . . . . . F
OTHER PUBLIC SECTOR G

(SPECIFY)

PROBE TO IDENTIFY THE TYPE OF SOURCE. PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC . . . . . . . . . . . . . H
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE PRIVATE DOCTOR . . . . . . . . . . . . . . . . . . . . . . I
SECTOR, WRITE THE NAME OF THE PLACE. MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . J
PHARMACY/CHEMIST/
DRUG STORE . . . . . . . . . . . . . . . . . . . . . . K
(NAME OF PLACE) FIELDWORKER . . . . . . . . . . . . . . . . . . . . . . . . . L
FP/PPAG CLINIC ...................... M
MATERNITY HOME . . . . . . . . . . . . . . . . . . . . . . N
OTHER PRIVATE MED SECTOR O

(SPECIFY)

OTHER SOURCE
SHOP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . P
CHURCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Q
FRIEND/RELATIVE . . . . . . . . . . . . . . . . . . . . . . R

OTHER X
(SPECIFY)

Appendix F • 211
 SECTION 4. PREGNANCY AND POSTNATAL CARE

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

401 CHECK 224C AND 224D: NO BIRTHS OR
ONE OR MORE BIRTHS IN ONE OR MORE STILLBIRTHS STILLBIRTHS IN
2012-2017 IN 2012-2017 2012-2017 500

402 CHECK 215, 220AB, 220AC, AND 220AD. RECORD THE PREGNANCY HISTORY NUMBER IN 403 AND THE NAME AND
SURVIVAL STATUS IN 404 FOR THE MOST RECENT LIVE BIRTH OR STILLBIRTH IN 2012-2017. IF THERE WAS MORE THAN
ONE BIRTH OR STILLBIRTH SINCE 2012, ASK ONLY ABOUT THE LAST (MOST RECENT) BIRTH OR STILLBIRTH.

403 PREGNANCY HISTORY NUMBER FROM 212 IN MOST RECENT BIRTH OR STILLBIRTH
PREGNANCY HISTORY.
PREGNANCY HISTORY
NUMBER . . . . . . . . . . . . . . . . . . . . . . . . .

404 FROM 212, 212A, AND 216: NAME

USE 'BABY' IF NO NAME IS PROVIDED. STILLBIRTH BIRTH BIRTH

(LIVING) (DEAD)

405 Now I would like to ask some questions about the YES .................................... 1 407
health care you received when you were pregnant with NO .................................... 2
(NAME) and after the birth of (NAME).

Did you see anyone for antenatal care for this

pregnancy?

406 Why did you not see anyone? NOT NECESSARY . . . . . . . . . . . . . . . . . . . . . . . . . A

NOT CUSTOMARY . . . . . . . . . . . . . . . . . . . . . . . . . B
PROBE: Any other reason? LACK OF MONEY . . . . . . . . . . . . . . . . . . . . . . . . . C
TOO FAR .............................. D
RECORD ALL MENTIONED. TRANSPORTATION PROBLEM . . . . . . . . . . . . . E
NO ONE TO ACCOMPANY ................ F
GOOD SERVICE NOT AVAILABLE .......... G
NOT PERMITTED BY FAMILY . . . . . . . . . . . . . . . . H 414
BETTER SERVICE AT HOME . . . . . . . . . . . . . . . . I
DID NOT KNOW WHERE TO GO . . . . . . . . . . . . . J
NO FEMALE DOCTOR AVAILABLE . . . . . . . . . . K
INCONVENIENT SERVICE HOUR . . . . . . . . . . . . . L
AFRAID TO GO . . . . . . . . . . . . . . . . . . . . . . . . . . . M
LONG WAITING TIME . . . . . . . . . . . . . . . . . . . . . . N
RELIGIOUS REASON . . . . . . . . . . . . . . . . . . . . . . O
OTHER X
(SPECIFY)

407 Whom did you see? HEALTH PERSONNEL

DOCTOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A
Anyone else? NURSE/MIDWIFE . . . . . . . . . . . . . . . . . . . . . . B
COM. HEALTH OFFICER/NURSE . . . . . . . . . . C
PROBE TO IDENTIFY EACH TYPE OF PERSON AND
RECORD ALL MENTIONED. OTHER PERSON
TRADITIONAL BIRTH ATTENDANT . . . . . . . . D
VILLAGE HEALTH VOLUNTEER . . . . . . . . . . E
TRADITIONAL HEALTH
PRACTITIONER . . . . . . . . . . . . . . . . . . . . . . F
OTHER X
(SPECIFY)

212 • Appendix F
 SECTION 4. PREGNANCY AND POSTNATAL CARE

MOST RECENT BIRTH OR STILLBIRTH

NO. QUESTIONS AND FILTERS NAME

408 Where did you receive antenatal care for this HOME
pregnancy? HER HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . A
OTHER HOME . . . . . . . . . . . . . . . . . . . . . . . . . B
Anywhere else?
PUBLIC SECTOR
GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . C
PROBE TO IDENTIFY THE TYPE OF SOURCE. GOVT HEALTH CENTER/CLINIC . . . . . . . . . . D
GOVT HEALTH POST/CHPS . . . . . . . . . . . . . E
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . F
OTHER PUBLIC SECTOR G

IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE (SPECIFY)

SECTOR, WRITE THE NAME OF THE PLACE.
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC . . . . . . . . . . . . . H
FP/PPAG CLINIC ...................... I
(NAME OF PLACE) MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . J
MATERNITY HOME . . . . . . . . . . . . . . . . . . . . . . K
OTHER PRIVATE MED SECTOR L

(SPECIFY)

OTHER X
(SPECIFY)

409 How many months pregnant were you when you first
received antenatal care for this pregnancy? MONTHS . . . . . . . . . . . . . . . . . . . . . . . . .

DON'T KNOW ........................... 98

410 The very first time you went for antenatal care when PROBLEM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
you were pregnant with (NAME), did you go because of JUST CHECKUP ......................... 2 412
problems with the pregnancy or just for a checkup?

411 What problems did you have when you first went for HEADACHE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A
antenatal care when you were pregnant with (NAME)? BLURRY VISION ......................... B
EDEMA/PRE-ECLAMPSIA . . . . . . . . . . . . . . . . . . . C
PROBE: Anything else? VAGINAL BLEEDING . . . . . . . . . . . . . . . . . . . . . . D
CONVULSIONS/ECLAMPSIA . . . . . . . . . . . . . . . . E
CIRCLE ALL MENTIONED. TETANUS .............................. F
FOUL-SMELLING DISCHARGE . . . . . . . . . . . . . G
LOWER ABDOMINAL PAIN ................ H
FELL DOWN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I
BABY MOVEMENT WAS LOW ............. J
VARICOSE VEIN ......................... K
EXCESSIVE VOMITING ................... L
OTHER X
(SPECIFY)

412 How many times did you receive antenatal care during NUMBER
this pregnancy? OF TIMES ...................

DON'T KNOW ........................... 98

413 As part of your antenatal care during this pregnancy,

were any of the following done at least once: YES NO

a) Was your blood pressure measured? a) BP . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2

b) Did you give a urine sample? b) URINE ...................... 1 2
c) Did you give a blood sample? c) BLOOD . . . . . . . . . . . . . . . . . . . . . . 1 2
d) Were you weighed? d) WEIGHT . . . . . . . . . . . . . . . . . . . . . . 1 2

413E During (any of) your antenatal care visit(s), were you YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
told about the signs of pregnancy complications? NO .................................... 2
414
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Appendix F • 213
 SECTION 4. PREGNANCY AND POSTNATAL CARE

MOST RECENT BIRTH OR STILLBIRTH

NO. QUESTIONS AND FILTERS NAME

413F Were you told where to go if you had any of these YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
complications? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

414 During this pregnancy, were you given an injection in YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

the arm to prevent the baby from getting tetanus, that NO .................................... 2
417
is, convulsions after birth? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

415 During this pregnancy, how many times did you get a
tetanus injection? TIMES ........ ......................

DON'T KNOW ........................... 8

416 CHECK 415: 2 OR MORE OTHER

TIMES

(SKIP TO 420)

417 At any time before this pregnancy, did you receive any YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
tetanus injections? NO .................................... 2
420
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

418 Before this pregnancy, how many times did you receive
a tetanus injection? TIMES ........ ......................

DON'T KNOW ........................... 8

IF 7 OR MORE TIMES, RECORD '7'.

419 CHECK 418:

ONLY MORE
ONE THAN ONE
a) How many years b) How many years ago
ago did you receive did you receive the last
that tetanus tetanus injection prior YEARS AGO . . . . . . . . . . . . . . . . . . . . . .
injection? to this pregnancy?

420 During this pregnancy, were you given or did you buy YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
any iron tablets or iron syrup? NO .................................... 2
422
SHOW TABLETS/SYRUP. DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

421 During the whole pregnancy, for how many days did
you take the tablets or syrup? DAYS . . . . . . . . . . . . . . . . . . . . . .

IF ANSWER IS NOT NUMERIC, PROBE FOR DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 998

APPROXIMATE NUMBER OF DAYS.

422 During this pregnancy, did you take any drug for YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
intestinal worms? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

423 During this pregnancy, did you take SP/Fansidar to YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

keep you from getting malaria? NO .................................... 2
426A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

424 How many times did you take SP/Fansidar during this
pregnancy? TIMES .........................

425 Did you get the SP/Fansidar during any antenatal care ANTENATAL VISIT . . . . . . . . . . . . . . . . . . . . . . . . . 1
visit, during another visit to a health facility or from ANOTHER FACILITY VISIT . . . . . . . . . . . . . . . . . . . 2
another source? OTHER SOURCE . . . . . . . . . . . . . . . . . . . . . . . . . 6
IF MORE THAN ONE SOURCE, RECORD THE
HIGHEST SOURCE ON THE LIST.

214 • Appendix F
 SECTION 4. PREGNANCY AND POSTNATAL CARE

MOST RECENT BIRTH OR STILLBIRTH

NO. QUESTIONS AND FILTERS NAME

426A CHECK 404:

LIVE BIRTH STILLBIRTH
429
(WHETHER CURRENTLY ALIVE OR DEAD)

426B When (NAME) was born, was (NAME) very large, VERY LARGE . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
larger than average, average, smaller than average, or LARGER THAN AVERAGE ................ 2
very small? AVERAGE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
SMALLER THAN AVERAGE . . . . . . . . . . . . . . . . 4
VERY SMALL ........................... 5
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

427 Was (NAME) weighed at birth? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
429
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

428 How much did (NAME) weigh?

KG FROM CARD 1 .

RECORD WEIGHT IN KILOGRAMS FROM HEALTH KG FROM RECALL 2 .

CARD, IF AVAILABLE.
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . .9998

429 Who assisted with the delivery of (NAME)? HEALTH PERSONNEL

DOCTOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A
Anyone else? NURSE/MIDWIFE . . . . . . . . . . . . . . . . . . . . . . B
COM. HEALTH OFFICER/NURSE . . . . . . . . . . C

PROBE FOR THE TYPE(S) OF PERSON(S) AND OTHER PERSON

RECORD ALL MENTIONED. TRADITIONAL BIRTH ATTENDANT . . . . . . . . D
VILLAGE HEALTH VOLUNTEER . . . . . . . . . . E
TRADITIONAL HEALTH
IF RESPONDENT SAYS NO ONE ASSISTED, PRACTITIONER . . . . . . . . . . . . . . . . . . . . . . F
PROBE TO DETERMINE WHETHER ANY ADULTS RELATIVE/FRIEND . . . . . . . . . . . . . . . . . . . . . . G
WERE PRESENT AT THE DELIVERY. OTHER X
(SPECIFY)
NO ONE ASSISTED ...................... Y

430 Where did you give birth to (NAME)? HOME

HER HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
OTHER HOME . . . . . . . . . . . . . . . . . . . . . . . . . 12

PROBE TO IDENTIFY THE TYPE OF SOURCE. PUBLIC SECTOR

GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . 21
GOVT HEALTH CENTER/CLINIC . . . . . . . . . . 22
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE GOVT HEALTH POST/CHPS . . . . . . . . . . . . . 23
SECTOR, WRITE THE NAME OF THE PLACE. MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 24
OTHER PUBLIC SECTOR 26

(SPECIFY)
431B
(NAME OF PLACE)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC . . . . . . . . . . . . . 31
FP/PPAG CLINIC ...................... 32
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 33
MATERNITY HOME . . . . . . . . . . . . . . . . . . . . . . 34
OTHER PRIVATE MED SECTOR 36

(SPECIFY)

OTHER 96
(SPECIFY)

Appendix F • 215
 SECTION 4. PREGNANCY AND POSTNATAL CARE

MOST RECENT BIRTH OR STILLBIRTH

NO. QUESTIONS AND FILTERS NAME

431A Why did you not deliver at a hospital or health centre? NOT NECESSARY . . . . . . . . . . . . . . . . . . . . . . . . . A
NOT CUSTOMARY . . . . . . . . . . . . . . . . . . . . . . . . . B
PROBE: Any other reason? LACK OF MONEY . . . . . . . . . . . . . . . . . . . . . . . . . C
TOO FAR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D
CIRCLE ALL MENTIONED. TRANSPORTATION PROBLEM . . . . . . . . . . . . . E
NO ONE TO ACCOMPANY ................ F
GOOD SERVICE NOT AVAILABLE .......... G
NOT PERMITTED BY FAMILY . . . . . . . . . . . . . . . . H 431C
BETTER SERVICE AT HOME . . . . . . . . . . . . . . . . I
DID NOT KNOW WHERE TO GO . . . . . . . . . . . . . J
NO FEMALE DOCTOR AVAILABLE . . . . . . . . . . K
INCONVENIENT SERVICE HOUR . . . . . . . . . . . . . L
AFRAID TO GO . . . . . . . . . . . . . . . . . . . . . . . . . . . M
LONG WAITING TIME . . . . . . . . . . . . . . . . . . . . . . N
RELIGIOUS REASON . . . . . . . . . . . . . . . . . . . . . . O
OTHER X
(SPECIFY)

431B Were any of the following procedures performed at the

time of delivery? YES NO

a) Instruments were used to get the baby out (forceps a) FORCEPS ................... 1 2
or vacuum?)
b) Received blood transfusion b) BLOOD TRANSFUSION ........ 1 2
c) Received intravenous fluid (IV) c) INTRAVENOUS FLUID . . . . . . . . . . 1 2

431C At any time just before, during, or after the delivery of YES .................................... 1
(NAME), did you suffer from any problems? NO .................................... 2 431N

431D What problem did you have? HEADACHE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A

BLURRY VISION ......................... B
PROBE: Anything else? EDEMA/PRE-ECLAMPSIA . . . . . . . . . . . . . . . . . . . C
EXCESSIVE BLEEDING ................... D
CIRCLE ALL MENTIONED. CONVULSIONS/ECLAMPSIA . . . . . . . . . . . . . . . . E
TETANUS .............................. F
FOUL-SMELLING DISCHARGE . . . . . . . . . . . . . G
BABY MOVEMENT WAS LOW ............. H
BABY'S HANDS/FEET CAME OUT FIRST ..... I
PROLONGED LABOUR ................... J
OBSTRUCTED LABOUR . . . . . . . . . . . . . . . . . . . K
TORN UTERUS . . . . . . . . . . . . . . . . . . . . . . . . . . . L
PLACENTA PREVIA/RETAINED . . . . . . . . . . . . . M
HIGH FEVER ........................... N
FISTULA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . O
OTHER X
(SPECIFY)

431E Did you see anyone about (this/these) problem(s)? YES .................................... 1 431G
NO .................................... 2

431F Why did you not see anyone? NOT NECESSARY . . . . . . . . . . . . . . . . . . . . . . . . . A

NOT CUSTOMARY . . . . . . . . . . . . . . . . . . . . . . . . . B
PROBE: Any other reason? LACK OF MONEY . . . . . . . . . . . . . . . . . . . . . . . . . C
TOO FAR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D
RECORD ALL MENTIONED. TRANSPORTATION PROBLEM . . . . . . . . . . . . . E
NO ONE TO ACCOMPANY ................ F
GOOD SERVICE NOT AVAILABLE .......... G
NOT PERMITTED BY FAMILY . . . . . . . . . . . . . . . . H 431N
BETTER SERVICE AT HOME . . . . . . . . . . . . . . . . I
DID NOT KNOW WHERE TO GO . . . . . . . . . . . . . J
NO FEMALE DOCTOR AVAILABLE . . . . . . . . . . K
INCONVENIENT SERVICE HOUR . . . . . . . . . . . . . L
AFRAID TO GO . . . . . . . . . . . . . . . . . . . . . . . . . . . M
LONG WAITING TIME . . . . . . . . . . . . . . . . . . . . . . N
RELIGIOUS REASON . . . . . . . . . . . . . . . . . . . . . . O
NOT LIFE THREATENING . . . . . . . . . . . . . . . . . . . P
OTHER X
(SPECIFY)

216 • Appendix F
 SECTION 4. PREGNANCY AND POSTNATAL CARE

MOST RECENT BIRTH OR STILLBIRTH

NO. QUESTIONS AND FILTERS NAME

431G Who did you see about (this/these) problem(s)? HEALTH PERSONNEL
DOCTOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A
PROBE: Anyone else? NURSE/MIDWIFE . . . . . . . . . . . . . . . . . . . . . . B
COM. HEALTH OFFICER/NURSE . . . . . . . . . . C

PROBE FOR THE TYPE(S) OF PERSON(S) AND OTHER PERSON

RECORD ALL MENTIONED. TRADITIONAL BIRTH ATTENDANT . . . . . . . . D
VILLAGE HEALTH VOLUNTEER . . . . . . . . . . E
TRADITIONAL HEALTH
PRACTITIONER . . . . . . . . . . . . . . . . . . . . . . F
RELATIVE/FRIEND . . . . . . . . . . . . . . . . . . . . . . G
OTHER X
(SPECIFY)

431H Where were you treated for (this/these) problem(s)? HOME

HER HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
OTHER HOME . . . . . . . . . . . . . . . . . . . . . . . . . 12

PROBE TO IDENTIFY THE TYPE OF SOURCE. PUBLIC SECTOR

GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . 21
GOVT HEALTH CENTER/CLINIC . . . . . . . . . . 22
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE GOVT HEALTH POST/CHPS . . . . . . . . . . . . . 23
SECTOR, WRITE THE NAME OF THE PLACE. MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 24
OTHER PUBLIC SECTOR 26

(SPECIFY)
(NAME OF PLACE)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC . . . . . . . . . . . . . 31
FP/PPAG CLINIC ...................... 32
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 33
MATERNITY HOME . . . . . . . . . . . . . . . . . . . . . . 34
OTHER PRIVATE MED SECTOR 36

(SPECIFY)

OTHER 96
(SPECIFY)

431I Did your condition improve after you were treated at NO CHANGE ........................... 1
this place? IMPROVED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
WORSENED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

431J Were you referred or told to go to another place for YES .................................... 1
treatment or advice? NO .................................... 2 431N

Appendix F • 217
 SECTION 4. PREGNANCY AND POSTNATAL CARE

MOST RECENT BIRTH OR STILLBIRTH

NO. QUESTIONS AND FILTERS NAME

431K Where were you referred or told to go for treatment or PUBLIC SECTOR
advice? GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . 21
GOVT HEALTH CENTER/CLINIC . . . . . . . . . . 22
GOVT HEALTH POST/CHPS . . . . . . . . . . . . . 23
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 24
OTHER PUBLIC SECTOR 26

IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE (SPECIFY)

SECTOR, WRITE THE NAME OF THE PLACE.
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC . . . . . . . . . . . . . 31
FP/PPAG CLINIC ...................... 32
(NAME OF PLACE) MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 33
MATERNITY HOME . . . . . . . . . . . . . . . . . . . . . . 34
OTHER PRIVATE MED SECTOR 36

(SPECIFY)

OTHER 96
(SPECIFY)

431L Did you go to the place you were referred to or told to YES .................................... 1 431N
go for treatment? NO .................................... 2

431M Why did you not go to the referred place or any other NOT NECESSARY . . . . . . . . . . . . . . . . . . . . . . . . . A
place for treatment? NOT CUSTOMARY . . . . . . . . . . . . . . . . . . . . . . . . . B
LACK OF MONEY . . . . . . . . . . . . . . . . . . . . . . . . . C
PROBE: Any other reason? TOO FAR .............................. D
TRANSPORTATION PROBLEM . . . . . . . . . . . . . E
CIRCLE ALL MENTIONED NO ONE TO ACCOMPANY ................ F
GOOD SERVICE NOT AVAILABLE .......... G
NOT PERMITTED BY FAMILY . . . . . . . . . . . . . . . . H
BETTER SERVICE AT HOME . . . . . . . . . . . . . . . . I
DID NOT KNOW WHERE TO GO . . . . . . . . . . . . . J
NO FEMALE DOCTOR AVAILABLE . . . . . . . . . . K
INCONVENIENT SERVICE HOUR . . . . . . . . . . . . . L
AFRAID TO GO . . . . . . . . . . . . . . . . . . . . . . . . . . . M
LONG WAITING TIME . . . . . . . . . . . . . . . . . . . . . . N
RELIGIOUS REASON . . . . . . . . . . . . . . . . . . . . . . O
NOT LIFE THREATENING . . . . . . . . . . . . . . . . . . . P
OTHER X
(SPECIFY)

431N CHECK 430:

ANY CODE 21 - 36 CODE 11, 12, OR 96 CIRCLED
433C
CIRCLED

432 How long after (NAME) was delivered did you stay
there? HOURS ...................... 1

DAYS . . . . . . . . . . . . . . . . . . . . . . . . . 2
IF LESS THAN ONE DAY,
RECORD HOURS; WEEKS ...................... 3
IF LESS THAN ONE WEEK,
RECORD DAYS. DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 998

433A Was (NAME) delivered by caesarean, that is, did they YES .................................... 1
cut your belly open to take the baby out? NO .................................... 2 433C

433B When was the decision made to have the caesarean BEFORE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
section? Was it before or after your labour pains AFTER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
started?

218 • Appendix F
 SECTION 4. PREGNANCY AND POSTNATAL CARE

MOST RECENT BIRTH OR STILLBIRTH

NO. QUESTIONS AND FILTERS NAME

433C CHECK 404:

LIVE BIRTH STILLBIRTH
434B
(WHETHER CURRENTLY ALIVE OR DEAD)

434 Immediately after the birth, was (NAME) put directly on YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
your chest? NO .................................... 2
434B
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

434A Was (NAME'S) bare skin touching your bare skin? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

434B CHECK 430: PLACE OF DELIVERY CODE 11, 12,

OR 96 OTHER
CIRCLED

(SKIP TO 449)

435 I would like to talk to you about checks on your health

after delivery, for example, someone asking you
questions about your health or examining you. Did YES .................................... 1
anyone check on your health while you were still in the NO .................................... 2 438A
facility?

436 How long after delivery did the first check take place?
HOURS ...................... 1

DAYS . . . . . . . . . . . . . . . . . . . . . . . . . 2
IF LESS THAN ONE DAY,
RECORD HOURS; WEEKS ...................... 3
IF LESS THAN ONE WEEK,
RECORD DAYS. DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 998

437 Who checked on your health at that time? HEALTH PERSONNEL

DOCTOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
NURSE/MIDWIFE . . . . . . . . . . . . . . . . . . . . . . 12
COM. HEALTH OFFICER/NURSE . . . . . . . . . . 13
PROBE FOR MOST QUALIFIED PERSON.
OTHER PERSON
TRADITIONAL BIRTH ATTENDANT . . . . . . . . 21
VILLAGE HEALTH VOLUNTEER . . . . . . . . . . 22
TRADITIONAL HEALTH
PRACTITIONER . . . . . . . . . . . . . . . . . . . . . . 23
OTHER 96
(SPECIFY)

438A CHECK 404:

LIVE BIRTH STILLBIRTH
441
(WHETHER CURRENTLY ALIVE OR DEAD)

438B Now I would like to talk to you about checks on

(NAME)’s health after delivery – for example, someone
examining (NAME), checking the cord, or seeing if YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
(NAME) is OK. Did anyone check on (NAME)’s health NO .................................... 2
441
while you were still in the facility? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

439 How long after delivery was (NAME)’s health first

checked? HOURS ...................... 1

DAYS . . . . . . . . . . . . . . . . . . . . . . . . . 2
IF LESS THAN ONE DAY,
RECORD HOURS; WEEKS ...................... 3
IF LESS THAN ONE WEEK,
RECORD DAYS. DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 998

Appendix F • 219
 SECTION 4. PREGNANCY AND POSTNATAL CARE

MOST RECENT BIRTH OR STILLBIRTH

NO. QUESTIONS AND FILTERS NAME

440 Who checked on (NAME)’s health at that time? HEALTH PERSONNEL

DOCTOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
NURSE/MIDWIFE . . . . . . . . . . . . . . . . . . . . . . 12
COM. HEALTH OFFICER/NURSE . . . . . . . . . . 13
PROBE FOR MOST QUALIFIED PERSON.
OTHER PERSON
TRADITIONAL BIRTH ATTENDANT . . . . . . . . 21
VILLAGE HEALTH VOLUNTEER . . . . . . . . . . 22
TRADITIONAL HEALTH
PRACTITIONER . . . . . . . . . . . . . . . . . . . . . . 23
OTHER 96
(SPECIFY)

441 Now I want to talk to you about what happened after YES .................................... 1
you left the facility. Did anyone check on your health NO .................................... 2 445A
after you left the facility?

442 How long after delivery did that check take place?
HOURS ...................... 1

DAYS . . . . . . . . . . . . . . . . . . . . . . . . . 2
IF LESS THAN ONE DAY,
RECORD HOURS; WEEKS ...................... 3
IF LESS THAN ONE WEEK,
RECORD DAYS. DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 998

443 Who checked on your health at that time? HEALTH PERSONNEL

DOCTOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
NURSE/MIDWIFE . . . . . . . . . . . . . . . . . . . . . . 12
COM. HEALTH OFFICER/NURSE . . . . . . . . . . 13
PROBE FOR MOST QUALIFIED PERSON.
OTHER PERSON
TRADITIONAL BIRTH ATTENDANT . . . . . . . . 21
VILLAGE HEALTH VOLUNTEER . . . . . . . . . . 22
TRADITIONAL HEALTH
PRACTITIONER . . . . . . . . . . . . . . . . . . . . . . 23
OTHER 96
(SPECIFY)

444 Where did the check take place? HOME

HER HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
OTHER HOME . . . . . . . . . . . . . . . . . . . . . . . . . 12

PROBE TO IDENTIFY THE TYPE OF SOURCE. PUBLIC SECTOR

GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . 21
GOVT HEALTH CENTER/CLINIC . . . . . . . . . . 22
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE GOVT HEALTH POST/CHPS . . . . . . . . . . . . . 23
SECTOR, WRITE THE NAME OF THE PLACE. MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 24
OTHER PUBLIC SECTOR 26

(SPECIFY)
(NAME OF PLACE)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC . . . . . . . . . . . . . 31
FP/PPAG CLINIC ...................... 32
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 33
MATERNITY HOME . . . . . . . . . . . . . . . . . . . . . . 34
OTHER PRIVATE MED SECTOR 36

(SPECIFY)

OTHER 96
(SPECIFY)

220 • Appendix F
 SECTION 4. PREGNANCY AND POSTNATAL CARE

MOST RECENT BIRTH OR STILLBIRTH

NO. QUESTIONS AND FILTERS NAME

445A CHECK 404:

LIVE BIRTH STILLBIRTH
500
(WHETHER CURRENTLY ALIVE OR DEAD)

445B I would like to talk to you about checks on (NAME)’s

health after you left (FACILITY IN 430). Did any health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
care provider or a traditional birth attendant check on NO .................................... 2
457
(NAME)’s health in the two months after you left DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
(FACILITY IN 430)?

446 How many hours, days or weeks after the birth of

(NAME) did that check take place? HOURS ...................... 1

DAYS . . . . . . . . . . . . . . . . . . . . . . . . . 2

IF LESS THAN ONE DAY, WEEKS ...................... 3

RECORD HOURS;
IF LESS THAN ONE WEEK, DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 998
RECORD DAYS.

447 Who checked on (NAME)’s health at that time? HEALTH PERSONNEL

DOCTOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
NURSE/MIDWIFE . . . . . . . . . . . . . . . . . . . . . . 12
COM. HEALTH OFFICER/NURSE . . . . . . . . . . 13
PROBE FOR MOST QUALIFIED PERSON.
OTHER PERSON
TRADITIONAL BIRTH ATTENDANT . . . . . . . . 21
VILLAGE HEALTH VOLUNTEER . . . . . . . . . . 22
TRADITIONAL HEALTH
PRACTITIONER . . . . . . . . . . . . . . . . . . . . . . 23
OTHER 96
(SPECIFY)

448 Where did this check of (NAME) take place? HOME

HER HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
OTHER HOME . . . . . . . . . . . . . . . . . . . . . . . . . 12

PROBE TO IDENTIFY THE TYPE OF SOURCE. PUBLIC SECTOR

GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . 21
GOVT HEALTH CENTER/CLINIC . . . . . . . . . . 22
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE GOVT HEALTH POST/CHPS . . . . . . . . . . . . . 23
SECTOR, WRITE THE NAME OF THE PLACE. MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 24
OTHER PUBLIC SECTOR 26

(SPECIFY)
457
(NAME OF PLACE)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC . . . . . . . . . . . . . 31
FP/PPAG CLINIC ...................... 32
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 33
MATERNITY HOME . . . . . . . . . . . . . . . . . . . . . . 34
OTHER PRIVATE MED SECTOR 36

(SPECIFY)

OTHER 96
(SPECIFY)

449 I would like to talk to you about checks on your health

after delivery, for example, someone asking you YES .................................... 1
questions about your health or examining you. Did NO .................................... 2 453A
anyone check on your health after you gave birth to
(NAME)?

Appendix F • 221
 SECTION 4. PREGNANCY AND POSTNATAL CARE

MOST RECENT BIRTH OR STILLBIRTH

NO. QUESTIONS AND FILTERS NAME

450 How long after delivery did the first check take place?
HOURS ...................... 1

DAYS . . . . . . . . . . . . . . . . . . . . . . . . . 2
IF LESS THAN ONE DAY,
RECORD HOURS; WEEKS ...................... 3
IF LESS THAN ONE WEEK,
RECORD DAYS. DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 998

451 Who checked on your health at that time? HEALTH PERSONNEL

DOCTOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
NURSE/MIDWIFE . . . . . . . . . . . . . . . . . . . . . . 12
COM. HEALTH OFFICER/NURSE . . . . . . . . . . 13
PROBE FOR MOST QUALIFIED PERSON.
OTHER PERSON
TRADITIONAL BIRTH ATTENDANT . . . . . . . . 21
VILLAGE HEALTH VOLUNTEER . . . . . . . . . . 22
TRADITIONAL HEALTH
PRACTITIONER . . . . . . . . . . . . . . . . . . . . . . 23
OTHER 96
(SPECIFY)

452 Where did this first check take place? HOME

HER HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
OTHER HOME . . . . . . . . . . . . . . . . . . . . . . . . . 12

PROBE TO IDENTIFY THE TYPE OF SOURCE. PUBLIC SECTOR

GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . 21
GOVT HEALTH CENTER/CLINIC . . . . . . . . . . 22
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE GOVT HEALTH POST/CHPS . . . . . . . . . . . . . 23
SECTOR, WRITE THE NAME OF THE PLACE. MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 24
OTHER PUBLIC SECTOR 26

(SPECIFY)
(NAME OF PLACE)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC . . . . . . . . . . . . . 31
FP/PPAG CLINIC ...................... 32
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 33
MATERNITY HOME . . . . . . . . . . . . . . . . . . . . . . 34
OTHER PRIVATE MED SECTOR 36

(SPECIFY)

OTHER 96
(SPECIFY)

453A CHECK 404:

LIVE BIRTH STILLBIRTH
500
(WHETHER CURRENTLY ALIVE OR DEAD)

453B I would like to talk to you about checks on (NAME)’s

health after delivery – for example, someone YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
examining (NAME), checking the cord, or seeing if NO .................................... 2
457
(NAME) is OK. In the two months after (NAME) was DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
born, did any health care provider or a traditional birth
attendant check on (NAME)'s health?

454 How many hours, days or weeks after the birth of

(NAME) did the first check take place? HOURS ...................... 1

DAYS . . . . . . . . . . . . . . . . . . . . . . . . . 2
IF LESS THAN ONE DAY,
RECORD HOURS; WEEKS ...................... 3
IF LESS THAN ONE WEEK,
RECORD DAYS. DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 998

222 • Appendix F
 SECTION 4. PREGNANCY AND POSTNATAL CARE

MOST RECENT BIRTH OR STILLBIRTH

NO. QUESTIONS AND FILTERS NAME

455 Who checked on (NAME)'s health at that time? HEALTH PERSONNEL

DOCTOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
NURSE/MIDWIFE . . . . . . . . . . . . . . . . . . . . . . 12
COM. HEALTH OFFICER/NURSE . . . . . . . . . . 13
PROBE FOR MOST QUALIFIED PERSON.
OTHER PERSON
TRADITIONAL BIRTH ATTENDANT . . . . . . . . 21
VILLAGE HEALTH VOLUNTEER . . . . . . . . . . 22
TRADITIONAL HEALTH
PRACTITIONER . . . . . . . . . . . . . . . . . . . . . . 23
OTHER 96
(SPECIFY)

456 Where did this first check of (NAME) take place? HOME
HER HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
OTHER HOME . . . . . . . . . . . . . . . . . . . . . . . . . 12

PROBE TO IDENTIFY THE TYPE OF SOURCE. PUBLIC SECTOR

GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . 21
GOVT HEALTH CENTER/CLINIC . . . . . . . . . . 22
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE GOVT HEALTH POST/CHPS . . . . . . . . . . . . . 23
SECTOR, WRITE THE NAME OF THE PLACE. MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 24
OTHER PUBLIC SECTOR 26

(SPECIFY)
(NAME OF PLACE)
PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC . . . . . . . . . . . . . 31
FP/PPAG CLINIC ...................... 32
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 33
MATERNITY HOME . . . . . . . . . . . . . . . . . . . . . . 34
OTHER PRIVATE MED SECTOR 36

(SPECIFY)

OTHER 96
(SPECIFY)

457 During the first two days after (NAME)’s birth, did any
health care provider do the following: YES NO DK

a) Examine the cord? a) CORD ................... 1 2 8

b) Measure (NAME)’s temperature? b) TEMPERATURE .......... 1 2 8
c) Counsel you on danger signs for newborns? c) SIGNS ................... 1 2 8
d) Counsel you on breastfeeding? d) COUNSEL
BREASTFEEDING . . . . . . . . 1 2 8
e) Observe (NAME) breastfeeding? e) OBSERVE
BREASTFEEDING . . . . . . . . 1 2 8

Appendix F • 223
 SECTION 5. ABORTION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

500 CHECK 224A:

ONE OR MORE ABORTIONS NO ABORTIONS
576
IN 2012-2017 IN 2012-2017

501 CHECK 224A:

YEAR OF MOST RECENT ABORTION BETWEEN 2012-2017:

502A You said your last abortion was in (YEAR FROM HEALTH OF MOTHER . . . . . . . . . . . . . . . . . . . . . . 01
Q.501). Now I would like to ask you some questions RISK OF BIRTH DEFECT . . . . . . . . . . . . . . . . . . . 02
about this pregnancy that ended in an abortion. FETUS NOT VIABLE. . . . . . . . . . . . . . . . . . . . . . . . . 03
NO MONEY TO TAKE CARE OF BABY . . . . . . . . 04
What was the main reason you decided to have this TOO YOUNG TO HAVE CHILD. . . . . . . . . . . . . . . . 05
abortion? NOT READY TO BE A MOTHER . . . . . . . . . . . . . 06
NO ONE TO HELP ME
LOOK AFTER THE CHILD . . . . . . . . . . . . . . . . 07
WANTED TO DELAY CHILDBEARING. . . . . . . . . . 08
WANTED TO SPACE CHILD . . . . . . . . . . . . . . . . 09
WANTED TO CONTINUE SCHOOLING . . . . . . . . 10
WANTED TO CONTINUE WORKING . . . . . . . . . . 11
WANTED NO MORE CHILDREN . . . . . . . . . . . . . 12
DID NOT LOVE THE FATHER . . . . . . . . . . . . . . . . 13
DID NOT WANT TO STAY
WITH THE FATHER . . . . . . . . . . . . . . . . . . . . . . 14
PARTNER DID NOT WANT CHILD/DENIED
THE PREGNANCY . . . . . . . . . . . . . . . . . . . . . . 15
FATHER OF CHILD DIED . . . . . . . . . . . . . . . . . . . 16
CHILD'S SEX ........................... 17
BECAUSE OF RAPE ...................... 18
TO AVOID SHAME . . . . . . . . . . . . . . . . . . . . . . . . . 19
AFRAID OF PARENTS . . . . . . . . . . . . . . . . . . . . . . 20
PARENTS INSISTED . . . . . . . . . . . . . . . . . . . . . . 21
OTHER 96
(SPECIFY)

502B Were there any other reasons? YES .................................... 1

NO .................................... 2 503

502C What other reasons did you have? HEALTH OF MOTHER . . . . . . . . . . . . . . . . . . . . . . A

RISK OF BIRTH DEFECT . . . . . . . . . . . . . . . . . . . B
CIRCLE ALL MENTIONED FETUS NOT VIABLE. . . . . . . . . . . . . . . . . . . . . . . . . C
NO MONEY TO TAKE CARE OF BABY . . . . . . . . D
TOO YOUNG TO HAVE CHILD. . . . . . . . . . . . . . . . E
NOT READY TO BE A MOTHER . . . . . . . . . . . . . F
NO ONE TO HELP ME
LOOK AFTER THE CHILD . . . . . . . . . . . . . . . . G
WANTED TO DELAY CHILDBEARING. . . . . . . . . . H
WANTED TO SPACE CHILD . . . . . . . . . . . . . . . . I
WANTED TO CONTINUE SCHOOLING . . . . . . . . J
WANTED TO CONTINUE WORKING . . . . . . . . . . K
WANTED NO MORE CHILDREN . . . . . . . . . . . . . L
DID NOT LOVE THE FATHER . . . . . . . . . . . . . . . . M
DID NOT WANT TO STAY
WITH THE FATHER . . . . . . . . . . . . . . . . . . . . . . N
PARTNER DID NOT WANT CHILD/DENIED
THE PREGNANCY . . . . . . . . . . . . . . . . . . . . . . O
FATHER OF CHILD DIED . . . . . . . . . . . . . . . . . . . P
CHILD'S SEX ........................... Q
BECAUSE OF RAPE ...................... R
TO AVOID SHAME . . . . . . . . . . . . . . . . . . . . . . . . . S
AFRAID OF PARENTS . . . . . . . . . . . . . . . . . . . . . . T
PARENTS INSISTED . . . . . . . . . . . . . . . . . . . . . . U
OTHER X
(SPECIFY)

224 • Appendix F
 SECTION 5. ABORTION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

503 What was the attitude of your partner toward you FAVORED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
having the abortion? OPPOSED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
NEUTRAL .............................. 3
HE DID NOT KNOW ...................... 4
DON'T KNOW/DON'T REMEMBER . . . . . . . . . . 5

504 Women sometimes take many steps to stop a YES .................................... 1

pregnancy. Did you do more than one thing to end this NO .................................... 2 533b)
pregnancy?

505 How many days or weeks was it between your first

attempt to end this pregnancy and when you actually DAYS . . . . . . . . . . . . . . . . . . . . . . 1
succeeded in stopping it?
WEEKS ................... 2
RECORD ANSWER IN UNITS GIVEN.
DON'T KNOW ......................... 998

506 What did you first do to end this pregnancy? DRANK MILK/COFFEE/ALCOHOL/OTHER LIQUID
WITH LOTS OF SUGAR ................ 11
DRANK HERBAL CONCOCTION . . . . . . . . . . . . . 12
DRANK OTHER HOME REMEDIES . . . . . . . . . . 13
USED ANY HERBAL ENEMA . . . . . . . . . . . . . . . . 14
INSERTED HERB/OBJECT/OTHER
SUBSTANCE IN THE VAGINA . . . . . . . . . . . . . 15
HEAVY MASSAGE . . . . . . . . . . . . . . . . . . . . . . . . . 16
EXCESSIVE PHYSICAL ACTIVITY .......... 17
TABLETS (EXACT KIND UNKNOWN) . . . . . . . . . . 18

CYTOTEC TABLETS (MISOPROSTOL) . . . . . . . . 21

MIFEPRISTONE + MISOPROSTOL
(MEDABON, ETC) . . . . . . . . . . . . . . . . . . . . . . 22
IV / OXYTOCIN . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

D&C / D&E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
VACUUM ASPIRATION . . . . . . . . . . . . . . . . . . . . . . 32
INJECTION IN ABDOMEN
(SALINE INSTILLATION) . . . . . . . . . . . . . . . . 33
CATHETER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
OTHER INJECTION . . . . . . . . . . . . . . . . . . . . . . . . . 35

OTHER 96
(SPECIFY)

507 Who did you see to get this first step done? HEALTH PERSONNEL
DOCTOR . . . . . . . . . . . . . . . . . . . . . . . . . . . 01
NURSE/MIDWIFE . . . . . . . . . . . . . . . . . . . . . . 02
COM. HEALTH OFFICER/NURSE . . . . . . . . 03

OTHER PERSON
PHARMACIST/CHEMICAL SELLER . . . . . . . . 04
TRADITIONAL BIRTH ATTENDANT . . . . . . . . 05
IF MORE THAN ONE PERSON WAS SEEN, CIRCLE COMMUNITY HEALTH VOLUNTEER . . . . . . . . 06
THE HIGHEST OPTION IN LIST. RELATIVE/FRIEND . . . . . . . . . . . . . . . . . . . . . . 07
TRADITIONAL PRACTITIONER . . . . . . . . . . 08

NO ONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 09
OTHER 96
(SPECIFY)

Appendix F • 225
 SECTION 5. ABORTION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

508 Where did you go to get this first step done? PUBLIC SECTOR
GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . 11
GOVT HEALTH CENTER/CLINIC . . . . . . . . . . 12
GOVT HEALTH POST/CHPS . . . . . . . . . . . . . 13
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 14
OTHER PUBLIC SECTOR
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE 16
SECTOR, WRITE THE NAME OF THE PLACE. (SPECIFY)

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC . . . . . . . . . . . . . 21
(NAME OF PLACE) FP/PPAG CLINIC ...................... 22
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 23
MATERNITY HOME . . . . . . . . . . . . . . . . . . . . . . 24
PHARMACY/CHEMIST/DRUG STORE. . . . . . . . 25
OTHER PRIVATE MEDICAL SECTOR
26
(SPECIFY)

HOME
RESPONDENT'S HOME. . . . . . . . . . . . . . . . . . . 31
OTHER HOME . . . . . . . . . . . . . . . . . . . . . . . . . 32
TBA'S HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

OTHER 96
(SPECIFY)

509A Was anything paid to get this procedure done? YES .................................... 1
NO .................................... 2 510

509B Who paid to get this procedure done? RESPONDENT . . . . . . . . . . . . . . . . . . . . . . . . . . . A

PARTNER .............................. B
PROBE: Anyone else? MOTHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C
FATHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D
CIRCLE ALL MENTIONED. OTHER FAMILY MEMBER . . . . . . . . . . . . . . . . . . . E
FRIEND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F
OTHER X
(SPECIFY)

510 Now I would like to talk about any problems that you YES .................................... 1
may have had when you had this first thing done to NO .................................... 2 512
stop the pregnancy.

Did you have any bleeding?

511 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

512 Did you have any pain? YES .................................... 1

NO .................................... 2 514

513 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

226 • Appendix F
 SECTION 5. ABORTION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

514 Did you have any fever? YES .................................... 1

NO .................................... 2 516

515 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

516 Did you suffer any injury or perforation? YES .................................... 1

NO .................................... 2 518

517 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

518 Did you have any foul-smelling vaginal discharge? YES .................................... 1
NO .................................... 2 520

519 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

520 Did you have any other problems? YES .................................... 1

NO .................................... 2 532

521 What problem did you have?

522 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

523 Did you have any other problem? YES .................................... 1

NO .................................... 2 532

524 What problem did you have?

525 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

526 Did you have any other problem? YES .................................... 1

NO .................................... 2 532

527 What problem did you have?

528 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Appendix F • 227
 SECTION 5. ABORTION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

529 Did you have any other problem? YES .................................... 1

NO .................................... 2 532

530 What problem did you have?

531 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

532 Did you take any pain relievers? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

533 CHECK 504: MORE THAN ONE EFFORT TO END DRANK MILK/COFFEE/ALCOHOL/OTHER LIQUID
PREGNANCY WITH LOTS OF SUGAR ................ 11
DRANK HERBAL CONCOCTION . . . . . . . . . . . . . 12
YES NO DRANK OTHER HOME REMEDIES . . . . . . . . . . 13
USED ANY HERBAL ENEMA . . . . . . . . . . . . . . . . 14
a) What was the last b) What did you do to INSERTED HERB/OBJECT/OTHER
thing you did to end end this pregnancy? SUBSTANCE IN THE VAGINA . . . . . . . . . . . . . 15
this pregnancy? HEAVY MASSAGE . . . . . . . . . . . . . . . . . . . . . . . . . 16
EXCESSIVE PHYSICAL ACTIVITY .......... 17
TABLETS (EXACT KIND UNKNOWN) . . . . . . . . . . 18

CYTOTEC TABLETS (MISOPROSTOL) . . . . . . . . 21

MIFEPRISTONE + MISOPROSTOL
(MEDABON, ETC) . . . . . . . . . . . . . . . . . . . . . . 22
IV / OXYTOCIN . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

D&C / D&E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
VACUUM ASPIRATION . . . . . . . . . . . . . . . . . . . . . . 32
INJECTION IN ABDOMEN
(SALINE INSTILLATION) . . . . . . . . . . . . . . . . 33
CATHETER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
OTHER INJECTION . . . . . . . . . . . . . . . . . . . . . . . . . 35

OTHER 96
(SPECIFY)

534 Who did you see to get this (last step) done? HEALTH PERSONNEL
DOCTOR . . . . . . . . . . . . . . . . . . . . . . . . . . . 01
NURSE/MIDWIFE . . . . . . . . . . . . . . . . . . . . . . 02
COM. HEALTH OFFICER/NURSE . . . . . . . . 03

OTHER PERSON
PHARMACIST/CHEMICAL SELLER . . . . . . . . 04
TRADITIONAL BIRTH ATTENDANT . . . . . . . . 05
COMMUNITY HEALTH VOLUNTEER . . . . . . . . 06
RELATIVE/FRIEND . . . . . . . . . . . . . . . . . . . . . . 07
TRADITIONAL PRACTITIONER . . . . . . . . . . 08

NO ONE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 09
OTHER 96
(SPECIFY)

228 • Appendix F
 SECTION 5. ABORTION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

535 Where did you go to get this (last step) done? PUBLIC SECTOR
GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . 11
GOVT HEALTH CENTER/CLINIC . . . . . . . . . . 12
GOVT HEALTH POST/CHPS . . . . . . . . . . . . . 13
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 14
OTHER PUBLIC SECTOR
16
(SPECIFY)

IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE PRIVATE MEDICAL SECTOR

SECTOR, WRITE THE NAME OF THE PLACE. PRIVATE HOSPITAL/CLINIC . . . . . . . . . . . . . 21
FP/PPAG CLINIC ...................... 22
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 23
MATERNITY HOME . . . . . . . . . . . . . . . . . . . . . . 24
(NAME OF PLACE) PHARMACY/CHEMIST/DRUG STORE. . . . . . . . 25
OTHER PRIVATE MEDICAL SECTOR
26
(SPECIFY)

HOME
RESPONDENT'S HOME. . . . . . . . . . . . . . . . . . . 31
OTHER HOME . . . . . . . . . . . . . . . . . . . . . . . . . 32
TBA'S HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

OTHER 96
(SPECIFY)

536A Was anything paid to get this procedure done? YES .................................... 1
NO .................................... 2 537

536B Who paid to get this procedure done? RESPONDENT . . . . . . . . . . . . . . . . . . . . . . . . . . . A

PARTNER .............................. B
PROBE: Anyone else? MOTHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C
FATHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D
CIRCLE ALL MENTIONED. OTHER FAMILY MEMBER . . . . . . . . . . . . . . . . . . . E
FRIEND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . F
OTHER X
(SPECIFY)

537 Did you take any antibiotics after this abortion? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

538 Did you take any pain relievers? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

539A CHECK 533:

CODE 31, 32, 33, OR 34 BLANK OR
540
CIRCLED: ANY OTHER CODE CIRCLED:

539B Did you have any local or general (intravenous) LOCAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

anaethesia for this abortion? By local I mean an GENERAL .............................. 2
injection in the vagina opening? NEITHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

540 In the first one month after the abortion, did you have YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
any health problems because of the abortion? NO .................................... 2
563A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

541 Did you have any bleeding? YES .................................... 1

NO .................................... 2 543

542 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Appendix F • 229
 SECTION 5. ABORTION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

543 Did you have any pain? YES .................................... 1

NO .................................... 2 545

544 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

545 Did you have any fever? YES .................................... 1

NO .................................... 2 547

546 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

547 Did you suffer any injury or perforation? YES .................................... 1

NO .................................... 2 549

548 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

549 Did you have any foul-smelling vaginal discharge? YES .................................... 1
NO .................................... 2 551

550 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

551 Did you have any other problems? YES .................................... 1

NO .................................... 2 563B

552 What problem did you have?

553 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

554 Did you have any other problem? YES .................................... 1

NO .................................... 2 563B

555 What problem did you have?

556 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

557 Did you have any other problem? YES .................................... 1

NO .................................... 2 563B

558 What problem did you have?

559 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

230 • Appendix F
 SECTION 5. ABORTION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

560 Did you have any other problem? YES .................................... 1

NO .................................... 2 563B

561 What problem did you have?

562 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
563B
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

563A CHECK 510, 512, 514, 516, 518, 520:

ANY 'YES' TO ANY OF 'NO', 'DON'T KNOW', OR BLANK/NOT ASKED TO
567
THOSE QUESTIONS ALL OF THOSE QUESTIONS

563B Did you get any treatment for the health problems you YES .................................... 1
had because of the abortion? NO .................................... 2 567

564 What kind of treatment did you receive? OPERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A

BLOOD TRANSFUSION. . . . . . . . . . . . . . . . . . . . . . B
CIRCLE ALL MENTIONED. ANTIBIOTICS ........................... C
OTHER X
(SPECIFY)

565 Where did you go to get this treatment? PUBLIC SECTOR

GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . A
CIRCLE ALL SOURCES MENTIONED GOVT HEALTH CENTER/CLINIC . . . . . . . . . . B
GOVT HEALTH POST/CHPS . . . . . . . . . . . . . C
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . D
OTHER PUBLIC SECTOR
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE E
SECTOR, WRITE THE NAME OF THE PLACE. (SPECIFY)

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC . . . . . . . . . . . . . F
(NAME OF PLACE) FP/PPAG CLINIC ...................... G
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . H
MATERNITY HOME . . . . . . . . . . . . . . . . . . . . . . I
PHARMACY/CHEMIST/DRUG STORE. . . . . . . . J
OTHER PRIVATE MEDICAL SECTOR
K
(SPECIFY)

HOME
RESPONDENT'S HOME. . . . . . . . . . . . . . . . . . . L
OTHER HOME . . . . . . . . . . . . . . . . . . . . . . . . . M
TBA'S HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . N

OTHER X
(SPECIFY)

566A In the first one month after this abortion, did you spend YES .................................... 1
any nights in a health facility? NO .................................... 2 567

566B In the first one month after this abortion, how many
nights did you spend in a health facility (including NIGHTS . . . . . . . . . . . . . . . . . . . 1
readmissions)?
WEEKS ................... 2

DON'T KNOW ......................... 998

567 Either before or after the abortion, did a doctor or other YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
health worker visit you? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Appendix F • 231
 SECTION 5. ABORTION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

568 After six months, did you have any health problems as YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
a result of this abortion? NO .................................... 2
NOT YET 6 MONTHS . . . . . . . . . . . . . . . . . . . . . . 3 570
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

569 What health problems did you have? ABDOMINAL PAIN . . . . . . . . . . . . . . . . . . . . . . . . . A

STERILITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B
PROBE: Any other? INFECTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C
LACK OF PERIOD . . . . . . . . . . . . . . . . . . . . . . . . . D
CIRCLE ALL MENTIONED. IRREGULAR PERIOD . . . . . . . . . . . . . . . . . . . . . . E
MORE PAINFUL PERIOD . . . . . . . . . . . . . . . . . . . F
OTHER X
(SPECIFY)

570 At the time you got pregnant, were you using any YES .................................... 1
method of contraception? NO .................................... 2 572

571 What method of contraception were you using? FEMALE STERILIZATION . . . . . . . . . . . . . . . . . . . 01

MALE STERILIZATION . . . . . . . . . . . . . . . . . . . . . . 02
IF MORE THAN ONE METHOD IS MENTIONED, IUD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 03
CIRCLE THE HIGHEST METHOD ON THE LIST. INJECTABLES . . . . . . . . . . . . . . . . . . . . . . . . . . . 04
IMPLANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 05
PILL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 06
CONDOM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 07
FEMALE CONDOM . . . . . . . . . . . . . . . . . . . . . . . . . 08
DIAPHRAGM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 09
FOAM/JELLY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
LACTATIONAL AMENORRHEA METHOD ..... 11
RHYTHM METHOD . . . . . . . . . . . . . . . . . . . . . . . . . 12
WITHDRAWAL . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
OTHER 96
(SPECIFY)

572 Either before or after the abortion, did a doctor or other YES .................................... 1
health professional talk to you about contraception? NO .................................... 2 574

573 Was it before the abortion, after the abortion, or both BEFORE THE ABORTION . . . . . . . . . . . . . . . . . . . 1
before and after the abortion? AFTER THE ABORTION . . . . . . . . . . . . . . . . . . . 2
BOTH BEFORE AND AFTER THE
ABORTION . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

574 After this abortion, did a doctor or health worker give YES .................................... 1
you a method of contraception, prescribe a method of NO .................................... 2 581
contraception, or refer you to a family planning clinic?

575 Did they give you the method of contraception, give GAVE METHOD . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
you a prescription, or give you a referral? PRESCRIBED A METHOD ................ 2
581
GAVE REFERRAL . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

232 • Appendix F
 SECTION 5. ABORTION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

576 CHECK 220AD:

ALL NO OR BLANK = ANY YES =
NO ABORTIONS ONE OR MORE ABORTIONS
581

577 Have you heard of abortion? YES .................................... 1

NO .................................... 2 600
IF NO, PROBE: That is a woman can deliberately end
a pregnancy that she does not want. Have you heard
about this?

