The 2007 Ghana Maternal Health Survey (GMHS) is intended to serve as a source of data on maternal health and maternal death for policymakers and the research community involved in the R3M program. Specifically, the data collected in the GMHS is intended to help the GoG and the consortium of organizations participating in the R3M program to launch a series of collaborative efforts to significantly expand women’s access to modern family planning services and comprehensive abortion care (CAC), reduce unwanted fertility, and reduce severe complications and deaths resulting from unsafe abortion.
The GMHS collected data from a nationally representative sample of households and women of reproductive age (15-49). The data were collected in two phases. The primary objectives of the 2007 GMHS were:
• To collect data at the national level that will allow an assessment of the level of maternal mortality in Ghana for the country as a whole, for the R3M program regions (Greater Accra, Ashanti and Eastern Regions), and for the non-program regions;
• To identify specific causes of maternal and non-maternal deaths, and specifically to be able to identify deaths due to abortion-related causes, among adult women;
• To collect data on women’s perceptions and experience with antenatal, maternity, and emergency obstetrical care, especially with regard to care received before, during, and after the termination or abortion of a pregnancy;
• To measure indicators of the utilization of maternal health services and especially post-abortion care services in Ghana; and
• To provide baseline data for the R3M program and for follow-on studies and surveys that will be used to observe possible reductions in maternal mortality as well as reductions in abortion-related mortality.
Kind of Data
Sample survey data [ssd]
Unit of Analysis
- Women age 15-49
The 2007 Ghana Maternal and Health Survey covered the following topics:
- Household Demographic Characteristics
- Deceased Women Background
- Signs and Symptoms During the Final Illness
- Signs and Symptoms During the Final Illness Related to Reproductive Health
- History of Injury/Accident
- Treatment and Health Service Use for Final Illness
- Risk Factors
- Data Extracted from Health Certificate
- Data Extracted from Other Health Record
- Respondent's Background
- Antenatal, Delivery and Postnatal Care
- Marriage an Sexual Activity
- Maternal Mortality
Producers and sponsors
Ghana Statistical Service (GSS)
Ghana Health Service (GHS)
Technical assistance and administered funding for the project
Technical assistance in questionnaire design
Sample size: Phase I:240,000 households, Phase II: 4,203 verbal autopsies,10,858 households and 10,370 women age 15-49
Note: See detailed sample implementation tables is provided in APPENDIX B of the report which is presented in this documentation.
A total of 11,579 households were selected for the sample, of which 10,994 were occupied at the time of the survey and 10,858 (or 99 percent) were successfully interviewed. The difference is primarily due to dwellings being vacant or the inhabitants being gone for an extended period at the time of the survey. In the interviewed households, 10,627 women were identified as eligible for the individual interview (women age 15-49), and interviews were completed for 10,370, or 98 percent. The principal reason for nonresponse among eligible women was the failure to find them at home, despite repeated visits to the household. The refusal rate was low in both urban and rural areas.
Note: See summarized response rates in Table 1.2 of the report which is presented in this documentation.
Dates of Data Collection
Data Collection Mode
Data Collection Notes
Training and Fieldwork
Listing and data collection during the first phase was carried out by 15 teams (each with 5 listers and 5 mappers) and 10 experienced staff supervising the operation. Data collection for the second phase of the survey was carried out by 20 interviewing teams. Each interviewing team consisted of a supervisor, a female editor, and four female interviewers. GSS and GHS were responsible for the recruitment and training of all team members. The implementing organizations recruited and trained a number of staff in excess of the number needed for the 20 interviewing teams, to allow for some attrition during the training period and the early phase of fieldwork. Personnel trained for field positions were well educated, with prior field experience, and the ability to speak one or two of the local languages. They were recruited on the basis of maturity, friendliness, language skills, and willingness to work away from home during the three months of fieldwork.
The implementing organizations were also responsible for conducting the training of team supervisors, editors, and interviewers. The training course lasted two weeks and included a question-by-question explanation of the content of the questionnaires, instructions on how to fill out each question in the questionnaires, instructions on interviewing procedures, and field procedures to be followed during the survey. Training consisted of classroom lectures, mock interviews in the classroom, and practice interviewing in an area close to the training site. Each interviewer completed at least three practice interviews during the training period. These practice interviews were carefully edited to catch interviewing errors and were used in the selection of interviewers for the fieldwork. As part of the training program, participants were given a thorough understanding of their duties and responsibilities. Following the completion of the main training, field staff selected to be supervisors and editors underwent an additional day’s training on field logistics and editing procedures. Supervisors and editors received special training on administering the verbal autopsy questionnaires. During recruitment, special emphasis was given to the selection of field staff with strong health backgrounds to become supervisors and editors.
