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Resource Flows Surveys on Family Planning in Uganda 2018, Seventh Round

Uganda, 2018
Uganda Bureau of Statistics (UBOS)
Last modified March 29, 2022 Page views 483 Metadata DDI/XML JSON
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Identification

IDNO
UGA-UBOS-RFS-2018-v01
Title
Resource Flows Surveys on Family Planning in Uganda 2018, Seventh Round
Subtitle
Seventh Round
Country
Name Country code
Uganda UGA
Abstract
Statistical information on Family Planning expenditures within a country is critical for evidence-based policy and decision making in resource allocation in the Health sector. The information is also critical for monitoring progress in achievement of Government commitments to FP service provision in Uganda. The Uganda Bureau of Statistics (UBOS) has been conducting the Resource Flows Survey (RFS) in Uganda since 2011. The 2018 RFS covered all institutions undertaking Family Planning (FP) activities namely; Government Ministries, Department and Agencies (MDA), Non-Government Organisations (NGO), Importers of Contraceptives and Private Health facilities in 30 of the 128 districts in Uganda. Field data collection was spread over a 2-month period from November 2018 to December 2018. A total of 471 institutions were covered including 371 private health facilities scientifically selected countrywide. The Survey focused on income received and domestic expenditures on Family Planning activities in the country in Calendar year 2016-2017 and Financial year 2016/17-2017/18.

Income received and spent on Family Planning activities in Uganda
The 2018 Resource Flows Survey on Family Planning in Uganda revealed that about UGX 106Billion was received for Family Planning (FP) activities in 2017; reflecting a 34 percent increment from about UGX 79Billion that was received in 2016. Financial Year (FY) findings showed that there was an increase in income received for FP from UGX 71Billion in 2016/17 to UGX 80Billion in 2017/18. International organisations remained the main source of income for Family Planning activities in Uganda in 2017 accounting for 73 percent (UGX 76 Billion) of the total income received in 2017.
FP funds absorption was reportedly high at about 92 percent in 2017/18 and 96 percent in 2017. Internal service staff cost took the greatest share of the total FP expenditures in 2017 at about 28 percent. Purchase of Contraceptives, medicine & other consumables constituted the largest proportion (42%) of Family Planning expenditure in FY 2017/18. Condoms were the most purchased contraceptive accounting for 30 percent of the expenditure towards Contraceptives medicine & other consumables in 2017 and 29 percent in 2017/18.

Income received and spent on Family Planning activities among Government Ministries, Departments and Agencies (MDAs)
A total of UGX 16Billion was received for Family planning in 2017/18; an increment from UGX 10Billion in 2016/17. Purchase and distribution of Contraceptives, medicine, and other consumables took the greatest share of the FP funds at about 93 percent in 2017/18. Of the FP income spent on Contraceptives, medicine & other consumables in 2016/17 and 2017/18, more than a third was spent on purchase of IUDs followed by condoms.

Findings from the national budget showed that UGX 1.70 Billion was spent by Government of Uganda on FP activities in 2017/18. This was a decrease from UGX 1.74 Billion in FY 2016/17. About UGX 1Billion was spent on Human Resource in both years.

Income received and spent on Family Planning activities in the Private Sector

There was an increase in income received from FP services in the private sector from UGX 78Billion in 2016 to UGX 105Billion in 2017. Of the income received, almost all was spent (99% in 2016 and 96% in 2017).

Non-Government Organisations (NGOs) reported receipt of UGX 101Billion in 2017; an increment from UGX 73Billion in 2016. Most of the FP income in 2017 (28%) was spent on internal service staff cost for direct FP service provision. A reduction in the percentage spent on long term FP methods namely injectables (15% to 12%), implants (17% to 12%) and IUDs (22% to 14%) was realized between 2016 and 2017.

Private Health Facilities on the other hand reported a decrease in income received for FP activities from UGX 4.9Billion in 2016 to UGX 3.9Billion in 2017. Most of the expenditures towards FP services (38%) in public health facilities were on purchase and provision of Contraceptives, medicine & other FP consumables in 2017. The most purchased contraceptives were injectables at 19 percent in 2017 and 27 percent in FY 2017/18.

Importers of FP commodities. There was an increase in expenditure towards importation of FP contraceptives from UGX 46Billion in 2016 to UGX 58Billion in 2017.
Kind of Data
Sample survey data [ssd]

Version

Version number
v1.1: Edited data, for internal use only.
Version Date
2019-05-31

Scope

Topic Classification
Topic Vocabulary
Population & Reproductive Health World Bank
Keywords
Keyword
Family Planning

Coverage

Geographic Coverage
National Coverage

Producers and sponsors

Authoring entity/Primary investigators
Agency Name Affiliation
Uganda Bureau of Statistics (UBOS) Ministry of Finance, Planning and Economic Development
Funding Agency/Sponsor
Name Abbreviation Role
Marie Stopes International MSI Part funding
United States Agency forInternational Development USAID Part funding
Population Services International PSI Part funding
Department for International Development DFID
Ministry of Health MoH
AMREF Health Africa AMREF
United Nations Population Fund UNFPA
International Development Association IDA
Bill and Melinda Gates foundation BMGF
Uganda Health Marketing Group UHMG
Population Cares Uganda PCU
The david and lucile parkad foundation DLPF
SEGAL foundation SFL
The Global Fund
Own income
Other Identifications/Acknowledgments
Name
Wellspring International Philanthropic fund
Reproductive Health Uganda
Hewett
Better Hag Uganda

Sampling

Sampling Procedure
Sampling Design:
From a list of FP impllementing partners in the counrty a total of 12 Government MDAs, 80 NGOs and 12 importers of FP contraceptives were identified. All 104 FP implementing partners in Uganda, were visited with the exception of private health facilities where sampling was done.

The frame for Private Health Care Facilities (HFs) that provided Family Planning services as of December 2017 in 125 districts was obtained from the District Health Management Information System (DHMIS) at Ministry of Health, comprising of 1,444 Private Health Facilities. All facilities with less than 10 FP users (0.04% of total FP users) in 2017 were dropped from the frame (8% of the private HFs were excluded).

Given that the data from the sampling frame (DHMIS) was incomplete without data on expenditures towards FP among the private health facilities, the available variable number of FP users was used as a proxy measure for FP financial expenditure. Hence the sample selection at all stages was done using Probability Proportional to Size (PPS), the size being the number of Family Planning users.

Sample Size determination:
A number of factors were taken into consideration during the determination of a sample size that is nationally representative and these included;
1. Contraceptive Prevalence Rate among married women (39%) and sexually active unmarried women (51%) in the reproductive age group (15-49 years) from the 2016 UDHS
2. Non-response among health facilities (1.3%) based on other health facility based studies and
3. The overall cost of the survey among others.
A sample size of 450 private Health Facilities were then selected. Based on findings from the pre-test, clinics were excluded in the sampling due to inadequate data and duplication in FP methods provision.

Sample Selection:
The sample selection followed a two-stage stratified sampling design.
In the first stage, all districts were grouped into 15 sub regions of similar socio-economic characteristics prior to sampling. These included; North Buganda, South Buganda, Kampala, Ankole, Bukedi, Busoga, Acholi, Lango, West Nile, Bunyoro, Kigezi, Tooro, Teso, Elgon and Karamoja. A total of 30 districts with regional representation were then selected using Probability Proportional to Size (PPS), the size being the number of Family Planning users in each district.

In the second stage, the number of Private Health facilities to be included in the sample from each district was also determined using PPS including (41 Hospitals, 10 Health Centre IVs, and 156 HC IIIs) in the selected districts, all of which were included in the sample. The 243 HC IIs were then selected using PPS in each district.

Finally, a total of 554 organisations including 12 Government MDAs, 80 NGOs, 12 Pharmacies and agencies that import contraceptives, and 450 private health facilities were identified and visited.
Response Rate
Throughout the survey process, Ministry of Health through the FP technical committee and FP2020 office took lead in contacting stakeholders to ensure that non-response was minimized. The survey yielded a response rate of 82.1 percent with the least response rate (76%) realized among NGOs. This was majorly attributed to the fact that data collection was undertaken during a busy period when accountants were preparing for or undergoing financial audits.
Weighting
Given that data from private health facilities was based on a sample, weights were generated to provide national level figures on financial flows towards FP in these facilities. In order for the sample estimates from the 2018 RFS to be representative of the total private health facilities, a sample weight was applied to the data. The weight for each sampled private health facility was equal to the inverse of its probability of selection (calculated by multiplying the selection probabilities at each sampling stage). The individual weight was attached to each health facility within the district records in the data files. The sampling probabilities at each stage of selection were maintained in an Excel spreadsheet with information from the sampling frame for each sample cluster and stratum, so that the overall probabilities and corresponding weights could be calculated. Following the adjustment of the weights for non-response, the weights were generally normalized so that relative weights could be used for the analysis of the survey data.

Data Collection

Dates of Data Collection (YYYY/MM/DD)
Start date End date
2018-11-01 2018-12-31
Mode of data collection
Face-to-face [f2f]
Supervision
The 2018 RFS on FP data collection was conducted by 15 Research Assistants who were selected from the UBOS database and 5 Supervisors selected among Statistical Assistants at the Bureau. They underwent a three-day training on data collection techniques at institutional level. This was aimed at ensuring unison understanding of the questionnaire content (concepts and data requirements), completeness and accuracy in the data collected.

Prior to the start of data collection; UBOS and MoH provided the field staff with introductory letters to the selected institutions requesting their cooperation by providing the required data.
A soft copy and printed data collection tools (upon request) were delivered to the selected institutions and shared on line, a discussion of the tools with the focal person was done and a date(s) was scheduled for pick-up of the completed tool. Teams collecting data from health facilities conducted face to face interviews with the respondent using CAPI and paper questionnaires in case of system failure. The data collectors continuously followed up the focal persons through phone calls and physical visits to guide them in filling in the questionnaire.

UBOS supervisors, and MoH FP focal persons made desk calls to institutions that refused or were reluctant to provide information. The data collection lasted for a period of about two months from November to December 2018.
Type of Research Instrument
The 2018 RFS on FP used a set of four (4) questionnaires each with an accompanying manual of instructions. These were developed by NIDI and localised by UBOS in consultation with stakeholders. The questionnaires collected information on income received by source, funds absorption by type (recurrent expenses and capital investment), specific FP programme expenditure details, expenditure on contraceptives by commodity, and future expected expenditures.

The survey questionnaires included:
1) National Consultant questionnaire which was filled in by the survey coordinator from UBOS-lead implementing agency. This provided information on average price of contraceptives from administrative sources.
2) Government questionnaire for the public sector which was filled in by accountants in consultation with the technical officers from Government MDAs providing information on the income received and spent on FP activities.
3) Private Sector questionnaires that included;
i. Non-Government Organisations (Non-Profit Institutions) questionnaire which was administered to NGOs, Universities, Foundations among others and filled in accountants in consultation with the technical officers.
ii. Corporations' questionnaire providing information on the income received and spent on FP activities by Private for Profit agencies like private hospitals and Pharmacies. Corporations in this survey refer to the private providers of Family Planning services and methods.

The Government and NGO questionnaires were sent to respondents (accountants who worked with the technical officers) via email or hand delivered by the data collector. Where possible, face to face interviews were conducted with the respondent. Computer Assisted Personal Interviews (CAPI) were conducted at the selected Private Health Facilities.
Data Collectors
Name Abbreviation Affiliation
Uganda Bureau of Statistics UBOS Ministry of Planning

Data Processing

Cleaning Operations
Two data editors were identified among the data collectors whose main tasks included making the relevant edits to ensure that:
a) The dates most especially for the financial year dates and the project period time are correct.
b) The totals on income in section B equals to the summation of breakdowns on income received from domestic, international and own incomes in section c
c) The expenditure distribution of all individual projects in section D is equaled to the given / indicated total expenditure in section B.
d) The totals for recurrent and capital expenditures. These should equal to the expenditure reported in section B.
e) The percentages indicated for the utilization of the different family planning consumables added up to 100%.
f) Transfer the data sets into the MS Excel questionnaire format for government and NGOs only as iis required by NIDI.

CAPI managers - DIT, shared two datasets (2016 and 2017) for corporations (mainly health facilities), Non Profit Institutions and the Government institutions with the editing team. Since the dataset was small with about 40 NGOs and Govt agencies responding, edits were done per institution with phone calls made in case of any queries in the data to the respondent. Of the 450 health facilities, 321 provided data and these were edited following consultations with respondents or following the data story.
Other Processing
Quality Control
In order to reduce on the non-response rate and improve data quality, the following approaches were undertaken:
1) A sensitisation workshop was held for all the selected participating institutions to demystify to them what the survey is about and the required data.

2) All field staff underwent a three-days training on the questionnaire content and survey procedures.
3) The Computer Assisted Personal interviews (CAPI) were used for data collection from the health facilities. This had inbuilt checks to ensure accuracy and consistency in the data provided.
4) During data collection, a progress review meeting was held to check progress and address any issues arising in order to achieve the set survey objectives.
5) Supervisors checked on survey progress per field staff to ensure that work is done within the allocated time and also check for authenticity, completeness, consistency and plausibility of the data collected. They also addressed any challenges faced by the field staff.
6) A data validation workshop was held for ownership of the survey findings at institutional and national levels to build consensus about the results of the situation of FP funding in Uganda.

Data access

Contact
Name Affiliation Email URI
Uganda Bureau of Statistics (UBOS) Ministry of Finance, Planning and Economic Development ubos@ubos.org www.ubos.org
Confidentiality Declaration
An example of statement could be the following: Confidentiality of respondents is guaranteed by Sections (4) and (20) of the Uganda Bureau of Statistics Act 1998. Before being granted access to the dataset, all users have to formally agree: 1. To make no copies of any files or portions of files to which s/he is granted access except those authorized by the data depositor. 2. Not to use any technique in an attempt to learn the identity of any person, establishment, or sampling unit not identified on public use data files. 3. To hold in strictest confidence the identification of any establishment or individual that may be inadvertently revealed in any documents or discussion, or analysis. Such inadvertent identification revealed in her/his analysis will be immediately brought to the attention of the data depositor.
Conditions
This dataset is accessible to all for statistical and research purposes only, under the following terms and conditions:
1. The data and other materials will not be redistributed or sold to other individuals, institutions, or organizations without the written agreement of the Uganda Bureau of Statistics.
2. The data will be used for statistical and scientific research purposes only. They will be used solely for reporting of aggregated information, and not for investigation of specific individuals or organizations.
3. No attempt will be made to re-identify respondents, and no use will be made of the identity of any person or establishment discovered inadvertently. Any such discovery would immediately be reported to the Uganda Bureau of Statistics.
4. No attempt will be made to produce links among datasets provided by the Uganda Bureau of Statistics, or among data from the Uganda Bureau of Statistics and other datasets that could identify individuals or organizations.
5. Any books, articles, conference papers, theses, dissertations, reports, or other publications that employ data obtained from the [National Data Archive] will cite the source of data in accordance with the Citation Requirement provided with each dataset.
6. An electronic copy of all reports and publications based on the requested data will be sent to the Uganda Bureau of Statistics.

The Uganda Bureau of Statistics], and the relevant funding agencies bear no responsibility for use of the data or for interpretations or inferences based upon such uses.
Citation requirement
"The Uganda Bureau of Statistics (UBOS), Resource Flows Surveys on Family Planning in Uganda 2018 (RFS 2018), Version 1.1 of the public use dataset (September 2020), provided by the National Data Archive. www.ubos.org"

Disclaimer and copyrights

Disclaimer
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.
Copyright
(c) 2018, Uganda Bureau of Statistics

Contacts

Contact
Name Affiliation Email URI
Director, Population and Social Statistics Uganda Bureau of Statistics ubos@ubos.org www.ubos.org

Metadata production

Document ID
DDI-UGA-UBOS-RFS-2018-v01
Producers
Name Abbreviation Affiliation Role
Uganda Bureau of Statistics UBOS Ministry of Finance, Planning and Economic Development Documentation of the survey
Date of Production
2021-12-10
Document version
Version 1.0 (December 2021)
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