578 If you wanted to could you decide on your own to get YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
an abortion? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

579 Do you know where to go to get an abortion? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
581
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

580 Where is that? PUBLIC SECTOR

GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . A
Any other place? GOVT HEALTH CENTER/CLINIC . . . . . . . . . . B
GOVT HEALTH POST/CHPS . . . . . . . . . . . . . C
PROBE TO IDENTIFY EACH TYPE OF SOURCE MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . D
AND CIRCLE THE APPROPRIATE CODE(S). FAMILY PLANNING CLINIC ............. E
FIELDWORKER . . . . . . . . . . . . . . . . . . . . . . . . . F
OTHER PUBLIC SECTOR G

(SPECIFY)

IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE PRIVATE MEDICAL SECTOR

SECTOR, WRITE THE NAME OF THE PLACE. PRIVATE HOSPITAL/CLINIC . . . . . . . . . . . . . H
PRIVATE DOCTOR . . . . . . . . . . . . . . . . . . . . . . I
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . J
PHARMACY/CHEMIST/
(NAME OF PLACE) DRUG STORE . . . . . . . . . . . . . . . . . . . . . . K
FIELDWORKER . . . . . . . . . . . . . . . . . . . . . . . . . L
FP/PPAG CLINIC ...................... M
MATERNITY HOME . . . . . . . . . . . . . . . . . . . . . . N
OTHER PRIVATE MED SECTOR O

(SPECIFY)

OTHER SOURCE
SHOP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . P
CHURCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Q
FRIEND/RELATIVE . . . . . . . . . . . . . . . . . . . . . . R

OTHER X
(SPECIFY)

581 Is abortion legal in Ghana? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
600
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

582 Under what conditions is abortion legal in Ghana? RAPE/DEFILEMENT ...................... A

INCEST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B
PROBE: Anything else? LIFE OF MOTHER IN DANGER . . . . . . . . . . . . . C
RISK TO PHYSICAL HEALTH OF MOTHER . . . . . D
CIRCLE ALL MENTIONED. RISK TO MENTAL HEALTH OF MOTHER ..... E
FOETAL ABNORMALITY . . . . . . . . . . . . . . . . . . . F
DURING FIRST TRIMESTER ONLY . . . . . . . . . . G
UP TO THE SECOND TRIMESTER . . . . . . . . . . H
MOTHER MENTALLY NOT SOUND . . . . . . . . . . I
OTHER X
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . Z

Appendix F • 233
 SECTION 6. MISCARRIAGE

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

600 CHECK 224B:

NO
ONE OR MORE MISCARRIAGES
701
MISCARRIAGES IN 2012-2017 IN 2012-2017

601 CHECK 224B:

YEAR OF MOST RECENT MISCARRIAGE BETWEEN 2012-2017:

602 You said you had a miscarriage in YEAR FROM Q.601. ACCIDENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Now I would like to ask you some questions about this ATE SOMETHING . . . . . . . . . . . . . . . . . . . . . . . . . 2
pregnancy that ended in a miscarriage. SOMEONE HURT ME . . . . . . . . . . . . . . . . . . . . . . 3
SPONTANEOUS ......................... 4
What caused this miscarriage to happen? OTHER 6
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

603 Where did this miscarriage start or take place? PUBLIC SECTOR
GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . 11
GOVT HEALTH CENTER/CLINIC . . . . . . . . . . 12
GOVT HEALTH POST/CHPS . . . . . . . . . . . . . 13
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 14
OTHER PUBLIC SECTOR
16
(SPECIFY)

IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE PRIVATE MEDICAL SECTOR

SECTOR, WRITE THE NAME OF THE PLACE. PRIVATE HOSPITAL/CLINIC . . . . . . . . . . . . . 21
FP/PPAG CLINIC ...................... 22
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 23
MATERNITY HOME . . . . . . . . . . . . . . . . . . . . . . 24
(NAME OF PLACE) PHARMACY/CHEMIST/DRUG STORE. . . . . . . . 25
OTHER PRIVATE MEDICAL SECTOR
26
(SPECIFY)

HOME
RESPONDENT'S HOME . . . . . . . . . . . . . . . . 31
OTHER HOME . . . . . . . . . . . . . . . . . . . . . . . . . 32
TBA'S HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

WORKPLACE . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
PUBLIC PLACE . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

OTHER 96
(SPECIFY)

604A Did you seek help from anyone for this miscarriage? YES .................................... 1
NO .................................... 2 605

604B Who did you see? HEALTH PERSONNEL

DOCTOR ........................... A
PROBE: Anyone else? NURSE/MIDWIFE . . . . . . . . . . . . . . . . . . . . . . B
COM. HEALTH OFFICER/NURSE ........ C
CIRCLE ALL MENTIONED.
OTHER PERSON
PHARMACIST/CHEMICAL SELLER . . . . . . . . D
TRADITIONAL BIRTH ATTENDANT . . . . . . . . E
COMMUNITY HEALTH VOLUNTEER . . . . . . . . F
RELATIVE/FRIEND . . . . . . . . . . . . . . . . . . . . . . G
TRADITIONAL PRACTITIONER . . . . . . . . . . H

OTHER X
(SPECIFY)

234 • Appendix F
 SECTION 6. MISCARRIAGE

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

604C Where did you go to get this help? PUBLIC SECTOR

GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . A
GOVT HEALTH CENTER/CLINIC . . . . . . . . . . B
GOVT HEALTH POST/CHPS . . . . . . . . . . . . . C
CIRCLE ALL MENTIONED. MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . D
OTHER PUBLIC SECTOR
E
(SPECIFY)
IF UNABLE TO DETERMINE IF PUBLIC OR PRIVATE
SECTOR, WRITE THE NAME OF THE PLACE. PRIVATE MEDICAL SECTOR
PRIVATE HOSPITAL/CLINIC . . . . . . . . . . . . . F
FP/PPAG CLINIC ...................... G
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . H
(NAME OF PLACE) MATERNITY HOME . . . . . . . . . . . . . . . . . . . . . . I
PHARMACY/CHEMIST/DRUG STORE. . . . . . . . J
OTHER PRIVATE MEDICAL SECTOR
K
(SPECIFY)

HOME
RESPONDENT'S HOME. . . . . . . . . . . . . . . . . . . L
OTHER HOME . . . . . . . . . . . . . . . . . . . . . . . . . M
TBA'S HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . N

OTHER X
(SPECIFY)

605 Did you have your uterus cleaned after the YES .................................... 1
miscarriage? NO .................................... 2 607

606 What method was used to clean your uterus following D&C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 01
the miscarriage? VACUUM ASPIRATION . . . . . . . . . . . . . . . . . . . . . . 02
OXYTOCIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 03
CYTOTEC TABLETS (MISOPROSTOL) . . . . . . . . 04
MIFEPRISTONE + MISOPROSTO . . . . . . . . . . . . . 05
CATHETER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 06
TABLETS FOR INSERTION. . . . . . . . . . . . . . . . . . . 07
HERBAL MIXTURE INSERTION . . . . . . . . . . . . . 08
OTHER 96
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 98

607 Did you take any antibiotics after this miscarriage? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

608 Were you given any pain relievers? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

609A CHECK 606:

CODE 01, 02, OR 06 BLANK OR
610
CIRCLED: CODE 03, 04, 05, 07, 08, 96, OR 98 CIRCLED:

609B Did you have any local or general (intravenous) LOCAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

anaethesia for this miscarriage? By local I mean an GENERAL .............................. 2
injection in the vagina opening? NEITHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

610 In the first one month after the miscarriage, did you YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
have any health problems because of the miscarriage? NO .................................... 2
637
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

611 Did you have any bleeding? YES .................................... 1

NO .................................... 2 613

Appendix F • 235
 SECTION 6. MISCARRIAGE

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

612 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

613 Did you have any pain? YES .................................... 1

NO .................................... 2 615

614 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

615 Did you have any fever? YES .................................... 1

NO .................................... 2 617

616 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

617 Did you suffer any injury or perforation? YES .................................... 1

NO .................................... 2 619

618 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

619 Did you have any foul-smelling vaginal discharge? YES .................................... 1
NO .................................... 2 621

620 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

621 Did you have any other problems? YES .................................... 1

NO .................................... 2 633

622 What problem did you have?

623 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

624 Did you have any other problem? YES .................................... 1

NO .................................... 2 633

625 What problem did you have?

626 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

627 Did you have any other problem? YES .................................... 1

NO .................................... 2 633

628 What problem did you have?

236 • Appendix F
 SECTION 6. MISCARRIAGE

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

629 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

630 Did you have any other problem? YES .................................... 1

NO .................................... 2 633

631 What problem did you have?

632 Was it mild, moderate or severe? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

633 Did you get any treatment for the health problems you YES .................................... 1
had because of the miscarriage? NO .................................... 2 637

634 What kind of treatment did you receive? OPERATION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A

BLOOD TRANSFUSION ................... B
CIRCLE ALL MENTIONED. ANTIBIOTICS ........................... C
OTHER X
(SPECIFY)

635 Where did you go to get this treatment? PUBLIC SECTOR

GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . A
CIRCLE ALL SOURCES MENTIONED GOVT HEALTH CENTER/CLINIC . . . . . . . . . . B
GOVT HEALTH POST/CHPS . . . . . . . . . . . . . C
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . D
OTHER PUBLIC SECTOR
E
(SPECIFY)

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC . . . . . . . . . . . . . F
FP/PPAG CLINIC ...................... G
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . H
MATERNITY HOME . . . . . . . . . . . . . . . . . . . . . . I
PHARMACY/CHEMIST/DRUG STORE. . . . . . . . J
OTHER PRIVATE MEDICAL SECTOR
K
(SPECIFY)

HOME
RESPONDENT'S HOME. . . . . . . . . . . . . . . . . . . L
OTHER HOME . . . . . . . . . . . . . . . . . . . . . . . . . M
TBA'S HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . N

OTHER X
(SPECIFY)

636A In the first one month after this miscarriage, did you YES .................................... 1
spend any nights in a health facility? NO .................................... 2 637

636B In the first one month after this miscarriage, how many
nights did you spend in a health facility (including NIGHTS . . . . . . . . . . . . . . . . . . . 1
readmissions)?
WEEKS ................... 2

DON'T KNOW ......................... 998

637 Either before or after the miscarriage, did a doctor or YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

other health worker visit you? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Appendix F • 237
 SECTION 6. MISCARRIAGE

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

638 After six months, did you have any health problems as YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
a result of this miscarriage? NO .................................... 2
NOT YET 6 MONTHS . . . . . . . . . . . . . . . . . . . . . . 3 640
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

639 What health problems did you have? ABDOMINAL PAIN . . . . . . . . . . . . . . . . . . . . . . . . . A

STERILITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B
PROBE: Any other? INFECTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C
LACK OF PERIOD . . . . . . . . . . . . . . . . . . . . . . . . . D
CIRCLE ALL MENTIONED. IRREGULAR PERIOD . . . . . . . . . . . . . . . . . . . . . . E
MORE PAINFUL PERIOD . . . . . . . . . . . . . . . . . . . F
OTHER X
(SPECIFY)

640 At the time you got pregnant, were you using any YES .................................... 1
method of contraception? NO .................................... 2 642

641 What method of contraception were you using? FEMALE STERILIZATION . . . . . . . . . . . . . . . . . . . 01

MALE STERILIZATION . . . . . . . . . . . . . . . . . . . . . . 02
IF MORE THAN ONE METHOD IS MENTIONED, IUD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 03
CIRCLE THE HIGHEST METHOD ON THE LIST. INJECTABLES . . . . . . . . . . . . . . . . . . . . . . . . . . . 04
IMPLANTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 05
PILL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 06
CONDOM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 07
FEMALE CONDOM . . . . . . . . . . . . . . . . . . . . . . . . . 08
DIAPHRAGM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 09
FOAM/JELLY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
LACTATIONAL AMENORRHEA METHOD ..... 11
RHYTHM METHOD . . . . . . . . . . . . . . . . . . . . . . . . . 12
WITHDRAWAL . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
OTHER 96
(SPECIFY)

642 Either before or after the miscarriage, did a doctor or YES .................................... 1
other health professional talk to you about NO .................................... 2 644
contraception?

643 Was it before the miscarriage, after the miscarriage, or BEFORE THE MISCARRIAGE ............. 1
both before and after the miscarriage? AFTER THE MISCARRIAGE . . . . . . . . . . . . . . . . 2
BOTH BEFORE AND AFTER THE
MISCARRIAGE . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

644 After this miscarriage, did a doctor or health worker YES .................................... 1
give you a method of contraception, prescribe a NO .................................... 2 701
method of contraception, or refer you to a family
planning clinic?

645 Did they give you the method of contraception, give GAVE METHOD . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
you a prescription, or give you a referral? PRESCRIBED A METHOD ................ 2
GAVE REFERRAL . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

238 • Appendix F
 SECTION 7. MARRIAGE AND SEXUAL ACTIVITY

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

701 Are you currently married or living together with a man YES, CURRENTLY MARRIED . . . . . . . . . . . . . . . . 1
704
as if married? YES, LIVING WITH A MAN . . . . . . . . . . . . . . . . . . . 2
NO, NOT IN UNION . . . . . . . . . . . . . . . . . . . . . . . . . 3

702 Have you ever been married or lived together with a YES, FORMERLY MARRIED . . . . . . . . . . . . . . . . 1
man as if married? YES, LIVED WITH A MAN . . . . . . . . . . . . . . . . . . . 2
NO .................................... 3 712

703 What is your marital status now: are you widowed, WIDOWED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
divorced, or separated? DIVORCED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 709
SEPARATED ........................... 3

704 Is your (husband/partner) living with you now or is he LIVING WITH HER . . . . . . . . . . . . . . . . . . . . . . . . . 1
staying elsewhere? STAYING ELSEWHERE ................... 2

705 RECORD THE HUSBAND'S/PARTNER'S NAME AND NAME

LINE NUMBER FROM THE HOUSEHOLD
QUESTIONNAIRE. IF HE IS NOT LISTED IN THE
HOUSEHOLD, RECORD '00'. LINE NO. . . . . . . . . . . . . . . . . . . . . . . . . .

706 Does your (husband/partner) have other wives or does YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

he live with other women as if married? NO .................................... 2
709
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

707 Including yourself, in total, how many wives or live-in TOTAL NUMBER OF WIVES
partners does he have? AND LIVE-IN PARTNERS . . . . . . . .

DON'T KNOW ........................... 98

708 Are you the first, second, … wife?

RANK .........................

709 Have you been married or lived with a man only once ONLY ONCE ........................... 1
or more than once? MORE THAN ONCE ...................... 2

710 CHECK 709:

MARRIED/
MARRIED/ LIVED WITH A
LIVED WITH A MAN MAN MORE MONTH .........................
ONLY ONCE THAN ONCE
a) In what month and b) Now I would like to ask DON'T KNOW MONTH . . . . . . . . . . . . . . . . . . . 98
year did you start living about your first
with your (husband/partner). In
712
(husband/partner)? what month and year YEAR .............
did you start living with
him?
DON'T KNOW YEAR ................... 9998

711 How old were you when you first started living with him?
AGE ...........................

Appendix F • 239
 SECTION 7. MARRIAGE AND SEXUAL ACTIVITY

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

712 CHECK FOR PRESENCE OF OTHERS. BEFORE CONTINUING, MAKE EVERY EFFORT TO ENSURE PRIVACY.

713 Now I would like to ask some questions about sexual

activity in order to gain a better understanding of some
important life issues. Let me assure you again that your NEVER HAD SEXUAL
answers are completely confidential and will not be told INTERCOURSE . . . . . . . . . . . . . . . . . . . . . . . . . 00 801
to anyone. If we should come to any question that you
don't want to answer, just let me know and we will go
to the next question. How old were you when you had AGE IN YEARS . . . . . . . . . . . . . . . . . . .
sexual intercourse for the very first time?
REFUSED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97

IF 7 YEARS OR BELOW, PUT '07'.

714 I would like to ask you about your recent sexual

activity. When was the last time you had sexual DAYS AGO ............. 1
intercourse?
WEEKS AGO ............. 2

IF LESS THAN 12 MONTHS, ANSWER MUST BE MONTHS AGO ............. 3

RECORDED IN DAYS, WEEKS OR MONTHS. IF 12
MONTHS (ONE YEAR) OR MORE, ANSWER MUST YEARS AGO ............. 4
BE RECORDED IN YEARS.

240 • Appendix F
 SECTION 8. ADULT AND MATERNAL MORTALITY MODULE

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

801 Now I would like to ask you some questions about your brothers and sisters born to your natural mother, including
those who are living with you, those living elsewhere and those who have died. From our experience in prior surveys,
we know it may sometimes be difficult to establish a complete list of all the children born to your natural mother. We
will work together to draw the most complete list and work to recall all your siblings. Could you please now give me
the names of all of your brothers and sisters born to your natural mother.
DO NOT FILL IN THE ORDER NUMBER YET.
NAME ORDER NUMBER NAME ORDER NUMBER

a k

b l

c m

d n

e o

f p

g q

h r

i s

j t

802 CHECK 801:

ONE OR MORE BROTHERS NO BROTHERS
804
OR SISTERS LISTED OR SISTERS LISTED

803 READ THE NAMES OF THE BROTHERS AND SISTERS TO THE RESPONDENT AND AFTER THE LAST ONE
ASK: Are there any other brothers and sisters from the same mother that you have not mentioned?
NO YES
LIST ADDITIONAL BROTHERS AND SISTERS IN 801.

804 Sometimes people forget to mention children born to their natural mother because they do not live with them or they
do not see them very often. Are there any brothers or sisters who do not live with you that you have not mentioned?

NO YES
LIST ADDITIONAL BROTHERS AND SISTERS IN 801.

805 Sometimes people forget to mention children born to their natural mother because they have died. Are there any
brothers or sisters who died that you have not mentioned?
NO YES
LIST ADDITIONAL BROTHERS AND SISTERS IN 801.

806 Some people have brothers or sisters from the same mother but a different father. Are there any brothers or sisters
born to your natural mother, but who have a different natural father, that you have not mentioned?
NO YES
LIST ADDITIONAL BROTHERS AND SISTERS IN 801.

807 COUNT THE NUMBER OF BROTHERS AND

SISTERS RECORDED IN 801. TOTAL BROTHERS AND SISTERS ..

Appendix F • 241
 SECTION 8. ADULT AND MATERNAL MORTALITY MODULE

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

808 CHECK 807:

Just to make sure that I have this right: Your mother had in TOTAL ________ births, excluding you, during her
lifetime. Is that correct?
YES NO
PROBE AND CORRECT 801 AND/OR 807.

809 CHECK 807:

ONE OR MORE NO
901
BROTHERS/SISTERS BROTHER OR SISTER

810 Please tell me, which brother or sister was born first? And which was born next?
RECORD '01' FOR THE ORDER NUMBER IN 801 FOR THE FIRST BROTHER OR SISTER, '02' FOR THE
SECOND, AND SO ON UNTIL YOU HAVE RECORDED THE ORDER NUMBER FOR ALL BROTHERS AND
SISTERS.

811 How many births did your mother have before you
were born? NUMBER OF PRECEDING BIRTHS ..

242 • Appendix F
 SECTION 8. ADULT AND MATERNAL MORTALITY MODULE

812 IN 813, LIST THE BROTHERS AND SISTERS ACCORDING TO THE ORDER NUMBER IN 801. ASK 814 TO 824 FOR ONE
BROTHER OR SISTER BEFORE ASKING ABOUT THE NEXT BROTHER OR SISTER. IF THERE ARE MORE THAN 12
BROTHERS AND SISTERS, USE AN ADDITIONAL QUESTIONNAIRE. USE AN 'X' TO MARK THE RESPONDENT'S PLACE
BETWEEN SIBLINGS.

813 NAME OF (01) (02) (03) (04) (05) (06)

BROTHER OR
SISTER.

814 Is (NAME) male MALE . . . . 1 MALE . . . . 1 MALE . . . . 1 MALE . . . . 1 MALE . . . . 1 MALE . . . . 1

or female? FEMALE . 2 FEMALE . 2 FEMALE . 2 FEMALE . 2 FEMALE . 2 FEMALE . 2

815 Is (NAME) still YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1

alive? NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2
GO TO 817 GO TO 817 GO TO 817 GO TO 817 GO TO 817 GO TO 817
DK ...... 8 DK ...... 8 DK ...... 8 DK ...... 8 DK ...... 8 DK ...... 8
GO TO (02) GO TO (03) GO TO (04) GO TO (05) GO TO (06) GO TO (07)

816 How old is

(NAME)?
GO TO (02) GO TO (03) GO TO (04) GO TO (05) GO TO (06) GO TO (07)

817 How many years

ago did (NAME)
die?

818 How old was

(NAME) when
(he/she) died?

IF DON'T IF FEMALE IF FEMALE IF FEMALE IF FEMALE IF FEMALE IF FEMALE

KNOW, PROBE DIED BEFORE DIED BEFORE DIED BEFORE DIED BEFORE DIED BEFORE DIED BEFORE
AND ASK 12 YEARS OF 12 YEARS OF 12 YEARS OF 12 YEARS OF 12 YEARS OF 12 YEARS OF
ADDITIONAL AGE, OR AGE, OR AGE, OR AGE, OR AGE, OR AGE, OR
QUESTIONS MALE DIED AT MALE DIED AT MALE DIED AT MALE DIED AT MALE DIED AT MALE DIED AT
TO GET AN ANY AGE, GO ANY AGE, GO ANY AGE, GO ANY AGE, GO ANY AGE, GO ANY AGE, GO
ESTIMATE. TO 823 TO 823 TO 823 TO 823 TO 823 TO 823

819 Was (NAME) YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1

pregnant when GO TO 823 GO TO 823 GO TO 823 GO TO 823 GO TO 823 GO TO 823
she died? NO ...... 2 NO ...... 2 NO ...... 2 NO ...... 2 NO ...... 2 NO ...... 2

820 Did (NAME) die YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1
during childbirth? GO TO (02) GO TO (03) GO TO (04) GO TO (05) GO TO (06) GO TO (07)
NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2

821 Did (NAME) die

within two YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1
months after the NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2
end of a GO TO 823 GO TO 823 GO TO 823 GO TO 823 GO TO 823 GO TO 823
pregnancy or
childbirth?

822 How many days

after the end of
the pregnancy or
childbirth did
(NAME) die?

823 Was (NAME)'s YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1

death due to an GO TO (02) GO TO (03) GO TO (04) GO TO (05) GO TO (06) GO TO (07)
act of violence? NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2

824 Was (NAME)'s YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1

death due to an NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2
accident?
GO TO (02) GO TO (03) GO TO (04) GO TO (05) GO TO (06) GO TO (07)

IF NO MORE BROTHERS OR SISTERS, GO TO 901.

Appendix F • 243
 SECTION 8. ADULT AND MATERNAL MORTALITY MODULE

812 IN 813, LIST THE BROTHERS AND SISTERS ACCORDING TO THE ORDER NUMBER IN 801. ASK 814 TO 824 FOR ONE
BROTHER OR SISTER BEFORE ASKING ABOUT THE NEXT BROTHER OR SISTER. IF THERE ARE MORE THAN 12
BROTHERS AND SISTERS, USE AN ADDITIONAL QUESTIONNAIRE. USE AN 'X' TO MARK THE RESPONDENT'S PLACE
BETWEEN SIBLINGS.

813 NAME OF (07) (08) (09) (10) (11) (12)

BROTHER OR
SISTER.

814 Is (NAME) male MALE . . . . 1 MALE . . . . 1 MALE . . . . 1 MALE . . . . 1 MALE . . . . 1 MALE . . . . 1

or female? FEMALE . 2 FEMALE . 2 FEMALE . 2 FEMALE . 2 FEMALE . 2 FEMALE . 2

815 Is (NAME) still YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1

alive? NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2
GO TO 817 GO TO 817 GO TO 817 GO TO 817 GO TO 817 GO TO 817
DK ...... 8 DK ...... 8 DK ...... 8 DK ...... 8 DK ...... 8 DK ...... 8
GO TO (08) GO TO (09) GO TO (10) GO TO (11) GO TO (12) GO TO (13)

816 How old is

(NAME)?
GO TO (08) GO TO (09) GO TO (10) GO TO (11) GO TO (12) GO TO (13)

817 How many years

ago did (NAME)
die?

818 How old was

(NAME) when
(he/she) died?

IF DON'T IF FEMALE IF FEMALE IF FEMALE IF FEMALE IF FEMALE IF FEMALE

KNOW, PROBE DIED BEFORE DIED BEFORE DIED BEFORE DIED BEFORE DIED BEFORE DIED BEFORE
AND ASK 12 YEARS OF 12 YEARS OF 12 YEARS OF 12 YEARS OF 12 YEARS OF 12 YEARS OF
ADDITIONAL AGE, OR AGE, OR AGE, OR AGE, OR AGE, OR AGE, OR
QUESTIONS MALE DIED AT MALE DIED AT MALE DIED AT MALE DIED AT MALE DIED AT MALE DIED AT
TO GET AN ANY AGE, GO ANY AGE, GO ANY AGE, GO ANY AGE, GO ANY AGE, GO ANY AGE, GO
ESTIMATE. TO 823 TO 823 TO 823 TO 823 TO 823 TO 823

819 Was (NAME) YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1

pregnant when GO TO 823 GO TO 823 GO TO 823 GO TO 823 GO TO 823 GO TO 823
she died? NO ...... 2 NO ...... 2 NO ...... 2 NO ...... 2 NO ...... 2 NO ...... 2

820 Did (NAME) die YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1
during childbirth? GO TO (08) GO TO (09) GO TO (10) GO TO (11) GO TO (12) GO TO (13)
NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2

821 Did (NAME) die

within two YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1
months after the NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2
end of a GO TO 823 GO TO 823 GO TO 823 GO TO 823 GO TO 823 GO TO 823
pregnancy or
childbirth?

822 How many days

after the end of
the pregnancy or
childbirth did
(NAME) die?

823 Was (NAME)'s YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1

death due to an GO TO (08) GO TO (09) GO TO (10) GO TO (11) GO TO (12) GO TO (13)
act of violence? NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2

824 Was (NAME)'s YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1 YES . . . . . . 1

death due to an NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2 NO . . . . . . 2
accident?
GO TO (08) GO TO (09) GO TO (10) GO TO (11) GO TO (12) GO TO (13)

IF NO MORE BROTHERS OR SISTERS, GO TO 901.

244 • Appendix F
 SECTION 9. HEALTH CARE ACCESS, INSURANCE, AND DISABILITY

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

901 Many different factors can prevent women from getting

medical advice or treatment for themselves. When you NOT A
are sick and want to get medical advice or treatment, is BIG BIG
each of the following a big problem or not a big PROB- PROB-
problem: LEM LEM

a) Getting permission to go to the doctor? PERMISSION TO GO 1 2

b) Getting money needed for advice or treatment? GETTING MONEY 1 2
c) The distance to the health facility? DISTANCE 1 2
d) Not wanting to go alone? GO ALONE 1 2

902 Are you registered with any health insurance? YES .................................... 1
NO .................................... 2 907

903 Are you covered by any health insurance? YES .................................... 1

NO .................................... 2

904 What type of heatlh insurance are you NATIONAL/DISTRICT HEALTH

(covered/registered) by? INSURANCE (NHIS) . . . . . . . . . . . . . . . . . . . . . . A
HEALTH INSURANCE THROUGH
RECORD ALL MENTIONED. EMPLOYER . . . . . . . . . . . . . . . . . . . . . . . . . . . B
MUTUAL HEALTH ORGANIZATION/
COMMUNITY-BASED HEALTH INS. . . . . . . . . C
OTHER PRIVATELY PURCHASED/
COMMERCIAL HEALTH INSURANCE ..... D
OTHER X
(SPECIFY)

905 Does your insurance cover any of the following

maternity benefits: YES NO DK

a) Antenatal health care? ANTENATAL . . . . . . . . . . . . . . . . . . . 1 2 8

b) Childbirth health care in a health facility? CHILDBIRTH . . . . . . . . . . . . . . . . . . . 1 2 8
c) Postnatal health care for the mother? PNC MOTHER . . . . . . . . . . . . . . . . 1 2 8
d) Postnatal health care for the child? PNC CHILD . . . . . . . . . . . . . . . . . . . 1 2 8
e) Cash benefits during maternity leave? CASH BENEFITS . . . . . . . . . . . . . 1 2 8
f) Other maternity benefits? OTHER 1 2 8

(SPECIFY)

906 Do you have to pay out of pocket for drugs and YES, ALWAYS . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
services? YES, SOMETIMES . . . . . . . . . . . . . . . . . . . . . . . . . 2
NO, NEVER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

907 CHECK 408:

ANY CODE C, D, E, F, G BLANK/NO RESPONSE
910
CIRCLED OR OTHER CODE CIRCLED

908 When you went for ANC during your pregnancy with YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
(NAME FROM 404), were you asked to make any NO .................................... 2
910
payments? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

909 When you went for ANC during your pregnancy with
(NAME FROM 404), were you asked to pay: YES NO DK

a) To see the doctor or nurse? SERVICES . . . . . . . . . . . . . . . . . . . 1 2 8

b) For drugs? DRUGS . . . . . . . . . . . . . . . . . . . . . . 1 2 8
c) For laboratory tests? LAB TESTS . . . . . . . . . . . . . . . . . . . 1 2 8
d) For other supplies? SUPPLIES . . . . . . . . . . . . . . . . . . . 1 2 8
e) For anything else? OTHER 1 2 8

(SPECIFY)

Appendix F • 245
 SECTION 9. HEALTH CARE ACCESS, INSURANCE, AND DISABILITY

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

910 CHECK 430: BLANK/NO RESPONSE 917

ANY CODE 21-26 OTHER CODE CIRCLED
913
CIRCLED

911 When you went to deliver (NAME FROM 404), were YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
you asked to make any payments? NO .................................... 2
913
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

912 When you went to deliver (NAME FROM 404), were

you asked to pay: YES NO DK

a) To see the doctor or nurse? SERVICES . . . . . . . . . . . . . . . . . . . 1 2 8

b) For drugs? DRUGS . . . . . . . . . . . . . . . . . . . . . . 1 2 8
c) For laboratory tests? LAB TESTS . . . . . . . . . . . . . . . . . . . 1 2 8
d) For other supplies? SUPPLIES . . . . . . . . . . . . . . . . . . . 1 2 8
e) For anything else? OTHER 1 2 8

(SPECIFY)

913 CHECK 435 OR 449:

BLANK/NO RESPONSE OR
CODE 1 OTHER CODE CIRCLED
915
CIRCLED

914 After you had given birth to (NAME FROM 404), were YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
you asked to make any payments for checks on your NO .................................... 2
health? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

915 CHECK 438B OR 453B:

BLANK/NO RESPONSE OR
CODE 1 OTHER CODE CIRCLED
917
CIRCLED

916 After you had given birth to (NAME FROM 404), were YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
you asked to make any payments for checks on NO .................................... 2
(NAME FROM 404)'s health? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

917 The next questions ask about difficulties you may have YES .................................... 1
doing certain activities. NO .................................... 2 919

Do you wear glasses or contact lenses to help you see?

918 I would like to know if you have difficulty seeing even NO DIFFICULTY ......................... 1
when wearing glasses or contact lenses. Would you SOME DIFFICULTY ...................... 2
say that you have no difficulty seeing, some difficulty, a A LOT OF DIFFICULTY ................... 3 920
lot of difficulty, or cannot see at all? CANNOT AT ALL ......................... 4
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

919 I would like to know if you have difficulty seeing. Would NO DIFFICULTY ......................... 1
you say that you have no difficulty seeing, some SOME DIFFICULTY ...................... 2
difficulty, a lot of difficulty, or cannot see at all? A LOT OF DIFFICULTY ................... 3
CANNOT AT ALL ......................... 4
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

920 I would like to know if you have difficulty hearing. NO DIFFICULTY ......................... 1
Would you say that you have no difficulty hearing, SOME DIFFICULTY ...................... 2
some difficulty, a lot of difficulty, or cannot hear at all? A LOT OF DIFFICULTY ................... 3
CANNOT AT ALL ......................... 4
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

246 • Appendix F
 SECTION 9. HEALTH CARE ACCESS, INSURANCE, AND DISABILITY

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

921 I would like to know if you have difficulty NO DIFFICULTY ......................... 1

communicating when using your usual language. SOME DIFFICULTY ...................... 2
Would you say that you have no difficulty A LOT OF DIFFICULTY ................... 3
understanding or being understood, some difficulty, a CANNOT AT ALL ......................... 4
lot of difficulty, or cannot communicate at all? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

922 I would like to know if you have difficulty remembering NO DIFFICULTY ......................... 1
or concentrating. Would you say that you have no SOME DIFFICULTY ...................... 2
difficulty remembering or concentrating, some difficulty, A LOT OF DIFFICULTY ................... 3
a lot of difficulty, or cannot remember or concentrate at CANNOT AT ALL ......................... 4
all? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

923 I would like to know if you have difficulty walking or NO DIFFICULTY ......................... 1
climbing steps. Would you say that you have no SOME DIFFICULTY ...................... 2
difficulty walking or climbing steps, some difficulty, a lot A LOT OF DIFFICULTY ................... 3
of difficulty, or cannot walk or climb steps at all? CANNOT AT ALL ......................... 4
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

924 I would like to know if you have difficulty washing all NO DIFFICULTY ......................... 1
over or dressing. Would you say that you have no SOME DIFFICULTY ...................... 2
difficulty washing all over or dressing, some difficulty, a A LOT OF DIFFICULTY ................... 3
lot of difficulty, or cannot wash all over or dress at all? CANNOT AT ALL ......................... 4
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

925 RECORD THE TIME INTERVIEW ENDED.

HOURS .........................

MINUTES . . . . . . . . . . . . . . . . . . . . . . . . .

Appendix F • 247
 INTERVIEWER'S OBSERVATIONS
TO BE FILLED IN AFTER COMPLETING INTERVIEW

COMMENTS ABOUT INTERVIEW:

COMMENTS ON SPECIFIC QUESTIONS:

ANY OTHER COMMENTS:

SUPERVISOR'S OBSERVATIONS

248 • Appendix F
 FORMATTING DATE: 7 June 2017
ENGLISH LANGUAGE: 7 June 2017
2017 GHANA MATERNAL HEALTH SURVEY
PHASE 2 VERBAL AUTOPSY QUESTIONNAIRE
GHANA STATISTICAL SERVICE

IDENTIFICATION

LOCALITY NAME

NAME OF HOUSEHOLD HEAD

REGION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DISTRICT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CLUSTER NUMBER ...................................................................... 0

HOUSEHOLD NUMBER ...................................................................

DECEASED WOMAN'S NAME AND LINE NUMBER FROM HH LISTING

INTERVIEWER VISITS

1 2 3 FINAL VISIT

DATE DAY

MONTH

YEAR 2 0 1 7
INTERVIEWER'S
NAME INT. NO.

RESULT* RESULT*

NEXT VISIT: DATE

TOTAL NUMBER
TIME OF VISITS

*RESULT CODES:

1 COMPLETED
2 NO HOUSEHOLD MEMBER AT HOME OR NO COMPETENT RESPONDENT
AT HOME AT TIME OF VISIT
3 ENTIRE HOUSEHOLD ABSENT FOR EXTENDED PERIOD OF TIME
4 POSTPONED
5 REFUSED
6 DWELLING VACANT OR ADDRESS NOT A DWELLING
7 DWELLING DESTROYED
8 DWELLING NOT FOUND
9 OTHER
(SPECIFY)

LANGUAGE OF
QUESTIONNAIRE** 0 0 LANGUAGE OF
INTERVIEW**
NATIVE LANGUAGE
OF RESPONDENT**
TRANSLATOR USED
(YES = 1, NO = 2)

LANGUAGE OF
QUESTIONNAIRE** ENGLISH **LANGUAGE CODES:
00 ENGLISH 05 MOLE-DAGBANI
01 AKAN 06 GRUSI
02 GA 07 GURMA
03 EWE 08 MANDE
04 GUAN 96 OTHER
(SPECIFY)

SUPERVISOR

NAME NUMBER

Appendix F • 249
 THIS PAGE IS INTENTIONALLY BLANK

250 • Appendix F
 INTRODUCTION AND CONSENT

Hello. My name is _______________________________________ and I am working with the Ghana Statistical Service. We are conducting
a national survey that asks about women's health issues. We would very much appreciate your participation in this survey. A few months
ago when we visited your house, we were informed about the death of (NAME). I am here now to ask you about the circumstances that led
to her death. This information will help the government to improve women's health services. The survey will take between 30 and 60
minutes to complete. All of the answers you give will be confidential and will not be shared with anyone other than members of our survey
team.

Participation in this survey is voluntary, and if we should come to any question you don't want to answer, just let me know and I will go to the
next question; or you can stop the interview at any time. However, we hope that you will participate in this survey since your views are
important.

In case you need more information about the survey, you may contact the person listed on this card.

GIVE CARD WITH CONTACT INFORMATION

At this time, do you want to ask me anything about the survey?

May I begin the interview now?

SIGNATURE OF INTERVIEWER DATE

RESPONDENT AGREES RESPONDENT DOES NOT AGREE

TO BE INTERVIEWED . . 1 TO BE INTERVIEWED . . 2 END

100 RECORD THE TIME.

HOURS .........................

MINUTES . . . . . . . . . . . . . . . . . . . . . . . . .

SECTION 1. DECEASED WOMAN'S BACKGROUND AND RESPONDENT'S RELATIONSHIP

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

101 In what day, month, and year was (NAME) born?

DAY ...........................

DON'T KNOW DAY . . . . . . . . . . . . . . . . . . . . . . . . . 98

MONTH .........................

DON'T KNOW MONTH . . . . . . . . . . . . . . . . . . . . . . 98

YEAR . . . . . . . . . . . . . . . .

102 In what day, month, and year did (NAME) die?

DAY ...........................

DON'T KNOW DAY . . . . . . . . . . . . . . . . . . . . . . . . . 98

MONTH .........................

DON'T KNOW MONTH . . . . . . . . . . . . . . . . . . . . . . 98

YEAR . . . . . . . . . . . . . . . .

103 CHECK 102:

DIED IN 2012, 2013, 2014, 2015, 2016, OR 2017 DIED BEFORE 2012 END

Appendix F • 251
 SECTION 1. DECEASED WOMAN'S BACKGROUND AND RESPONDENT'S RELATIONSHIP

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

104 How old was (NAME) when she died?

AGE AT DEATH . . . . . . . . . . . . . . . . . . .

RECORD AGE IN COMPLETED YEARS

COMPARE AND CORRECT 101, 102, AND/OR 104 IF

INCONSISTENT

105 CHECK 104:

AGE AT DEATH 11 YEARS OR YOUNGER
AGE AT DEATH BETWEEN 12 AND 49 YEARS END
AGE AT DEATH 50 YEARS OR OLDER

106 Was (NAME) pregnant when she died? YES .................................... 1 108C
NO .................................... 2

107 Did (NAME) die during childbirth? YES .................................... 1 109

NO .................................... 2

108A Did (NAME) die within two months after the end of a YES .................................... 1
pregnancy or childbirth? NO .................................... 2 108C

108B How many days after the end of the pregnancy or

childbirth did (NAME) die? DAYS . . . . . . . . . . . . . . . . . . . . . . . . . . .

