Expanded Community Based Distribution Project: Impact Analysis Report, Zimbabwe Inga Adams Hatai Kraushaar September 2005 Advance Africa Project This report was made possible through support provided by the US Agency for International Development, under the terms of Cooperative Agreement Number HRN-A-00-00-00002-00. The opinions expressed herein are those of the author(s) and do not necessarily reflect the views of the US Agency for International Development. Management Sciences for Health 4301 North Fairfax Drive, Suite 400 Arlington, Virginia 22203 Telephone: 703-310-3500 Expanding family planning and reproductive health services in Africa Advance Africa is sponsored by the United States Agency for International Development 4301 N. Fairfax Drive Suite 400 Arlington, VA 22203 Tel: (703) 310-3500 Fax: (703) 524-7898 www.advanceafrica.org Expanded Community Based Distribution Project Impact Analysis Report Zimbabwe September 2005 Inga Adams Hatai Kraushaar Management Sciences for Health Advance Africa © 2005 Advance Africa Working to improve the health and well-being of African families through strengthened reproductive health and family planning services 4301 North Fairfax Drive, Suite 400 Arlington, Virginia 22203 USA E-mail: eseidner@advanceafrica.org Website: www.advanceafrica.org Funding for Expanded Community Based Distribution Project: Impact Evaluation Report, Zimbabwe was provided by the United States Agency for International Development (USAID). The views expressed are those of the authors and do not necessarily reflect those of USAID. i Table of Contents Table of Contents ...............................................................................................................i Acronyms...........................................................................................................................iii Acknowledgements .......................................................................................................... iv Executive Summary ..........................................................................................................1 Background....................................................................................................................................................1 Key Findings...................................................................................................................................................1 Increased % of respondents married or in a union..........................................................................2 Improved knowledge of risk factors for STIs and HIV/AIDS.........................................................2 Increased awareness of STIs and HIV/AIDS ......................................................................................2 Increased testing and referral on HIV/AIDS......................................................................................2 Improved knowledge of family planning methods............................................................................3 Sources of information on family planning and HIV/AIDS..............................................................3 Increased use of family planning methods..........................................................................................3 Sources of family planning commodities.............................................................................................4 Program Background........................................................................................................5 Overview........................................................................................................................................................5 Program Limitations ....................................................................................................................................6 Evaluation Process.............................................................................................................7 Baseline Evaluation Process .......................................................................................................................7 Baseline evaluation objective.................................................................................................................7 Methodology/questionnaire design......................................................................................................7 Sampling design ........................................................................................................................................7 Final baseline sample size.......................................................................................................................8 Training and fieldwork............................................................................................................................8 Data entry and analysis...........................................................................................................................8 Endline Evaluation Process.........................................................................................................................9 Endline evaluation objective..................................................................................................................9 Methodology/questionnaire design......................................................................................................9 Sampling design ..................................................................................................................................... 10 Final endline sample size ..................................................................................................................... 11 Data entry and analysis........................................................................................................................ 11 Overall Impact Evaluation Process........................................................................................................ 11 Study Limitations....................................................................................................................................... 12 Characteristics of Respondents......................................................................................13 Total Sample Size ...................................................................................................................................... 13 Distribution of Respondents by Gender.............................................................................................. 13 ii Distribution of Respondents by Marital Status................................................................................... 14 Distribution of Respondents by Age and Level of Education.......................................................... 15 Findings.............................................................................................................................17 Sexual Experience ..................................................................................................................................... 17 Number of sexual partners in the last 12 months........................................................................ 17 Use of family planning methods at last sexual encounter............................................................ 18 Types of family planning methods used at last sexual encounter.............................................. 19 Family Planning........................................................................................................................................... 21 Types of family planning methods respondents have heard of................................................... 21 Source of information on the family planning methods respondents have heard of............. 24 Currently using a family planning method....................................................................................... 26 Type of family planning methods respondents are currently using........................................... 28 Source of family planning methods respondents are currently using ....................................... 30 STIs & HIV/AIDS ....................................................................................................................................... 32 Awareness of STIs................................................................................................................................ 32 Awareness of HIV/AIDS...................................................................................................................... 34 Awareness of HIV/AIDS risk factors................................................................................................ 35 HIV/AIDS testing................................................................................................................................... 37 Date of HIV/AIDS test......................................................................................................................... 38 HIV/AIDS test referral sources ......................................................................................................... 39 Willingness to be tested for HIV ...................................................................................................... 40 References ........................................................................................................................42 Annexes ............................................................................................................................43 Annex 1: Revisions to Original Impact Evaluation Analysis............................................................. 44 Annex 2: Baseline Evaluation Male Questionnaire ........................................................................... 46 Annex 3: Baseline Evaluation Female Questionnaire....................................................................... 56 Annex 4: Endline Evaluation Male Questionnaire............................................................................. 70 Annex 5: Endline Evaluation Female Questionnaire ........................................................................ 82 Annex 6: Data Analysis Tables............................................................................................................... 94 Respondent Background Tables........................................................................................................ 94 Sexual Experience Tables.................................................................................................................... 97 Family Planning Tables .......................................................................................................................100 STI & HIV/AIDS Tables......................................................................................................................109 Annex 7: Baseline and Endline Data Analysis Process and Notes ..............................................114 General Notes.....................................................................................................................................114 Reformatting........................................................................................................................................114 Recoding ...............................................................................................................................................115 Labeling (see the Variable View page in the SPSS databases) ...................................................118 Key Differences between the Baseline and Endline Forms.......................................................119 Notes Specific to the Baseline Database.......................................................................................120 Notes Specific to the Endline Database ........................................................................................121 iii Acronyms AIDS ................................................................................... acquired immune deficiency syndrome CBD ................................................................................................ Community Based Distribution CPR.....................................................................................................contraceptive prevalence rate FP .............................................................................................................................family planning HIV .................................................................................................human immunodeficiency virus RH...................................................................................................................... reproductive health STI......................................................................................................sexually transmitted infection VIDCO........................................................................................Village Development Committees ZDHS ..........................................................................Zimbabwe Demographic and Health Survey ZNFPC ..................................................................... Zimbabwe National Family Planning Council iv Acknowledgements This evaluation report is based on the original baseline assessment work of the Evaluation and Research Unit of the Zimbabwe National Family Planning Council (ZNFPC). The authors of that report, which is referenced throughout this document, are Ronika Nyakauru and Caroline S. Marangwanda of ANFPC and Youssouff Quedraogo of Advance Africa. The endline data analysis is based on the original work of Select Research on behalf of ZNFPC. Hatai Kraushaar played a key role in recoding the data, refining the databases and running data tables. Thank you to Issakha Diallo, Nina Pruyn and Erin Seidner of Advance Africa for providing direction and clarifying information for this evaluation. CBD Impact Analysis: Executive Summary 1 Executive Summary Background In 2001, USAID/Zimbabwe asked Advance Africa to implement a major program designed to strengthen the Zimbabwe Community Based Distribution (CBD) Program for family planning. Through this program, CBD agents can more effectively deliver comprehensive reproductive health services, including HIV/AIDS prevention and referral. Advance Africa supported the USAID/Zimbabwe strategic objective to mitigate the spread of HIV/AIDS through the integration of HIV services into the national CBD Program, thereby creating the Expanded CBD Program1 . At the start of Advance Africa’s programming in Zimbabwe, the Evaluation and Research Unit of the Zimbabwe National Family Planning Council (ZNFPC) conducted a baseline evaluation of the CBD program. A follow-up evaluation was carried out in 2004 to provide a pre-post analysis. In September 2005 the baseline and endline data were reanalyzed to prepare this impact evaluation report. Key Findings The impact evaluation assessed 15-34 year olds in the program and control provinces using a household survey. Respondents were asked a series of questions at baseline and endline relating to: • Respondent’s background and characteristics • Knowledge of family planning (FP) methods, sexually transmitted infections (STIs) and HIV/AIDS • Sources of information, commodities and referrals • Use of family planning methods and other services In many cases, rates for many of the key indicators were similar across control and intervention groups at endline. However, comparisons to the baseline data reveal several positive improvement trends for the intervention provinces. Overall, there were improvements in the intervention region in specific areas of HIV/AIDS programming, including awareness of risk factors, HIV/AIDS testing history and improved referrals from CBDs for HIV/AIDS testing. Meanwhile, though the Advance Africa program did not directly support the family planning work of CBDs, there was improvement in several family planning indicators from baseline to endline. This suggests that the addition of HIV/AIDS programming did not negatively impact the family planning work of the CBDs. Some of the key findings are highlighted below. 1 http://www.advanceafrica.org/where_we_work/Zimbabwe.html CBD Impact Analysis: Executive Summary 2 Increased % of respondents married or in a union Rates of marriage were analyzed for male and female respondents. Respondents were grouped as married/in a union or not married/not in a union. Rates of married/in union increased for both males and females from baseline to endline in the control and intervention groups. At endline, more intervention group females were married/in union (62%) than control group females (50%), intervention group males (36%) or control group males (30%). Improved knowledge of risk factors for STIs and HIV/AIDS A high number of sexual partners in the last twelve months is a risk factor for the transmission of sexually transmitted infections (STIs), including HIV/AIDS. The evaluation identified an increase in the percent of respondents with only one partner in the previous 12 months. At endline, 16% more males in both the intervention and control groups reported having only one partner in the last 12 months than at baseline. The proportion of males with three or more partners in the last 12 months fell by 13% in both groups. While among males there was a reduction in multiple partners, among females there was an increase in zero partners. At endline, more females in both the intervention (93%) and control (92%) group reported having zero or one partner. Few females in either study group reported having multiple partners. When asked to list specific HIV/AIDS risk factors, more respondents at endline were able to correctly name a risk factor than at baseline. At endline 95% of intervention group respondents were aware of at least one correct risk factor for HIV/AIDS, up from 23% at baseline (72% improvement). Similarly, 98% of control group respondents were aware of at least one correct risk factor at endline, up from 29% at baseline (69% improvement). In analyzing the incorrect answers, there was a significant drop in the percent of respondents naming “using condoms” as a way that HIV/AIDS can be transmitted. Increased awareness of STIs and HIV/AIDS Respondents were asked if they had head of diseases that can be transmitted by sexual intercourse. The majority of respondents in both the control (98%) and intervention (97%) groups had heard of STIs. This was a slight improvement from baseline to endline. Respondents were asked to list the types of STIs they had heard of as a measure of awareness of STIs. There was high awareness of HIV/AIDS at both baseline and endline, though mention of HIV/AIDS decrease by 5% in the intervention group. Awareness of other STIs improved. When respondents were asked specifically if they had heard about HIV/AIDS, almost all respondents in both study groups answered that they had heard of HIV/AIDS. Increased referral and testing for HIV/AIDS Respondents were asked if they had ever been tested for HIV. While overall a low percentage reported that they had been tested, there was some improvement from baseline to endline. In the intervention group 19% reported that they had been tested for HIV/AIDS, up 11% from baseline. Only 11% had been tested in the control group, up 6% from baseline. Most had been tested in the two previous years (2003 or 2004). CBD Impact Analysis: Executive Summary 3 CBDs do not provide HIV/AIDS testing, but instead refer patients to testing centers. In the intervention group 48% of respondents who had been tested at endline were referred by a health system source. Of note, there was a 10% increase in the number that had been referred through a CBD. Most control group respondents who had been tested were referred by health system sources (57%) at endline, though only 3% had been referred through a CBD. Improved knowledge of family planning methods Awareness of different types of family planning methods improved for both the control and intervention groups. Over 90% of all respondents in both groups stated that they had heard of the male condom at endline, and awareness of the contraceptive pill was second most common. Among females there was increased awareness of the male condom in the control (8% increase) and intervention (7% increase) groups. Among males awareness of the contraceptive pill and female condom improved most. Sources of information on family planning and HIV/AIDS All survey respondents were asked to name the source of information for the family planning methods they had heard of and of their source of information on HIV/AIDS. While responses indicated that the main sources of information on family planning methods were from non-health system sources (such as radio, friends, school, etc), there was an increase in the percent who received information from a health system source (such as physicians, CBD, etc.), including CBDs, in the intervention and control groups. Similarly, while most respondents listed non-health system sources as their main source of information on HIV/AIDS, there was an increase in the mention of health system sources. Specifically, more respondents listed CBDs as their main source of HIV/AIDS information at endline than at baseline in both the intervention (18% increase) and control (12% increase) groups. Increased use of family planning methods The evaluation found a modest increase in the percent of respondents who had used some method of family planning to prevent pregnancy or disease at their last sexual encounter. Sixty￾five percent of people interviewed in the intervention provinces had used a FP method at their last sexual encounter (4% increase) as had 67% of the control group (13% increase). Similarly, when asked if they were currently using a family planning method, over 60% in both groups reported that they were currently using a family planning method at endline. There was an 8% increase in use of FP among the control group while in the intervention group the current use of FP dropped by 1%. This was offset, however, by an increase in the percent that were currently pregnant. The types of family planning methods used were similar for the control and intervention groups. At their last sexual encounter, most reported using the pill or the male condom. Use of the pill increased while use of the male condom dropped slightly for both the control and intervention groups. Similarly, when asked what they were currently using in terms of FP methods, most reported use of the pill, though females in the intervention group reported a modest 2% increase CBD Impact Analysis: Executive Summary 4 in the use of the male condom. Those who were married/in a union were more likely to mention current use of the contraceptive pill at endline, while those not married/not in a union mentioned the male condom most frequently. Sources of family planning commodities Respondents were asked to name the source of the family planning method they were currently using. In contrast to the source of information on all family planning methods, which was primarily non-health system, the main source of actual family planning commodities was the health system for both the control and intervention groups. CBD Impact Analysis: Program Background 5 Program Background Overview2 The Zimbabwean Family Planning (ZNFPC) program is one of the oldest Family Planning programs in Africa. It began in 1953 and the Community Based Distribution (CBD) component was added in 1965. The CBD program’s aim was to provide safe, effective, and low-cost family planning (FP) service to rural and urban clients. Originally the program was started to combat poor awareness in these target populations, where there was a perception of family planning as a conspiracy by white settlers against African multiplication and there was a general resistance to the novelty of medicine-based family planning. Given these circumstances it was felt prudent to provide FP services through a door-to-door approach. In this manner, privacy and confidentiality could be guaranteed. Questions could also be asked in a non threatening environment while men, who had never played a significant role in reproductive health before, could be better accessed and motivated together with their spouses. In 1988 Zimbabwe Demographic and Health Survey (ZDHS) showed a contraceptive prevalence rate (CPR) of 54%. The survey also showed that 25% of users of modern family planning methods, mainly in rural areas, obtained their methods from CBDs (the CBDs did and still do offer both condoms and pills). The proportion served by CBDs declined to 18% in 1994 and further to 6% in 1999. The decline in the CBD contribution to the contraceptive prevalence rate (CPR) was mainly due to: • The increase in the number of Ministry of Health and Child Welfare (MOH & CW) clinics since 1980 • The shift by clients from short term family planning methods to long term methods • The increase in the number of organizations providing family planning services ZNFPC had also begun to re-evaluate the function of the CBDs and found that their time usage was not optimal as they spent much time travelling across their usually vast areas of coverage and not actually interacting with clients. From interviews with clients and CBDs, it was also noted that the clients were becoming more sophisticated and requesting more information and explanations. The communities were also expecting much more from the CBD than just FP services. Challenges brought by HIV/AIDS and other reproductive health (RH) needs were creating more demands on the CBDs than they were trained to deal with. In view of the devastating impact of the HIV/AIDS epidemic in Zimbabwe (where prevalence is estimated to be 25%), and considering the low contribution (6%) of the CBDs to the national FP program, ZNFPC with technical assistance and funding from USAID through Advance Africa, expanded the roles of CBDs beyond the provision of family planning information and services. The major objectives of expanding CBD roles included: 2 The background and limitations sections were provided by Advance Africa CBD Impact Analysis: Program Background 6 • Increasing the knowledge about transmission and prevention of STIs/HIV/AIDS among community members • Outreach to young people whom CBDs previously excluded • Motivating those at-risk for voluntary counseling and testing • Providing supportive counseling to both the infected and the affected • Promoting the adoption of safer sexual behavior. The collaborative intervention of Advance Africa and ZNFPC was evaluated in two ways: from service statistics data, and from two population surveys conducted by a local consultant (which is the subject of this report). Program Limitations Prior to the Advance Africa intervention with the ZNFPC CBD program, CBDs in recent years have only reached approximately 6% of all family planning users. Therefore, it was expected that the proportion of the overall population receiving the HIV/AIDS prevention and referral from the CBDs would be less than this 6%. The low proportion of the population using the CBD services (6%) and the huge number of institutions and players involved in the HIV prevention and treatment in Zimbabwe meant that the rest of the population would most likely be targeted by other collaborating agencies (CAs) and donors. The reason the CBD involvement was still crucial was that the population that they target and reach are the most rural and poorest populations in Zimbabwe. Due to the inaccessibility of this scattered target population and the need for HIV/AIDS education given the acute affect of the disease on the Zimbabwe population CBDs were chosen as the best means of reaching them. However, the location of the potential CBDs clients, who did not have access to the government and NGO facilities, was not known and determined at the design of the project implementation. Therefore the quantitative evaluation of the trend over time of the number of people reached by CBDs using the services statistics captured a more accurate picture of CBD performance and effectiveness than the contributive proportion shown in the population survey. The ideal situation would have been to evaluate the CBD coverage rate within a population that cannot access existing official public and private services. The low proportion of CBD coverage compared to the other service sources does not tell much about the profile and location of people reached, which in most cases are the hard to reach who cannot access government or NGO health facilities. Unfortunately, the study did not provide any information on the client’s economical status, geographical location, and accessibility to the health facilities. When reviewing the results presented in this report, the reader should bear in mind the limitation of any comparison of CBD agent contributions to the results from all service sources. CBD Impact Analysis: Evaluation Process 7 Evaluation Process A baseline evaluation of the Community Based Distribution (CBD) program was conducted in August 2001 by the Evaluation and Research Unit of the Zimbabwe National Family Planning Council (ZNFPC). A follow-up evaluation was carried out in 2004 by Select Research to provide a pre-post analysis. In August and September 2005 the baseline and endline databases were reanalyzed to prepare this impact evaluation report. A summary of the issues addressed in the August 2005 reanalysis are provided in Annex 1. In this section the evaluation processes for the baseline and endline are summarized utilizing the information provided by ZNFPC and Select Research in their respective reports. Baseline Evaluation Process The baseline evaluation was carried out in August 2001 by ZNFPC prior to the implementation of the expanded CBD pilot program in eight pilot districts. Baseline evaluation objective The objective of the baseline survey was to collect data that could be used as a benchmark in evaluating outcomes that the CBD program. The study was designed to assess respondent’s reproductive health and HIV/AIDS knowledge, attitudes, and behaviors. Methodology/questionnaire design Male and female questionnaires were designed as part of the baseline evaluation and were prepared in English and two major local languages (Shona and Ndebele). The questionnaires were designed to collect data on the background characteristics of young adults aged 15 to 29 on fertility; sexual experience and practices relating to high risk; family planning knowledge and practice; knowledge about STIs/HIV/AIDS; and CBD interaction with clients3 . The English￾language baseline questionnaires are available in Annexes 2 and 3. Sampling design4 A district has an average of about 10 CBDs. In each of the six selected districts for the study, catchment areas for five of the ten CBDs were randomly selected for data collection. A total of 30 CBD catchment areas were, therefore, visited for the study. Twenty of the catchment areas are in experimental sites while 10 are in comparison sites. In the Expanded CBD Programme, a CBD catchment area includes an average of six villages. Supervisors for the research teams identified and listed names of all the villages in the selected catchment areas. They then selected two adjacent villages for male interviews and another two adjacent villages for the female interviews in each catchment area. 3 From 2001 Baseline report (Nyakauru) 4 This section is excerpted from the 2001 Baseline report (Nyakauru) CBD Impact Analysis: Evaluation Process 8 The target sample size for the baseline survey from all the selected sites was 1,800 respondents aged 15 to 29. Sixty respondents (30 males and 30 females) were to be interviewed in each of the selected CBD catchment areas. This meant that 300 respondents (150 males and 150 females) were to be interviewed in each selected district/site.5 Final baseline sample size The breakdown of sample sizes and provinces visited in the baseline is as follows in Tables 1 and 2: Table 1: Number of respondents by study group, baseline Control Intervention Total 599 1,212 1,811 Table 2: Number of respondents by province and study group, baseline Control Intervention Matebeleland South (Bulilimamangwe) Midlands (Zvishavane) Manicaland (Makoni North) Manicaland (Makoni South) Mashonaland East (Marondera) Matebeleland North (Umguza) Masvingo (Gutu North) Masvingo (Gutu South) 301 298 193 117 302 299 120 181 Training and fieldwork6 Twelve research assistants and three supervisors were trained on how to conduct the survey from the 15th to 19th of August 2001 at the ZNFPC Headquarters. The 12 research assistants were mainly social science students and graduates from the University of Zimbabwe while the three supervisors were ZNFPC officers from provinces. Three teams composed of four research assistants and a supervisor, were formed at the end of the training. Each team covered two districts (10 CBD catchment areas). Three ZNFPC Head Office staff (Programme Manager Research, Acting Assistant Director Service Delivery Unit and Assistant Director IEC) each supervised a team during fieldwork. The fieldwork was undertaken from the 20th to 31st August 2001. Male research assistants collected data from male respondents while female research assistants collected data from female respondents. All eligible persons in each sampled household were listed on the questionnaire and one person in the relevant age group was randomly selected from each household for the interview. Data entry and analysis ZNFPC used EPIINFO for the baseline data entry and conducted data analysis in October 2001. The baseline survey report was prepared and distributed following data analysis. 5 When the survey was conducted, political parties were holding rallies to campaign for a parliamentary seat in Makoni district. Due to the study’s tight time schedule, the research team for Makoni had to interview some of the people who were at a political rally since there were no people in the households. This resulted in a few extra respondents for the survey, whose information was included in the analysis. 6 This section is excerpted from the 2001 Baseline report (Nyakauru) CBD Impact Analysis: Evaluation Process 9 The baseline database (in SPSS format), questionnaires, and report were supplied to MSH in August 2005. The database was reformatted at that time for consistency with the endline database, and any necessary coding was applied. All tables were run in SPSS and exported into Excel for formatting. All tables generated in the analysis are presented in Annex 6. A summary of the coding and analysis process followed in August 2005 is included in Annex 7. Endline Evaluation Process The endline evaluation was carried out in November and December 2004 by Select Research of Zimbabwe, three years after the start of the pilot program that expanded CBD services. The structure of the endline survey was intended to replicate that of the baseline to allow for pre-post comparisons. Endline evaluation objective The objectives of the endline survey, as stated in the endline report, were to evaluate the impact of the expanded CBD program along the following lines: • Assess awareness and effectiveness of the expanded CBD program • Assess changes in reproductive behavior by the population • Assess perceptions of reproductive health issues by the population, and • Measure the extent to which the expanded CBD program has influenced changes in reproductive behavior7 Methodology/questionnaire design The questionnaires applied in the endline study (Annexes 4 and 5) were identical to those of the baseline, with a few exceptions: Table 3: Differences between baseline and endline questionnaires Question Differences Age The upper age limit for Baseline respondents was 29 while it was 34 in the Endline 404 The Baseline asks about the respondent and his/her partner while the Endline asks only about the respondent 405 The Baseline asks about the respondent and his/her partner while the Endline asks only about the respondent 406 The Baseline data does not specify that data collectors should record “other” answers In addition, a qualitative component was added to the endline, comprising focus groups and in￾depth interviews with key stakeholders. The qualitative information is not included in this report due to unavailability of the information. 7 This section is excerpted from the 2004 Impact Evaluation report (Select Research) CBD Impact Analysis: Evaluation Process 10 Sampling design The endline evaluation was conducted in the same districts as the baseline. The sampling techniques were modified somewhat at endline, as follows8 : • Instead of randomly selecting five (5) CBDs from each of the districts to be studied, only three (3) CBDs were randomly selected. This was the first stage cluster and the three CBDs in each district were selected using simple random selection. • Within each CBD selected, two (2) Village Development Committees (VIDCOs) were randomly selected, second stage cluster, again, using the same simple random selection method. A further two (2) adjacent VIDCOs to the two (2) randomly selected were purposively included in the study, third stage cluster. In addition, the endline evaluation report specifies the following steps in selection of the respondents9 : • The survey was conducted among men and women aged between 15 and 34 years falling within the expanded CBD programme’s catchment area. Apart from age, the exercise did not seek to discriminate respondents on any specially predetermined criteria. • Area sampling procedures was applied. Sampling involved simple random selection of numbered grids within the selected VIDCOs. Because of the unplanned pattern of homestead location in parts of rural areas, identification of starting points and the systematic selection process was not the same in every centre. Some homesteads are along the road, river or foothills while others were scattered over a plain. Moreover, because distances between house clusters are not necessarily uniform, it is not always possible to specify the number of households to skip before trying the next interview. In this case, we selected those homesteads that were axially related along the North￾South or East-West direction (from the centre of the grid) depending on the date of the interview. On even numbered dates interviewers consider the North-South axis while on odd numbered dates the East-West axis was the rule. Approximately the same interval (e.g. 100m) will be observed between interviews. Every precaution was taken to ensure that an even distribution of interviews is achieved. In total 5 interviews were conducted within each randomly selected grid to avoid area bias, with a total of 15 interviews in each VIDICO. • At each selected homestead or household, specific respondent selection was done randomly using the Kish Grid method. This process of random selection involved listing all male or female, depending on gender of respondent required at that household, family members aged between 15 and 34 years in chronological order and selecting a family member whose position corresponds with the last digit of the questionnaire to be administered on that household. This process removed interviewer bias in respondent selection. 8 This section is excerpted from the 2004 Impact Evaluation report (Select Research) 9 This section is excerpted from the 2004 Impact Evaluation report (Select Research) CBD Impact Analysis: Evaluation Process 11 • Substitution was effected at both household and specific respondent levels. If there were no people at a selected household, two callbacks were effected before substituting with the next household. However, a maximum of three callbacks were effected before substituting the selected person in that household. Final endline sample size The breakdown of sample sizes and provinces visited in the endline is as follows in Tables 4 and 5: Table 4: Number of respondents by study group, endline Control Intervention Total 341 709 1,050 Table 5: Number of respondents by province and study group, endline Control Intervention Matebeleland South (Bulilimamangwe) Midlands (Zvishavane) Manicaland (Makoni North) Manicaland (Makoni South) Mashonaland East (Marondera) Matebeleland North (Umguza) Masvingo (Gutu North) Masvingo (Gutu South) 172 169 52 117 178 184 0 178 Data entry and analysis Select Research used the statistical software SPSS Version 11.0 for the endline data entry and data entry verification (using double entry techniques). Data analysis was conducted by Select Research using the final checked SPSS database. The endline database, questionnaires, and report were supplied to MSH in August 2005. The endline database was reformatted at that time to improve usability and to apply any necessary coding. All tables were run in SPSS and exported into Excel for formatting. All tables generated in the analysis are presented in Annex 6. A summary of the coding and analysis process in August 2005 is included in Annex 7. The reanalysis conducted in August 2005 was structured to allow for an identical analysis of the baseline and endline data. Overall Impact Evaluation Process In August 2005 an evaluation team at MSH reviewed the available data, databases, reports, and data collection tools to design an approach for the revised impact evaluation. In collaboration with Advance Africa staff, the evaluation team reviewed the data collection questionnaires to identify questions on the questionnaire that were of specific interest. Due to time constraints, these were selected as the key indicators to be included in the impact evaluation study. The database for the baseline and endline were reformatted and coded as needed for the indicators of interest (See Annex 7). Other indicators that were not studied were maintained in the database. CBD Impact Analysis: Evaluation Process 12 The indicators were run in SPSS for the endline first, and checked for quality assurance. The baseline data were analyzed second. Tables were formatted for the baseline-endline comparison using Excel. Figures were generated for each of the indicators as needed. Study Limitations Key limitations to this study include the following: • Age ranges of respondents changed from baseline to endline, therefore there was a change in the study group design that amplified the pool of respondents at the time of the endline survey. • The population targeted by the CBD program was in a remote rural area and is reported to represent 6% of the overall population in the intervention provinces. It is unclear if sampling methods applied at baseline and endline were able to ensure that these rural locations were covered in the survey exercise. • During the same time period as the Advance Africa CBD intervention, urban areas and regular rural areas were also inundated with RH/FP and HIV/AIDS education messages from other NGOs. Data trends in the “control zone” cited in the endline survey show significant increases and therefore, may have been located in another NGO’s intervention site. Thus only baseline and endline data from the intervention areas was ultimately used to assess the success of the program. • The impact analysis had to be prioritized around key indicators identified in the questionnaires. Therefore some questions were not analyzed at the time of this report. • Original data collection forms were not available at the time of the impact evaluation so data entry quality could not be verified. CBD Impact Analysis: Characteristics of Respondents 13 Characteristics of Respondents Total Sample Size At both baseline and endline the control group formed 33% of the total sample size (Table 6). The overall sample size dropped by 761 respondents at the endline. Table 6: Number of respondents by study group Control Intervention Total Baseline 599 1,212 1,811 Endline 341 709 1,050 All provinces were visited at both endline and baseline with the exception of Mazvingo (Gutu North) which was not visited in the endline (Table 7). Table 7: Number of respondents by province and study group Control Intervention Matebeleland South (Bulilimamangwe) Midlands (Zvishavane) Manicaland (Makoni North) Manicaland (Makoni South) Mashonaland East (Marondera) Matebeleland North (Umguza) Masvingo (Gutu North) Masvingo (Gutu South) Baseline 301 298 193 117 302 299 120 181 Endline 172 169 52 117 178 184 0 178 Distribution of Respondents by Gender In both the baseline and endline the distribution of respondents by gender was approximately equivalent in both study groups (Figure 1). Figure 1 Distribution of Respondents by Sex (%) Control and Intervention Groups 50% 50% 50% 50% 49% 51% 50% 50% 0% 20% 40% 60% 80% 100% Control Male Control Female Intervention Male Intervention Female Baseline Endline CBD Impact Analysis: Characteristics of Respondents 14 Distribution of Respondents by Marital Status The respondent’s marital status was collected at both baseline and endline. Among male respondents in both study groups there was an increase in the percent of respondents who reported being married or in a union (Figure 2). Twenty-one percent more control group males reported being married or in a union at endline as compared to baseline. Among intervention group males 8% more males were married or in a union at endline. Overall slightly more intervention group males were married or in a union at endline (36%) than were control group males (30%). Figure 2 Distribution of Male Respondents by Marital Status (%) Control and Intervention Groups 9% 91% 28% 72% 30% 70% 36% 64% 0% 20% 40% 60% 80% 100% Control Married/In Union Control Not Married/Not in Union Intervention Married/In Union Intervention Not Married/Not in Union Baseline Endline A similar increase was seen among female respondents (Figure 3). Twenty percent more control group females were married or in a union at endline as compared to baseline. There was an increase of 17% intervention group females who were married or in a union at endline. Overall 12% more intervention group females were married or in a union at endline as compared to the control group. In addition, at both endline and baseline a much greater proportion of female respondents reported being married or in a union than did male respondents. CBD Impact Analysis: Characteristics of Respondents 15 Figure 3 Distribution of Female Respondents by Marital Status (%) Control and Intervention Groups 30% 70% 45% 55% 50% 50% 62% 38% 0% 20% 40% 60% 80% 100% Control Married/In Union Control Not Married/Not in Union Intervention Married/In Union Intervention Not Married/Not in Union Baseline Endline Distribution of Respondents by Age and Level of Education The age range included in the study was expanded in the endline evaluation. The baseline study included respondents aged 15-29 while the endline study included respondents aged 15-34. The age ranges and education distributions for the control group are summarized in Table 8. At both baseline and endline, the majority of control group respondents (66% and 76% respectively) reported secondary school as the highest level of education they had attained. Table 8: Age and level of education, control group Control Baseline Endline Control (n=599) Control (n=341) Male Female Total Male Female Total Age 15-19 52.0% 44.2% 48.1% 28.3% 33.1% 30.8% 20-24 31.2% 32.9% 32.1% 31.9% 29.7% 30.8% 25-29 16.8% 22.9% 19.9% 15.1% 16.6% 15.8% 30-34 NA NA NA 24.7% 20.6% 22.6% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% Highest Level of Education Never attended school 0.3% 0.0% 0.2% 0.0% 1.1% 0.6% Primary 36.6% 29.9% 33.2% 16.3% 26.3% 21.4% Secondary 63.1% 68.8% 65.9% 80.7% 72.0% 76.2% College 0.0% 1.0% 0.5% 2.4% 0.6% 1.5% University 0.0% 0.3% 0.2% 0.6% 0.0% 0.3% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% CBD Impact Analysis: Characteristics of Respondents 16 The age ranges and education distributions for the intervention group are summarized in Table 9. At both baseline and endline, the majority of intervention group respondents (73% and 69% respectively) reported secondary school as the highest level of education they had attained. Table 9: Age and level of education, intervention group Baseline Endline Intervention (n=1,212) Intervention (n=709) Male Female Total Male Female Total Age 15-19 36.4% 38.3% 37.4% 27.0% 21.0% 24.0% 20-24 34.3% 36.2% 35.2% 37.9% 32.3% 35.1% 25-29 29.3% 25.5% 27.4% 18.3% 21.5% 19.9% 30-34 NA NA NA 16.9% 25.2% 21.0% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% Highest Level of Education Never attended school 0.0% 0.5% 0.2% 0.3% 0.3% 0.3% Primary 21.3% 29.0% 25.1% 22.5% 36.5% 29.5% Secondary 76.8% 69.8% 73.3% 75.6% 62.0% 68.8% College 2.0% 0.7% 1.3% 1.4% 0.8% 1.1% University 0.0% 0.0% 0.0% 0.3% 0.3% 0.3% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% CBD Impact Analysis: Findings 17 Findings The questionnaires were divided into key topic areas. This section will elaborate on the key findings according to the following topics: • Sexual Experience • Family Planning • STIs & HIV/AIDS In addition to the data presented here, additional data tables with greater detail are available in Annex 6 for each topic area. Sexual Experience Number of sexual partners in the last 12 months Figure 4 A high number of sexual partners in the last twelve months is a potential risk factor for transmission of sexually transmitted infections (STIs), including HIV/AIDS. At endline, 16% more males in both the intervention and control groups reported having only one partner in the last 12 months than at baseline. Sixty￾five percent of control group males reported having only one partner, as compared to 49% at baseline (Figure 4). Figure 5 Sixty-nine percent of intervention group males reported having only one partner, up from 53% at baseline (Figure 5). The proportion of males with three or more partners in the last 12 months fell by 13% in both groups. Reported Number of Sexual Partners in Last 12 Months (%) Male Intervention Group 10% 49% 16% 9% 15% 7% 65% 16% 4% 7% 0% 20% 40% 60% 80% 100% 0 1 2 3 >3 Baseline Endline Reported Number of Sexual Partners in Last 12 Months (%) Male Control Group 10% 53% 15% 7% 16% 7% 69% 14% 8% 2% 0% 20% 40% 60% 80% 100% 0 1 2 3 >3 Baseline Endline CBD Impact Analysis: Findings 18 While among men there was a reduction in multiple partners, among females there was an increase in zero partners. At endline, more females in both the intervention (93%) and control (92%) group reported having zero or one partner. Very few females in either study group reported having multiple partners (Figures 6 & 7). Figure 6 Figure 7 Use of family planning methods at last sexual encounter A question was included to ascertain respondents’ use of family planning (FP) methods at the time of their last sexual encounter. Responses were categorized as: • Yes – Used FP at last sex o Yes to prevent pregnancy o Yes to prevent disease o Yes to prevent both pregnancy and disease • No – Did not use FP at last sex Among the control group respondents, 13% more reported using FP at endline than at baseline (Figure 8). There was a small decrease in the percent that did not use any FP methods at last sex. Figure 8 Reported Number of Sexual Partners in Last 12 Months (%) Female Intervention Group 0% 93% 4% 3% 1% 7% 86% 5% 2% 1% 0% 20% 40% 60% 80% 100% 0 1 2 3 >3 Baseline Endline Reported Number of Sexual Partners in Last 12 Months (%) Female Control Group 0% 90% 8% 2% 1% 6% 86% 7% 1% 0% 0% 20% 40% 60% 80% 100% 0 1 2 3 >3 Baseline Endline % Respondents Using Methods to Prevent Pregnancy or Disease at Last Sex Control Group 23% 4% 27% 46% 43% 1% 23% 33% 0% 20% 40% 60% 80% 100% Yes to prevent pregnancy Yes to prevent disease Yes to prevent both disease & pregnancy No Baseline Endline Yes Responses: Baseline 54% Endline 67% 13% increase CBD Impact Analysis: Findings 19 Among intervention respondents there was 4% increase in use of FP methods at the time of their last sexual encounter (Figure 9). Figure 9 % Respondents Using Methods to Prevent Pregnancy or Disease at Last Sex Intervention Group 39% 7% 15% 39% 43% 10% 12% 35% 0% 20% 40% 60% 80% 100% Yes to prevent pregnancy Yes to prevent disease Yes to prevent both disease & pregnancy No Baseline Endline Yes Responses: Baseline 61% Endline 65% 4% increase Among both the control and intervention groups FP was used more frequently to prevent pregnancy than to prevent disease. Types of family planning methods used at last sexual encounter If respondents had used any family planning method at their last sexual encounter they were asked to name the types of methods they had used. Respondents were able to name multiple FP methods. The majority of responses in both study groups were for the contraceptive pill and the male condom (Figures 10 and 11). There was an increase in the use of the pill among the control group (16% increase) and the intervention group (4% increase). Use of the condom was lower overall among intervention group respondents and dropped by 15% among control group respondents from baseline to endline. CBD Impact Analysis: Findings 20 Figure 10 Family Planning Methods Used to Prevent Pregnancy or Disease at Last Sex (% respondents mentioning each method - More than one response allowed) Control Group 31% 65% 8% 1% 1% 47% 50% 8% 0% 2% 0% 20% 40% 60% 80% 100% Pill Male condom Injection Female condom Other methods Baseline Endline Figure 11 Family Planning Methods Used to Prevent Pregnancy or Disease at Last Sex (% respondents mentioning each method - More than one response allowed) Intervention Group 47% 45% 7% 1% 4% 51% 44% 7% 1% 2% 0% 20% 40% 60% 80% 100% Pill Male condom Injection Female condom Other methods Baseline Endline When the same data are analyzed by marital status it appears that the pill was used more frequently among those who were married or in a union (Table 10). Use of the pill among those married or in a union increased for both the control (22% increase) and intervention groups (25% increase). CBD Impact Analysis: Findings 21 Table 10: Method used at last sex (by marital status) Control Intervention Baseline Endline Baseline Endline Married or in a union (n=48) Not married and not in a union (n=145) Married or in a union (n=81) Not married and not in a union (n=93) Married or in a union (n=171) Not married and not in a union (n=335) Married or in a union (n=221) Not married and not in a union (n=159) Pill 50.0% 24.1% 71.6% 24.7% 50.9% 45.4% 75.1% 17.0% Male condom 43.8% 71.7% 21.0% 75.3% 46.2% 44.8% 19.0% 78.6% Injection 4.2% 9.0% 11.1% 5.4% 4.7% 7.5% 8.1% 5.0% Female condom 0.0% 0.7% 0.0% 0.0% 1.2% 0.9% 0.9% 1.9% Other methods 2.1% 0.7% 2.5% 2.2% 2.3% 5.1% 2.3% 0.6% The male condom was used more frequently by those who were not married or not in a union. Use of the male condom by those unmarried or not in a union increased by 3% for the control group and by 34% for the intervention group when comparing baseline to endline. Family Planning Types of family planning methods respondents have heard of As a measure of awareness of family planning methods respondents were asked to list methods that could be used to delay or avoid pregnancy. Their responses were noted as spontaneous or prompted, and they were asked to provide the source of information for each method they mentioned. Over 90% of all respondents in both groups mentioned the male condom and the pill at endline. All methods mentioned by control group respondents are listed in Tables 11 and are summarized in Figure 12. Control group females became more aware of the male condom (8% increase), injection (5% increase), female condom (20% increase), IUD (8% increase), tubal ligation (6% increase) and periodic abstinence (9% increase). Control group males became more aware of the pill (13% increase), injection (16% increase) female condom (26% increase), and IUD (22% increase), among others. CBD Impact Analysis: Findings 22 Table 11: Family planning methods respondents have heard of, control group (multiple responses, by gender) Control Baseline Endline Male (n=284) Female (n=286) Total (n=570) Male (n=166) Female (n=174) Total (n=340) Male condom 95.8% 87.8% 91.8% 97.0% 96.0% 96.5% Pill 78.5% 96.5% 87.5% 91.6% 97.1% 94.4% Injection 59.2% 87.1% 73.2% 75.3% 92.0% 83.8% Female condom 58.1% 60.8% 59.5% 83.7% 79.9% 81.8% IUD 28.9% 53.1% 41.1% 50.6% 60.9% 55.9% Tubal ligation 38.4% 34.6% 36.5% 48.8% 40.8% 44.7% Norplant 7.7% 19.9% 13.9% 24.1% 39.7% 32.1% Vasectomy 29.9% 19.9% 24.9% 30.1% 16.7% 23.2% Periodic abstinence 15.1% 10.1% 12.6% 22.3% 19.0% 20.6% Diaphragm/ foam 18.3% 23.1% 20.7% 30.1% 20.1% 25.0% Other methods 0.7% 3.1% 1.9% 3.0% 3.4% 3.2% Figure 12 Family Planning Methods Respondents had Heard of (% respondents mentioning each method - More than one response allowed) Control Group 0% 20% 40% 60% 80% 100% Baseline 91.8% 87.5% 73.2% 59.5% 41.1% 36.5% 13.9% 24.9% 12.6% 20.7% 1.9% Endline 96.5% 94.4% 83.8% 81.8% 55.9% 44.7% 32.1% 23.2% 20.6% 25.0% 3.2% Male condom Pill Injection Female condom IUD Tubal ligation Norplant Vasectomy Periodic abstinence Diaphram/ foam Other methods Among the control group respondents there was an increase in the mention of all methods, most notably the female condom, with the exception of vasectomy. CBD Impact Analysis: Findings 23 Intervention group females became more aware of the male condom (7% increase), injection (3% increase), female condom (11% increase) and IUD (11% increase) and Norplant (15% increase). Awareness of other methods declined or stayed the same among intervention group females (Table 12). Intervention group males became more aware of the pill (4% increase), female condom (8% increase) and IUD (8% increase). Awareness of other methods declined or stayed the same among intervention group males. Table 12: Family Planning methods respondents have heard of, intervention group (multiple responses, by gender) Intervention Baseline Endline Male (n=598) Female (n=581) Total (n=1,179) Male (n=356) Female (n=353) Total (n=709) Male condom 97.7% 89.3% 93.6% 96.3% 96.3% 96.3% Pill 91.1% 97.2% 94.1% 94.7% 96.0% 95.3% Injection 73.6% 89.8% 81.6% 69.7% 92.6% 81.1% Female condom 74.2% 66.6% 70.5% 82.0% 78.2% 80.1% IUD 36.6% 55.1% 45.7% 44.7% 66.0% 55.3% Tubal ligation 52.8% 57.1% 55.0% 33.7% 44.8% 39.2% Norplant 10.7% 24.6% 17.6% 11.0% 40.8% 25.8% Vasectomy 38.8% 30.3% 34.6% 26.7% 20.4% 23.6% Periodic abstinence 30.8% 17.2% 24.1% 30.6% 15.9% 23.3% Diaphragm/ foam 24.7% 21.2% 23.0% 18.5% 15.9% 17.2% Other methods 1.3% 3.3% 2.3% 5.3% 6.2% 5.8% CBD Impact Analysis: Findings 24 While there was not as much change in the mention of all methods among intervention group respondents there was a slight increase in the mention of the male condom, the pill, and the female condom (Figure 13). Figure 13 Family Planning Methods Respondents had Heard of (% respondents mentioning each method - More than one response allowed) Intervention Group 0% 20% 40% 60% 80% 100% Baseline 93.6% 94.1% 81.6% 70.5% 45.7% 55.0% 17.6% 34.6% 24.1% 23.0% 2.3% Endline 96.3% 95.3% 81.1% 80.1% 55.3% 39.2% 25.8% 23.6% 23.3% 17.2% 5.8% Male condom Pill Injection Female condom IUD Tubal ligation Norplant Vasectomy Periodic abstinence Diaphram/ foam Other methods Source of information on the family planning methods respondents have heard of Respondents were asked to name the source of information for each family planning method that they had heard of Sources included physicians, schools, media, CBDs, and others. All responses were categorized as health system sources or non-health system sources. When a CBD or ZNFPC was mentioned it was categorized as a health system source. The categorizations are described in Annex 7. The sources mentioned for all family planning methods were combined to analyze which the main sources of information for each group were. Both the control and intervention groups mentioned health system sources more frequently at baseline than at endline (Figures 14 and 15), though non-health system sources remained the principle sources of information. For the control group 10% more respondents listed health system sources as their source of information for family planning methods than at baseline. Within that there was a slight increase in the percent who mentioned the CBD as a source. However, at endline 61% of respondents received information from non-health system sources while 39% mentioned health system sources. CBD Impact Analysis: Findings 25 Figure 14 Main Source of Information on Family Planning Methods Respondents had Heard of (% for all FP methods combined) Control Group 29% 5% 0% 24% 71% 39% 11% 0% 28% 61% 0% 20% 40% 60% 80% 100% Health System Source (Doctor, CBD, etc) CBD ZNFPC Other health systems Non-Health System Source (Media, Friend, etc) Baseline Endline For the intervention group 11% more respondents listed the health system as their source of information for family planning methods at endline than at baseline. As with the control group there was a slight increase in the percent who mentioned the CBD as a source. At endline 55% of respondents received information from non-health system sources while 45% mentioned health system sources. Figure 15 Main Source of Information on Family Planning Methods Respondents had Heard of (% for all FP methods combined) Intervention Group 34% 8% 0% 26% 66% 45% 10% 0% 35% 55% 0% 20% 40% 60% 80% 100% Health System Source (Doctor, CBD, etc) CBD ZNFPC Other health systems Non-Health System Source (Media, Friend, etc) Baseline Endline CBD Impact Analysis: Findings 26 The sources were also analyzed for each family planning method. Overall the intervention group was more likely to mention a health system source than the control group. For example, at endline 39% of intervention group respondents mentioned the health system as the main source of information on the male condom, while only 29% of control group respondents did so (Table 13). This also represented an increase of 10% from the baseline for the intervention group. Table 13: Main source of information on the male condom Control Intervention Baseline (n=510) Endline (n=322) Baseline (n=1075) Endline (n=666) Total for health system sources only 24.9% 28.9% 28.2% 37.8% CBD 5.3% 7.8% 9.4% 9.6% ZNFPC 0.0% 0.0% 0.3% 0.5% Other health systems 19.6% 21.1% 18.5% 27.8% Total for non-health system sources only 75.1% 71.1% 71.8% 62.2% Total for all sources 100.0% 100.0% 100.0% 100.0% Similarly, at endline 59% of intervention group respondents mentioned the health system as the main source of information on the pill, while only 50% of control group respondents did so (Table 14). This represented an increase of 14% from the baseline for the intervention group. Table 14: Main source of information on the pill Control Intervention Baseline (n=498) Endline (n=321) Baseline (n=1105) Endline (n=665) Total for health system sources only 32.3% 49.5% 45.0% 58.8% CBD 8.2% 17.4% 15.6% 15.0% ZNFPC 0.2% 0.0% 0.1% 0.3% Other health systems 23.9% 32.1% 29.3% 43.5% Total for non-health system sources only 67.7% 50.5% 55.0% 41.2% Total for all sources 100.0% 100.0% 100.0% 100.0% Annex 6 provides a full set of tables presenting the main sources of information given by control and intervention group respondents for each family planning method. Currently using a family planning method After listing the family planning methods that they had heard of, all respondents were asked if they were currently using a family planning method (Figures 16 & 17). While over 60% in both groups reported that they were currently using a family planning method at endline, there was an 8% increase in use of FP among the control group while in the intervention group the current use of FP dropped by 1%. This was offset, however, by an increase in the percent that were currently pregnant. CBD Impact Analysis: Findings 27 Figure 16 % Respondents Currently Using Any Family Planning Method Control Group 41% 57% 2% 29% 65% 6% 0% 20% 40% 60% 80% 100% No Yes Currently pregnant Baseline Endline Figure 17 % Respondents Currently Using Any Family Planning Method Intervention Group 31% 67% 2% 30% 66% 4% 0% 20% 40% 60% 80% 100% No Yes Currently pregnant Baseline Endline The rates of current use of FP are consistent with the percent of respondents who reported using FP at their last sexual encounter. CBD Impact Analysis: Findings 28 Type of family planning methods respondents are currently using All respondents were asked what type of family planning methods they were currently using. This question differed from the previous question of which family planning method was used at the last sexual encounter in that the previous question was limited to those who had used some family planning method during their last sexual encounter. Among male respondents in both the control and intervention group there was a decrease in the use of the condom and an increase in the use of the pill (Figures 18 & 19). Rate of use of the pill was higher in the intervention group (61%) than in the control group (31%) and increased for both from baseline to endline. Figure 18 Family Planning Methods Respondents Are Currently Using (% respondents mentioning each method - More than one response allowed) Male Control Group 12% 88% 1% 4% 31% 69% 5% 1% 0% 20% 40% 60% 80% 100% Pill Male condom Injection Other methods Baseline Endline Figure 19 Family Planning Methods Respondents Are Currently Using (% respondents mentioning each method - More than one response allowed) Male Intervention Group 38% 66% 3% 2% 61% 48% 4% 2% 0% 20% 40% 60% 80% 100% Pill Male condom Injection Other methods Baseline Endline CBD Impact Analysis: Findings 29 Among female respondents in both the control and intervention group there was an increase in the use of the pill (Figures 20 & 21). Rate of use of the pill was higher in the intervention group (77%) than in the control group (72%) and increased slightly for both groups from baseline to endline. Use of the condom by females was lower than the male respondents. Figure 20 Family Planning Methods Respondents Are Currently Using (% respondents mentioning each method - More than one response allowed) Female Control Group 67% 16% 16% 5% 72% 14% 14% 1% 0% 20% 40% 60% 80% 100% Pill Male condom Injection Other methods Baseline Endline Figure 21 Family Planning Methods Respondents Are Currently Using (% respondents mentioning each method - More than one response allowed) Female Intervention Group 75% 7% 16% 4% 77% 9% 13% 4% 0% 20% 40% 60% 80% 100% Pill Male condom Injection Other methods Baseline Endline The data were also analyzed according to marital status (Table 15) to identify any trends in the use of the pill and the male condom. Those who were married or in a union were more likely to mention current use of the pill at endline for both the control (76%) and intervention groups (83%). Those not married or not in a union mentioned the male condom most frequently (80% control and 68% intervention). CBD Impact Analysis: Findings 30 Table 15: Family planning methods currently in use (by marital status) Control Intervention Baseline Endline Baseline Endline Married or in a union (n=28) Not married and not in a union (n=114) Married or in a union (n=80) Not married and not in a union (n=66) Married or in a union (n=163) Not married and not in a union (n=284) Married or in a union (n=215) Not married and not in a union (n=81) Pill 57.1% 28.1% 77.5% 18.2% 59.5% 53.2% 83.3% 35.8% Male condom 35.7% 64.9% 12.5% 80.3% 36.8% 39.4% 8.8% 67.9% Injection 10.7% 6.1% 13.8% 4.5% 10.4% 8.8% 9.8% 8.6% Other methods 0.0% 5.3% 0.0% 3.0% 1.2% 4.2% 3.3% 3.7% Source of family planning methods respondents are currently using Respondents were asked to name the source of the family planning method they were currently using. In contrast to the source of information on all family planning methods, which was primarily non-health system, the main source of actual family planning commodities was the health system (Figure 22) for both the control and intervention groups. Figure 22 Source of Family Planning Methods Respondents Are Currently Using (% by source) 100% 0% 100% 0% 98% 2% 99% 1% 0% 20% 40% 60% 80% 100% Health System Source (Doctor, CBD, etc) Non-Health System Source (Media, Friend, etc) Health System Source (Doctor, CBD, etc) Non-Health System Source (Media, Friend, etc) Control Intervention Baseline Endline Among control group respondents there was a 4% drop in the proportion of respondents who received FP commodities from CBDs and an increase of 10% among those who named ZNFPC as the source (Figure 23). Overall, health system sources were mentioned by 98% of the control group at endline. CBD Impact Analysis: Findings 31 Figure 23 Source of Family Planning Methods Respondents Are Currently Using (% by source) Control Group 100% 29% 2% 69% 0% 98% 25% 12% 60% 2% 0% 20% 40% 60% 80% 100% Health System Source (Doctor, CBD, etc) CBD ZNFPC Other health systems Non-Health System Source (Media, Friend, etc) Baseline Endline Among intervention group respondents there was a 13% decrease in the proportion of respondents who received FP commodities from CBDs and an increase of 8% among those who named ZNFPC as the source (Figure 24). Overall, health system sources were named by 99% of the intervention group at endline. Figure 24 Source of Family Planning Methods Respondents Are Currently Using (% by source) Intervention Group 100% 41% 8% 51% 0% 99% 28% 16% 55% 1% 0% 20% 40% 60% 80% 100% Health System Source (Doctor, CBD, etc) CBD ZNFPC Other health systems Non-Health System Source (Media, Friend, etc) Baseline Endline CBD Impact Analysis: Findings 32 STIs & HIV/AIDS The survey assessed respondents on their knowledge of sexually transmitted infections (STIs) and HIV/AIDS. Respondents were also asked about their history of having been tested for HIV/AIDS. Awareness of STIs Respondents were asked if they had head of diseases that can be transmitted by sexual intercourse. The majority of respondents in both the control (98%) and intervention (97%) groups had heard of STIs and showed slight improvement from baseline to endline (Figure 25). Figure 25 Has respondent heard of diseases that can be transmitted by sexual intercourse? 6% 94% 5% 95% 2% 98% 3% 97% 0% 20% 40% 60% 80% 100% No Yes No Yes Control Baseline Endline Intervention ×4% ×2% Awarenes of STIs was generally high, yet there was some improvement from baseline to endline. In the intervention group there was an increase in the percent of females (4% increase) who had heard of STIs, while in the control group there was a small increase among both males (4%) and females (5%) as see in Table 16. Table 16: Has respondent heard of diseases that can be transmitted by sexual intercourse? Control Intervention Baseline (n=599) Endline (n=341) Baseline (n=1212) Endline (n=709) No Yes No Yes No Yes No Yes Male 5.0% 95.0% 1.2% 98.8% 1.6% 98.4% 1.4% 98.6% Female 7.0% 93.0% 2.3% 97.7% 8.3% 91.7% 4.2% 95.8% Total 6.0% 94.0% 1.8% 98.2% 5.0% 95.0% 2.8% 97.2% CBD Impact Analysis: Findings 33 Respondents were asked to list the types of STIs they had heard of as a measure of awareness of STIs. Most frequently mentioned were HIV/AIDS, gonorrhea and syphilis (Figures 26 & 27). There seemed to be high awareness of HIV/AIDS at both baseline and endline, though mention of HIV/AIDS decrease by 5% in the intervention group. Awareness of other STIs improved. For example, awareness of gonorrhea improved for the control (36% increase) and intervention (14% increase) groups. Awareness of syphilis also improved for the control (28% increase) and intervention (13% increase) groups. Figure 26 Which STIs have respondents heard of (multiple responses)? Control Group 93% 26% 31% 5% 3% 41% 1% 96% 62% 59% 25% 16% 11% 4% 0% 20% 40% 60% 80% 100% HIV/AIDS Gonorrhea Syphilis Herpes Chancroid Other Chlamydia Baseline Endline Figure 27 Which STIs have respondents heard of (multiple responses)? Intervention Group 96% 38% 35% 6% 6% 34% 1% 91% 52% 48% 20% 17% 12% 4% 0% 20% 40% 60% 80% 100% HIV/AIDS Gonorrhea Syphilis Herpes Chancroid Other Chlamydia Baseline Endline CBD Impact Analysis: Findings 34 Awareness of HIV/AIDS Respondents were asked specifically if they had heard about HIV/AIDS. The findings corroborate the data in the previous section and indicate that almost all respondents in both study groups have heard of HIV/AIDS (Figure 28). Figure 28 Has respondent heard of HIV/AIDS? 0% 100% 1% 99% 0% 100% 1% 99% 0% 20% 40% 60% 80% 100% No Yes No Yes Control Intervention Baseline Endline Respondents listed their source of information on HIV/AIDS. While most respondents listed non-health system sources as their main source of information on HIV/AIDS, there was an increase in the mention of health system sources, specifically CBDs, from baseline to endline for both control (12% increase) and intervention (18% increase) groups (Figure 29). Figure 29 Main source of information about HIV/AIDS? 17% 83% 17% 83% 29% 71% 35% 65% 0% 20% 40% 60% 80% 100% Health System Source (Doctor, CBD, etc) Non-Health System Source (Media, Friend, etc) Health System Source (Doctor, CBD, etc) Non-Health System Source (Media, Friend, etc) Control Baseline Endline Intervention 12% increase 18% increase CBD Impact Analysis: Findings 35 Awareness of HIV/AIDS risk factors To ascertain awareness of HIV/AIDS risk factors respondents were asked to list how a person can become infected with HIV/AIDS. Respondents gave multiple answers, which were categorized as correct or incorrect responses. Among the correct responses most respondents in the control and intervention groups listed sexual relations with an infected partner (88% and 80% respectively). In addition, 48% of control respondents and 23% of intervention respondents mentioned sexual relations with multiple partners, whereas none had mentioned this in the baseline. Other correct risk factors are listed in Figures 30 and 31 below. Figure 