IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v311y2022ics0277953622006244.html
   My bibliography  Save this article

Cognitive testing of questions about antenatal care and nutrition interventions in southern Nepal

Author

Listed:
  • L-Thorne-Lyman, Andrew
  • Lama, Tsering Pema
  • Heidkamp, Rebecca A.
  • Manandhar, Porcia
  • Subedi, Seema
  • Munos, Melinda K.
  • Bryce, Emily
  • Khatry, Subarna K.
  • LeClerq, Steven C.
  • Katz, Joanne

Abstract

Large scale surveys such as the Demographic and Health Surveys (DHS) are used to measure the coverage and quality of antenatal care (ANC)-related services. Studies have increasingly validated questions from these surveys, though few have explored respondent comprehension or associated thought processes. This study aimed to use cognitive testing and validation approaches to understand how survey respondents understand questions related to ANC-related nutrition services. The study was nested within a larger validation study in southern Nepal. Pregnant women's receipt of ANC related services was directly observed at five health posts followed by a recall interview at 6 months postpartum. A week later, a survey module was re-administered to 30 women containing 15 questions about receipt of ANC care and specifically nutrition-related services. Detailed probing was used to identify cognitive challenges related to comprehension, retrieval, judgement, and response. Respondents accurately recalled the four specific ANC visits recommended by the government of Nepal but those with more visits struggled to estimate the total number of ANC visits they had made. A number of terms including “antenatal care, “nutrition” and “breastfeeding” were challenging for many respondents to understand. Visits to private providers including for ultrasounds were inconsistently included in ANC visit counts suggesting that question wording could better specify the type of care. Many respondents over-estimated the number of iron folic acid (IFA) supplements taken during pregnancy, and recall was challenging. Calculations were based on estimating the number of months between first ANC visit to delivery, and only sometimes factored in missed tablets. Opportunities exist to improve questions to facilitate better comprehension by respondents through a combination of using local terms and explanations, reordering some questions, and adapting questions to better match respondents' approaches to estimating numeric responses.

Suggested Citation

  • L-Thorne-Lyman, Andrew & Lama, Tsering Pema & Heidkamp, Rebecca A. & Manandhar, Porcia & Subedi, Seema & Munos, Melinda K. & Bryce, Emily & Khatry, Subarna K. & LeClerq, Steven C. & Katz, Joanne, 2022. "Cognitive testing of questions about antenatal care and nutrition interventions in southern Nepal," Social Science & Medicine, Elsevier, vol. 311(C).
  • Handle: RePEc:eee:socmed:v:311:y:2022:i:c:s0277953622006244
    DOI: 10.1016/j.socscimed.2022.115318
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953622006244
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.socscimed.2022.115318?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:311:y:2022:i:c:s0277953622006244. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.