108C Was (NAME)'s death due to an act of violence? YES .................................... 1 109
NO .................................... 2

108D Was (NAME)'s death due to an accident? YES .................................... 1

NO .................................... 2

109 What was (NAME)'s marital status? NEVER MARRIED . . . . . . . . . . . . . . . . . . . . . . . . . 1

MARRIED .............................. 2
LIVING WITH A PARTNER . . . . . . . . . . . . . . . . . . . 3
SEPARATED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
DIVORCED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
WIDOWED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

110 What is the highest level of school (NAME) had PRIMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

attended: primary, middle, JSS/JHS, secondary, MIDDLE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SSS/SHS, higher, or had (NAME) never attended JSS/JHS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
school? SECONDARY ........................... 4
SSS/SHS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
HIGHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
NEVER ATTENDED SCHOOL . . . . . . . . . . . . . . . . 7
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

111 Did (NAME) do any work in the 12 months before her YES .................................... 1
death? NO .................................... 2 113

112 What was her occupation? That is, what kind of work
did (NAME) mainly do?

BOXES FOR OFFICE USE ONLY

252 • Appendix F
 SECTION 1. DECEASED WOMAN'S BACKGROUND AND RESPONDENT'S RELATIONSHIP

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

113 What was (NAME)'s religion? CATHOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 01

ANGLICAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 02
METHODIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 03
PRESBYTERIAN ......................... 04
PENTECOSTAL/CHARISMATIC . . . . . . . . . . . . . 05
OTHER CHRISTIAN . . . . . . . . . . . . . . . . . . . . . . . . . 06
ISLAM ................................. 07
TRADITIONAL/SPIRITUALIST . . . . . . . . . . . . . . . . 08
NO RELIGION . . . . . . . . . . . . . . . . . . . . . . . . . . . 09

OTHER 96
(SPECIFY)
DON'T KNOW ........................... 98

114 What ethnic group did (NAME) belong to? AKAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 01

GA/DANGME ........................... 02
EWE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 03
GUAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 04
MOLE-DAGBANI ......................... 05
GRUSI ................................. 06
GURMA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 07
MANDE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 08

OTHER 96
(SPECIFY)

115 Where did (NAME) die? HER HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

OTHER HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
HEALTH FACILITY . . . . . . . . . . . . . . . . . . . . . . . . . 3
EN ROUTE TO HEALTH FACILITY .......... 4
SHRINE/PRAYER CAMP . . . . . . . . . . . . . . . . . . . 5

OTHER 6
(SPECIFY)

116 Where was (NAME)'s usual place of residence? IN THIS HOUSE ......................... 1
IN THIS LOCALITY ...................... 2
IN A DIFFERENT VILLAGE/TOWN ........ 3

OTHER 6
(SPECIFY)

117 Where did the burial take place? IN THIS HOUSE ......................... 1
IN THIS LOCALITY ...................... 2
IN A DIFFERENT VILLAGE/TOWN ........ 3
BURIAL NOT YET PERFORMED .......... 4

OTHER 6
(SPECIFY)

118 During which season did (NAME) die? WET SEASON ........................... 1
DRY SEASON ........................... 2

OTHER 6
(SPECIFY)

119 What was your relationship with (NAME)? HUSBAND/PARTNER . . . . . . . . . . . . . . . . . . . . . . 1

PARENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
CHILD ................................. 3
SIBLING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
OTHER FAMILY MEMBER . . . . . . . . . . . . . . . . . . . 5
FRIEND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
ANOTHER RELATIONSHIP ................ 7

120 Did you live with (NAME) in the period leading to her YES .................................... 1
death? NO .................................... 2

Appendix F • 253
 SECTION 2. NARRATIVE

NO. QUESTION

201 Now could you please tell me about the illnesses and events leading to (NAME)'s death?

IMPORTANT: READ YOUR NOTES BACK TO THE RESPONDENT SO HE OR SHE CAN CORRECT OR CLARIFY
ALSO IMPORTANT: MAKE SURE YOUR HANDWRITING CAN BE READ BY SOMEONE ELSE

254 • Appendix F
 SECTION 2. NARRATIVE

NO. QUESTION

Appendix F • 255
 SECTION 2. NARRATIVE

NO. QUESTION

256 • Appendix F
 SECTION 3. HISTORY OF INJURIES/ACCIDENTS

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

301 Just to confirm, did (NAME) suffer from any injury or YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
accident that led to her death? NO .................................... 2
401A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

302A Was it a road traffic accident? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
303
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

302B What was her role in the road traffic accident? PEDESTRIAN . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
DRIVER OR PASSENGER IN CAR OR
LIGHT VEHICLE ...................... 2
DRIVER OR PASSENGER IN BUS OR
HEAVY VEHICLE ...................... 3
DRIVER OR PASSENGER ON
MOTORCYCLE . . . . . . . . . . . . . . . . . . . . . . . . . 4
DRIVER OR PASSENGER ON
PEDAL CYCLE . . . . . . . . . . . . . . . . . . . . . . . . . 5
OTHER 6
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

302C What was the counterpart during the road traffic PEDESTRIAN . . . . . . . . . . . . . . . . . . . . . . . . . . . A
accident? STATIONARY OBJECT ................... B
CAR OR LIGHT VEHICLE . . . . . . . . . . . . . . . . . . . C
BUS OR HEAVY VEHICLE . . . . . . . . . . . . . . . . . . . D
MOTORCYCLE . . . . . . . . . . . . . . . . . . . . . . . . . . . E
PEDAL CYCLE . . . . . . . . . . . . . . . . . . . . . . . . . . . F
DITCH/VERGE/SIDE OF ROAD . . . . . . . . . . . . . H
ROAD SURFACE . . . . . . . . . . . . . . . . . . . . . . . . . I
OTHER X
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . Y

303 Was (NAME) injured in a non-road transport accident? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

304 Was (NAME) injured in a fall? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

305 Was there any poisoning? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

306 Did (NAME) die of drowning? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

307A Was (NAME) injured by a bite or sting of venomous YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 307C

animal? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

307B Was (NAME) injured by an animal or insect (non- YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

venomous)? NO .................................... 2
308
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

307C What was the animal or insect? DOG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

SNAKE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
INSECT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
SCORPION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
OTHER 6
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Appendix F • 257
 SECTION 3. HISTORY OF INJURIES/ACCIDENTS

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

308 Was (NAME) injured by burns or fire? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

309 Was (NAME) subject to violence (suicide, homicide, or YES, SUICIDE . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

abuse?) YES, HOMICIDE ......................... 2
YES, ABUSE ........................... 3
NO .................................... 4
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

310 Was (NAME) injured by a firearm? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

311 Was (NAME) stabbed, cut, or pierced? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

312 Was (NAME) strangled? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

313 Was (NAME) injured by a blunt force? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

314 Was (NAME) injured by a force of nature? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

315 Was (NAME) electrocuted? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

316 Was (NAME) injured by some other injury? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

317 Was the injury accidental? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

318 Was the accident or injury self-inflicted? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

319 Was the accident or injury intentionally inflicted by YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

someone else? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

258 • Appendix F
 SECTION 4. MEDICAL HISTORY ASSOCIATED WITH FINAL ILLNESS

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

401A For how long was (NAME) ill before (NAME) died?
DAYS . . . . . . . . . . . . . . . . . . . . . . . . . 1

WEEKS ...................... 2

RECORD ANSWER IN UNITS GIVEN

MONTHS . . . . . . . . . . . . . . . . . . . . . . 3
IF LESS THAN ONE DAY, RECORD '00' IN DAYS

YEARS ...................... 4

401B CHECK 401A:

ANSWER IN UNIT OTHER THAN DAYS, OR DAYS = 00 403
IN DAYS AND MORE THAN 00

402 Did (NAME) die suddenly? YES .................................... 1

NO .................................... 2

403 Was there any diagnosis by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker of tuberculosis or TB? NO .................................... 2
405A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

404 For how many months or years prior to death was

(NAME) diagnosed with tuberculosis or TB? MONTHS . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS.

YEARS ...................... 2

DON'T KNOW ......................... 998

405A Was (NAME) ever tested for HIV? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
409
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

405B How many days, weeks, or months prior to death was

(NAME) tested for HIV? DAYS ...................... 1

WEEKS ...................... 2

MONTHS . . . . . . . . . . . . . . . . . . . . . . 3

DON'T KNOW ......................... 998

406 What was the result of that test? POSITIVE .............................. 1

NEGATIVE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 409
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

407 Was there any diagnosis by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker of AIDS? NO .................................... 2
409
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Appendix F • 259
 SECTION 4. MEDICAL HISTORY ASSOCIATED WITH FINAL ILLNESS

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

408 For how many months or years prior to death was

(NAME) diagnosed with AIDS? MONTHS . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS.

YEARS ...................... 2

DON'T KNOW ......................... 998

409 Did (NAME) have a recent test by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker for malaria? NO .................................... 2
413
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

410A What was the result of that test? POSITIVE .............................. 1

NEGATIVE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

410B For how many days, weeks, or months prior to death

was (NAME) tested for malaria? DAYS ...................... 1

WEEKS ...................... 2

MONTHS . . . . . . . . . . . . . . . . . . . . . . 3

DON'T KNOW ......................... 998

413 Was there any diagnosis by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker of measles? NO .................................... 2
415
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

414 For how many months or years prior to death was

(NAME) diagnosed with measles? MONTHS . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS.

YEARS ...................... 2

DON'T KNOW ......................... 998

415 Was there any diagnosis by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker of high blood pressure? NO .................................... 2
417
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

416 For how many months or years prior to death was

(NAME) diagnosed with high blood pressure? MONTHS . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS.

YEARS ...................... 2

DON'T KNOW ......................... 998

417 Was there any diagnosis by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker of heart disease? NO .................................... 2
419
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

260 • Appendix F
 SECTION 4. MEDICAL HISTORY ASSOCIATED WITH FINAL ILLNESS

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

418 For how many months or years prior to death was

(NAME) diagnosed with heart disease? MONTHS . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS.

YEARS ...................... 2

DON'T KNOW ......................... 998

419 Was there any diagnosis by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker of diabetes? NO .................................... 2
421
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

420 For how many months or years prior to death was

(NAME) diagnosed with diabetes? MONTHS . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS.

YEARS ...................... 2

DON'T KNOW ......................... 998

421 Was there any diagnosis by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker of asthma? NO .................................... 2
423
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

422 For how many months or years prior to death was

(NAME) diagnosed with asthma? MONTHS . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS.

YEARS ...................... 2

DON'T KNOW ......................... 998

423 Was there any diagnosis by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker of epilepsy? NO .................................... 2
425
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

424 For how many months or years prior to death was

(NAME) diagnosed with epilepsy? MONTHS . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS.

YEARS ...................... 2

DON'T KNOW ......................... 998

425 Was there any diagnosis by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker of cancer? NO .................................... 2
428
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

426 What kind of cancer? LUNG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

BREAST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
CERVIX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
LIVER ................................. 14
THROAT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
COLON . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

OTHER 96
(SPECIFY)
DON'T KNOW ........................... 98

Appendix F • 261
 SECTION 4. MEDICAL HISTORY ASSOCIATED WITH FINAL ILLNESS

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

427 For how many months or years prior to death was

(NAME) diagnosed with cancer? MONTHS . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS.

YEARS ...................... 2

DON'T KNOW ......................... 998

428 Was there any diagnosis by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker of chronic obstructive pulmonary disease NO .................................... 2
430
(COPD)? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

429 For how many months or years prior to death was

(NAME) diagnosed with chronic obstructive pulmonary MONTHS . . . . . . . . . . . . . . . . . . . . . . 1
disease (COPD)?

YEARS ...................... 2

DON'T KNOW ......................... 998

IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS.

430 Was there any diagnosis by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker of dementia? NO .................................... 2
432
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

431 For how many months or years prior to death was

(NAME) diagnosed with dementia? MONTHS . . . . . . . . . . . . . . . . . . . . . . 1

YEARS ...................... 2
IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS.
DON'T KNOW ......................... 998

432 Was there any diagnosis by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker of depression? NO .................................... 2
434
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

433 For how many months or years prior to death was

(NAME) diagnosed with depression? MONTHS . . . . . . . . . . . . . . . . . . . . . . 1

YEARS ...................... 2

DON'T KNOW ......................... 998

IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS.

434 Was there any diagnosis by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker of other mental disorder? NO .................................... 2
437
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

435 What was the mental disorder? BIPOLAR DISORDER . . . . . . . . . . . . . . . . . . . . . . 1

SCHIZOPHRENIA . . . . . . . . . . . . . . . . . . . . . . . . . 2
OTHER 6
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

262 • Appendix F
 SECTION 4. MEDICAL HISTORY ASSOCIATED WITH FINAL ILLNESS

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

436 For how many months or years prior to death was

(NAME) diagnosed with other mental disorder? MONTHS . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS.

YEARS ...................... 2

DON'T KNOW ......................... 998

437 Was there any diagnosis by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker of stroke? NO .................................... 2
439
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

438 For how many months or years prior to death was

(NAME) diagnosed with stroke? MONTHS . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS.

YEARS ...................... 2

DON'T KNOW ......................... 998

439 Was there any diagnosis by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker of sickle cell disease? NO .................................... 2
441
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

440 For how many months or years prior to death was

(NAME) diagnosed with sickle cell disease? MONTHS . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS.

YEARS ...................... 2

DON'T KNOW ......................... 998

441 Was there any diagnosis by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker of kidney disease? NO .................................... 2
443
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

442 For how many months or years prior to death was

(NAME) diagnosed with kidney disease? MONTHS . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS.

YEARS ...................... 2

DON'T KNOW ......................... 998

443 Was there any diagnosis by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker of liver disease? NO .................................... 2
445
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

444 For how many months or years prior to death was

(NAME) diagnosed with liver disease? MONTHS . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS.

YEARS ...................... 2

DON'T KNOW ......................... 998

Appendix F • 263
 SECTION 4. MEDICAL HISTORY ASSOCIATED WITH FINAL ILLNESS

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

445 Was there any diagnosis by a physician or health YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

worker of other chronic illness? NO .................................... 2
448
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

446 What was the illness? LUPUS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

RHEUMATOID ARTHRITIS ................ 2

OTHER 6
(SPECIFY)
DON'T KNOW ........................... 8

447 For how many months or years prior to death was

(NAME) diagnosed with (other chronic illness)? MONTHS . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS.

YEARS ...................... 2

DON'T KNOW ......................... 998

448 What do you think was the cause of death?

WRITE EXACTLY AS THE RESPONDENT TELLS YOU

IMPORTANT: READ YOUR NOTES BACK TO THE RESPONDENT SO HE OR SHE CAN CORRECT OR CLARIFY

264 • Appendix F
 SECTION 5. GENERAL SIGNS AND SYMPTOMS ASSOCIATED WITH FINAL ILLNESS

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

501A At this time I would like to ask you some questions

concerning symptoms that (NAME) had or showed
when (NAME) was ill. Some of these questions may
not appear directly related to her health. Please bear
with me and answer all the questions. Your answers
will help us get a clear picture of all possible symptoms
that (NAME) may have had. YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO .................................... 2
501F
Did (NAME) have a fever? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

501B For how many days did the fever last?

DAYS . . . . . . . . . . . . . . . . . . . . . . . . .
IF LESS THAN 1 DAY, RECORD '00'.
IF 95 OR MORE DAYS, RECORD '95'. DON'T KNOW ........................... 98

501C Did the fever continue until death? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

501D How severe was the fever? MILD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

MODERATE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
SEVERE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

501E What was the pattern of the fever? CONTINUOUS . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

ON AND OFF ........................... 2
PROBE: Continuous, off and on, only at night? ONLY AT NIGHT ......................... 3
ONLY DURING DAY ...................... 4
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

501F Did (NAME) have night sweats? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

502A Did (NAME) have a cough? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
503A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

502B For how many days did (NAME) have a cough?

DAYS . . . . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 MONTH, RECORD IN DAYS.

IF LESS THAN 1 YEAR, RECORD IN MONTHS. MONTHS . . . . . . . . . . . . . . . . . . . . . . 2

YEARS ...................... 3

DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 998

502C Was the cough productive, with sputum? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

502D Was the cough very severe? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

502E Did (NAME) cough up blood? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
PROBE TO MAKE SURE BLOOD WAS COUGHED, DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
NOT VOMITED

Appendix F • 265
 SECTION 5. GENERAL SIGNS AND SYMPTOMS ASSOCIATED WITH FINAL ILLNESS

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

503A Did (NAME) have any difficulty breathing? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
504A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

503B For how long did the difficulty breathing last?

DAYS . . . . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 MONTH, RECORD IN DAYS.

IF LESS THAN 1 YEAR, RECORD IN MONTHS. MONTHS . . . . . . . . . . . . . . . . . . . . . . 2

YEARS ...................... 3

DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 998

503C Was the difficulty continuous or on and off? CONTINUOUS ........................... 1

ON AND OFF ........................... 2
DON'T KNOW ........................... 8

504A During the (illness/events/circumstances) that led to YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

death, did (NAME) have fast breathing? NO .................................... 2
505A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

504B For how many days did the fast breathing last?
DAYS . . . . . . . . . . . . . . . . . . . . . . . . . . .
IF LESS THAN 1 DAY, RECORD '00'.
IF 95 OR MORE DAYS, RECORD '95'. DON'T KNOW ........................... 98

505A Did (NAME) have breathlessness? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
506
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

505B For how many days did (NAME) have breathlessness?

DAYS . . . . . . . . . . . . . . . . . . . . . . . . . . .
IF LESS THAN 1 DAY, RECORD '00'.
IF 95 OR MORE DAYS, RECORD '95'. DON'T KNOW ........................... 98

505C Was (NAME) unable to carry out daily routines due to YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
breathlessness? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

505D Was (NAME) breathless while lying flat? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

506 During the (illness/events/circumstances) that led to YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

death did her breathing sound like wheezing? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

507A Did (NAME) have chest pain? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
508A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

507B Was the chest pain severe? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

507C How many days before death did (NAME) have chest
pain? DAYS . . . . . . . . . . . . . . . . . . . . . . . . . . .
IF LESS THAN 1 DAY, RECORD '00'.
IF 95 OR MORE DAYS, RECORD '95'. DON'T KNOW ........................... 98

266 • Appendix F
 SECTION 5. GENERAL SIGNS AND SYMPTOMS ASSOCIATED WITH FINAL ILLNESS

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

507D How many minutes or hours did the pain last?

MINUTES . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 HOUR, RECORD IN MINUTES.