During the main survey work, close communication was maintained at all times between the GMHS survey office at the GSS headquarters and the interviewing teams in the field. The procedure for supervision and communication between headquarters and the field staff during data collection was specified in the Listing Manual and the Interviewer’s and Supervisor’s Manuals and discussed during training for the survey. The implementing organizations—with the help of an accounting firm hired to monitor and disburse project funds—were responsible for ensuring that sufficient funds were transferred in a timely manner to team supervisors, to cover the costs of operating vehicles, communications, and per diem payments to all team members. GSS and GHS were responsible for ensuring that field staff had their materials (maps and lists of households to be interviewed) and supplies (questionnaires).
The GMHS involved four questionnaires:
(1) a Phase I short household questionnaire administered at the time of listing;
(2) a Phase II verbal autopsy questionnaire administered in households identified at listing as having experienced the death of a female household member age 12-49;
(3) a Phase II long-form household questionnaire administered in independently selected households chosen for the individual woman’s interview, and
(4) a Phase II questionnaire for individual women age 15-49 in the same phase two selected households.
The primary purpose of the short household questionnaire administered at the time of listing during Phase I was to identify deaths to women age 12-49, for administering the verbal autopsy questionnaire on the causes of female deaths, particularly maternal deaths and abortion-related deaths. Unique identifiers for households in phase one and households in phase two were not maintained; therefore households cannot be matched across both phases of the survey.
All questionnaires for the GMHS were returned to Accra for data processing at GSS. Data processing, including training of data entry personnel, began in October 2007 and was completed by the end of January 2008. Additional data entry of the first phase household questionnaires was completed in September 2008. The processing operation consisted of office editing, coding of open-ended questions, data entry, and resolving inconsistencies found by the computer edit programs. The data were processed on microcomputers using CSPro.
Three physicians selected to review the verbal autopsy questionnaires to assign the causes of death were trained for a week in the International Classification of Diseases (ICD)-10 (WHO, 2004c) coding procedure by a consultant hired by Macro. Coding on the cause of death was completed between mid-February 2008 and August 2008. Each death was coded independently by two physicians and issued with a death certificate identifying the underlying cause of death. All discordant cases were reviewed a second time by the same two physicians and assigned a final (third) death certificate jointly. Discordant causes of death not resolved by the third review were deemed as indeterminate.
Estimates of Sampling Error
See detailed sampling error tables in APPENDIX D of the report which is presented in this documentation.
Data Quality Tables
- Household age distribution
- Age distribution of eligible and interviewed women
- Completeness of reporting
- Births by calendar years
- Reporting of age at death in days
- Reporting of age at death in months
- Data on siblings
- Indicators of data quality
- Sibship size and sex ratio of siblings
- Additional data on siblings
- Imputation of data on living female siblings by age group
Note: See detailed tables in APPENDIX C of the report which is presented in this documentation.
Data and Data Related Resources
MEASURE DHS believes that widespread access to survey data by responsible researchers has enormous advantages for the countries concerned and the international community in general. Therefore, MEASURE DHS policy is to release survey data to researchers after the main survey report is published, generally within 12 months after the end of fieldwork. with few limitations these data have been made available for wide use.
DISTRIBUTION OF DATASETS
MEASURE DHS is authorized to distribute, at no cost, unrestricted survey data files for legitimate academic research, with the condition that we receive a description of any research project that will be using the data.
Registration is required for access to data.
Datasets are available for download to all registered users, free of charge. To download datasets, you must first register online and request the country(ies) and datasets that you are interested in. When submitting a dataset request, users must include a brief description of how the data will be used.
Datasets are made available with the following conditions:
- Survey data files are distributed by MEASURE DHS for academic research/statistical analysis. Researchers need to provide a description of any research/analysis that will be using the data, before access is granted to the datasets.
- Once downloaded, the datasets must not be passed on to other researchers without the written consent of MEASURE DHS.
- All reports and publications based on the requested data must be sent to the MEASURE DHS Data Archive as a Portable Format Document (pdf) or a hard copy, for us to forward to the country(ies) whose data have been used.
Use of the dataset must be acknowledged using a citation which would include:
- the Identification of the Primary Investigator
- the title of the survey (including acronym and year of implementation)
- the survey reference number
- the source and date of download
Ghana Statistical Service (GSS) and Ghana Health Service (GHS), and Macro International, Calverton, Maryland USA. Ghana Maternal Health Survey 2007. Dataset downloaded from http://www.measuredhs.com on [date].
Disclaimer and copyrights
The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses.