Table 2 Potential solutions to improve reporting of pregnancy and adverse pregnancy outcomes in surveys

Interview process

Guaranteeing privacy and confidentiality

Detailed and comprehensive consent

Using language respondent is comfortable with and the interviewer is fluent in (most commonly used language)

Realistic number of interviews per interviewer each day

Interviewer training

Development of enhanced training module for interviewers, with prospective assessment to understand its effect

Interactive and reciprocal training that involves the experienced interviewers sharing their strategies to make respondents more comfortable and open up

Classroom and field practice interviews

Thorough training of interviewers to ensure in-depth understanding of the study and ability to explain its purpose to others

Interviewer skills, strategies and knowledge

Interviewer sensitivity to cultural semantics and taboos

Building rapport

Probing skills

Empathy

Sensitivity

Understanding of psycho-social impact of grief

Skills in interviewing adolescents

Selecting interviewers from the same jurisdiction (though not the actual villages in which they will work)

Tools

Translation of tools using accurate and culturally recognised definitions e.g. of the different APOs

Contextual adaptation guide to ensure more accurate and consistent reporting in different cultures and languages

Shorter tools

Respondents and community

Conducting sensitisation before the study begins, including a clear explanation on purpose, benefits and any incentives to be given

Consent from different gate keepers

Provision of feedback on the study