IF 95 HOURS OR MORE, RECORD '95' IN HOURS. HOURS ...................... 2

DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 998

508A Did (NAME) have more frequent loose or liquid stools YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
than usual? NO .................................... 2
508C
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

508B For how many days did (NAME) have frequent loose or
liquid stools? DAYS . . . . . . . . . . . . . . . . . . . . . . . . . . .
IF LESS THAN 1 DAY, RECORD '00'.
IF 95 OR MORE DAYS, RECORD '95'. DON'T KNOW ........................... 98

508C At any time during the final YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

(illness/events/circumstances) was there blood in the NO .................................... 2
509A
stools? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

508D Was there blood in the stool up until death? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

509A Did (NAME) vomit? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
510
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

509B Did (NAME) vomit in the week preceding death? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
510
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

509C For how many days before death did (NAME) vomit?
DAYS . . . . . . . . . . . . . . . . . . . . . . . . . . .
IF LESS THAN 1 DAY, RECORD '00'.
IF 95 OR MORE DAYS, RECORD '95'. DON'T KNOW ........................... 98

509D Did (NAME) vomit blood? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

PROBE TO MAKE SURE BLOOD WAS VOMITED, NO .................................... 2
NOT COUGHED DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

509E Was the vomit black? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

510 Did (NAME) have any belly (abdominal) problems? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
514
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

511A Did (NAME) have any belly (abdominal) pain? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
512A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

511B Was the belly (abdominal) pain severe? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Appendix F • 267
 SECTION 5. GENERAL SIGNS AND SYMPTOMS ASSOCIATED WITH FINAL ILLNESS

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

511C For how long before death did (NAME) have abdominal
pain? HOURS ...................... 1

DAYS . . . . . . . . . . . . . . . . . . . . . . . . . 2

IF LESS THAN 1 HOUR, RECORD '00' IN HOURS.

IF LESS THAN 1 DAY, RECORD IN HOURS. WEEKS ...................... 3
IF LESS THAN 1 WEEK, RECORD IN DAYS.
IF LESS THAN 1 MONTH, RECORD IN WEEKS.
MONTHS . . . . . . . . . . . . . . . . . . . . . . 4
IF 95 OR MORE MONTHS, RECORD '95' IN MONTHS.
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 998

511D Was the pain in the upper or lower abdomen? UPPER ABDOMEN . . . . . . . . . . . . . . . . . . . . . . . . . 1
LOWER ABDOMEN ...................... 2
UPPER AND LOWER ABDOMEN .......... 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

512A Did (NAME) have a more than usually protruding YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

abdomen? NO .................................... 2
513A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

512B For how long did (NAME) have a more than usually
protruding abdomen? DAYS . . . . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 DAY, RECORD '00' IN DAYS.

IF LESS THAN 1 MONTH, RECORD IN DAYS. MONTHS . . . . . . . . . . . . . . . . . . . . . . 2
IF 95 OR MORE MONTHS, RECORD '95' IN MONTHS.
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 998

512C How rapidly did (NAME) develop the protruding RAPIDLY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

abdomen? SLOWLY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

513A Did (NAME) have any mass in the abdomen? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
514
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

513B For how long before death did (NAME) have a mass in
the abdomen? DAYS . . . . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 DAY, RECORD '00' IN DAYS.

IF LESS THAN 1 MONTH, RECORD IN DAYS. MONTHS . . . . . . . . . . . . . . . . . . . . . . 2
IF 95 OR MORE MONTHS, RECORD '95' IN MONTHS.
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 998

514 Did (NAME) have a severe headache? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

515A Did (NAME) have a stiff neck during the YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

(illness/events/circumstances) that led to death? NO .................................... 2
516A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

515B For how many days before death did (NAME) have a
stiff neck? DAYS . . . . . . . . . . . . . . . . . . . . . . . . . . .
IF LESS THAN 1 DAY, RECORD '00'.
IF 95 OR MORE DAYS, RECORD '95'. DON'T KNOW ........................... 98

268 • Appendix F
 SECTION 5. GENERAL SIGNS AND SYMPTOMS ASSOCIATED WITH FINAL ILLNESS

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

516A Did (NAME) have a painful neck during the YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

(illness/events/circumstances) that led to death? NO .................................... 2
517A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

516B For how many days before death did (NAME) have a
painful neck? DAYS . . . . . . . . . . . . . . . . . . . . . . . . . . .
IF LESS THAN 1 DAY, RECORD '00'.
IF 95 OR MORE DAYS, RECORD '95'. DON'T KNOW ........................... 98

517A Did (NAME) have mental confusion? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
518A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

517B For how long did (NAME) have mental confusion?

MONTHS . . . . . . . . . . . . . . . . . . . . . . 1

IF LESS THAN 1 MONTH, RECORD '00' IN MONTHS

YEARS ...................... 2

DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 998

518A Was (NAME) unconscious during the YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

(illness/events/circumstances) that led to death? NO .................................... 2
519A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

518B Was (NAME) unconscious for more than 24 hours YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

before death? NO .................................... 2
519A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

518C Did the unconsciousness start suddenly or quickly, at YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

least within a single day? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

518D Did the unconsciousness continue until death? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

519A Did (NAME) have convulsions? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
520A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

519B For how many minutes did the convulsions last?

MINUTES . . . . . . . . . . . . . . . . . . . . . . . . .

IF LESS THAN 1 MINUTE, RECORD '00'. DON'T KNOW ........................... 98

IF 95 MINUTES OR MORE, RECORD '95'.

519C Did (NAME) become unconscious immediately after YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

the convulsion? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

520A Did (NAME) have any urine problems? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
522A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

520B Did (NAME) stop urinating? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

520C Did (NAME) go to urinate more often than usual? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Appendix F • 269
 SECTION 5. GENERAL SIGNS AND SYMPTOMS ASSOCIATED WITH FINAL ILLNESS

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

520D During the final (illness/events/circumstances) did YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

(NAME) ever pass blood in the urine? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

522A Did (NAME) have sores? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
523A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

522B Did the sores have clear fluid or pus? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

523A Did (NAME) have an ulcer or pit on the foot? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
524A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

523B Did the ulcer on the foot ooze pus? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
524A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

523C For how many days did the ulcer on the foot ooze pus?
DAYS . . . . . . . . . . . . . . . . . . . . . . . . . . .
IF LESS THAN 1 DAY, RECORD '00'.
IF 95 OR MORE DAYS, RECORD '95'. DON'T KNOW ........................... 98

524A During the (illness/events/circumstances) that led to YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

death, did (NAME) have any skin rash? NO .................................... 2
525
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

524B For how many days did (NAME) have the skin rash?
DAYS . . . . . . . . . . . . . . . . . . . . . . . . . . .
IF LESS THAN 1 DAY, RECORD '00'.
IF 95 OR MORE DAYS, RECORD '95'. DON'T KNOW ........................... 98

524C Where was the rash? FACE/HEAD ........................... A

TRUNK OR ABDOMEN ................... B
EXTREMITIES . . . . . . . . . . . . . . . . . . . . . . . . . . . C
EVERYWHERE . . . . . . . . . . . . . . . . . . . . . . . . . . . D
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . Y

525 Did (NAME) ever have shingles or herpes zoster? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

526 During the (illness/events/circumstances) that led to YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

death, did her skin flake off in patches? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

527A During the (illness/events/circumstances) that led to YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

death, did (NAME) bleed from anywhere? NO .................................... 2
528
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

527B Did (NAME) bleed from the mouth, nose, or anus? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

270 • Appendix F
 SECTION 5. GENERAL SIGNS AND SYMPTOMS ASSOCIATED WITH FINAL ILLNESS

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

528 Did (NAME) have noticeable weight loss? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

529 Was (NAME) severely thin or wasted? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

530 During the (illness/events/circumstances) that led to YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

death, did (NAME) have a whitish rash inside the NO .................................... 2
mouth or on the tongue? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

531 Did (NAME) have stiffness of the whole body or was YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
unable to open the mouth? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

532A Did (NAME) have puffiness of the face? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
533A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

532B For how many days did (NAME) have puffiness of the
face? DAYS . . . . . . . . . . . . . . . . . . . . . . . . . . .
IF LESS THAN 1 DAY, RECORD '00'.
IF 95 OR MORE DAYS, RECORD '95'. DON'T KNOW ........................... 98

533A During the (illness/events/circumstances) that led to YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

death, did (NAME) have swollen legs or feet? NO .................................... 2
534
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

533B How many days did the swelling last?

DAYS . . . . . . . . . . . . . . . . . . . . . . . . . . .
IF LESS THAN 1 DAY, RECORD '00'.
IF 95 OR MORE DAYS, RECORD '95'. DON'T KNOW ........................... 98

533C Did (NAME) have both feet swollen? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

534 Did (NAME) have general puffiness all over her body? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

535A Did (NAME) have any lumps? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
536A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

535B Did (NAME) have any lumps or lesions in the mouth? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

535C Did (NAME) have any lumps on the neck? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

535D Did (NAME) have any lumps on the armpit? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

535E Did (NAME) have any lumps on the groin? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Appendix F • 271
 SECTION 5. GENERAL SIGNS AND SYMPTOMS ASSOCIATED WITH FINAL ILLNESS

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

536A Was (NAME) in any way paralysed? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
537A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

536B Did (NAME) have paralysis of only one side of the YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
body? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

536C Which were the limbs or body parts paralysed? RIGHT SIDE OF BODY ................... 01
LEFT SIDE OF BODY . . . . . . . . . . . . . . . . . . . . . . 02
LOWER PART OF BODY . . . . . . . . . . . . . . . . . . . 03
UPPER PART OF BODY . . . . . . . . . . . . . . . . . . . 04
ONE LEG ONLY ......................... 05
ONE ARM ONLY ......................... 06
WHOLE BODY . . . . . . . . . . . . . . . . . . . . . . . . . . . 07
OTHER 08
(SPECIFY)
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 98

537A Did (NAME) have difficulty swallowing? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
538
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

537B For how many days before death did (NAME) have
difficulty swallowing? DAYS . . . . . . . . . . . . . . . . . . . . . . . . . . .
IF LESS THAN 1 DAY, RECORD '00'.
IF 95 OR MORE DAYS, RECORD '95'. DON'T KNOW ........................... 98

537C Was the difficulty with swallowing with solids, liquids, or SOLIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
both? LIQUIDS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
BOTH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

538 Did (NAME) have pain upon swallowing? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

539A Did (NAME) have yellow discoloration of the eyes? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
540
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

539B For how many days did (NAME) have the yellow
discoloration? DAYS . . . . . . . . . . . . . . . . . . . . . . . . . . .
IF LESS THAN 1 DAY, RECORD '00'.
IF 95 OR MORE DAYS, RECORD '95'. DON'T KNOW ........................... 98

540 Did her hair change in colour to a reddish or yellowish YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

colour? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

541 Did (NAME) look pale (thinning/lack of blood) or have YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

pale palms, eyes, or nail beds? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

542 Did (NAME) drink a lot more water than usual? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

272 • Appendix F
 SECTION 6. SIGNS AND SYMPTOMS ASSOCIATED WITH PREGNANCY AND WOMEN

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

601 Did (NAME) have any swelling or lump in the breast? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

602 Did (NAME) have any ulcers (pits) in the breast? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

603A Did (NAME) ever have a period or menstruate? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
604
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

603B Did (NAME) have vaginal bleeding in between YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

menstrual periods? NO .................................... 2
603D
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

603C Was the bleeding excessive? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

603D CHECK 104:

AGE AT DEATH 41-49 AGE AT DEATH 12-40 603G

603E Did her menstrual period stop naturally because of YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

menopause? NO .................................... 2
603G
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

603F Did (NAME) have vaginal bleeding after cessation of YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

menstruation? NO .................................... 2 701
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

603G Was there excessive vaginal bleeding in the week prior YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
to death? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

603I At the time of death was her period overdue? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
604
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

603J For how many weeks had her period been overdue?
WEEKS .........................
IF LESS THAN 1 WEEK, RECORD '00'.
IF 95 WEEKS OR MORE, RECORD '95'. DON'T KNOW ........................... 98

604 Did (NAME) have a sharp pain in her abdomen shortly YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
before death? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

605 Was (NAME) pregnant at the time of death? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 609

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

606 Did (NAME) die during or within 6 weeks of labour, YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 609
delivery, abortion, or miscarriage? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

608 Did (NAME) die less than 1 year after being pregnant YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 609
or delivering a baby? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Appendix F • 273
 SECTION 6. SIGNS AND SYMPTOMS ASSOCIATED WITH PREGNANCY AND WOMEN

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

608A Please confirm: you said (NAME) was not pregnant and had not been pregnant or delivered in the 12 months before
(NAME) died, is that right?

NO OR DON'T KNOW YES

(RESPONDENT CONFIRMS 701
PROBE 605-606 AND NO PREGNANCY IN 12 MONTHS
CORRECT 605-609 AS BEFORE DEATH)
NECESSARY.

609 For how many months was (NAME) pregnant?

MONTHS . . . . . . . . . . . . . . . . . . . . . . . . .

IF LESS THAN 1 MONTH, RECORD '00'. DON'T KNOW ........................... 98

611 Did she die during labour or delivery? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 614

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

612A Did (NAME) die after delivering a baby? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
613
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

612B Did (NAME) die within 24 hours after delivery? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 614
NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

613 Did (NAME) die within 6 weeks of childbirth? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

614 CHECK 611:

NO OR YES
DON'T KNOW

a) Did (NAME) give birth b) Did (NAME) give birth YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

to a live baby within 6 to a live baby? NO .................................... 2
weeks before death? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

615 Did (NAME) die during or after a multiple pregnancy? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

616A CHECK IF MOTHER LIVED MORE THAN 24 HOURS AFTER BIRTH TO A LIVE BABY (ABLE TO BREASTFEED)

IF 611 = NO AND 612B = NO AND 614 = YES, IF MOTHER DIED DURING DELIVERY (611 = YES) 617A
MOTHER SURVIVED MORE THAN 24 HOURS OR WITHIN 24 HOURS OF DELIVERY (612B = YES)
& BABY WAS BORN ALIVE OR BABY WAS NOT BORN ALIVE
(614 = NO OR DON'T KNOW)

274 • Appendix F
 SECTION 6. SIGNS AND SYMPTOMS ASSOCIATED WITH PREGNANCY AND WOMEN

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

616B Was (NAME) breastfeeding the child in the days before YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
death? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

617A How many births, including stillbirths, did (NAME) have

before this (baby/pregnancy)? BIRTHS .........................

DON'T KNOW ........................... 98

617B CHECK 617A:

NO. OF BIRTHS GREATER THAN ZERO NO. OF BIRTHS EQUAL TO ZERO 618

617C Had (NAME) had any previous caesarean section? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

618 During this pregnancy, did (NAME) suffer from high YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
blood pressure? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

619 Did (NAME) have foul smelling vaginal discharge YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

during pregnancy or after delivery? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

620 Did bleeding occur while (NAME) was pregnant? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
622A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

621 Was there vaginal bleeding during the first 6 months of YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
pregnancy? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

622A CHECK 609:

DON'T KNOW, OR 5 MONTHS OR LESS 624
>= 6 MONTHS

622B During the last 3 months of pregnancy, did (NAME) YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

suffer from convulsions? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

622C During the last 3 months of pregnancy, did (NAME) YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

suffer from blurred vision? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

622D Was there vaginal bleeding during the last 3 months of YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
pregnancy but before labour started? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

623A Did (NAME) have excessive bleeding during labour or YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

delivery? NO .................................... 2
NA - LABOUR NEVER STARTED . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

623B Did (NAME)'s water break before labour started or BEFORE LABOUR STARTED . . . . . . . . . . . . . . . . 1
during labour? DURING LABOUR . . . . . . . . . . . . . . . . . . . . . . . . . 2
NA - WATER NEVER BROKE . . . . . . . . . . . . . . . . 3 624
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

623C Was the baby delivered less than 24 hours after LESS THAN 24 HOURS ................... 1
(NAME)'s water broke? MORE THAN 24 HOURS . . . . . . . . . . . . . . . . . . . 2
NA - BABY NEVER DELIVERED . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Appendix F • 275
 SECTION 6. SIGNS AND SYMPTOMS ASSOCIATED WITH PREGNANCY AND WOMEN

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

623D When (NAME)'s water broke, did the water smell foul? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

624 Did (NAME) have excessive bleeding after YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

(delivery/miscarriage/abortion)? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

625 Did (NAME) attempt to terminate the pregnancy? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

626 Did (NAME) recently have a pregnancy that ended in a YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

miscarriage or abortion? NO .................................... 2
629A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

627 Did (NAME) die during a miscarriage or abortion? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

628 Did (NAME) die within 6 weeks of having a miscarriage YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

or abortion? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

629A CHECK 611

NO OR DON'T KNOW YES 630

629B CHECK 612A

YES NO OR DON'T KNOW 701

630 Where did (NAME) give birth? PUBLIC SECTOR

GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . . . 11
GOVT HEALTH CENTER/CLINIC . . . . . . . . . . 12
GOVT HEALTH POST/CHPS . . . . . . . . . . . . . 13
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 14
OTHER PUBLIC SECTOR
16
(SPECIFY)

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC . . . . . . . . . . . . . 21
FP/PPAG CLINIC ...................... 22
MOBILE CLINIC/OUTREACH . . . . . . . . . . . . . 23
MATERNITY HOME . . . . . . . . . . . . . . . . . . . . . . 24
OTHER PRIVATE MEDICAL SECTOR
26
(SPECIFY)

HOME
DECEASED WOMAN'S HOME . . . . . . . . . . 31
OTHER HOME . . . . . . . . . . . . . . . . . . . . . . . . . 32
TBA'S HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

OTHER 96
(SPECIFY)

631 Did (NAME) receive professional assistance during the YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

delivery? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

276 • Appendix F
 SECTION 6. SIGNS AND SYMPTOMS ASSOCIATED WITH PREGNANCY AND WOMEN

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

632 Who delivered the baby? HEALTH PERSONNEL

DOCTOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A
NURSE/MIDWIFE . . . . . . . . . . . . . . . . . . . . . . B
COM. HEALTH OFFICER/NURSE ........ C

CIRCLE ALL MENTIONED. OTHER PERSON

TRADITIONAL BIRTH ATTENDANT . . . . . . . . D
VILLAGE HEALTH VOLUNTEER . . . . . . . . . . E
TRADITIONAL HEALTH
PRACTITIONER . . . . . . . . . . . . . . . . . . . . . . F
RELATIVE/FRIEND . . . . . . . . . . . . . . . . . . . . . . G
OTHER X
(SPECIFY)
NO ONE ASSISTED ...................... Y

633 Did (NAME) have an operation to remove her uterus YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

shortly before death because of problems with NO .................................... 2
labour/delivery? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

634 Was the delivery normal vaginal, without forceps or YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 637
vacuum? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

635 Was it a vaginal delivery with forceps or vacuum? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 637

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

636 Was the delivery a caesarean section? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

637 Was the baby born more than one month early? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

638 Was the placenta completely delivered? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

639 Did (NAME) deliver or try to deliver an abnormally YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

positioned baby? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

640 For how many hours was (NAME) in labour?

HOURS .........................

IF LESS THAN 1 HOUR, RECORD '00'. NEVER IN LABOUR . . . . . . . . . . . . . . . . . . . . . . 96

IF 95 OR MORE HOURS, RECORD '95'. DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 98

Appendix F • 277
 SECTION 7. RISK FACTORS
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

701 Did (NAME) drink alcohol at least once a week? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO ................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

702A Did (NAME) use tobacco? (Cigarette, cigar, pipe, etc.) YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO ................................... 2
801
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

702B What kind of tobacco did (NAME) use? CIGARETTES . . . . . . . . . . . . . . . . . . . . . . . . . . . A

PIPE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B
CHEWING TOBACCO . . . . . . . . . . . . . . . . . . . . . C
801
FOLLOW SKIP FOR HIGHEST CODE CIRCLED. SNUFF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . Y

702C How many cigarettes did (NAME) smoke daily?

NUMBER . . . . . . . . . . . . . . . . . . . . . . . .

IF LESS THAN ONCE PER DAY, RECORD '00'. DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 98

278 • Appendix F
 SECTION 8. TREATMENT RECEIVED AND HEALTH SERVICE UTILISATION
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

801 Did (NAME) receive any treatment for the YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

(illness/events/circumstances) that led to her death? NO ................................... 2
810A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

802 Did (NAME) receive oral rehydration salts? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO ................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

803 Did (NAME) receive (or need) intravenous fluids (drip) YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
treatment? NO ................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

804 Did (NAME) receive (or need) a blood transfusion? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO ................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

805 Did (NAME) receive (or need) treatment/food through YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

a tube passed through the nose? NO ................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

806 Did (NAME) receive (or need) injectable antibiotics? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO ................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

807 Did (NAME) receive (or need) antiretroviral therapy YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

(ART)? NO ................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

808A Did (NAME) have (or need) an operation for the YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
(illness/events/circumstances)? NO ................................... 2
809
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

808B Did (NAME) have the operation within 1 month before YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
death? NO ................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

809 Was (NAME) discharged from hospital very ill? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO ................................... 2
NEVER ADMITTED . . . . . . . . . . . . . . . . . . . . . . . . 3
NEVER DISCHARGED . . . . . . . . . . . . . . . . . . . . . 4
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

810A Was care sought outside the home while (NAME) had YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
this (illness/events/circumstances)? NO ................................... 2
811A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Appendix F • 279
 SECTION 8. TREATMENT RECEIVED AND HEALTH SERVICE UTILISATION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

810B Where was care sought? PUBLIC SECTOR

GOVT HOSPITAL . . . . . . . . . . . . . . . . . . . . . A
PROBE: Any others? GOVT HEALTH CENTER/CLINIC . . . . . . . . . . B
GOVT HEALTH POST/CHPS . . . . . . . . . . . . . C
MOBILE CLINIC . . . . . . . . . . . . . . . . . . . . . . . . D
OTHER PUBLIC SECTOR
E
(SPECIFY)

PRIVATE MEDICAL SECTOR

PRIVATE HOSPITAL/CLINIC . . . . . . . . . . . . . F
FP/PPAG CLINIC ..................... G
CIRCLE ALL MENTIONED. MOBILE CLINIC . . . . . . . . . . . . . . . . . . . . . . . . H
MATERNITY HOME . . . . . . . . . . . . . . . . . . . . . I
PHARMACY/CHEMIST/DRUG STORE. . . . . . . J
OTHER PRIVATE MEDICAL SECTOR
K
(SPECIFY)

HOME
DECEASED WOMAN'S HOME .......... L
OTHER HOME . . . . . . . . . . . . . . . . . . . . . . . . M
TBA'S HOME . . . . . . . . . . . . . . . . . . . . . . . . . . . N

OTHER PLACE
PRAYER CAMP/SHRINE ................ O

OTHER X
(SPECIFY)

810C IF NOT MENTIONED IN 810B, PROBE TO

DETERMINE THE NAME OF THE MAIN SOURCE OF
CARE.

RECORD NAME OR ADDRESS OF THE MAIN

SOURCE OF CARE.

811A Did a health care worker tell you the cause of death? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
NO ................................... 2
812A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

811B What did the health care worker say?

WRITE EXACTLY AS THE RESPONDENT TELLS YOU.

IMPORTANT: READ YOUR NOTES BACK TO THE RESPONDENT SO HE OR SHE CAN CORRECT OR CLARIFY

812A Do you have any health records that belonged to YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

(NAME)? NO ................................... 2
901A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

812B Can I see the health records? YES ................................... 1

NO ................................... 2 901A

280 • Appendix F
 SECTION 8. TREATMENT RECEIVED AND HEALTH SERVICE UTILISATION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

812C RECORD THE KIND OF HEALTH RECORDS MATERNAL HEALTH BOOK . . . . . . . . . . . . . . . . A

PROVIDED. PRESCRIPTION FORM .................. B
TREATMENT CARDS . . . . . . . . . . . . . . . . . . . . . C
DISCHARGE FORM ..................... D
LABORATORY RESULTS . . . . . . . . . . . . . . . . . . E
PATIENT FOLDER . . . . . . . . . . . . . . . . . . . . . . . . F
IMAGING/SCAN . . . . . . . . . . . . . . . . . . . . . . . . . . . G
INSURANCE FORM ..................... H

OTHER X
(SPECIFY)

813A RECORD THE DATE OF THE MOST RECENT (LAST)

VISIT. DAY ...........................

DAY NOT RECORDED .................. 98

MONTH ........................

MONTH NOT RECORDED . . . . . . . . . . . . . . . . 98

YEAR . . . . . . . . . . . . . . . .

YEAR NOT RECORDED . . . . . . . . . . . . . . . . . .9998

813B RECORD THE WEIGHT WRITTEN AT THE MOST

RECENT (LAST) VISIT. KILOS ..... .

WEIGHT NOT RECORDED . . . . . . . . . . . . . . 99998

..

814A RECORD THE DATE OF THE LAST BUT ONE NO SECOND LAST VISIT . . . . . . . . . . . . . . . . . . 96 815A
(SECOND LAST) VISIT.

DAY ...........................

DAY NOT RECORDED .................. 98

MONTH ........................

MONTH NOT RECORDED . . . . . . . . . . . . . . . . 98

YEAR . . . . . . . . . . . . . . . .

YEAR NOT RECORDED . . . . . . . . . . . . . . . . . .9998

814B RECORD THE WEIGHT WRITTEN AT THE LAST

BUT ONE (SECOND LAST) VISIT. KILOS ..... .

WEIGHT NOT RECORDED . . . . . . . . . . . . . . 99998

..

Appendix F • 281
 SECTION 8. TREATMENT RECEIVED AND HEALTH SERVICE UTILISATION

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

815A RECORD THE DATE OF THE MOST RECENT (LAST) NO NOTE ............................. 96 901A
NOTE.

DAY ...........................

DAY NOT RECORDED .................. 98

MONTH ........................

MONTH NOT RECORDED . . . . . . . . . . . . . . . . 98

YEAR . . . . . . . . . . . . . . . .

YEAR NOT RECORDED . . . . . . . . . . . . . . . . . .9998

815B TRANSCRIBE THE LAST NOTE ON THE HEALTH RECORDS.

WRITE EXACTLY WHAT IS WRITTEN ON THE HEALTH RECORD.

282 • Appendix F
 SECTION 9. BACKGROUND AND CONTEXT, ACCESS AND QUALITY OF SERVICES

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

901A In the final days before death, did (NAME) travel to a YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
hospital or health facility? NO .................................... 2
906
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

901B What is the name of the health facility? NAME 1

(SPECIFY)
DON'T KNOW ........................... 8

902A Did (NAME) use motorised transport to get to the YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

hospital or health facility? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 903

902B What was the main means of transport (NAME) used SHARED TAXI . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
to get to the health facility? INDIVIDUAL TAXI . . . . . . . . . . . . . . . . . . . . . . . . . 12
TROTRO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
BUS (METRO MASS) . . . . . . . . . . . . . . . . . . . . . . 14
PRIVATE CAR . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
TRAIN ................................. 16
MOTORCYCLE . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
CANOE/BOAT/FERRY WITH MOTOR ........ 18
AMBULANCE ........................... 19

CANOE/BOAT/FERRY, NO MOTOR . . . . . . . . . . 20
BICYCLE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
ON FOOT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

OTHER 96
(SPECIFY)
DON'T KNOW ........................... 98 903

902C How long did it take to get to the health facility?

MINUTES . . . . . . . . . . . . . . . . . . .

CONVERT TIME GIVEN INTO MINUTES DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 998

IF 995 MINUTES OR MORE, RECORD '995'

903 Were there any problems in being received at the YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

hospital or health facility? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

904 Were there any problems with the way (NAME) was YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
treated in the hospital or health facility? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
PROBE: Problems with the medical treatment,
procedures, interpersonal attitudes, respect, dignity?

905 Were there any problems getting medications or YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

diagnostic tests in the hospital or health facility? NO .................................... 2
N/A - DEAD ON ARRIVAL . . . . . . . . . . . . . . . . . . . 3
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

906 How long does it take to get to the nearest 24-hour

health facililty from (NAME)'s household? MINUTES . . . . . . . . . . . . . . . . . . .

CONVERT TIME GIVEN INTO MINUTES DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 998

IF 995 MINUTES OR MORE, RECORD '995'

Appendix F • 283
 SECTION 9. BACKGROUND AND CONTEXT, ACCESS AND QUALITY OF SERVICES

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

907 In the final days before death, were there any doubts YES, THERE WERE DOUBTS ............. 1
about whether medical care was needed? NO DOUBTS - ILLNESS NOT SERIOUS . . . . . . . . 2
NO DOUBTS - DEATH INEVITABLE . . . . . . . . . . 3
PROBE IF NO: Why not? NO DOUBTS - WENT TO FACILITY . . . . . . . . . . 4
NO DOUBTS - NOT SICK BEFORE DEATH . . . . . 5
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

908 In the final days before death, was traditional/herbal or YES, TRADITIONAL/HERBAL ONLY ........ 1
spiritual medicine used? YES, SPIRITUAL ONLY ................... 2
YES, BOTH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
NO .................................... 4
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

909 In the final days before death, did anyone use a YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
telephone or cell phone to call for help? NO .................................... 2
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

910 Over the course of (illness/events/circumstances), did YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

the total costs of care and treatment prohibit other NO .................................... 2
household payments? DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

284 • Appendix F
 SECTION 10. DEATH CERTIFICATE AND BURIAL PERMIT

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

1001A Do you have a death certificate for (NAME)? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
1004A
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

1001B Can I see the death certificate? YES .................................... 1

NO .................................... 2 1004A

1002A COPY DAY, MONTH, AND YEAR OF DEATH FROM

THE DEATH CERTIFICATE. DAY ...........................

DAY NOT RECORDED . . . . . . . . . . . . . . . . . . . 98

MONTH .........................

MONTH NOT RECORDED . . . . . . . . . . . . . . . . 98

YEAR . . . . . . . . . . . . . . . .

YEAR NOT RECORDED . . . . . . . . . . . . . . . . . . 9998

.

1002B COPY DAY, MONTH, AND YEAR OF ISSUE OF

DEATH CERTIFICATE. DAY ...........................

DAY NOT RECORDED . . . . . . . . . . . . . . . . . . . 98

MONTH .........................

MONTH NOT RECORDED . . . . . . . . . . . . . . . . 98

YEAR . . . . . . . . . . . . . . . .

YEAR NOT RECORDED . . . . . . . . . . . . . . . . . . 9998

.

1003A RECORD THE CAUSE OF DEATH FROM THE FIRST (TOP) LINE OF THE DEATH CERTIFICATE:

1003B RECORD THE CAUSE OF DEATH FROM THE SECOND LINE OF THE DEATH CERTIFICATE (IF ANY):

1003C RECORD THE CAUSE OF DEATH FROM THE THIRD LINE OF THE DEATH CERTIFICATE (IF ANY):

1003D RECORD THE CAUSE OF DEATH FROM THE FOURTH LINE OF THE DEATH CERTIFICATE (IF ANY):

Appendix F • 285
 SECTION 10. DEATH CERTIFICATE AND BURIAL PERMIT

NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

1004A Do you have a burial permit for (NAME)? YES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

NO .................................... 2
1007
DON'T KNOW . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

1004B Can I see the burial permit? YES .................................... 1

NO .................................... 2 1007

1005 COPY DAY, MONTH, AND YEAR OF ISSUE OF

BURIAL PERMIT. DAY ...........................

DAY NOT RECORDED . . . . . . . . . . . . . . . . . . . 98

MONTH .........................

MONTH NOT RECORDED . . . . . . . . . . . . . . . . 98

YEAR . . . . . . . . . . . . . . . .

YEAR NOT RECORDED . . . . . . . . . . . . . . . . . . 9998

.

1006 RECORD THE CAUSE OF DEATH FROM THE BURIAL PERMIT:

1007 RECORD THE TIME.

HOURS .........................

MINUTES . . . . . . . . . . . . . . . . . . . . . . . . .

286 • Appendix F
 INTERVIEWER'S OBSERVATIONS
TO BE FILLED IN AFTER COMPLETING INTERVIEW

COMMENTS ABOUT INTERVIEW:

COMMENTS ON SPECIFIC QUESTIONS:

ANY OTHER COMMENTS:

SUPERVISOR'S OBSERVATIONS

Appendix F • 287
288 • Appendix F
 14 DEC 2016
2017 GHANA MATERNAL HEALTH SURVEY
FIELDWORKER QUESTIONNAIRE
GHANA STATISTICAL SERVICES LANGUAGE OF
QUESTIONNAIRE ENGLISH
NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

100 What is your name?

NAME

101 RECORD FIELDWORKER NUMBER

NUMBER . . . . . . . . . . . . . .

INSTRUCTIONS
We are collecting information on the 2017 GMHS field staff. Please fill in the information below. The information will be part of the survey data
files. Your name will not be in the data files; your information will remain anonymous. If there is any question you do not want to answer you
may skip it and go to the next question.

102 In what Region do you live? WESTERN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 01

CENTRAL ............................... 02
GREATER ACCRA . . . . . . . . . . . . . . . . . . . . . . . . . 03
VOLTA ............................... 04
EASTERN ............................... 05
ASHANTI ............................... 06
BRONG AHAFO ......................... 07
NOTHERN ............................ 08
UPPER EAST ............................ 09
UPPER WEST . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

103 Do you live in a city, town, or rural area? CITY .................................. 1

TOWN .................................. 2
RURAL .................................. 3

104 How old are you?

RECORD AGE IN COMPLETED YEARS. AGE ............................

105 Are you male or female? MALE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

FEMALE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

106 What is your current marital status? CURRENTLY MARRIED ................... 1

LIVING WITH A MAN/WOMAN . . . . . . . . . . . . . . . . . 2
WIDOWED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
DIVORCED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
SEPARATED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
NEVER MARRIED OR LIVED
WITH A MAN/WOMAN . . . . . . . . . . . . . . . . . . . 6

107 How many living children do you have?

INCLUDE ONLY CHILDREN WHO ARE YOUR LIVING
BIOLOGICAL CHILDREN. CHILDREN ...................

108 Have you ever had a child who died? YES ..................................... 1
NO ..................................... 2

109 What is the highest level of school you attended: PRIMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

primary, middle, JSS/JHS, SSS/SHS, secondary, or MIDDLE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
higher? JSS/JHS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
SECONDARY ............................ 4
SSS/SHS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
HIGHER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

110 What is the highest GRADE you completed at that

level?
IF COMPLETED LESS THAN ONE YEAR AT THAT GRADE .........................
LEVEL, RECORD '00'.

Appendix F • 289
 NO. QUESTIONS AND FILTERS CODING CATEGORIES SKIP

111 What is your religion? CATHOLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 01

ANGLICAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 02
METHODIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 03
PRESBYTERIAN ...................... 04
PENTECOSTAL/CHARISMATIC . . . . . . . . . . . . . . 05
OTHER CHRISTIAN ...................... 06
ISLAM .................................. 07
TRADITIONAL/SPIRITUALIST . . . . . . . . . . . . . . . . . 08

NO RELIGION . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95

OTHER 96
(SPECIFY)

112 What is your ethnicity? AKAN ............................... 01

GA/DANGME ............................ 02
EWE .................................. 03
GUAN ............................... 04
MOLE-DAGBANI ......................... 05
GRUSI ............................... 06
GURMA ............................... 07
MANDE ............................... 08

OTHER
(SPECIFY) 96

113 What languages can you speak? AKAN .................................. A

GA .................................. B
EWE .................................. C
RECORD ALL LANGUAGES YOU CAN SPEAK. ENGLISH ............................... D

OTHER X
(SPECIFY)

114 What is your mother tongue/native language (language AKAN .................................. A

spoken at home growing up)? GA .................................. B
EWE .................................. C

OTHER X
(SPECIFY)

115 Have you ever worked on a DHS survey prior to this YES ..................................... 1
one? NO ..................................... 2

116 Have you ever worked on any other survey prior to this YES ..................................... 1
one (not a DHS)? NO ..................................... 2

117 Were you already working for the Ghana Health YES, GHS ............................... 1
Service (GHS) or the Ghana Statistical Service (GSS) YES, GSS ............................... 2
at the time you were employed to work on this MHS?
NO ..................................... 3 119

118 Are you a permanent or temporary employee of the

Ghana Health Service (GHS) or the Ghana Statistical PERMANENT ............................ 1
Service (GSS)? TEMPORARY ............................ 2

119 If you have comments, please write them here.

290 • Appendix F
 ADDITIONAL DHS PROGRAM RESOURCES

The DHS Program Website – Download free DHS DHSprogram.com

reports, standard documentation, key indicator data,
and training tools, and view announcements.

STATcompiler – Build custom tables, graphs, and Statcompiler.com

maps with data from 90 countries and thousands of
indicators.

DHS Program Mobile App – Access key DHS Search DHS Program in your
indicators for 90 countries on your mobile device iTunes or Google Play store
(Apple, Android, or Windows).

DHS Program User Forum – Post questions about userforum.DHSprogram.com

DHS data, and search our archive of FAQs.

Tutorial Videos – Watch interviews with experts and www.youtube.com/DHSProgram

learn DHS basics, such as sampling and weighting,
downloading datasets, and how to read DHS tables.

Datasets – Download DHS datasets for analysis. DHSprogram.com/Data

Spatial Data Repository – Download geographically- spatialdata.DHSprogram.com

linked health and demographic data for mapping in a
geographic information system (GIS).

Social Media – Follow The DHS Program and join the conversation. Stay up to date through:

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