30 Risk Factors: Correct Responses to "How can a person become infected with HIV/AIDS"? Control Group 69% 0% 2% 10% 2% 0% 1% 88% 48% 11% 12% 5% 9% 3% 0% 20% 40% 60% 80% 100% Sexual relations with an infected partner Multiple sexual partners Contaminated sharps Receiving blood transfusions Having unprotected sex Mother to child transmission during birth Other correct Baseline Endline Figure 31 Risk Factors: Correct Responses to "How can a person become infected with HIV/AIDS"? Intervention Group 75% 0% 5% 6% 3% 0% 1% 80% 23% 14% 9% 9% 8% 5% 0% 20% 40% 60% 80% 100% Sexual relations with an infected partner Multiple sexual partners Contaminated sharps Receiving blood transfusions Having unprotected sex Mother to child transmission during birth Other correct Baseline Endline CBD Impact Analysis: Findings 36 Among the incorrect responses most respondents in the control and intervention groups listed using a razor and kissing on the mouth (Figures 32 & 33). Notably, there was a significant drop in the percent of respondents who listed using condoms as a way that a person can become infected with HIV/AIDS, which also shows some improvement in knowledge of risk factors. While at baseline 35% of control group respondents mentioned using condoms as a risk factor, at endline only 1% mentioned condoms. Similarly, in the intervention group, at baseline 26% of respondents mentioned using condoms as a risk factor while at endline only 1% mentioned it. Figure 32 Risk Factors: Incorrect Responses to "How can a person become infected with HIV/AIDS"? Control Group 3% 1% 1% 35% 11% 11% 9% 1% 1% 5% 0% 20% 40% 60% 80% 100% Razor Kissing on the mouth Shaking hands Using condoms Other incorrect Baseline Endline Figure 33 Risk Factors: Incorrect Responses to "How can a person become infected with HIV/AIDS"? Intervention Group 3% 2% 0% 26% 10% 13% 8% 3% 1% 4% 0% 20% 40% 60% 80% 100% Razor Kissing on the mouth Shaking hands Using condoms Other incorrect Baseline Endline CBD Impact Analysis: Findings 37 Overall, at endline 95% of intervention group respondents were aware of at least one correct risk factor for HIV/AIDS, up from 23% at baseline (72% improvement). Similarly, 98% of control group respondents were aware of at least one correct risk factor at endline, up from 29% at baseline (69% improvement). HIV/AIDS testing CBDs do not provide HIV/AIDS testing, but instead refer patients to testing centers. Respondents were asked if they had ever been tested for HIV. While overall a low percentage reported that they had been tested, there was some improvement from baseline to endline. In the intervention group 19% reported that they had been tested for HIV/AIDS, up 11% from baseline. Fewer had been tested in the control group (11%), up 6% from baseline (Figure 34). Figure 34 Has respondent ever been tested for HIV/AIDS? 95% 5% 92% 8% 89% 11% 81% 19% 0% 20% 40% 60% 80% 100% No Yes No Yes Control Intervention Baseline Endline ↑ 6% ↑ 11% When analyzed by gender, at endline approximately the same proportion of female and male respondents had been tested in the intervention group (19%). In the control group slightly more females had been tested than males (15% versus 7%). The 20-24 age group was more likely to have been tested than any other age group in both the control and intervention group (Table 17). CBD Impact Analysis: Findings 38 Table 17: Have respondents ever been tested for HIV (by age range)? Control Intervention Baseline (n=598) Endline (n=341) Baseline (n=1199) Endline (n=705) No Yes No Yes No Yes No Yes no age given 0.0% 0.0% 0.0% 0.0% 0.2% 0.0% 0.0% 0.0% 15-19 47.2% 0.8% 29.0% 1.8% 35.4% 1.8% 21.4% 2.6% 20-24 29.9% 2.2% 25.5% 5.3% 31.9% 3.0% 27.2% 7.9% 25-29 17.7% 2.2% 14.4% 1.5% 24.9% 2.8% 15.9% 4.0% 30-34 0.0% 0.0% 19.9% 2.6% 0.0% 0.0% 16.9% 4.1% Total 94.8% 5.2% 88.9% 11.1% 92.3% 7.7% 81.4% 18.6% Date of HIV/AIDS test Respondents who had been tested were asked to provide the date of their last HIV/AIDS test. Not all were able to provide the date, but for those who did the data show that at baseline most respondents in both the control and intervention groups had received the test within the two years (2000 or 2001) prior to the survey (Figure 35). Figure 35 Year of Last HIV/AIDS test (% respondents who had been tested, by year) Baseline Respondents 7% 17% 23% 33% 20% 13% 9% 14% 34% 29% 0% 20% 40% 60% 80% 100% 1997 or earlier 1998 1999 2000 2001 Control (N=30) Intervention (N=91) Similarly, at endline, most respondents who had been administered an HIV/AIDS test had taken the test in the previous two years (2003 or 2004). In the control group there was a spike in 2003, while 39% of intervention group respondents had the test in 2004. Overall there is an upward trend over time for the intervention group (Figure 36). CBD Impact Analysis: Findings 39 Figure 36 Year of Last HIV/AIDS test (% respondents who had been tested, by year) Endline Respondents 14% 11% 5% 49% 22% 10% 8% 19% 25% 39% 0% 20% 40% 60% 80% 100% 2000 or earlier 2001 2002 2003 2004 Control (N=37) Intervention (N=124) HIV/AIDS test referral sources CBDs do not provide HIV/AIDS testing, but instead refer patients to testing centers. To identify how people are referred to HIV/AIDS testing centers respondents were asked how they found out about the testing center. Again the findings were grouped into health system and non-health system sources. Most control group respondents (57%) were referred by health system sources (Figure 37). There was no change in the health system vs. non-health system source from baseline to endline, though at endline 3% had been referred through a CBD. Figure 37 Source of referral to testing center (among respondents who have been tested for HIV/AIDS) Control Group 57% 0% 57% 43% 57% 3% 54% 43% 0% 20% 40% 60% 80% 100% Total for health system sources only CBD Other health systems Total for non-health system sources only Baseline Endline 3% increase CBD Impact Analysis: Findings 40 In the intervention group most respondents (52%) were referred for HIV/AIDS testing by non￾health system sources (Figure 38). However, among the health system sources there was an increase of 10% in the number that had been referred through a CBD. Figure 38 Source of referral to testing center (among respondents who have been tested for HIV/AIDS) Intervention Group 60% 0% 60% 40% 48% 10% 38% 52% 0% 20% 40% 60% 80% 100% Total for health system sources only CBD Other health systems Total for non-health system sources only Baseline Endline 10% increase Willingness to be tested for HIV All people interviewed were asked if they would be willing to be tested for HIV/AIDS. At the time of the endline intervention group respondents were somewhat more willing to be tested (81%) than the control group (75%). Both groups showed a slight improvement in willingness to be tested from baseline to endline (Figure 39). CBD Impact Analysis: Findings 41 Figure 39 Would respondent be willing to be tested for HIV/AIDS? 27% 73% 24% 76% 25% 75% 19% 81% 0% 20% 40% 60% 80% 100% No Yes No Yes Control Intervention Baseline Endline 2% increase 5% increase CBD Impact Analysis: References 42 References Nyakauru, Ronika & Caroline S. Marangwanda. Expanded Community Based Distribution (CBD) Programme: 2001 Baseline Survey Results. Select Research. Expanded Community Based Distribution (CBD) Impact Evaluation Report. December 2004. “Zimbabwe Background” in Advance Africa website http://www.advanceafrica.org/where_we_work/Zimbabwe.html (Washington, DC: Advance Africa [cited September 23, 2005]). CBD Impact Analysis: Annexes 43 Annexes Annexes ............................................................................................................................43 Annex 1: Revisions to Original Impact Evaluation Analysis............................................................. 44 Annex 2: Baseline Evaluation Male Questionnaire ........................................................................... 46 Annex 3: Baseline Evaluation Female Questionnaire....................................................................... 56 Annex 4: Endline Evaluation Male Questionnaire............................................................................. 70 Annex 5: Endline Evaluation Female Questionnaire ........................................................................ 82 Annex 6: Data Analysis Tables............................................................................................................... 94 Respondent Background Tables........................................................................................................ 94 Sexual Experience Tables.................................................................................................................... 97 Family Planning Tables .......................................................................................................................100 STI & HIV/AIDS Tables......................................................................................................................109 Annex 7: Baseline and Endline Data Analysis Process and Notes ..............................................114 General Notes.....................................................................................................................................114 Reformatting........................................................................................................................................114 Recoding ...............................................................................................................................................115 Labeling (see the Variable View page in the SPSS databases) ...................................................118 Key Differences between the Baseline and Endline Forms.......................................................119 Notes Specific to the Baseline Database.......................................................................................120 Notes Specific to the Endline Database ........................................................................................121 CBD Impact Analysis: Annexes 44 Annex 1: Revisions to Original Impact Evaluation Analysis On April 25, 2005 ZNFPC submitted a letter of concern to FHI regarding the status of the impact evaluation for the CBD Program Phase 1. The letter specifies problems with the impact evaluation report prepared by Select Research in Zimbabwe, the firm hired to conduct the endline impact evaluation, which submitted the impact evaluation report in February 2005. Concerns cited by ZNFPC included issues with the evaluation process, quality of the analysis, and completeness of deliverables. The letter was provided to Inga Adams at the time of re-analysis (August 2005) to inform the re￾analysis and to help ensure that necessary issues were addressed where possible. The table below lists the specific concerns cited by ZNFPC. The column on the right side of the table lists the steps taken in the re-analysis to address the concern, where possible. Concern Comment at endline re-analysis The report did not conform to the agreed upon format The originally agreed upon format is not clear. The re-analysis was conducted and report prepared using a standard outline covering evaluation methods, findings, and conclusions. Portions of this were extracted from the Select Research report to provide information on the field work. Analysis did not address evaluation objectives We are unclear what these objectives originally were. There were some objectives described in the endline report, but these do not seem to be the objectives of interest to ZNFPC. To define the necessary areas of study for the re-analysis, Inga Adams met with Issakha Diallo and Erin Seidner to identify areas of the questionnaire to be analyzed. It was agreed that the endline analysis would be conducted first on the key indicators of interest, and the baseline analysis would follow if time allowed. Analysis did not separate experimental site data from comparison site data The endline report prepared by Select Research did not break any of the indicators down to compare the intervention and control groups. The reanalysis of the endline data was prepared separating responses into control group or intervention group. CBD Impact Analysis: Annexes 45 The report needed editing in terms of language and other grammatical parameters. Agreed. For the redone analysis report, sections of the Select Research report will be quoted but edited. The report was too long, hence needed a lot of pruning The redone endline report will be more concise and will focus in on the indicators of interest. Three more versions of the report were produced without any significant improvements The version of the report we have on file is dated 02-04-05. Hopefully this is the most recent version of the report. It was observed that the data entry screen had not been properly designed to accurately capture data for multiple response questions. We concur that the database was poorly designed and could have led to data entry errors. This also made data analysis very cumbersome. Ideally we would have reviewed the original data collection forms and re-entered or checked entries, but the original forms were not available. Instead, we reformatted and recoded the endline database as needed, conserving the original entries, prior to data analysis. This made data analysis more feasible. It was noted that Select Research incorrectly value labeled the variables for the 2001 baseline data The baseline database was reviewed and compared to the baseline questionnaires. While the value labels were often not entered into the baseline database, the question numbers were entered, so it was possible to confirm what type of information had been entered for each variable. Value labels were added as needed. The consultants were supposed to indicate “what” and “how much” change, if any, had occurred at the program or population level. The additional time allotted to study the baseline data will allow for a pre-post comparison of intervention and control groups for key indicators of interest. Appropriate statistical techniques (not adequately done) There is mention of the need for ANOVA and logistic regression. The time available for this analysis does not allow for the analysis of statistical significance of differences between the two study groups at baseline and at endline. The findings also show, at endline, that differences between intervention and control groups were slight, and in such cases the evaluation of differences between the two groups would not add to the analysis. CBD Impact Analysis: Annexes 46 Annex 2: Baseline Evaluation Male Questionnaire ZNFPC EXPANDED CBD BASELINE SURVEY MALE QUESTIONNAIRE Date …. / …… / Aug 2001 FOR OFFICIAL USE: QUESTIONNAIRE No. IDENTIFICATION Provincial Codes 1 = Manicaland (Makoni North) 2 = Manicaland (Makoni South) 3 = Mashonaland East (Marondera) 4 = Matabeleland North (Umguza) 5 = Matabeleland South (Bulilimamangwe) 6 = Midlands (Zvishavane) 7 = Masvingo (Gutu North) 8 = Masvingo (Gutu South) Ward …………………………… Village ……………………………. Name of Household Head___________________________ 100. Please give the first names of all usual residents of the household between 15 and 29 years of age who are not attending full time Primary or Secondary school First Name Age (in years) Sex (1=Male, 2=Female) 1. 2. 3. 4. 5. 6. Interviewer: select one male at random for interview and record his name below First Name of respondent …………………………………………. Age Call back? Yes No CBD Impact Analysis: Annexes 47 Section 1 Background Information (NGITHANDA UKWAZI NGAWE) Q. No. Questions Codes Skips 101 In what month and year were you born? Must be after 7-71 and before 7-86 Month Year 19 Enter 99 if month not known 102 What is your current marital status? 1 Married, living with wife 2 Married, wife living away 3 Widower 4 Cohabiting 5 Divorced / separated 6 Never married 7 Other (specify)_____________ 104 104 103 103 103 103 103 Do you currently have partner? 1 Yes 2 No 104 105 104 Does your wife/partner have other boyfriends? 1. Yes 2. No 3 Don't know 105 Which is the highest level of school you have completed (DO NOT READ LIST) 1. Never attended school 0 2. Primary 1 2 3 4 5 6 7 3. Secondary 1 2 3 4 5 6 4. College 1 2 3 4 5 6 5. University 1 2 3 4 5 6 106 What was your main activity in the last 12 months? (Do not read list) 1 Paid employee 2 Employer 3 Own account worker / Communal farmer 4 Unpaid family worker 5 Looking for work/Unemployed 6 Student 7 Homemaker 8 Other (Specify)_____________ 107 107 107 107 108 108 108 108 107 What was your main occupation during the last 12 months? __________________ Go to 109 108 What is your main source of income? Only one answer allowed. 1 Parents 2 Wife 3 Other family member(s) 4 Other (Specify) …………………… 109 Which languages can you speak? MORE THAN ONE ANSWER ALLOWED 1 Shona 2 Ndebele 3 English 4 Other (Specify) ………………… 110 Which languages can you read? MORE THAN ONE ANSWER ALLOWED 1. Shona 2. Ndebele 3. English 4. Other (Specify) ………………… CBD Impact Analysis: Annexes 48 SECTION 2 FERTILITY Q. No. Questions Codes Skips 201 Have you ever had children? 1 Yes 2 No If No, skip to 209 202 How many of your children were born alive? 203 Have you ever had any children who were dead when delivered? No 0 Yes, state number of stillbirths 204 Has your wife/any of your partners ever had a pregnancy which resulted in an abortion or miscarriage? No 0 Yes, state number no. of miscarriages 205 Have any of your babies who were born alive later died? No 0 Yes, state no. of deaths 206 Are any of your children twins or triplets? No 0 Twins x sets of twins Triplets x sets of triplets 207 In which month and year was your first child born? Month Year Enter 99 if month not known If only one live birth, repeat entry for 207 and go to 209 208 In which month and year was your last child born? Month Year Enter 99 if month not known 209 Is your wife / any of your partners pregnant now? 1 Yes 2 No 3 Don't know 9 No reply 301 210 210 210 210 Do you want to have a baby within the next one year? 1 Yes 2 No 3 Don’t know 9 No reply CBD Impact Analysis: Annexes 49 Section 3 SEXUAL EXPERIENCE 301 IF 201=0 ASK 301, OTHERWISE SKIP TO 302 Have you ever had sexual intercourse? 1 Yes 2 No 302 401 302 At what age did you first experience sexual intercourse? 303 With how many women have you had sexual intercourse in the last 12 months? 304 What was your relationship to the last woman you had sex with? 1 wife 2 partner/Cohabitee 3 Fiance / girlfriend 4 Occasional partner 5 Stranger / just met 6 Rape 8 Other (specify) ………………… 305 When you last had sexual intercourse, did you use any method to prevent pregnancy or/and disease? 1 Yes to prevent pregnancy 2 Yes to prevent disease 3 Yes to prevent both 4 No 5 Don’t remember 307 401 306 Which method(s) did you use when you last had sexual intercourse? MORE THAN ONE ANSWER ALLOWED 1 Pill 2 IUCD 3 Injection 4 Norplant 5 Diaphragm, foam 6 Male condom 7 Female condom 8 TL 9 Vasectomy 10 Natural methods 11 Other (Specify)……………………… All go to 401 307 What was the main reason for not using any method to prevent pregnancy or/and disease during your last sexual intercourse? ONLY ONE ANSWER ALLOWED 1 Wanted to have a baby 2 Sex just happended 3 Partner refused to use condom 4 Respondent refused to use condom 5 Raped 6 Felt to be at low risk of getting someone pregnant 7 Felt to be at low risk of disease 8 Other (Specify) ……………………. …. CBD Impact Analysis: Annexes 50 SECTION 4 FAMILY PLANNING Q. No. Questions Codes Skips "Now I would like to talk about family planning - the various ways or methods that people can use to delay or avoid a pregnancy" 401 Which ways or methods of Family Planning have you heard about? Tick in the single box in 401 for each method mentioned spontaneously, then proceed down the column headed “Method”, reading the name and description of each method not mentioned spontaneously. Enter code 0 if method is not recognized. For each method with code 1 or 2, ask what was the main source of information for finding out about the method and enter the appropriate code. Method Spontaneous 2 Probed 1 Not Known 0 What was the main source of information for finding out about (METHOD)? 1 Doctor, nurse,clinic 2 CBD 3 Other community worker 4 Radio 5 Public meeting 6 School 7 Newspaper, magazine 8 Poster, pamphlet 9 Friends, neighbours, relatives 10 Other (Specify) ……………... Pill. Women can take a pill every day IUD. Women can have a loop or coil placed inside them by a doctor or nurse Injection. Women can have an injection by a doctor or nurse Norplant. Women can have several small rods placed in their upper arm by a doctor or nurse Diaphragm, foam, jelly. Women can place a sponge, suppository, diaphragm, jelly or cream inside themselves before intercourse Male condom. Men can put a rubber sheath on their penis before intercourse Female condom. Women can insert a rubber sheath inside themselves before intercourse TL. Women can have an operation to avoid having any more children Vasectomy. Men can have an operation to avoid having any more children Periodic abstinence. A woman can avoid sex on the days of the month she is most likely to become pregnant 401 Other methods (Specify) ____________________ CBD Impact Analysis: Annexes 51 402 Have you or any of your partners ever used any FP method? 1 Yes 2 No 3 No reply 403 404 404 403 Please tell me ALL the methods of FP that you, or your partner, have ever used. MORE THAN ONE ANSWER ALLOWED DO NOT READ LIST 1 Male condom 2 Female condom 3 Withdrawal 4 Rhythm 5 Pill 6 IUD/Loop 7 Injection 8 Norplant 9 Diaphragm, foam 10 TL 11 Vasectomy 12 Other (Specify)…….. …………… 404 Are you or your partner presently using any FP method? If "Yes", check that 402=Yes. If not, repeat 402 1 Yes 2 No 405 If 402=1, 407 If 402=2, 501 405 Which method(s) are you currently using with your partner? MORE THAN ONE ANSWER ALLOWED DO NOT READ LIST 1 Male condom 2 Female condom 3 Withdrawal 4 Rhythm 5 Pill 6 IUD/Loop 7 Injection 8 Diaphragm, foam 9 Norplant 10 TL 11 Vasectomy 12 Other (Specify)…….. …………… 406 From where do you obtain your supplies? DO NOT READ LIST 1 ZNFPC clinic 2 Ministry of Health and Child Welfare clinic 3 Private Health facility / Dr 4 CBD 5 Other Community Health Worker 6 Buys from pharmacy or shop 7 Not applicable 501 407 Which method(s) did you last use? MORE THAN ONE ANSWER ALLOWED DO NOT READ LIST 1. Male condom 2. Female condom 3. Withdrawal 4. Rhythm 5. Pill 6. IUD/Loop 7. Injection 8. Diaphragm, foam 9. Norplant 10. TL 11. Vasectomy 12. Other (Specify)………… …………… 408 When did you stop using this method? 1. Less than 1 month ago 2. 1 month – 3 months ago 3. More than 3 months CBD Impact Analysis: Annexes 52 409 What was the source of the last FP method that you used? 1. ZNFPC clinic 2. MOH clinic 3. Private Health facility / Dr 4. CBD 5. Other Community Health Worker 6. Buys from pharmacy or shop 7 Don’t Know 8 Not applicable SECTION 5 STI / HIV / AIDS 501 Have you heard of diseases that can be transmitted by having sexual intercourse? 1. Yes 2. No Skip to 503 502 What diseases of this kind have you heard of? MORE THAN ONE ANSWER ALLOWED DO NOT READ THE LIST 1. AIDS 2. Gonorrhea 3. Syphilis 4. Chancroid 5. Chlamydia 6. Herpes 7. Other (Specify) ………… 503 Have you heard of HIV / AIDS? 1. Yes 2. No Skip to 601 504 What is your main source of information on HIV/AIDS? ONLY ONE ANSWER ALLOWED Main source of information 1. Doctor, nurse 2. CBD 3. Other community worker 4. Radio 5. Public meeting 6. School / teachers 7. Newspaper, magazine 8. Poster, pamphlet 9. Friends, neighbours, relatives 10. Other (Specify) ……………………….. 505 How can a person become infected with HIV/AIDS? MORE THAN ONE ANSWER ALLOWED DO NOT READ THE LIST 1. Kissing on the mouth 2. Shaking hands 3. Having sexual relations with an infected partner 4. Receiving a blood transfusion 5. Mosquito bites 7. Witchcraft 8. Mother-to-baby during birth 9. Using condoms 10. Multiple sexual partners 11. Other (Specify) …………………. 506 Do you think that there is a cure for HIV / AIDS? 1 Yes 2 No 3 Don’t know 507 Do you think that your risk of getting HIV/AIDS is high, medium, low or no risk at all? 1 Low 2 No risk 3 Medium 4 High 5 I already have HIV/AIDS 6 Don’t know 508 508 509 509 511 510 CBD Impact Analysis: Annexes 53 508 Why do you think you are at low/no risk of getting HIV/AIDS? DO NOT READ THE LIST 1 Not yet sexually active 2 Abstains from sex 3 Only has one partner 4 Always uses condoms 5 Doesn’t inject drugs 6 Only has trustworthy partners 7 Other (Specify)……………………. All go to 510 509 Why do you think you have a medium / high risk of getting HIV/AIDS? DO NOT READ THE LIST 1 Has more than one partner 2 Has many girlfriends 3 Doesn’t use condoms 4 Patner has multiple partners 5 Doesn’t trust partner 6 Injects drugs 7 Other (Specify).……………………. 510 Have you ever been tested for HIV? 1 Yes 2 No 511 513 511 When were you last tested for HIV? Month Year 512 How did you find out about the testing centre? 1 Was referred by doctor / nurse 2 Was referred by CBD 3 Was referred by other CHW 4 Newspaper 5 Radio 6 Friend / neighbour / relative 7 School 8 Other (Specify)………………….. 513 Do you know of a specific place where you can be tested for HIV? 1 Can name specific centre 2 Cannot name specifically 3 Don’t know 514 515 515 514 From where did you obtain this information? 1 Doctor, nurse 2 CBD 3 Other community worker 4 Radio 5 Public meeting 6 School 7 Newspaper, magazine 8 Poster, pamphlet 9 Friends, neighbours, relatives 10 Rumours, gossip 11 Other (Specify)…………………….. 515 Would you be willing to be tested for HIV? 1. Yes 2. No 516 517 516 Why could you be willing to go for VCT 1. Just to know own status 2. Other (Specify)…………………… All go to 601 517 Why would you be unwilling to go for VCT? 1 No need 2 Afraid of positive result 3 Afraid of being seen in testing centre 4 Too expensive 5 Other (Specify)……………………….. CBD Impact Analysis: Annexes 54 SECTION 6 INTERACTION WITH CBDs Q. No. Questions Codes Skips 601 Which health workers operate at community level in your area? 1 None 2 ZNFPC Community Based Distributor 3 Depot Holder 4 Village Health worker 5 Peer Educator 6 Environmental Health Technician 7 VCW 8 Other (Specify)_________ 602 Do you know the name of the local ZNFPC CBD? 1 Name known and correct 2 Name given but incorrect 3 Not known 603 Do you know the name of the local Depot Holder? 1 Name known and correct 2 Name given but incorrect 3 Not known 604 Have you ever been visited by the ZNFPC CBD ? 1. Yes 2. No 605 Have you ever attended a meeting addressed by the CBD, ………….. (name of CBD) 1. Yes 2. No 606 607 606 What did ……………. (name of CBD) talk about? 1 Family Planning 2 HIV/AIDS 3 STIs 4 Home Based Care 5 Voluntary Counselling and Testing 6 Youth RH 7 Can’t remember 8 Other reproductive health topics 9 Other (Specify)__________ 607 Have you ever been advised or counselled by ………….. (name of CBD)? 1 Yes 2 No 608 610 608 What were you advised or counselled about? 1 Family Planning 2 HIV/AIDS 3 STIs 4 Home Based Care 5 Voluntary counselling and Testing 6 Youth RH 7 Can’t remember 8 Other reproductive health topics 9 Other (Specify)__________ 609 Has ………….. (Name of CBD) ever advised you to go for an HIV test? 1 Yes 2 No 9 Can’t remember 610 If you wanted information or counselling about HIV/AIDS, which type of person would you be most likely to consult first? READ OUT THE LIST 1 Doctor 2 Nurse at ZNFPC clinic 3 Nurse at health facility 4 CBD 5 Depot Holder 6 Village Health Worker 9 Any other person (Specify) ………………. CBD Impact Analysis: Annexes 55 Interviewer: Enter assessment of responses after completing interview Responses to sensitive questions: True information likely Respondent may be withholding some information False information suspected Comments …………………………………………………………………………………………… ……………………………………………………………………………………………. Completed by………………………………..Print name of interviewer Checked by…………………………………..Print name of supervisor Comments by Supervisor ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… CBD Impact Analysis: Annexes 56 Annex 3: Baseline Evaluation Female Questionnaire ZNFPC EXPANDED CBD BASELINE SURVEY FEMALE QUESTIONNAIRE Date …. / Aug/ 2001 FOR OFFICIAL USE: QUESTIONNAIRE No. IDENTIFICATION Provincial Codes 1 = Manicaland (Makoni North) 2 = Manicaland (Makoni South) 3 = Mashonaland East (Marondera) 4 = Matabeleland North (Umguza) 5 = Matabeleland South(Bulilimamangwe) 6 = Midlands (Zvishavane) 7 = Masvingo (Gutu North) 8 = Masvingo (Gutu South) Ward …………………………… Village ……………………………. Name of Household Head___________________________ 100. Please give the first names of all usual residents of the household between 15 and 29 years of age who are not attending full time Primary or Secondary school First Name Age (in years) Sex (1=Male, 2=Female) 1. 2. 3. 4. 5. 6. Interviewer: select one female at random for interview and record her name below First Name of respondent …………………………………………. Age Call back? Yes No CBD Impact Analysis: Annexes 57 Section 1 Background Information Q. No. Questions Codes Skips 101 In what month and year were you born? Must be after 7-71 and before 7-86 (Makazvarwa mugore ripi nemumwezi upi?) Month Year 19 Enter 99 if month not known 102 What is your current marital status? (Parizvino makaroorwa here?) 8 Married, living with husband 9 Married, husband living away 10 Widow 11 Cohabiting 12 Divorced / separated 13 Never married 14 Other (specify)_____________ 104 104 103 103 103 103 103 Do you currently have partner? Parizvino mune wamunodanana naye here?) 4 Yes 5 No 104 105 104 Does your husband/partner have other wives/girlfriends? (Murume wenyu kana wamunodanana naye ane vamwe vakadzi kana vasikana vaanodanana navo here?) 3. Yes 4. No 6 Don't know 105 Which is the highest level of education you have completed? (DO NOT READ LIST) (Makadzidza kusvika murugwaro rwupi?) 6. Never attended school 0 7. Primary 1 2 3 4 5 6 7 8. Secondary 1 2 3 4 5 6 9. College 1 2 3 4 5 6 10. University 1 2 3 4 5 6 106 What was your main activity in the last 12 months? (DO NOT READ LIST) (Mainyanya kuita basa ripi mugore rapfuura?) 9 Paid employee 10 Employer 11 Own account worker / Communal farmer 12 Unpaid family worker 13 Looking for work/Unemployed 14 Student 15 Homemaker / Housewife 16 Other (Specify)_____________ 107 107 107 107 108 108 108 108 107 What was your main occupation during the last 12 months? (Mainyanya kuita basa reyi gore rapfuura?) __________________ Go to 109 108 What is your main source of income? (Munonyanyowanepi mari yamunoshandisa?) ONLY ONE ANSWER ALLOWED. 5 Parents 6 Husband 7 Other family member(s) 8 Other (Specify) …………………… 109 Which languages can you speak? (Munokwanisa kutaura mitauro ipi?) MORE THAN ONE ANSWER ALLOWED 4 Shona 5 Ndebele 6 English 7 Other (Specify) ………………… 110 Which languages can you read? (Ndeipi mitauro yamunokwanisa kuverenga?) MORE THAN ONE ANSWER ALLOWED 5. Shona 6. Ndebele 7. English 8. Other (Specify) ………………… CBD Impact Analysis: Annexes 58 SECTION 2 FERTILITY PARIZVINO TAVA KUDA KURUKURA NEZVEMBEREKO Q. No. Questions Codes Skips 201 How many times have you been pregnant? (Makaita pamuviri kangani) If zero, skip to 209 202 How many times have you given birth to a live baby? (Makabereka vana vapenyu vangani?) 203 Have you ever given birth to a baby who was dead when delivered? (Makambosununguka mwana akazvarwa akafa here?) No 0 Yes, state number of stillbirths 204 Have you ever had a pregnancy, which resulted in an abortion or miscarriage? (Makambobva pamuviri here?) No 0 Yes, state number no. of miscarriages 205 Have any of your babies who were born alive later died? (Pavana venyu vamakabereka vari vapenyu, pane vakazofa here?) No 0 Yes, state no. of deaths 206 Have any of your pregnancies resulted in a multiple birth? (Pavana venyu vamakabereka pane vakanga vari manyambiri kana kuti mapatya here?) No 0 Twins x no. of pregnancies Triplets x no. of pregnancies Check that no. of pregnancies tallies with stated no. of live births, stillbirths and miscarriages, including any multiple births 207 In which month and year was your first child born? (Mwana wenyu wekutanga makamubereka rini?) [PROBE FOR MONTH AND YEAR] Month Year Enter 99 if month not known If only one live birth, repeat entry for 207 and go to 209 208 In which month and year was your last child born? (Mwana wenyu wekupedzisira makamubereka rini?) [PROBE FOR MONTH AND YEAR] Month Year Enter 99 if month not known 209 Are you pregnant now? (Parizvino, makazvitakura/mune pamuviri here?) 4 Yes 5 No 6 Don't know 17 No reply 210 211 211 211 210 How many months is the pregnancy? (Pamuviri penyu pane mwedzi mingani?) months skip to Section 3 211 Do you want to give birth within the next 12 months? (Mungade kuita mwana here mumwedzi gumi nemiviri inotevera?) 4 Yes 5 No 6 Don’t know 9 No reply CBD Impact Analysis: Annexes 59 Section 3 SEXUAL EXPERIENCE (Ikozvino tava kuda kumbokurukura nezvekusangana pabonde) Q. No. Questions Codes Skips 301 IF 201=0 ASK 301, OTHERWISE SKIP TO 302 Have you ever had sexual intercourse? (Makambosangana nemurume pabonde here?) 3 Yes 4 No 302 401 302 At what age did you first experience sexual intercourse? Makatanga kusangana nemurume pabonde muine makore mangani? 303 With how many men have you had sexual intercourse in the last 12 months? (Mumwedzi gumi nemiviri yapfuura, makasangana nevarume vangani pabonde?) 304 What was your relationship to the last man you had sex with? (Murume wamakapedzisira kusangana naye pabonde, chaive chii chenyu?) 7 Husband 8 Partner / Cohabittee 9 Fiancé / boyfriend 10 Occasional partner 11 Stranger / just met 12 Rape 7 Other (specify) ………………… 305 When you last had sex, did you use any method to prevent pregnancy or/and disease? (Pamakapedzisira kusangana nemurume pabonde makashandisa nzira dzekudzivirira pamuviri/kana zvirwere here?) 6 Yes to prevent pregnancy 7 Yes to prevent disease 8 Yes to prevent both disease & pregnancy 9 No 10 Don’t remember 307 401 306 Which method(s) did you use when you last had sex? (Makashandisa nzira dzipi dzekuronga mhuri kana kudzivirira pamuviri/kana zvirwere pamakapedzisira kusangana nemurume pabonde?) MORE THAN ONE ANSWER ALLOWED 1 Pill 2 IUD 3 Injection 4 Norplant 5 Diaphragm, foam 6 Male condom 7 Female condom 8 TL (Female Sterilisation) 9 Vasectomy (Male Sterilisation) 10 Natural methods 11 Other (Specify)……………………… All go to 401 307 What was the main reason you did not use any method to prevent pregnancy or / and disease during your last sexual intercourse? (Chii chikonzero chikuru chakaita kuti musashandisa nzira dzekudzivirira pamuviri kana zvirwere pamakapedzisira kusangana nemurume pabonde?) ONLY ONE ANSWER ALLOWED 8 Wanted to become pregnant 9 Sex just happened 10 Partner refused to use condom 11 Respondent refused to use condom 12 Raped 13 Felt to be at low risk of pregnancy 14 Felt to be at low risk of disease 8 Other (Specify) ……………………. …. CBD Impact Analysis: Annexes 60 SECTION 4 FAMILY PLANNING (Parizvino tava kuda kumbokurukura nenyaya dzezvekuronga mhuri) Q. No. Questions Codes Skips "Now I would like to talk about family planning - the various ways or methods that people can use to delay or avoid a pregnancy" 402 Which ways or methods of Family Planning have you heard about? (Ndedzipi nzira dzekuronga mhuri dzamakambonzwa nezvadzo?) Tick in the single box in 401 for each method mentioned spontaneously, then proceed down the column headed “Method”, reading the name and description of each method not mentioned spontaneously. Enter code 0 in the box if method is not recognized. For each method with code 1 or 2, ask what was the main source of information for finding out about the method and enter the appropriate code. Method Spontaneous 2 Probed 1 Not Known 0 What was your main source of information for finding out about (METHOD)? (Makanyanyowanepi ruzivo rwe? MENTION METHOD DO NOT READ LIST ONLY ONE ANSWER ALLOWED 1 Doctor, nurse, clinic 2 CBD 3 Other community worker 4 Radio 5 Public meeting 6 School 7 Newspaper, magazine 8 Poster, pamphlet 9 Friends, neighbours, relatives 18 Other (Specify) ……………... 1 Pill. Women can take a pill every day (Mapiritsi - Vanhukadzi vanokwanisa kunwa piritsi rimwe pazuva rega rega) 401 2 IUD. Women can have a loop or coil placed inside them by a doctor or nurse (Rupu. Inoiswa muchibereko chaamai nanesi kana chiremba) CBD Impact Analysis: Annexes 61 Method Spontaneous 2 Probed 1 Not Known 0 What was your main source of information for finding out about (METHOD)? (Makanyanyowanepi ruzivo rwe? MENTION METHOD DO NOT READ LIST ONLY ONE ANSWER ALLOWED 1 Doctor, nurse, clinic 2 CBD 3 Other community worker 4 Radio 5 Public meeting 6 School 7 Newspaper, magazine 8 Poster, pamphlet 9 Friends, neighbours, relatives 19 Other (Specify) ……………... 3 Injection/Depo provera Women can have an injection by a doctor or nurse (Jekiseni/Depo provera-Vanhukadzi vanobaiwa majekiseni nanesi kana chiremba rinodzivirira kubata pamuviri kwemwedzi yakati kuti) 4 Norplant. Women can have several small rods placed in their upper arm by a doctor or nurse (Implants:Chiremba vanogona kupfekedza vanhukadzi tunhu kumusoro kweruoko pedyo nebendekete tunodzivirira kuti vasabate pamuviri kwemakore akati kuti) 5 Diaphragm, foam, jelly. Women can place a sponge, suppository, diaphragm, jelly or cream inside themselves before intercourse (Diaphragm, Spermicides, Jellies: Vanhukadzi vanokwanisa kupfeka kana hwidibiro pamuromo wechibereko vasati vasangana nemurume kana mamwe mafuta okupfeka, kuti vasabatira pamuviri) CBD Impact Analysis: Annexes 62 Method Spontaneous 2 Probed 1 Not Known 0 What was your main source of information for finding out about (METHOD)? (Makanyanyowanepi ruzivo rwe? MENTION METHOD DO NOT READ LIST ONLY ONE ANSWER ALLOWED 1 Doctor, nurse, clinic 2 CBD 3 Other community worker 4 Radio 5 Public meeting 6 School 7 Newspaper, magazine 8 Poster, pamphlet 9 Friends, neighbours, relatives 20 Other (Specify) ……………... 6 Male condom. Men can put a rubber sheath on their penis before intercourse (Condom rechirume: Vanhurume vanokwanisa kupfeka chubhu (durex) vasati vasangana nevanhukadzi kudzivirira nhumbu nezvirwere) 7 Female condom. Women can insert a rubber sheath inside themselves before intercourse (Kondomu rechikadzi: Munhukadzi anokwanisa kupfekawo chubu /kondomu rakagadzirirwa vanhukadzi asati asangana nomunhurume kuti asabatira pamuviri kana zvirwere) 8 Tubal Ligation - Women can have an operation to avoid having any more children (Vanhukadzi vanokwanisa kuitwa oparesheni nachiremba inoita kuti vasaite nhumbu zvachose) 9 Vasectomy. Men can have an operation to avoid having any more children (Vasectomy: Vanhurume vanokwanisa kuitwa oparesheni yokusunga machubhu inoita kuti vasaitise nhumbu zvachose) CBD Impact Analysis: Annexes 63 Method Spontaneous 2 Probed 1 Not Known 0 What was your main source of information for finding out about (METHOD)? (Makanyanyowanepi ruzivo rwe? MENTION METHOD DO NOT READ LIST ONLY ONE ANSWER ALLOWED 1 Doctor, nurse, clinic 2 CBD 3 Other community worker 4 Radio 5 Public meeting 6 School 7 Newspaper, magazine 8 Poster, pamphlet 9 Friends, neighbours, relatives 21 Other (Specify) ……………... 10 Periodic abstinence. A woman can avoid sex on the days of the month she is most likely to become pregnant (Periodic Absitence or Rhythm: Vanhukadzi vanogona kuverenga mazuva avanofungidzira kuti vanogona kubata pamuviri vorega kusangana nevanhurume) 11 Other methods (Specify) ____________________ CBD Impact Analysis: Annexes 64 Q. No. Questions Codes Skips 402 Have you ever used any FP method? (Makamboshandisa nzira dzekuronga mhuri here?) 3 Yes 4 No 5 Other (Specify)…………………… 403 501 403 Please tell me ALL the methods of FP that you, or your partner, have ever used. (Ndedzipi nzira dzekuronga mhuri dzamakamboshandisa, imi kana kuti mumwe wenyu?) MORE THAN ONE ANSWER ALLOWED DO NOT READ THE LIST 13 Male condom 14 Female condom 15 Withdrawal 16 Rhythm 17 Pill 18 IUD / Loop 19 Injection 20 Norplant 21 Diaphragm, foam 22 TL 23 Vasectomy 24 Other (Specify)…….. …………… 404 Are you currently using any FP method? (Parizvino muri kushandisa nzira dzekuronga mhuri here?) If "Yes", check that 402=Yes. If not, repeat 402 If pregnant, circle”2” but do not ask 1 Yes 2 No 3 Currently pregnant 405 If 402=1, 407 If 402=1, 407 405 Which method(s) are you currently using? (Ndedzipi nzira dzekuronga mhuri dzamuri kushandisa parizvino?) DO NOT READ THE LIST MORE THAN ONE ANSWER ALLOWED 13 Male condom 14 Female condom 15 Withdrawal 16 Rhythm 17 Pill 18 IUD / Loop 19 Injection 20 Diaphragm, foam 21 Norplant 22 TL 23 Vasectomy 24 Other (Specify)…….. …………… 406 What is the source of FP method(s) you are currently using? (Nzira dzamurikushandisa parizvino muri kudziwana kupi?) DO NOT READ THE LIST 9 ZNFPC clinic 10 Ministry of Health & Child Welfare clinic 11 Private Health facility / Dr 12 CBD 13 Other Community Health Worker 14 Buys from pharmacy or shop 7 Not applicable 501 CBD Impact Analysis: Annexes 65 407 Which method(s) did you last use? (Makapedzisira kushandisa nzira dzipi dzekuronga mhuri?) DO NOT READ THE LIST MORE THAN ONE ANSWER ALLOWED 13. Male condom 14. Female condom 15. Withdrawal 16. Rhythm 17. Pill 18. IUD / Loop 19. Injection 20. Diaphragm, foam 21. Norplant 22. TL 23. Vasectomy 24. Other (Specify)………… ……… Q. No. Questions Codes Skips 408 When did you stop using this method? (Makaregera kushandisa nzira dzekuronga mhuri rinhi?) 4. Less than 1 month ago 5. 1 month – 3 months ago 6. More than 3 months 7. Can't remember 409 What was the source of the last FP method that you used? (Makawana kupi nzira dzekuronga mhuri dzamakapedzisira kushandisa?) 7. ZNFPC clinic 8. MOH clinic 9. Private Health facility / Doctor 10. CBD 11. Other Community Health Worker 12. Buys from pharmacy or shop 13. Don't know 8. Not applicable SECTION 5 STI / HIV / AIDS (Ikozvino tavakuda kumbokurukurirana nezvezvirwere zvinotapuriranwa pabonde) 501 Have you heard of diseases that can be transmitted by having sexual intercourse? (Makambonzwa here nezvezvirwere zvinotapuriranwa pabonde?) 3. Yes 4. No Skip to 503 502 What diseases of this kind have you heard of? (Ndezvipi zvirwere zvinotapuriranwa pabonde zvamakambonzwa nezvazvo?) MORE THAN ONE ANSWER ALLOWED DO NOT READ THE LIST 1. HIV/AIDS (Mukondombera) 2. Gonorrhea (Drop) 3. Syphilis (Njovera) 4. Chancroid (Maronda ekuzasi) 5. Chlamydia (Zvinobuda kuzasi zvinonhuwa) 6. Herpes (Zvidzimu / zvekuzasi/madzvausiku) 7. Other (Specify) ………… 503 Have you heard of HIV / AIDS? (Makambonzwa nezvemukondombera kana kuti HIV/AIDS here?) 3. Yes 4. No Skip to 601 CBD Impact Analysis: Annexes 66 504 What is your main source of information on HIV/AIDS? (Ndekupi kwamakanyanyowana ruzivo rwezvemukondombera?) Main source of information 11. Doctor, nurse 12. CBD 13. Other community worker 14. Radio 15. Public meeting 16. School / teachers 17. Newspaper, magazine 18. Poster, pamphlet 19. Friends, neighbours, relatives 20. Other (Specify) ……………………….. 505 How can a person become infected with HIV/AIDS? (Munhu anowana kana kubatira sei utachiona hweHIV/AIDS kana mukondombera?) MORE THAN ONE ANSWER ALLOWED DO NOT READ THE LIST 4. Kissing on the mouth 5. Shaking hands 6. Having sex with an infected partner 4. Receiving a blood transfusion 5. Mosquito bites 7. Witchcraft 8. Mother-to-baby during birth 9. Using condoms 10. Having multiple sexual partners 21. Other (Specify) …………………. Q. No. Questions Codes Skips 506 Do you think that there is a cure for HIV / AIDS? (Mukondombera / HIV/AIDS inorapika here?) 4 Yes 5 No 6 Don’t know 507 Do you think that your risk of getting HIV/AIDS is high, medium, low or no risk at all? (Munofunga kuti mukana wenyu wekubatira mukondombera/HIV/AIDS muhombe here, kana kuti uri pakati nepakati mudiki here kana kuti hamuna mukana wacho zvachose?) 8 Low 9 No risk 10 Medium 11 High 12 I have already HIV/AIDS 13 Don’t know 508 508 509 509 511 510 508 Why do you think you are at low/no risk of getting HIV/AIDS? (Sei muchifunga kuti mukana wenyu wekubatira mukondomera mushoma kana kuti hamutorina?) DO NOT READ THE LIST 7 Not yet sexually active 8 Abstains from sex 9 Only has one partner 10 Always uses condoms 11 Doesn’t inject drugs 12 Only has trustworthy partners 7 Other (Specify)……………………. All go to 510 509 Why do you think you have a medium / high risk of getting HIV/AIDS? ? (Sei muchifunga kuti mukana wenyu wekubatira mukondomera uri pakati nepakati kana kuti mukuru?) DO NOT READ THE LIST 8 Has more than one partner 9 Has many boyfriends 10 Doesn’t use condoms 11 Partner has multiple partners 12 Doesn’t trust partner 13 Injects drugs 7 Other (Specify)…………………. 510 Have you ever been tested for HIV? (Makambonoongororwa here hutachiona hwemukondomera/HIV?) 1 Yes 2 No 511 513 511 When were you last tested for HIV? (Makapedzisira kunoongororwa hutachiona hwemukondomera/HIV rinhi?) Month Year CBD Impact Analysis: Annexes 67 512 How did you find out about the testing centre? (Ruzivo rwenzvimbo yekuongororwa utachiona hwemukondombera / HIV makarwuwana kupi?) 1 Was referred by doctor / nurse 2 Was referred by CBD 3 Was referred by other CHW 4 Newspaper 5 Radio 6 Friend / neighbour / relative 7 School 8 Other ……………………….. 513 Do you know of a specific place where you can be tested for HIV? (Pane nzvimbo yamunonyatsoziva here yekunoongororwa mukondombera/HIV?) 1 Can name specific centre 2 Cannot name specifically 3 Don’t know 514 515 515 514 From where did you obtain this information? (Ruzivo rwezvenzvimbo iyi makaruwana kupi?) 1 Doctor, nurse 2 CBD 3 Other community worker 4 Radio 5 Public meeting 6 School 7 Newspaper, magazine 8 Poster, pamphlet 9 Friends, neighbours, relatives 10 Rumours, gossip 11 Other (Specify)……………………… 515 Would you be willing to be tested for HIV? (Mungade here kunotsanangurirwa nekuoongororwa hutachiwana hwemukombera / HIV?) 3. Yes 4. No 516 517 516 Why would you be willing to go for VCT? Mungadirei kuenda kunotsanangurirwa nekuongororwa hutachiona kemukondombera / HIV?) 3. Just to know own status 4. Other (Specify)…………………… All go to 601 517 Why would you be unwilling? (Sei musingadi kuenda kunotsanangurirwa nekuongororwa HIV/mukondombera?) 1 No need 2 Afraid of positive result 3 Afraid of being seen in testing centre 7 Too expensive 5 Other (Specify)………..………….. SECTION 6 INTERACTION WITH CBDs (Iyezvino tavakuda kumbokurukura nezvemashandiro avana mbuya/sekuru kuronga mhuri vemunharaunda yenyu) Q. No. Questions Codes Skips 601 Which health workers operate at community level in your area? (Ndevapi vashandi vezveutano vanosevenzera munharaunda yenyu?) MORE THAN ONE ANSWER ALLOWED DO NOT READ LIST 9 None 10 ZNFPC Community Based Distributor 11 Depot Holder 12 Village Health worker 13 Peer Educator 14 Environmental Health Technician 15 Village Community worker 8 Other (Specify)_________ 602 Do you know the name of the local ZNFPC CBD? (Mbuya/sekuru kuronga mhuri vemunharaunda yenyu vanonzi ani?) 4 Name known and correct 5 Name given but incorrect 6 Not known 603 Do you know the name of the local Depot Holder? (Depot holder anoshanda munharaunda yenyu achipa vanhu mapiriritsi ekuronga mhuri ari pamba anonzi ani?) 4 Name known and correct 5 Name given but incorrect 6 Not known 604 Have you ever been visited by the ZNFPC CBD? (Makamboshanyirwa here nambuya/sekuru kuronga mhuri?) 3. Yes 4. No 605 Have you ever attended a meeting addressed by the CBD, ………….. (name of CBD) (Makamboenda here kumusangano wakarongwa naCBD? ZITA) 3. Yes 4. No 606 607 606 What did ……………. (name of CBD) talk about? (Mbuya/sekuru kuronga mhuri vaitaura nezvei pamusangano iwoyo?) 10 Family Planning 11 HIV/AIDS 12 STIs CBD Impact Analysis: Annexes 68 MORE THAN ONE ANSWER ALLOWED DO NOT READ LIST 13 Home Based Care 14 Voluntary Counselling and Testing 15 Youth RH 16 Can’t remember 17 Other reproductive health topics (Specify)__________ 607 Have you ever been advised or counselled by …….. (name of CBD)? (Makambopiwa/kupangwa mazano nambuya/sekuru kuronga mhuri here?) 10 Yes 11 No 608 610 608 What were you advised or counselled about? (Makapangwa mazano/makakurukura nezvei?) MORE THAN ONE ANSWER ALLOWED DO NOT READ LIST 1 Family Planning 2 HIV/AIDS 12 STIs 13 Home Based Care 14 Voluntary counselling and Testing 15 Youth RH 16 Can’t remember 17 Other reproductive health topics (Specify)__________ 609 Has ………….. (Name of CBD) ever advised you to go for an HIV test? (Mbuya/sekuru kuronga mhuri vakambokukurudzirai here kuti munoongororwa hutachiona hwemukondombera / HIV/AIDS?) 1 Yes 2 No 3 Can’t remember 610 If you wanted information or counselling about HIV/AIDS, which type of person would you be most likely to consult first? (kana muri kuda kuwana ruzivo rwezvemukondombera HIV/AIDS ndeupi munhu wamungatanga kundobvunza?) DO NOT READ OUT THE LIST ONLY ONE ANSWER ALLOWED 1 Doctor 2 Nurse at ZNFPC clinic 3 Nurse at health facility 4 CBD 5 Depot Holder 6 Village Health Worker 9 Any other person (Specify) …………… Interviewer: Enter assessment of responses after completing interview Responses to sensitive questions: 1. True information likely 2. Respondent may be withholding some information 3. False information suspected Comments ……………………………………………………………………………… ……………………………………………………………………………… Completed by………………………………………………... INTERVIEWER Checked by………………………………………………….….SUPERVISOR Comments by the Supervisor CBD Impact Analysis: Annexes 69 ……………………………………………………………………………… ……………………………………………………………………………… ……………………………………………………………………………… ……………………………………………………………………………… CBD Impact Analysis: Annexes 70 Annex 4: Endline Evaluation Male Questionnaire ZNFPC EXPANDED CBD IMPACT EVALUATION SURVEY NDEBELE MALE QUESTIONNAIRE Date …. / Nov / 2004 FOR OFFICIAL USE: QUESTIONNAIRE No. IDENTIFICATION Provincial Codes 1 = Manicaland (Makoni North) 2 = Manicaland (Makoni South) 3 = Mashonaland East (Marondera) 4 = Matabeleland North (Umguza) 5 = Matabeleland South (Bulilimamangwe) 6 = Midlands (Zvishavane) 7 = Masvingo (Gutu North) 8 = Masvingo (Gutu South) Ward ……………………………… Village ……………………………. Name of Household Head___________________________ 100. Please give the first names of all usual residents of the household between 15 and 34 years of age who are not attending full time Primary or Secondary school ( First Name Age (in years) Sex (1=Male, 2=Female) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Interviewer: select one male at random for interview and record his name below First Name of respondent …………………………………………. Age Call back? Yes No CBD Impact Analysis: Annexes 71 Section 1 Background Information (NGITHANDA UKWAZI NGAWE) Q. No. Questions Codes Skips 101 In what month and year were you born? (Wazalwa ngawuphi umnyaka njalo ngenyanga iphi)? Must be after 11-70 and before 11-89 Month Year 19 Enter 99 if month not known 102 What is your current marital status? (Okwakathesi uthethe na?) 15 Married, living with Wife 16 Married, wife living away 17 Widow 18 Cohabiting 19 Divorced / separated 20 Never married 21 Other (specify)_____________ 104 104 104 103 Do you currently have partner? (Okwakhathesi ulomngane othandana laye na?) 7 Yes 8 No 104 105 104 Does your wife/partner have other husbands/ boyfriends?(Umkakho loba umngane wakho angaba leyinye indoda kumbe amanye amadoda athandana labo na? 5. Yes 6. No 9 Don't know 105 Which is the highest level of school you have completed? Wacina kusiphi isigaba emfundweni yakho?(DO NOT READ LIST) 11. Never attended school 0 12. Primary 1 2 3 4 5 6 7 13. Secondary 1 2 3 4 5 6 14. College 1 2 3 4 5 6 15. University 1 2 3 4 5 6 106 What was your main activity in the last 12 months? Kumnyaka odluleyo ubusenza msebenzi bani?(Do not read list) 22 Paid employee 23 Employer 24 Own account worker / Communal farmer 25 Unpaid family worker 26 Looking for work/Unemployed 27 Student 28 Homemaker / Housewife 29 Other (Specify)_____________ 108 108 108 108 107 What was your main occupation during the last 12 months? Kumnyaka odluleyo ubusebenza msebenzi bani? __________________ Go to 109 108 What is your main source of income? (Yiphi indlela oyithembileyo othola ngayo imali?) Only one answer allowed. 9 Parents 10 Husband 11 Other family member(s) 12 Other (Specify) …………………… 109 Which languages can you speak? (Ukhuluma ndimi ziphi?) MORE THAN ONE ANSWER ALLOWED 8 Shona 9 Ndebele 10 English 4 Other (Specify) ………………… 110 Which languages can you read? (Yiziphi indimi owenelisa ukuzibala) MORE THAN ONE ANSWER ALLOWED 9. Shona 10. Ndebele 11. English 12. Other (Specify) ………………… CBD Impact Analysis: Annexes 72 SECTION 2 FERTILITY KATHESI NGITAHANDA UKUTHI SIXOXE NGEZENZALO Q. No. Questions Codes Skips 201 Have you ever had children? (Sowake waba labantwana na?) 1 Yes 2 No If No, skip to 209 202 How many of your children were born alive? (Bangaki abantwana bakho abazalwa bephila ?) 203 Have you ever had any children who were dead when delivered? (Sewake wabalabantwana abazalwa befile na?) No 0 Yes, state number of stillbirths 204 Has your wife/any of your partners ever had a pregnancy which resulted in a miscarriage? (Wake waswela na?) No 0 Yes, state number no. of miscarriages 205 Have any of your children who were born alive later died? (Ebantwaneni bakho abazalwa bephila bakhona na abafayo?) No 0 Yes, state no. of deaths 206 Are any of your children twins or triplets? (Ebantwaneni bakho kukhona na amapahla kumbe abazalwa bebathathu?) No 0 1 Twins x no. of pregnancies 2 Triplets x no. of pregnancies Check that no. of pregnancies tallies with stated no. of live births, stillbirths and miscarriages, including any multiple births 207 In which month and year was your first child born? Umntwana wakho wakuqala wazalwa ngawuphi umnyaka njalo ngayiphi inyanga?) PROBE FOR MONTH AND YEAR. Month Year Enter 99 if month not known 208 In which month and year was your last child born? Umntwana wakho omcane wazalwa ngawuphi umnyaka njalo ngayiphi inyanga?) PROBE FOR MONTH AND YEAR. Month Year Enter 99 if month not known If only one live birth, repeat entry for 207 and go to 209 209 Is your wife/any of your partners pregnant now? Okwakathesi umkakho kumbe othandana laye uzithwele na?) 7 Yes 8 No 9 Don't know 4 No reply 211 211 211 211 Do you want to have a child within the next 12 months? (Ungafuna ukuba lomntwana kunyanga ezilitshumi lambili ezilandelayo na?) 7 Yes 8 No 9 Don’t know 4 No reply CBD Impact Analysis: Annexes 73 Section 3 SEXUAL EXPERIENCE (KATHESI SESIZAXOXA NGEZEMACANSINI) 301 IF 201=0 ASK 301, OTHERWISE SKIP TO 302 Have you ever had sexual intercourse? Sowake waya emacansini na?) 5 Yes 6 No 401 302 At what age did you first have sexual intercourse? (Waqalisa ulemnyaka emingaki ukuya emacansini?) 303 With how many women have you had sexual intercourse in the last 12 months? Sowahlangana labangane abangaki emacansini kunyanga ezilitshumi lambili ezidlulileyo?) 304 What was your relationship to the last woman you had sex with? (Waye engubani wakho owacina ukuhlangana laye emacansini?) 13 Husband 14 Partner / Cohabittee 15 Fiancé / boyfriend 16 Occasional partner 17 Stranger / just met 18 Rape 7 Other (specify) ………………… 305 When you last had sex, did you use any method to prevent pregnancy or/and disease? (Ukucina kwakho ukuya emacansini wasebenzisa na indlela yokuzivikela ukuzithwala kumbe emkhuhlaneni? Probe 11 Yes to prevent pregnancy 12 Yes to prevent disease 13 Yes to prevent both disease & pregnancy 14 No 15 Don’t remember 307 401 306 Which method(s) did you use when you last had sex? (Wasebenzisa ndlela bani zokwelamisela khatshana kumbe ukuvikela imikhuhlane ucina ukuya emacansini? Probe MORE THAN ONE ANSWER ALLOWED 12 Pill 13 IUD 14 Injection 15 Norplant 16 Diaphragm, foam 17 Male condom 18 Female condom 19 TL (Female Sterilisation) 20 Vasectomy (Male Sterilisation) 21 Natural methods 22 Other (Specify)……………………… All go to 401 307 What was the main reason for not using any method to prevent pregnancy or / and disease during your last sexual intercourse? (Kungani ungazivikelanga emikhuhlaneni lekuzithwaleni ucina ukuya emacansini?) 15 Wanted to become pregnant 16 Sex just happened 17 Partner refused to use condom 18 Respondent refused to use condom 19 Raped 20 Felt to be at low risk of pregnancy 21 Felt to be at low risk of disease 8 Other (Specify) ……………………. …. CBD Impact Analysis: Annexes 74 SECTION 4 FAMILY PLANNING (KHATHESI SESIXOXA NGENDLELA ZOKUWELAMISELA KHATSHANA (FP) ) Q. No. Questions Codes Skips "Now I would like to talk about family planning - the various ways or methods that people can use to delay or avoid a pregnancy" 403 Which ways or methods of Family Planning have you heard about? (Yeziphi indlela zokuwelamisela khatshana osowake wezwa ngazo?) Tick in the single box in 401 for each method mentioned spontaneously, then proceed down the column headed “Method”, reading the name and description of each method not mentioned spontaneously. Enter code 0 in the box if method is not recognized. For each method with code 1 or 2, ask what was the main source of information for finding out about the method and enter the appropriate code. Method Spontaneous 2 Prompted 1 Not Known 0 What was your main source of information for finding out about (METHOD)? ( Waluthola ngaphi ulwazi lolu ?) DO NOT READ LIST. ONE ANSWER ONLY. 1 Doctor, nurse 2 CBD 3 Other community worker 4 Radio 5 Public meeting 6 School 7 Newspaper, magazine 8 Poster, pamphlet 9 Friends, neighbours, relatives 10 Other (Specify) ……………... 12 Pill. Women can take a pill every day (Iphilisi - elinathwa nsuku zonke ngomama ) 2 1 0 13 IUD. Women can have a loop or coil placed inside them by a doctor or nurse (Ilupu –eliifakwa esibelethweni sikamama ngudokotela kumbe ngunesi)) 2 1 0 14 Injection. Women can have an injection by a doctor or nurse (Ijekiseni – Omama baphiwa ijekiseni ngemva kwenyanga ezintathu, ngudokotela kumbe ngunesi) 2 1 0 401 15 Norplant. Women can have several small rods placed in their upper arm by a doctor or nurse (Implants￾Okuzinhlamvana okuyisithupha okufakwa ngudokotela engalweni kamama, okusebenza iminyaka emihlanu) 2 1 0 CBD Impact Analysis: Annexes 75 Method Spontaneous 2 Prompted 1 Not Known 0 What was your main source of information for finding out about (METHOD)? 1 Doctor, nurse 2 CBD 3 Other community worker 4 Radio 5 Public meeting 6 School 7 Newspaper, magazine 8 Poster, pamphlet 9 Friends, neighbours, relatives 10 Other (Specify) ……………... 16 Diaphragm, foam, jelly. Women can place a sponge, suppository, diaphragm, jelly or cream inside themselves before intercourse (Diaphragm, Spermicides, Jellies – Ingcebetshana lemithi egcotshwa ngomama bayayigqoka ivala umlomo wesibeletho bengakahlangani lobaba, kumbe lamanye amaphilisi afakwa esibelethweni) 2 1 0 17 Male condom. Men can put a rubber sheath on their penis before intercourse (Condom yabobaba – Igqokwa ngobaba bengakahlangani labomama, ukuvikela ukuzithwala lemikhuhlane) 2 1 0 18 Female condom. Women can insert a rubber sheath inside themselves before intercourse (Khondomu yabomama – ifakwa ngomama bengakahlangani labobaba, ukuvikela ukuzithwala lemikhuhlane) 2 1 0 19 Tubal Ligation. Women can have an operation to avoid having any more children (Ukuvalwa inzalo kamama ngokubopha amatshubhu) 2 1 0 20 Vasectomy. Men can have an operation to avoid having any more children (Vasectomy- ukuvala inzalo kababa ngokubotshwa amatshubhu athwala inhlanyelo kababa isiya kumama) 2 1 0 CBD Impact Analysis: Annexes 76 Method Spontaneous 2 Prompted 1 Not Known 0 What was your main source of information for finding out about (METHOD)? 1 Doctor, nurse 2 CBD 3 Other community worker 4 Radio 5 Public meeting 6 School 7 Newspaper, magazine 8 Poster, pamphlet 9 Friends, neighbours, relatives 10 Other (Specify) ……………... 21 Periodic abstinence. A woman can avoid sex on the days of the month she is most likely to become pregnant (Periodic Absitence or Rhythm: Ukungahlangani lobaba ngesikhathi umama angenelisa ukuzithwala khona) 2 1 0 22 Other methods (Specify) ____________________ 2 1 0 CBD Impact Analysis: Annexes 77 Q. No. Questions Codes Skips 402 Have you ever used any FP method? (Wake wasebenzisa indlela zokuwelamisela khatshana na?) 6 Yes 7 No 403 501 403 Please tell me ALL the methods of FP that you, or your partner, have ever used. (Ngicela ungitshele indlela zonke zokwelamisela khatshana elake lazisebenzisa wena lomngane wakho?) MORE THAN ONE ANSWER ALLOWED DO NOT READ THE LIST 25 Male condom 26 Female condom 27 Withdrawal 28 Rhythm 29 Pill 30 IUD / Loop 31 Injection 32 Norplant 33 Diaphragm, foam 34 TL 35 Vasectomy 36 Other (Specify)…….. …………… 404 Are you currently using any FP method? (Khathesi uyasebenzisa na indlela zokuwelamisela khatshana?) If "Yes", check that 402=Yes. If not, repeat 402 If pregnant, circle”3” but do not ask 4 Yes 5 No 6 Currently pregnant If 402=1, 407 If 402=1, 407 405 Which method(s) are you currently using? (Okwakathesi usebenzisa ziphi indlela?) DO NOT READ THE LIST 25 Male condom 26 Female condom 27 Withdrawal 28 Rhythm 29 Pill 30 IUD / Loop 31 Injection 32 Diaphragm, foam 33 Norplant 34 TL 35 Vasectomy 36 Other (Specify)…….. …………… 406 What is the source of FP method(s) you are currently using? (Wayithola ngaphi indlela owayisebenzisayo?) DO NOT READ THE LIST 15 ZNFPC clinic 16 Ministry of Health & Child Welfare clinic 17 Private Health facility / Dr 18 CBD 19 Other Community Health Worker 20 Buys from pharmacy or shop 21 Not applicable 22 Other (Specify)…………………. 501 CBD Impact Analysis: Annexes 78 407 Which method(s) did you last use? (Wacina ngokusebenzisa ziphi indlela) DO NOT READ THE LIST MORE THAN ONE ANSWER ALLOWED 25. Male condom 26. Female condom 27. Withdrawal 28. Rhythm 29. Pill 30. IUD / Loop 31. Injection 32. Diaphragm, foam 33. Norplant 34. TL 35. Vasectomy 36. Other (Specify)………… …………… 408 When did you stop using this method? (Ucine nini ukusebenzisa indlela le?) 8. Less than 1 month ago 9. 1 month – 3 months ago 10. More than 3 months 409 What was the source of the last FP method that you used ? ((Wayithola ngaphi indlela owacina ukuyisebenzisa?) 14. ZNFPC clinic 15. MOH clinic 16. Private Health facility / Doctor 17. CBD 18. Other Community Health Worker 19. Buys from pharmacy or shop 23 Don’t know 24 Not applicable 25 Other (Specify)………… …………… SECTION 5 STI / HIV / AIDS KHATHESI SESIXOXA STI/HIV/AIDS Q. No. Questions Codes Skips 501 Have you heard of diseases that can be transmitted by having sexual intercourse? (Suke wezwangemikhuhlane ethelelwana emacansini na?) 5. Yes 6. No Skip to 503 502 What diseases of this kind have you heard of? (Yiphi imikhuhlane osokewezwa ngayo ?) MORE THAN ONE ANSWER ALLOWED DO NOT READ THE LIST 1. HIV/AIDS (Mukondombera) 2. Gonorrhea (Drop) 3. Syphilis (Njovera) 4. Chancroid (Maronda ekuzasi) 5. Chlamydia (Zvinobuda kuzasi zvinonhuwa) 6. Herpes (Zvironda zvekuzasi / madzvausiku) 7. Other (Specify) ………… 503 Have you heard of HIV / AIDS? (Sowake wezwa nge HIV/AIDS?) 5. Yes 6. No Skip to 601 CBD Impact Analysis: Annexes 79 504 What is your main source of information on HIV/AIDS? (Waluthola ngaphi ulwazi lolu?) ONLY ONE ANSWER ALLOWED Main source of information 22. Doctor, nurse 23. CBD 24. Other community worker 25. Radio 26. Public meeting 27. School / teachers 28. Newspaper, magazine 29. Poster, pamphlet 30. Friends, neighbours, relatives 31. Other (Specify) ……………………….. 505 How can a person become infected with HIV/AIDS? (Umuntu angawuthola njani umkhuhlane weHIV/AIDS?) MORE THAN ONE ANSWER ALLOWED DO NOT READ THE LIST 7. Kissing on the mouth 8. Shaking hands 9. Having sexual relations with an infected partner 4. Receiving a blood transfusion 5. Mosquito bites 7. Witchcraft 8. Mother-to-baby during birth 9. Using condoms 10. Multiple sexual partners 11. Other (Specify) …………………. 506 Do you think that there is a cure for HIV / AIDS? (Ucabanga ukuthi iAIDS iyelapheka na?) 8 Yes 9 No 10 Don’t know 507 Do you think that your risk of getting HIV/AIDS is high, medium, low or no risk at all? (Ucabanga ukuthi usengozini enganani, enkulu, ephakathi la phakathi, encane kumbe awukho engozini yokuthola umkhuhlane weHIV/AIDS?) 14 Low 15 No risk 16 Medium 17 High 18 I already have HIV/AIDS 19 Don’t know 509 509 511 510 508 Why do you think you are at low/no risk of getting HIV/AIDS? (Kungani ucabanga njalo?) DO NOT READ THE LIST 13 Not yet sexually active 14 Abstains from sex 15 Only has one partner 16 Always uses condoms 17 Doesn’t inject drugs 18 Only has trustworthy partners 19 Other (Specify)……………………… All go to 510 509 Why do you think you have a medium / high risk of getting HIV/AIDS? (Kungani ucabanga njalo? DO NOT READ THE LIST 14 Has more than one partner 15 Has many boyfriends 16 Doesn’t use condoms 17 Partner has multiple partners 18 Doesn’t trust partner 19 Injects drugs 20 Other (Specify)…………………….. 510 Have you ever been tested for HIV? (Suke wayahlolwa na amagcikwane eHIV?) 1 Yes 2 No 513 CBD Impact Analysis: Annexes 80 511 When were you last tested for HIV? (Wacina nini ukuhlolwa?) Month Year 512 How did you find out about the testing centre? (Wazi njani ngendawo lapho okuhlolelwa khona?) 1 Was referred by doctor / nurse 2 Was referred by CBD 3 Was referred by other CHW 4 Newspaper 5 Radio 6 Friend / neighbour / relative 7 School 8 Other Specify………………………. 513 Do you know of a specific place where you can be tested for HIV? (Ikhona yini indawo lapho okuhlolelwa khona amagcikwane eHIV oyaziyo?) 1 Can name specific centre 2 Cannot name specifically 3 Don’t know 515 515 514 From where did you obtain this information? (Waluthola ngaphi ulwazi lolu?) 1 Doctor, nurse 2 CBD 3 Other community worker 4 Radio 5 Public meeting 6 School 7 Newspaper, magazine 8 Poster, pamphlet 9 Friends, neighbours, relatives 10 Rumours, gossip 11Other (Specify)……………………… 515 Would you be willing to be tested for HIV? (Ungaba lesifiso sokuhlolwa amagcikwane eHIV na?) 5. Yes 6. No 517 516 Why would you be willing to go for VCT? (Kungani ufisa ukuya cetshiswa lokuyahlolwa?) 5. Just to know own status 6. Other (Specify)…………………… All go to 601 517 Why would you be unwilling to go for VCT? (Kungani ungela sifiso sokuya cetshiswa lokuyahlolwa?) 4 No need 5 Afraid of positive result 6 Afraid of being seen in testing centre 11 Too expensive 5 Other Specify..……………………. SECTION 6 INTERACTION WITH CBDs SESIZAXOXA NGOBUDLELWANO ELILABO LABOMAMA LABOBABA ABA BONA NGEZOKWELAMISELAKHATSHANA Q. No. Questions Codes Skips 601 Which health workers operate at community level in your area? (Yibaphi abazempila kahle abasebenza esigabeni lesi?) MORE THAN ONE ANSWER ALLOWED 16 None 17 ZNFPC Community Based Distributor 18 Depot Holder 19 Village Health worker 20 Peer Educator 21 Environmental Health Technician 22 VCW 8. Other (Specify)_________ 602 Do you know the name of the local ZNFPC CBD? (Ibizo likamama loba ubaba obona ngezokwelamisela khatshana walapha ngubani?) 7 Name known and correct 8 Name given but incorrect 9 Not known 603 Do you know the name of the local Depot Holder? (Uyamazi omunye othengisa amaphilisi okwelamisela khatshana nyaphandle kukaCBD esigabeni lesi?) 7 Name known and correct 8 Name given but incorrect 9 Not known CBD Impact Analysis: Annexes 81 604 Have you ever been visited by the ZNFPC CBD ? (Wake wavakatshelwa ngumCBD na?) 5. Yes 6. No 605 Have you ever attended a meeting addressed by the CBD, ………….. (name of CBD) (Wake waya emhlanganweni owawuphethwe nguCBD - - ibizo? 5. Yes 6. No 607 606 What did ……………. (name of CBD) talk about? (Wakhuluma ngani u - - -? (ibizo) MORE THAN ONE ANSWER ALLOWED DO NOT READ LIST 18 Family Planning 19 HIV/AIDS 20 STIs 21 Home Based Care 22 Voluntary Counselling and Testing 23 Youth RH 24 Can’t remember 25 Other reproductive health topics 26 Other Specify)__________ 607 Have you ever been advised or counselled by ………….. (name of CBD)? (Wake walaywa kumbe wacetshiswa nguCBD…..………?(Ibizo) 18 Yes 19 No 610 608 What were you advised or counselled about? (Walaywa kumbe wacetshiswa ngani?) MORE THAN ONE ANSWER ALLOWED 1 Family Planning 2 HIV/AIDS 20 STIs 21 Home Based Care 22 Voluntary counselling and Testing 23 Youth RH 24 Can’t remember 25 Other reproductive health topics 9 Other (Specify)__________ 609 Has ………….. (Name of CBD) ever advised you to go for an HIV test? (Uma -----uCBD wakucebisa yini ukuthi uyehlolwa amangcikwane eHIV?) 1 Yes 2 No 3 Can’t remember 610 If you wanted information or counselling about HIV/AIDS, which type of person would you be most likely to consult first? (Ungalanda umuntu onjani uma ufuna ukucetshiswa ngeHIV/AIDS? DO READ OUT THE LIST ONLY ONE ANSWER ALLOWED 1 Doctor 2 Nurse at ZNFPC clinic 3 Nurse at health facility 4 CBD 5 Depot Holder 6 Village Health Worker 7 Any other person (Specify) …………… NGIYABONGA Interviewer: Enter assessment of responses after completing interview Responses to sensitive questions: 1. True information likely 2. Respondent may be withholding some information 3. False information suspected Comments …………………………………………………………………………………………… ……………………………………………………………………………………………. Completed by………………………………..Print name of Interviewer Checked by…………………………………..Print name of supervisor Comments by Supervisor ………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………… CBD Impact Analysis: Annexes 82 Annex 5: Endline Evaluation Female Questionnaire ZNFPC EXPANDED CBD IMPACT EVALUATION SURVEY SHONA FEMALE QUESTIONNAIRE Date …. / DEC / 2004 FOR OFFICIAL USE: QUESTIONNAIRE No. IDENTIFICATION Provincial Codes 1 = Manicaland (Makoni North) 2 = Manicaland (Makoni South) 3 = Mashonaland East (Marondera) 4 = Matabeleland North (Umguza) 5 = Matabeleland South (Bulilimamangwe) 6 = Midlands (Zvishavane) 7 = Masvingo (Gutu North) 8 = Masvingo (Gutu South) Ward ……………………………… Village ……………………………. Name of Household Head___________________________ 100. Please give the first names of all usual residents of the household between 15 and 34 years of age who are not attending full time Primary or Secondary school ( First Name Age (in years) Sex (1=Male, 2=Female) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Interviewer: select one female at random for interview and record her name below First Name of respondent …………………………………………. AGE Call back? Yes No CBD Impact Analysis: Annexes 83 Section 1 Background Information (NGITHANDA UKWAZI NGAWE) Q. No. Questions Codes Skips 101 In what month and year were you born? (Makazvarwa mugore ripi uye nemumwedzi upi)? Must be after 11-70 and before 11-89 Month Year 19 Enter 99 if month not known 102 What is your current marital status? (Parizvino makaroorwa here?) 22 Married, living with husband 23 Married, husband living away 24 Widow 25 Cohabiting 26 Divorced / separated 27 Never married 28 Other (specify)_____________ 104 104 104 103 Do you currently have partner? (Parizvino munewamunodanana naye here?) 10 Yes 11 No 105 104 Does your husband/partner have other wives/girlfriends? (Murume wenyu kana wamunodanana naye ane vamwe vakadzi kana vasikana here? 7. Yes 8. No 12 Don't know 105 Which is the highest level of school you have completed? Makadzidza kusvika mugwaro ripi? DO NOT READ LIST) 16. Never attended school 0 17. Primary 1 2 3 4 5 6 7 18. Secondary 1 2 3 4 5 6 19. College 1 2 3 4 5 6 20. University 1 2 3 4 5 6 106 What was your main activity in the last 12 months? Mainyanya kuita basa ripi mumwedzi gumi ne miviri yapfuuraa?(Do not read list) 30 Paid employee 31 Employer 32 Own account worker / Communal farmer 33 Unpaid family worker 34 Looking for work/Unemployed 35 Student 36 Homemaker / Housewife 37 Other (Specify)_____________ 108 108 108 108 107 What was your main occupation during the last 12 months? Mainyanya kuita basa reyi mumwedzi gumi ne miviri yapfuura? __________________ Go to 109 108 What is your main source of income? (Munonyanyo wanepi mari yamunoshandisa?) Only one answer allowed. 13 Parents 14 Husband 15 Other family member(s) 16 Other (Specify) …………………… 109 Which languages can you speak? (Munokwanisa kutaira mitauro ipi?) MORE THAN ONE ANSWER ALLOWED 11 Shona 12 Ndebele 13 English 4 Other (Specify) ………………… 110 Which languages can you read? (Ndeipi mitauro yamunokwanisa kuverenga?) MORE THAN ONE ANSWER ALLOWED 13. Shona 14. Ndebele 15. English 16. Other (Specify) ………………… CBD Impact Analysis: Annexes 84 SECTION 2 FERTILITY KATHESI NGITAHANDA UKUTHI SIXOXE NGEZENZALO Q. No. Questions Codes Skips 201 How many times have you been pregnant? (Makaita pamuviri kangani?) If zero, skip to 209 202 How many times have you given birth to a live baby? (Makabereka vana vapenyu vangani?) 203 Have you ever given birth to a baby who was dead when delivered? (Makambosununguka mwana wakazvarwa akafa here?) No 0 Yes, state number of stillbirths 204 Have you ever had a pregnancy, which resulted in a miscarriage? (Makambobva pamuviri here?) No 0 Yes, state number no. of miscarriages 205 Have any of your children who were born alive later died? (Pavana venyu vamakabere vari vapenyu, pane vakazofa here?) No 0 Yes, state no. of deaths 206 Have any of your pregnancies resulted in a multiple birth? Makambobereka mapatya kana manyambiri here?) No 0 1. Twins x no. of pregnancies 2. Triplets x no. of pregnancies Check that no. of pregnancies tallies with stated no. of live births, stillbirths and miscarriages, including any multiple births 207 In which month and year was your first child born? Mwana wenyu wekutanga makamubereka rini? PROBE FOR MONTH AND YEAR. Month Year Enter 99 if month not known 208 In which month and year was your last child born? Mwana wenyu wekupedzisira makamubereka rini?) PROBE FOR MONTH AND YEAR. Month Year Enter 99 if month not known If only one live birth, repeat entry for 207 and go to 209 209 Are you pregnant now? Parizvino makazvitakura here?) 10 Yes 11 No 12 Don't know 4 No reply 211 211 211 210 How many months is the pregnancy? Pamuviri penyu pane mwedzi minganii? months skip to Section 3 211 Do you want to have a child within the next 12 months? Mungade kuita mwana here mumwedzi gumi nemiviri inotevera?) 10 Yes 11 No 12 Don’t know 4 No reply CBD Impact Analysis: Annexes 85 Section 3 SEXUAL EXPERIENCE (IKOZVINO TAVA KUDA KUMBOKURUKURA NEZVEKUSANGANA PABONDE) 301 IF 201=0 ASK 301, OTHERWISE SKIP TO 302 Have you ever had sexual intercourse? Makambosangana nemurume pabonde here?) 7 Yes 8 No 401 302 At what age did you first have sexual intercourse? (Makatanga kusangana nemurume pabonde muine makore mangani?) 303 With how many men have you had sexual intercourse in the last 12 months? Mumwedzi gumi nemiviri yapfuura makasangana nevarume vangani pabonde?) 304 What was your relationship to the last man you had sex with? (Murume wamakapedzisira kusangana naye pabonde aive chii chenyu?) 19 Husband 20 Partner / Cohabittee 21 Fiancé / boyfriend 22 Occasional partner 23 Stranger / just met 24 Rape 7 Other (specify) ………………… 305 When you last had sex, did you use any method to prevent pregnancy or/and disease? (Pamakapedzisira kusangana nemurume pabonde makashandisa nzira ? 16 Yes to prevent pregnancy 17 Yes to prevent disease 18 Yes to prevent both disease & pregnancy 19 No 20 Don’t remember 307 401 306 Which method(s) did you use when you last had sex? (Chii chikonzero chikuru chakaita kuti musashandisa nzira dzekudzivirira pamuviri kana zvirwere pamakapedzisira kusangana nemurume pabonde? MORE THAN ONE ANSWER ALLOWED 23 Pill 24 IUD 25 Injection 26 Norplant 27 Diaphragm, foam 28 Male condom 29 Female condom 30 TL (Female Sterilisation) 31 Vasectomy (Male Sterilisation) 32 Natural methods 33 Other (Specify)……………………… All go to 401 307 What was the main reason for not using any method to prevent pregnancy or / and disease during your last sexual intercourse? (Chii chikonzero chikuru chakaita kuti musashandisa nzira dzekudzivirira pamuviri kana zvirwere pamakapedzisira kusangana nemurume pabonde?) 22 Wanted to become pregnant 23 Sex just happened 24 Partner refused to use condom 25 Respondent refused to use condom 26 Raped 27 Felt to be at low risk of pregnancy 28 Felt to be at low risk of disease 8 Other (Specify) ……………………. …. CBD Impact Analysis: Annexes 86 SECTION 4 FAMILY PLANNING (Parizvino tava kuda kukurukura nenyaya dzezvekuronga mhuri) Q. No. Questions Codes Skips "Now I would like to talk about family planning - the various ways or methods that people can use to delay or avoid a pregnancy" “Parizvino tava kuda kukurukura nenyaya dzezvekuronga mhuri- nzira dzakasiyana siyana dzingashandiswa navanhu kudzivirira kubata pamuviri” 404 Which ways or methods of Family Planning have you heard about? (Ndedzipi nzira dzekuronga mhuri dzamakambonzwa nezvadzo?) Tick in the single box in 401 for each method mentioned spontaneously, then proceed down the column headed “Method”, reading the name and description of each method not mentioned spontaneously. Enter code 0 in the box if method is not recognized. For each method with code 1 or 2, ask what was the main source of information for finding out about the method and enter the appropriate code. Method Spontaneous 2 Prompted 1 Not Known 0 What was your main source of information for finding out about (METHOD)? (Makanyanyowanepi ruzivo rwe?) DO NOT READ LIST. ONE ANSWER ONLY. 1 Doctor, nurse 2 CBD 3 Other community worker 4 Radio 5 Public meeting 6 School 7 Newspaper, magazine 8 Poster, pamphlet 9 Friends, neighbours, relatives 10 Other (Specify) ……………... 23 Pill. Women can take a pill every day (Mapiritsii –Vanhukadzi vanogona kunwa piritsi rimwe pazuva rega rega) 2 1 0 24 IUD. Women can have a loop or coil placed inside them by a doctor or nurse (Rupu –Inoiswa muchibereko chaamai nanesi kana chiremba) 2 1 0 25 Injection/ Depo provera. Women can have an injection by a doctor or nurse (Jekiseni/Depo provera – Vanhukadzi vanobaiwa majekiseni nanesi kana chiremba rinodzivirira kubata pamuviri kwemwedzi yakati kuti) 2 1 0 401 26 Norplant. Women can have several small rods placed in their upper arm by a doctor or nurse (Implants- Chiremba vanogona kupfekedza vanhukadzi tunhu kumusoro kweruoko pedyo nbendekete tunodzivirira kuti vasabate pamuviri kwamakore akati kuti) 2 1 0 CBD Impact Analysis: Annexes 87 Method Spontaneous 2 Prompted 1 Not Known 0 What was your main source of information for finding out about (METHOD)? 1 Doctor, nurse 2 CBD 3 Other community worker 4 Radio 5 Public meeting 6 School 7 Newspaper, magazine 8 Poster, pamphlet 9 Friends, neighbours, relatives 10 Other (Specify) ……………... 27 Diaphragm, foam, jelly. Women can place a sponge, suppository, diaphragm, jelly or cream inside themselves before intercourse (Diaphragm, Spermicides, Jellies – Vanhukadzi vanokwanisa kupfeka kana hwidibiro pamuromo wechibereko vasat vasangana nemurume kana mamwe mafuta okupfeka, kuti vasabata pamuviri) 2 1 0 28 Male condom. Men can put a rubber sheath on their penis before intercourse (Condom rechirume- Vanhurume vanokwanisa kupfeka chubhu (durex) vasati vasangana nevanhukadzi kudzivirira nhumbu nezvirwere) 2 1 0 29 Female condom. Women can insert a rubber sheath inside themselves before intercourse (Kondomu rechikadzi – Munhukadzi anokwanisa kupfekawo chubhu/kondomu rakagadzirirwa vanhukadzi asati asangana nemunhurume kuti asabata pamuviri kana zvirwere) 2 1 0 30 Tubal Ligation. Women can have an operation to avoid having any more children (Vanhukadzi vanokwanisa kuitwa oparesheni nachiremba inoita kuti vasaite nhumbu zvachose)) 2 1 0 31 Vasectomy. Men can have an operation to avoid having any more children (Vasectomy- Vanhurume vanokwanisa kuitwa operation yokusunga machubhu inoita kuti vasaitise nhumbu zvachose) 2 1 0 CBD Impact Analysis: Annexes 88 32 Periodic abstinence. A woman can avoid sex on the days of the month she is most likely to become pregnant (Periodic Absitence or Rhythm: Vanhukadzi vanogona kuverenga mazuva avanofungidzira kuti vanogona kubata pamuviri vorega kusangana nevenhurume) 2 1 0 33 Other methods (Specify) ____________________ 2 1 0 Q. No. Questions Codes Skips 402 Have you ever used any FP method? (Makamboshandisa nzira dzekuronga mhuri here?) 8 Yes 9 No 501 403 Please tell me ALL the methods of FP that you, or your partner, have ever used. (Ndedzipi nzira dzekuronga mhuri dzamakamboshandisa, imi kana kuti mumwe wenyu?) MORE THAN ONE ANSWER ALLOWED DO NOT READ THE LIST 37 Male condom 38 Female condom 39 Withdrawal 40 Rhythm 41 Pill 42 IUD / Loop 43 Injection 44 Norplant 45 Diaphragm, foam 46 TL 47 Vasectomy 48 Other (Specify)…….. …………… 404 Are you currently using any FP method? (Parizvino muri kushandisa nzira dzokuronga mhuri here?) If "Yes", check that 402=Yes. If not, repeat 402 If pregnant, circle”3” but do not ask 7 Yes 8 No 9 Currently pregnant If 402=1, 407 If 402=1, 407 405 Which method(s) are you currently using? (Ndedzipi nzira dzekuronga mhuri dzamuri kushandisa parizvino?) DO NOT READ THE LIST 37 Male condom 38 Female condom 39 Withdrawal 40 Rhythm 41 Pill 42 IUD / Loop 43 Injection 44 Diaphragm, foam 45 Norplant 46 TL 47 Vasectomy 48 Other (Specify)…….. …………… CBD Impact Analysis: Annexes 89 406 What is the source of FP method(s) you are currently using? (Nzira dzamuri kushandisa parizvino muri kudziwana kupi?) DO NOT READ THE LIST 26 ZNFPC clinic 27 Ministry of Health & Child Welfare clinic 28 Private Health facility / Dr 29 CBD 30 Other Community Health Worker 31 Buys from pharmacy or shop 32 Not applicable 33 Other (Specify)………………………. 501 407 Which method(s) did you last use? (Makapedzisira kushandisa nzira dzipi dzekuronga mhuri?) DO NOT READ THE LIST MORE THAN ONE ANSWER ALLOWED 37. Male condom 38. Female condom 39. Withdrawal 40. Rhythm 41. Pill 42. IUD / Loop 43. Injection 44. Diaphragm, foam 45. Norplant 46. TL 47. Vasectomy 48. Other (Specify)………… …………… 408 When did you stop using this method? (Makaregedza kushandisa nzira dzekuronga mhuri rinhi?) 11. Less than 1 month ago 12. 1 month – 3 months ago 13. More than 3 months 409 What was the source of the last FP method that you used ? ((Makawana kupi nzira dzekuronga mhuri dzamakapedzisira kushandisa?) 20. ZNFPC clinic 21. MOH clinic 22. Private Health facility / Doctor 23. CBD 24. Other Community Health Worker 25. Buys from pharmacy or shop 34 Don’t know 35 Not applicable 36 Other (Specify)………… …………… SECTION 5 STI / HIV / AIDS (Ikozvino tavakuda kumbokurukurirana nezvezvirwere zvinotapuriranwa pabonde) Q. No. Questions Codes Skips 501 Have you heard of diseases that can be transmitted by having sexual intercourse? (Makambonzwa here nezvezvirwere zvinotapuriranwa pabonde?) 7. Yes 8. No Skip to 503 502 What diseases of this kind have you heard of? (Ndezvipi zvirwere zvinotapuriranwa pabonde ?) MORE THAN ONE ANSWER ALLOWED DO NOT READ THE LIST 1. HIV/AIDS (Mukondombera) 2. Gonorrhea (Drop) 3. Syphilis (Njovera) 4. Chancroid (Maronda ekuzasi) 5. Chlamydia (Zvinobuda kuzasi zvinonhuwa) 6. Herpes (Zvironda zvekuzasi / madzvausiku) 7. Other (Specify) ………… 503 Have you heard of HIV / AIDS? (Makambonzwa nezvemukondombera kana kuti HIV/AIDS here?) 7. Yes 8. No Skip to 601 CBD Impact Analysis: Annexes 90 504 What is your main source of information on HIV/AIDS? (Ndekupi kwamakanyanyowana ruzivo rwezvemukondombera?) ONLY ONE ANSWER ALLOWED Main source of information 32. Doctor, nurse 33. CBD 34. Other community worker 35. Radio 36. Public meeting 37. School / teachers 38. Newspaper, magazine 39. Poster, pamphlet 40. Friends, neighbours, relatives 41. Other (Specify) ……………………….. 505 How can a person become infected with HIV/AIDS? (Munhu anowana kana kubatira sei utachiona hweHIV/AIDS kana mukondombera?) MORE THAN ONE ANSWER ALLOWED DO NOT READ THE LIST 10. Kissing on the mouth 11. Shaking hands 12. Having sexual relations with an infected partner 4. Receiving a blood transfusion 5. Mosquito bites 7. Witchcraft 8. Mother-to-baby during birth 9. Using condoms 10. Multiple sexual partners 12. Other (Specify) …………………. 506 Do you think that there is a cure for HIV / AIDS? (Mukondombera/ HIV/AIDS inorapika here?) 12 Yes 13 No 14 Don’t know 507 Do you think that your risk of getting HIV/AIDS is high, medium, low or no risk at all? (Munofunga kuti mukana wenyu wekubatira mukondombera/HIV/AIDS muhombe here, kana kuti uri pakati nepakati, mudiki here kana kuti hamuna mukana wacho zvachose?) 20 Low 21 No risk 22 Medium 23 High 24 I already have HIV/AIDS 25 Don’t know 509 509 511 510 508 Why do you think you are at low/no risk of getting HIV/AIDS? (Sei muchifunga kuti mukana wenyu wekubatira mukondombera mushoma kana kuti hamutorina?) DO NOT READ THE LIST 20 Not yet sexually active 21 Abstains from sex 22 Only has one partner 23 Always uses condoms 24 Doesn’t inject drugs 25 Only has trustworthy partners 26 Other (Specify)……………………… All go to 510 509 Why do you think you have a medium / high risk of getting HIV/AIDS? (Sei muchifunga kuti mukana wenyu wekubatira mukondombera uri pakati nepakati kana kuti mukuru?) DO NOT READ THE LIST 21 Has more than one partner 22 Has many boyfriends 23 Doesn’t use condoms 24 Partner has multiple partners 25 Doesn’t trust partner 26 Injects drugs 27 Other (Specify)…………………….. 510 Have you ever been tested for HIV? (Makambonoongororwa here hutachiona hwemukondombera/HIV?) 1 Yes 2 No 513 CBD Impact Analysis: Annexes 91 511 When were you last tested for HIV? (Makapedzisira kuongororwa utachiona hwemukondombera/HIV rinhi?) Month Year 512 How did you find out about the testing centre? (Ruzivo rwenzvimbo yekuongororwa utachiona hwemukondombera/HIV makaruwana kupi?) 1 Was referred by doctor / nurse 2 Was referred by CBD 3 Was referred by other CHW 4 Newspaper 5 Radio 6 Friend / neighbour / relative 7 School 8 Other Specify………………………. 513 Do you know of a specific place where you can be tested for HIV? (Pane nzvimbo yamunonyatsoziva here yekunoongororwa mukondombera/HIV?) 1 Can name specific centre 2 Cannot name specifically 3 Don’t know 515 515 514 From where did you obtain this information? (Ruzvivo rwezvenzvimbo iyi makaruwana kupi?) 1 Doctor, nurse 2 CBD 3 Other community worker 4 Radio 5 Public meeting 6 School 7 Newspaper, magazine 8 Poster, pamphlet 9 Friends, neighbours, relatives 10 Rumours, gossip 11Other (Specify)……………………… 515 Would you be willing to be tested for HIV? (Mungade here kunotsanangurirwa nekuongororwa hutachiona hwemukondombera/HIV?) 7. Yes 8. No 517 516 Why would you be willing to go for VCT? (Mungadirei kunotsanangurirwa nekoungororwa hutachiona hwemukondombera/HIV?) 7. Just to know own status 8. Other (Specify)…………………… All go to 601 517 Why would you be unwilling to go for VCT? (Sei musingadi kuenda kunotsanangurirwa nekuongororwa HIV/mukondombera?) 7 No need 8 Afraid of positive result 9 Afraid of being seen in testing centre 15 Too expensive 5 Other Specify..……………………. SECTION 6 INTERACTION WITH CBDs (Iyezvino tavakuda kumbokurukura nezvemashandiro avana mbuya/sekuru kuronga mhuri vemunharaunda yenyu Q. No. Questions Codes Skips 601 Which health workers operate at community level in your area? (Ndevapi vashandi vezveutano vanosenzera munharaunda yenyu?) MORE THAN ONE ANSWER ALLOWED 23 None/ Don’t Know 24 ZNFPC Community Based Distributor 25 Depot Holder 26 Village Health worker 27 Peer Educator 28 Environmental Health Technician 29 VCW 8. Other (Specify)_________ 602 Do you know the name of the local ZNFPC CBD? (Mbuya/Sekuru kuronga mhuri vemunharaunda yenyu anonzi ani?) 10 Name known and correct 11 Name given but incorrect 12 Not known 603 Do you know the name of the local Depot Holder? (Depot holder anoshanda munharaunda yenyu achipa vanhu mapiritsi ekuronga mhuri ari pamba anonzi ani?) 10 Name known and correct 11 Name given but incorrect 12 Not known CBD Impact Analysis: Annexes 92 604 Have you ever been visited by the ZNFPC CBD ? (Makamboshanyirwa here nambuya/sekuru kuronga mhuri?) 7. Yes 8. No 605 Have you ever attended a meeting addressed by the CBD, ………….. (name of CBD) (Makamboenda here kumusangano wakarongwa naCBD …… Zita? 7. Yes 8. No 607 606 What did ……………. (name of CBD) talk about? (Mbuya/sekuru kuronga mhuri vaitaura nezvei? MORE THAN ONE ANSWER ALLOWED DO NOT READ LIST 27 Family Planning 28 HIV/AIDS 29 STIs 30 Home Based Care 31 Voluntary Counselling and Testing 32 Youth RH 33 Can’t remember 34 Other reproductive health topics 35 Other Specify)__________ 607 Have you ever been advised or counselled by ………….. (name of CBD)? (Makambopiwa/kupangwa mazano nambuya/sekuru kuronga mhuri here? 26 Yes 27 No 610 608 What were you advised or counselled about? (Makapangwa mazano/makakurukura nezvei?) MORE THAN ONE ANSWER ALLOWED 1 Family Planning 2 HIV/AIDS 28 STIs 29 Home Based Care 30 Voluntary counselling and Testing 31 Youth RH 32 Can’t remember 33 Other reproductive health topics 9 Other (Specify)__________ 609 Has ………….. (Name of CBD) ever advised you to go for an HIV test? (Mbuya/sekuru kuronga mhuri vakambokukurudzirai here kuti munoongorwa hutachiona hwemukondombera/HIV/AIDS?) 1 Yes 2 No 3 Can’t remember 610 If you wanted information or counselling about HIV/AIDS, which type of person would you be most likely to consult first? (Kana muri kuda kuwana ruzivo rwezvemukondombera HIV/AIDS ndeupi munhu wamungatanga kundobvunza? DO READ OUT THE LIST ONLY ONE ANSWER ALLOWED 1 Doctor 2 Nurse at ZNFPC clinic 3 Nurse at health facility 4 CBD 5 Depot Holder 6 Village Health Worker 7 Any other person (Specify) …………… Interviewer: Enter assessment of responses after completing interview Responses to sensitive questions: 1. True information likely 2. Respondent may be withholding some information 3. False information suspected Comments …………………………………………………………………………………………… ……………………………………………………………………………………………. CBD Impact Analysis: Annexes 93 Completed by………………………………..Print name of Interviewer Checked by…………………………………..Print name of supervisor Comments by Supervisor ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………………… CBD Impact Analysis: Annexes 94 Annex 6: Data Analysis Tables Respondent Background Tables Number and percent respondents by study group (intervention and control) at baseline and endline Control Intervention Total Control Intervention Total Baseline 599 1,212 1,811 Baseline 33.1% 66.9% 100.0% Endline 341 709 1,050 Endline 32.5% 67.5% 100.0% % of Respondents by Province Control Intervention Matebeleland South (Bulilimamangwe) Midlands (Zvishavane) Manicaland (Makoni North) Manicaland (Makoni South) Mashonaland East (Marondera) Matebeleland North (Umguza) Masvingo (Gutu North) Masvingo (Gutu South) 50.3% 49.7% 15.9% 9.7% 24.9% 24.7% 9.9% 14.9% 50.4% 49.6% 7.3% 16.5% 25.1% 26.0% 0.0% 25.1% CBD Impact Analysis: Annexes 95 Characteristics of Control Group Control Baseline Endline Control (n=599) Control (n=341) Male Female Total Male Female Total Sex 49.7% 50.3% 100.0% 48.7% 51.3% 100.0% Age 15-19 52.0% 44.2% 48.1% 28.3% 33.1% 30.8% 20-24 31.2% 32.9% 32.1% 31.9% 29.7% 30.8% 25-29 16.8% 22.9% 19.9% 15.1% 16.6% 15.8% 30-34 NA NA NA 24.7% 20.6% 22.6% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% Marital Status Married, living with spouse 8.1% 16.3% 12.2% 24.7% 33.7% 29.3% Married, spouse living away 1.3% 13.3% 7.3% 4.8% 16.0% 10.6% Cohabiting 0.0% 0.0% 0.0% 0.6% 0.0% 0.3% Total % of respondents married or in a union 9.4% 29.6% 19.5% 30.1% 49.7% 40.2% Widow/widower 1.0% 2.0% 1.5% 2.4% 3.4% 2.9% Divorced/separated 2.7% 5.3% 4.0% 3.6% 2.3% 2.9% Never married 86.9% 63.1% 75.0% 63.9% 44.6% 54.0% Total % of respondents not married and not in a union 90.6% 70.4% 80.5% 69.9% 50.3% 59.8% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% Highest Level of Education Never attended school 0.3% 0.0% 0.2% 0.0% 1.1% 0.6% Primary 36.6% 29.9% 33.2% 16.3% 26.3% 21.4% Secondary 63.1% 68.8% 65.9% 80.7% 72.0% 76.2% College 0.0% 1.0% 0.5% 2.4% 0.6% 1.5% University 0.0% 0.3% 0.2% 0.6% 0.0% 0.3% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% CBD Impact Analysis: Annexes 96 Characteristics of Intervention Group Intervention Baseline Endline Intervention (n=1,212) Intervention (n=709) Male Female Total Male Female Total Sex 50.2% 49.8% 100.0% 50.2% 49.8% 100.0% Age 15-19 36.4% 38.3% 37.4% 27.0% 21.0% 24.0% 20-24 34.3% 36.2% 35.2% 37.9% 32.3% 35.1% 25-29 29.3% 25.5% 27.4% 18.3% 21.5% 19.9% 30-34 NA NA NA 16.9% 25.2% 21.0% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% Marital Status Married, living with spouse 25.0% 36.8% 30.9% 32.6% 48.7% 40.6% Married, spouse living away 2.6% 8.3% 5.4% 3.4% 11.9% 7.6% Cohabiting 0.7% 0.3% 0.5% 0.0% 1.4% 0.7% Total % of respondents married or in a union 28.3% 45.4% 36.8% 36.0% 62.0% 48.9% Widow/widower 0.2% 3.0% 1.6% 0.3% 6.2% 3.2% Divorced/separated 3.3% 9.4% 6.4% 3.1% 10.5% 6.8% Never married 68.3% 42.2% 55.3% 60.7% 21.2% 41.0% Total % of respondents not married and not in a union 71.7% 54.6% 63.2% 64.0% 38.0% 51.1% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% Highest Level of Education Never attended school 0.0% 0.5% 0.2% 0.3% 0.3% 0.3% Primary 21.3% 29.0% 25.1% 22.5% 36.5% 29.5% Secondary 76.8% 69.8% 73.3% 75.6% 62.0% 68.8% College 2.0% 0.7% 1.3% 1.4% 0.8% 1.1% University 0.0% 0.0% 0.0% 0.3% 0.3% 0.3% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% CBD Impact Analysis: Annexes 97 Sexual Experience Tables Number of sexual partners in the last 12 months Control Baseline Endline Male (n=166) Female (n=192) Total (n=358) Male (n=122) Female (n=139) Total (n=261) 0 9.6% 0.0% 4.5% 6.6% 6.5% 6.5% 1 53.0% 90.1% 72.9% 68.9% 85.6% 77.8% 2 15.1% 7.8% 11.2% 13.9% 7.2% 10.3% 3 6.6% 1.6% 3.9% 8.2% 0.7% 4.2% >3 15.7% 0.5% 7.5% 2.5% 0.0% 1.1% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% Intervention Baseline Endline Male (n=422) Female (n=432) Total (n=854) Male (n=272) Female (n=309) Total (n=581) 0 10.4% 0.0% 5.2% 6.6% 7.1% 6.9% 1 48.8% 93.1% 71.2% 65.4% 86.1% 76.4% 2 16.4% 3.7% 10.0% 16.2% 4.5% 10.0% 3 9.0% 2.5% 5.7% 4.4% 1.6% 2.9% >3 15.4% 0.7% 8.0% 7.4% 0.6% 3.8% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% When respondents last had sex, was any method used to prevent pregnancy and/or disease (by control vs intervention group)? Control Intervention Baseline (n=360) Endline (n=261) Baseline (n=854) Endline (n=582) Yes to prevent pregnancy 22.5% 42.5% 39.3% 43.3% Yes to prevent disease 4.4% 1.1% 6.6% 10.0% Yes to prevent both disease & pregnancy 26.9% 23.0% 15.0% 12.0% Total "yes" responses 53.9% 66.7% 60.9% 65.3% No 46.1% 32.6% 38.9% 34.5% Does not remember 0.0% 0.8% 0.2% 0.2% Overall Total 100.0% 100.0% 100.0% 100.0% CBD Impact Analysis: Annexes 98 When respondents last had sex, was any method used to prevent pregnancy and/or disease (by marital status)? Control Baseline Endline Married or in a union (n=76) Not married and not in a union (n=284) Married or in a union (n=137) Not married and not in a union (n=124) Yes to prevent pregnancy 34.2% 19.4% 52.6% 31.5% Yes to prevent disease 2.6% 4.9% 0.0% 2.4% Yes to prevent both disease & pregnancy 18.4% 29.2% 6.6% 41.1% Total Yes responses 55.3% 53.5% 59.1% 75.0% No 44.7% 46.5% 40.1% 24.2% Do not remember 0.0% 0.0% 0.7% 0.8% Total 100.0% 100.0% 100.0% 100.0% Intervention Baseline Endline Married or in a union (n=323) Not married and not in a union (n=531) Married or in a union (n=347) Not married and not in a union (n=235) Yes to prevent pregnancy 41.5% 38.0% 55.3% 25.5% Yes to prevent disease 5.9% 7.0% 4.0% 18.7% Yes to prevent disease & pregnancy 12.4% 16.6% 4.3% 23.4% Total Yes responses 59.8% 61.6% 63.7% 67.7% No 40.2% 38.0% 36.3% 31.9% Do not remember 0.0% 0.4% 0.0% 0.4% Total 100.0% 100.0% 100.0% 100.0% Family planning methods used when respondents last had sex (more than one response allowed, by control vs intervention group) Control Intervention Baseline (n=193) Endline (n=174) Baseline (n=506) Endline (n=380) Pill 30.6% 46.6% 47.2% 50.8% Male condom 64.8% 50.0% 45.3% 43.9% Injection 7.8% 8.0% 6.5% 6.8% Female condom 0.5% 0.0% 1.0% 1.3% Other methods 1.0% 2.3% 4.0% 1.6% CBD Impact Analysis: Annexes 99 Family planning methods used when respondents last had sex (more than one response allowed, by marital status) Control Baseline Endline Married or in a union (n=48) Not married and not in a union (n=145) Married or in a union (n=81) Not married and not in a union (n=93) Pill 50.0% 24.1% 71.6% 24.7% Male condom 43.8% 71.7% 21.0% 75.3% Injection 4.2% 9.0% 11.1% 5.4% Female condom 0.0% 0.7% 0.0% 0.0% Other methods 2.1% 0.7% 2.5% 2.2% Intervention Baseline Endline Married or in a union (n=171) Not married and not in a union (n=335) Married or in a union (n=221) Not married and not in a union (n=159) Pill 50.9% 45.4% 75.1% 17.0% Male condom 46.2% 44.8% 19.0% 78.6% Injection 4.7% 7.5% 8.1% 5.0% Female condom 1.2% 0.9% 0.9% 1.9% Other methods 2.3% 5.1% 2.3% 0.6% CBD Impact Analysis: Annexes 100 Family Planning Tables Family Planning Methods Respondents have heard of (multiple responses, by gender) Control Baseline Endline Male (n=284) Female (n=286) Total (n=570) Male (n=166) Female (n=174) Total (n=340) Male condom 95.8% 87.8% 91.8% 97.0% 96.0% 96.5% Pill 78.5% 96.5% 87.5% 91.6% 97.1% 94.4% Injection 59.2% 87.1% 73.2% 75.3% 92.0% 83.8% Female condom 58.1% 60.8% 59.5% 83.7% 79.9% 81.8% IUD 28.9% 53.1% 41.1% 50.6% 60.9% 55.9% Tubal ligation 38.4% 34.6% 36.5% 48.8% 40.8% 44.7% Norplant 7.7% 19.9% 13.9% 24.1% 39.7% 32.1% Vasectomy 29.9% 19.9% 24.9% 30.1% 16.7% 23.2% Periodic abstinence 15.1% 10.1% 12.6% 22.3% 19.0% 20.6% Diaphram/ foam 18.3% 23.1% 20.7% 30.1% 20.1% 25.0% Other methods 0.7% 3.1% 1.9% 3.0% 3.4% 3.2% Intervention Baseline Endline Male (n=598) Female (n=581) Total (n=1,179) Male (n=356) Female (n=353) Total (n=709) Male condom 97.7% 89.3% 93.6% 96.3% 96.3% 96.3% Pill 91.1% 97.2% 94.1% 94.7% 96.0% 95.3% Injection 73.6% 89.8% 81.6% 69.7% 92.6% 81.1% Female condom 74.2% 66.6% 70.5% 82.0% 78.2% 80.1% IUD 36.6% 55.1% 45.7% 44.7% 66.0% 55.3% Tubal ligation 52.8% 57.1% 55.0% 33.7% 44.8% 39.2% Norplant 10.7% 24.6% 17.6% 11.0% 40.8% 25.8% Vasectomy 38.8% 30.3% 34.6% 26.7% 20.4% 23.6% Periodic abstinence 30.8% 17.2% 24.1% 30.6% 15.9% 23.3% Diaphram/ foam 24.7% 21.2% 23.0% 18.5% 15.9% 17.2% Other methods 1.3% 3.3% 2.3% 5.3% 6.2% 5.8% CBD Impact Analysis: Annexes 101 Family Planning Methods Respondents have heard of (multiple responses, by marital status) Control Baseline Endline Married or in a union (n=113) Not married and not in a union (n=457) Married or in a union (n=136) Not married and not in a union (n=204) Male condom 87.6% 92.8% 95.6% 97.1% Pill 95.6% 85.6% 96.3% 93.1% Injection 83.2% 70.7% 89.0% 80.4% Female condom 59.3% 59.5% 77.2% 84.8% IUD 52.2% 38.3% 64.0% 50.5% Tubal ligation 31.9% 37.6% 55.1% 37.7% Norplant 15.9% 13.3% 38.2% 27.9% Vasectomy 23.0% 25.4% 19.1% 26.0% Periodic abstinence 10.6% 13.1% 19.1% 21.6% Diaphram/ foam 25.7% 19.5% 27.2% 23.5% Other methods 2.7% 1.8% 5.1% 2.0% Intervention Baseline Endline Married or in a union (n=430) Not married and not in a union (n=749) Married or in a union (n=347) Not married and not in a union (n=362) Male condom 94.0% 93.3% 96.8% 95.9% Pill 97.0% 92.5% 96.5% 94.2% Injection 84.4% 80.0% 92.5% 70.2% Female condom 74.9% 68.0% 80.4% 79.8% IUD 49.5% 43.5% 64.6% 46.4% Tubal ligation 59.8% 52.2% 48.4% 30.4% Norplant 19.5% 16.4% 35.2% 16.9% Vasectomy 34.9% 34.4% 25.9% 21.3% Periodic abstinence 28.8% 21.4% 19.3% 27.1% Diaphram/ foam 25.1% 21.8% 17.0% 17.4% Other methods 2.6% 2.1% 6.6% 5.0% CBD Impact Analysis: Annexes 102 What was the source of information for the family planning methods respondents had heard of (for all methods mentioned by respondents)? Control Intervention Baseline (n=2504) Endline (n=1895) Baseline (n=6008) Endline (n=3767) Total for health system sources only 29.2% 38.8% 34.4% 44.9% CBD 5.0% 11.2% 8.1% 9.8% ZNFPC 0.1% 0.0% 0.1% 0.3% Other health systems 24.1% 27.5% 26.1% 34.8% Total for non-health system sources only 70.8% 61.2% 65.6% 55.1% Total for all sources 100.0% 100.0% 100.0% 100.0% What was the source of information on the male condom? Control Intervention Baseline (n=510) Endline (n=322) Baseline (n=1075) Endline (n=666) Total for health system sources only 24.9% 28.9% 28.2% 37.8% CBD 5.3% 7.8% 9.4% 9.6% ZNFPC 0.0% 0.0% 0.3% 0.5% Other health systems 19.6% 21.1% 18.5% 27.8% Total for non-health system sources only 75.1% 71.1% 71.8% 62.2% Total for all sources 100.0% 100.0% 100.0% 100.0% What was the source of information on the pill? Control Intervention Baseline (n=498) Endline (n=321) Baseline (n=1105) Endline (n=665) Total for health system sources only 32.3% 49.5% 45.0% 58.8% CBD 8.2% 17.4% 15.6% 15.0% ZNFPC 0.2% 0.0% 0.1% 0.3% Other health systems 23.9% 32.1% 29.3% 43.5% Total for non-health system sources only 67.7% 50.5% 55.0% 41.2% Total for all sources 100.0% 100.0% 100.0% 100.0% CBD Impact Analysis: Annexes 103 What was the source of information on injections? Control Intervention Baseline (n=416) Endline (n=283) Baseline (n=956) Endline (n=565) Total for health system sources only 34.9% 51.6% 45.3% 56.3% CBD 3.8% 13.1% 7.5% 9.0% ZNFPC 0.0% 0.0% 0.0% 0.2% Other health systems 31.0% 38.5% 37.8% 47.1% Total for non-health system sources only 65.1% 48.4% 54.7% 43.7% Total for all sources 100.0% 100.0% 100.0% 100.0% What was the source of information on the female condom? Control Intervention Baseline (n=327) Endline (n=275) Baseline (n=798) Endline (n=559) Total for health system sources only 27.8% 30.5% 30.2% 36.5% CBD 4.3% 8.7% 7.5% 10.7% ZNFPC 0.0% 0.0% 0.5% Other health systems 23.5% 21.8% 22.7% 25.2% Total for non-health system sources only 72.2% 69.5% 69.8% 63.5% Total for all sources 100.0% 100.0% 100.0% 100.0% What was the source of information on the IUD? Control Intervention Baseline (n=232) Endline (n=190) Baseline (n=532) Endline (n=384) Total for health system sources only 37.9% 44.7% 37.0% 53.9% CBD 3.4% 11.6% 5.6% 10.7% ZNFPC 0.4% 0.2% 0.3% Other health systems 34.1% 33.2% 31.2% 43.0% Total for non-health system sources only 62.1% 55.3% 63.0% 46.1% Total for all sources 100.0% 100.0% 100.0% 100.0% CBD Impact Analysis: Annexes 104 What was the source of information on tubal ligation? Control Intervention Baseline (n=197) Endline (n=151) Baseline (n=609) Endline (n=270) Total for health system sources only 24.4% 33.8% 32.2% 43.3% CBD 1.5% 11.9% 3.9% 6.3% ZNFPC 0.0% 0.0% 0.3% 0.0% Other health systems 22.8% 21.9% 27.9% 37.0% Total for non-health system sources only 75.6% 66.2% 67.8% 56.7% Total for all sources 100.0% 100.0% 100.0% 100.0% What was the source of information on Norplant? Control Intervention Baseline (n=75) Endline (n=109) Baseline (n=198) Endline (n=179) Total for health system sources only 48.0% 56.0% 43.4% 54.7% CBD 8.0% 13.8% 3.5% 10.1% ZNFPC 0.0% 0.0% 0.5% 0.0% Other health systems 40.0% 42.2% 39.4% 44.7% Total for non-health system sources only 52.0% 44.0% 56.6% 45.3% Total for all sources 100.0% 100.0% 100.0% 100.0% What was the source of information on Vasectomy? Control Intervention Baseline (n=83) Endline (n=79) Baseline (n=225) Endline (n=162) Total for health system sources only 1.2% 17.7% 14.2% 34.0% CBD 0.0% 3.8% 3.1% 6.8% ZNFPC 0.0% 0.0% 0.0% 0.0% Other health systems 1.2% 13.9% 11.1% 27.2% Total for non-health system sources only 98.8% 82.3% 85.8% 66.0% Total for all sources 100.0% 100.0% 100.0% 100.0% CBD Impact Analysis: Annexes 105 What was the source of information on Periodic Abstinence? Control Intervention Baseline (n=57) Endline (n=70) Baseline (n=253) Endline (n=163) Total for health system sources only 10.5% 8.6% 8.7% 13.5% CBD 1.8% 0.0% 1.2% 1.2% ZNFPC 0.0% 0.0% 0.0% 0.0% Other health systems 8.8% 8.6% 7.5% 12.3% Total for non-health system sources only 89.5% 91.4% 91.3% 86.5% Total for all sources 100.0% 100.0% 100.0% 100.0% What was the source of information on Diaphram/Foam? Control Intervention Baseline (n=109) Endline (n=85) Baseline (n=254) Endline (n=119) Total for health system sources only 25.7% 41.2% 23.2% 12.1% CBD 8.3% 15.3% 4.7% 3.0% ZNFPC 0.0% 0.0% Other health systems 17.4% 25.9% 18.5% 9.0% Total for non-health system sources only 74.3% 58.8% 76.8% 47.7% Total for all sources 100.0% 100.0% 100.0% 59.8% CBD Impact Analysis: Annexes 106 Currently using a Family Planning method (by gender)? Control Baseline Endline Male (n=135) Female (n=115) Total (n=250) Male (n=110) Female (n=114) Total (n=224) No 36.3% 46.1% 40.8% 27.3% 30.7% 29.0% Yes 63.0% 49.6% 56.8% 70.0% 60.5% 65.2% Currently pregnant 0.7% 4.3% 2.4% 2.7% 8.8% 5.8% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% Intervention Baseline Endline Male (n=350) Female (n=321) Total (n=671) Male (n=189) Female (n=262) Total (n=451) No 30.0% 31.5% 30.7% 33.3% 28.2% 30.4% Yes 69.4% 64.8% 67.2% 65.6% 65.6% 65.6% Currently pregnant 0.6% 3.7% 2.1% 1.1% 6.1% 4.0% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% Currently using a Family Planning method (by marital status)? Control Baseline (n=250) Endline (n=224) No Yes, or currently pregnant No Yes, or currently pregnant Married or in a union 9.2% 12.4% 10.7% 41.1% Not married and not in a union 31.6% 46.8% 18.3% 29.9% Total 40.8% 59.2% 29.0% 71.0% Intervention Baseline (n=671) Endline (n=451) No Yes, or currently pregnant No Yes, or currently pregnant Married or in a union 11.3% 25.6% 14.9% 51.2% Not married and not in a union 19.4% 43.7% 15.5% 18.4% Total 30.7% 69.3% 30.4% 69.6% CBD Impact Analysis: Annexes 107 What types of Family Planning methods are respondents currently using (multiple responses, by gender)? Control Baseline Endline Male (n=85) Female (n=57) Total (n=142) Male (n=77) Female (n=69) Total (n=146) Pill 11.8% 66.7% 33.8% 31.2% 72.5% 50.7% Male condom 88.2% 15.8% 59.2% 68.8% 14.5% 43.2% Injection 1.2% 15.8% 7.0% 5.2% 14.5% 9.6% Other methods 3.5% 5.3% 4.2% 1.3% 1.4% 1.4% Intervention Baseline Endline Male (n=239) Female (n=208) Total (n=447) Male (n=124) Female (n=172) Total (n=296) Pill 38.1% 75.5% 55.5% 61.3% 76.7% 70.3% Male condom 66.1% 6.7% 38.5% 47.6% 8.7% 25.0% Injection 3.3% 16.3% 9.4% 4.0% 13.4% 9.5% Other methods 2.1% 4.3% 3.1% 2.4% 4.1% 3.4% What types of Family Planning methods are respondents currently using (multiple responses, by marital status)? Control Baseline Endline Married or in a union (n=28) Not married and not in a union (n=114) Married or in a union (n=80) Not married and not in a union (n=66) Pill 57.1% 28.1% 77.5% 18.2% Male condom 35.7% 64.9% 12.5% 80.3% Injection 10.7% 6.1% 13.8% 4.5% Other methods 0.0% 5.3% 0.0% 3.0% Intervention Baseline Endline Married or in a union (n=163) Not married and not in a union (n=284) Married or in a union (n=215) Not married and not in a union (n=81) Pill 59.5% 53.2% 83.3% 35.8% Male condom 36.8% 39.4% 8.8% 67.9% Injection 10.4% 8.8% 9.8% 8.6% Other methods 1.2% 4.2% 3.3% 3.7% CBD Impact Analysis: Annexes 108 What was the source of the family planning method currently in use? Control Intervention Baseline (n=139) Endline (n=146) Baseline (n=446) Endline (n=294) Total for health system sources only 100.0% 97.9% 100.0% 99.0% CBD 28.8% 25.3% 41.0% 27.9% ZNFPC 2.2% 12.3% 7.8% 16.0% Other health systems 69.1% 60.3% 51.1% 55.1% Total for non-health system sources only 0.0% 2.1% 0.0% 1.0% Total for all sources 100.0% 100.0% 100.0% 100.0% CBD Impact Analysis: Annexes 109 STI & HIV/AIDS Tables Has respondent heard of diseases that can be transmitted by sexual intercourse? Control Intervention Baseline (n=599) Endline (n=341) Baseline (n=1212) Endline (n=709) No Yes No Yes No Yes No Yes Male 5.0% 95.0% 1.2% 98.8% 1.6% 98.4% 1.4% 98.6% Female 7.0% 93.0% 2.3% 97.7% 8.3% 91.7% 4.2% 95.8% Total 6.0% 94.0% 1.8% 98.2% 5.0% 95.0% 2.8% 97.2% Diseases respondents have heard of (not prompted, multiple responses) Control Intervention Baseline (n=563) Endline (n=335) Baseline (n=1152) Endline (n=688) HIV/AIDS 93.4% 95.8% 96.1% 90.6% Gonorrhea 25.9% 61.8% 38.5% 51.6% Syphilis 31.4% 58.5% 35.3% 48.3% Herpes 5.0% 25.4% 6.0% 20.3% Chancroid 3.2% 16.4% 5.9% 16.6% Other 41.4% 11.0% 34.5% 11.9% Chlamydia 0.7% 4.2% 1.0% 4.1% Have respondents heard of HIV/AIDS? Control Intervention Baseline (n=599) Endline (n=341) Baseline (n=1212) Endline (n=709) No Yes No Yes No Yes No Yes Male 0.0% 100.0% 0.0% 100.0% 0.2% 99.8% 0.6% 99.4% Female 0.3% 99.7% 0.0% 100.0% 1.7% 98.3% 0.6% 99.4% Total 0.2% 99.8% 0.0% 100.0% 0.9% 99.1% 0.6% 99.4% CBD Impact Analysis: Annexes 110 Main source of information on HIV AIDS, by category Control Baseline Endline Male (n=298) Female (n=300) Total (n=598) Male (n=166) Female (n=175) Total (n=341) Total for health system sources only 4.0% 30.3% 17.2% 18.7% 39.4% 29.3% CBD 0.3% 0.7% 0.5% 6.6% 4.0% 5.3% ZNFPC 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% Other health systems 3.7% 29.7% 16.7% 12.0% 35.4% 24.0% Total for non-health system sources only 96.0% 69.7% 82.8% 81.3% 60.6% 70.7% Total for all sources 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% Intervention Baseline Endline Male (n=607) Female (n=594) Total (n=1,201) Male (n=354) Female (n=351) Total (n=705) Total for health system sources only 7.7% 27.3% 17.4% 23.4% 45.9% 34.6% CBD 2.1% 1.7% 1.9% 7.9% 6.0% 7.0% ZNFPC 0.2% 0.0% 0.1% 0.0% 0.0% 0.0% Other health systems 5.4% 25.6% 15.4% 15.5% 39.9% 27.7% Total for non-health system sources only 92.3% 72.7% 82.6% 76.6% 54.1% 65.4% Total for all sources 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% Knowledge of HIV risk factors Control Intervention Baseline (n=577) Endline (n=339) Baseline (n=1166) Endline (n=694) Correct Responses Sexual relations with an infected partner 69.3% 88.5% 74.7% 79.7% Multiple sexual partners 0.0% 47.8% 0.0% 22.8% Contaminated sharps 2.3% 10.6% 5.0% 14.1% Receiving blood transfusions 10.2% 12.4% 6.0% 8.9% Having unprotected sex 1.9% 5.0% 3.4% 8.6% Mother to child transmission during birth 0.2% 8.8% 0.3% 7.6% Other correct 1.2% 2.7% 0.8% 4.8% Incorrect Responses Razor 3.3% 10.6% 3.1% 12.8% Kissing on the mouth 1.4% 10.9% 2.1% 8.1% Shaking hands 0.5% 1.2% 0.4% 3.5% Using condoms 35.2% 1.2% 26.2% 1.0% Other incorrect 9.4% 5.0% 10.4% 4.5% CBD Impact Analysis: Annexes 111 Knowledge of any correct HIV risk factor (by gender) Control Baseline Endline Male (n=298) Female (n=301) Total (n=599) Male (n=166) Female (n=175) Total (n=341) Knows of at least one correct risk factor 23.2% 34.2% 28.7% 98.2% 97.7% 97.9% Does not know any correct risk factors 76.8% 65.8% 71.3% 1.8% 2.3% 2.1% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% Intervention Baseline Endline Male (n=608) Female (n=604) Total (n=1212) Male (n=354) Female (n=351) Total (n=705) Knows of at least one correct risk factor 16.1% 30.5% 23.3% 95.8% 93.4% 94.6% Does not know any correct risk factors 83.9% 69.5% 76.7% 4.2% 6.6% 5.4% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% Have respondents ever been tested for HIV (by gender)? Control Intervention Baseline (n=598) Endline (n=341) Baseline (n=1199) Endline (n=705) No Yes No Yes No Yes No Yes Male 97.0% 3.0% 92.8% 7.2% 93.4% 6.6% 81.6% 18.4% Female 92.7% 7.3% 85.1% 14.9% 91.2% 8.8% 81.2% 18.8% Total 94.8% 5.2% 88.9% 11.1% 92.3% 7.7% 81.4% 18.6% Have respondents ever been tested for HIV (by age range)? Control Intervention Baseline (n=598) Endline (n=341) Baseline (n=1199) Endline (n=705) No Yes No Yes No Yes No Yes no age given 0.0% 0.0% 0.0% 0.0% 0.2% 0.0% 0.0% 0.0% 15-19 47.2% 0.8% 29.0% 1.8% 35.4% 1.8% 21.4% 2.6% 20-24 29.9% 2.2% 25.5% 5.3% 31.9% 3.0% 27.2% 7.9% 25-29 17.7% 2.2% 14.4% 1.5% 24.9% 2.8% 15.9% 4.0% 30-34 0.0% 0.0% 19.9% 2.6% 0.0% 0.0% 16.9% 4.1% Total 94.8% 5.2% 88.9% 11.1% 92.3% 7.7% 81.4% 18.6% CBD Impact Analysis: Annexes 112 Have respondents ever been tested for HIV (by education status)? Control Baseline (n=598) Endline (n=341) No Yes No Yes Never attended school 0.2% 0.0% 0.6% 0.0% Primary 31.8% 1.3% 19.6% 1.8% Secondary 62.5% 3.5% 67.7% 8.5% College 0.2% 0.3% 0.6% 0.9% University 0.2% 0.0% 0.3% 0.0% Total 94.8% 5.2% 88.9% 11.1% Intervention Baseline (n=1197) Endline (n=705) No Yes No Yes Never attended school 0.3% 0.0% 0.3% 0.0% Primary 23.7% 0.9% 25.4% 4.0% Secondary 67.4% 6.3% 54.8% 14.2% College 0.9% 0.4% 0.9% 0.3% University 0.0% 0.0% 0.1% 0.1% Total 92.3% 7.7% 81.4% 18.6% Respondents who have been tested - date of last HIV test (Baseline) Control Intervention Male (n=9) Female (n=21) Total (n=30) Male (n=40) Female (n=51)) Total (n=91) 2001 33.3% 14.3% 20.0% 25.0% 31.4% 28.6% 2000 11.1% 42.9% 33.3% 30.0% 37.3% 34.1% 1999 11.1% 28.6% 23.3% 10.0% 17.6% 14.3% 1998 22.2% 14.3% 16.7% 15.0% 3.9% 8.8% 1997 or earlier 22.2% 0.0% 6.7% 20.0% 7.8% 13.2% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% Respondents who have been tested - date of last HIV test (Endline) Control Intervention Male (n=12) Female (n=25) Total (n=37) Male (n=64) Female (n=60) Total (n=124) 2004 8.3% 28.0% 21.6% 51.6% 25.0% 38.7% 2003 41.7% 52.0% 48.6% 20.3% 30.0% 25.0% 2002 16.7% 5.4% 14.1% 23.3% 18.5% 2001 8.3% 12.0% 10.8% 6.3% 10.0% 8.1% 2000 or earlier 25.0% 8.0% 13.5% 7.8% 11.7% 9.7% Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% CBD Impact Analysis: Annexes 113 Respondents who have been tested - source of information on testing center Control Baseline Endline Male (n=9) Female (n=21) Total (n=30) Male (n=12) Female (n=25) Total (n=37) Total for health system sources only 44.4% 61.9% 56.7% 25.0% 72.0% 56.8% CBD 0.0% 0.0% 0.0% 0.0% 4.0% 2.7% Other health systems 44.4% 61.9% 56.7% 25.0% 68.0% 54.1% Total for non-health system sources only 55.6% 38.1% 43.3% 75.0% 28.0% 43.2% Total for all sources 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% Intervention Baseline Endline Male (n=39) Female (n=52) Total (n=91) Male (n=62) Female (n=58) Total (n=120) Total for health system sources only 41.0% 75.0% 60.4% 40.3% 56.9% 48.3% CBD 0.0% 0.0% 0.0% 16.1% 3.4% 10.0% Other health systems 41.0% 75.0% 60.4% 24.2% 53.4% 38.3% Total for non-health system sources only 59.0% 25.0% 39.6% 59.7% 43.1% 51.7% Total for all sources 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% Would respondents be willing to go in for voluntary counseling and testing on HIV/AIDS? Control Intervention Baseline (n=598) Endline (n=341) Baseline (n=1198) Endline (n=705) No Yes No Yes No Yes No Yes Male 34.2% 65.8% 27.1% 72.9% 24.5% 75.5% 16.7% 83.3% Female 20.7% 79.3% 22.3% 77.7% 22.9% 77.1% 21.7% 78.3% Total 27.4% 72.6% 24.6% 75.4% 23.7% 76.3% 19.1% 80.9% CBD Impact Analysis: Annexes 114 Annex 7: Baseline and Endline Data Analysis Process and Notes General Notes The Endline database could not be used in its original condition because it was not designed with the data analysis in mind. Consequently, extensive reformatting was necessary before any indicators could be calculated. In contrast, the design of the Baseline database was very easy to work with so any changes made were primarily to standardize its design with the final Endline database. The Endline analysis was done first and the Baseline analysis second. Due to time constraints it was not practical to reformat the entire Baseline database (as we did for the Endline database), so only the data for those questions used to calculate indicators of interest were exported to a new database and reformatted. All tables were generated using the Custom Tables function in SPSS. Reformatting Rearranging Data Many of the questions used to calculate the indicators allowed multiple answers. The data for these questions were rearranged so that there was one column per answer of interest. For example, the answers of interest as shown on the data collection form for question 306 (“Which method(s) did you use when you last had sex?”) were: 1. Pill 2. IUD 3. Injection 4. Norplant 5. Diaphragm, foam 6. Male condom 7. Female condom 8. TL 9. Vasectomy 10. Natural methods 11. Other (specify) ……… Therefore, the answers for question 306 were divided among at least 12 columns in the database. Based on this reformatting, the first 11 columns now contain data on whether or not a respondent mentioned each answer of interest. If a respondent answered that she used a female condom, a “1” was entered into the female condom column to indicate that method was mentioned. A “0” was entered into the columns for any method she did not mention. The same logic applies to CBD Impact Analysis: Annexes 115 “other” answers. If a respondent gave an answer that was considered to be “other” based on the above list, a “1” was entered into the “other” column. The 12th column contains a complete list of the “other” answers given by respondents. If respondents provided more than one “other” answer, additional columns were added to accommodate the data entry of these answers. Recoding The answers to certain questions (see tables below) were aggregated for the analysis so that certain groups of interest (e.g. age groups, control group, etc.) could be analyzed. This involved making a copy of the original answers and recoding them according to specific criteria. All the codes for the categories used in the Baseline and Endline SPSS databases can be found in the Values column of the Variable View page. Recoding of the databases involved coding for the following areas of interest: Province: Original answers Aggregated answers Manicaland (Makoni North) Manicaland (Makoni South) Mashonaland East (Marondera) Matabeleland North (Umguza) Masvingo (Gutu North) Masvingo (Gutu South) Intervention Matabeleland South (Bulilimamangwe) Midlands (Zvishavane) Control Age: Aggregated answers “15-19” “20-24” “25-29” “30-34” Question 102 – Marital status: Original answers Aggregated answers CBD Impact Analysis: Annexes 116 Married, living with wife Married, wife living away Cohabitating Married or in a union Widower Divorced/separated Never married Not married and not in a union Question 303 – Number of sexual partners in the previous 12 months Aggregated answers 1 partner 2 partners 3 partners >3 partners Question 401 – Knowledge of family planning methods Data for question 401 were coded several different ways: • Spontaneous vs. prompted answers • Any knowledge of the family planning method (i.e. no distinction between spontaneous and prompted answers) • Source of a respondent’s information on the family planning method • Type of information source (see notes below on how sources are categorized) Question 404 – Currently using a family planning method Original answers Aggregated answers Yes Currently pregnant Yes, or currently pregnant No No Question 505 – HIV risk factors All the answers provided by respondents were reviewed and grouped into the following categories Aggregated answers Total number of correct risk factors mentioned CBD Impact Analysis: Annexes 117 Total number of incorrect risk factors mentioned Aggregated answers At least one correct risk factor was mentioned No correct risk factors were mentioned Question 511 – Date of last HIV test Aggregated answers for Baseline Aggregated answers for Endline 2001 2004 2000 2003 1999 2002 1998 2001 1997 or earlier 2000 or earlier Questions 401, 406, 504, 512 – Sources for information and supplies All the answers provided by respondents were reviewed and grouped into the following categories: Aggregated answers Health systems source Non-health systems source Note: (The following is only applicable to the Endline database.) If a respondent mentioned more than one source, the overall category of sources said to have been used by the respondent was determined by the following criteria: • At least one health systems source → health systems source • No health systems source → non-health systems source Aggregated answers CBD ZNFPC Other health systems source Non-health system source CBD Impact Analysis: Annexes 118 Note: (The following is only applicable to the Endline database.) If a respondent mentioned more than one source, the overall category of sources said to have been used by the respondent was determined by the following criteria: • At least one CBD source → CBD • No CBD source but at least one ZNFPC source → ZNFPC • No CBD or ZNFPC source but at least one health systems source → other health systems source • No health systems source → non-health systems source Labeling (see the Variable View page in the SPSS databases) SPSS uses the text contained in the Label column to generate row and column headings for tables. The labels in the original databases were revised where necessary so that SPSS would produce tables in the desired format. CBD Impact Analysis: Annexes 119 Key Differences between the Baseline and Endline Forms Note: These comparisons are only for the questions used to calculate the indicators Question Differences Age The upper age limit for Baseline respondents was 29 while it was 34 in the Endline 404 The Baseline asks about the respondent and his/her partner while the Endline asks only about the respondent 405 The Baseline asks about the respondent and his/her partner while the Endline asks only about the respondent 406 The Baseline data does not specify that data collectors should record “other” answers CBD Impact Analysis: Annexes 120 Notes Specific to the Baseline Database General Corrections Data for “Other” responses were typically divided into two columns based on the gender of the respondents. These columns were merged into one column in the final database. Answers not recorded in English were excluded from the analysis. Specific Issues/Corrections in the Baseline Database, by Question 102 Only one “other” answer was given (“Just about to get married”), and it was recoded as “never married.” 401 For cases where a family planning method was incorrectly recorded as having been mentioned both spontaneously AND after prompting, the assumption was made that the spontaneous answer was the correct one. Therefore, the entry in the spontaneous column was deleted. Unlike the Endline database, the Baseline database did not record any “other” answers as having been prompted. There were many instances where sources were recorded for family planning methods not mentioned by respondents. We cannot identify if this was a data collection or data entry error. Therefore, these cases were excluded from the data analysis. Some answers for source of information in the original database were coded as “10.” There was no explanation for this code nor does it match the codes provided on the data collection form, so these records were excluded from the analysis. 505 Due to an error in the original database there are no data on the number of respondents who mentioned “multiple sexual partners” as a risk factor for contracting HIV/AIDS. The column that should have contained that data instead contained data on “other” risk factors mentioned by respondents. 511 There are no data for the years 2001 and 2000, but there were data for the years 1901 and 1900. The assumption was made that “1901” and “1900” refer to the years 2001 and 2000 respectively, and the correction was made. 512 One respondent said they heard about the testing center “through ZRP.” This source could not be identified as being either a health systems source or a non￾health systems source, so it was excluded from the analysis. CBD Impact Analysis: Annexes 121 Notes Specific to the Endline Database General Corrections Answers not recorded in English were excluded from the analysis. Specific Issues/Corrections in the Endline Database, by Question 401 For cases where a family planning method was incorrectly recorded as having been mentioned both spontaneously AND after prompting, the assumption was made that the spontaneous answer was the correct one. Therefore, the entry in the spontaneous column was deleted. Unlike the Baseline database, the Endline database recorded some “other” answers as having been prompted. There were a few instances where sources were recorded for family planning methods not mentioned by respondents. These cases were excluded from the data analysis.