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. 2018 Oct 3;6(3):413–424. doi: 10.9745/GHSP-D-18-00068

TABLE 1.

Overview of Net Promoter Score Iterative Testing

India Kenya and Nigeria El Salvador
Sample size N=188 N=590 N=226
What was tested Feasibility and acceptability of implementation approaches in low-resource clinical settings among clients with low-literacy levels Whether the methodology could be used to generate meaningful comparative information about the experience of different client groups Feasibility of a self-administered NPS survey using tablets with an online survey in DHIS 2
Description A convenience sample of 2 peri-urban clinics was selected based on client population (low literacy), client volume, proximity to reach both clinics in a single day, and willingness to participate.
Female clients exiting the clinic were asked how likely they are to recommend the service.
Interviewers alternated between face-to-face interviews and guiding the respondent to a drop box to circle her response in private as she exited the clinic.
The survey alternated between an 11-point numerical scale and an 11-point emoji-face scale.
Face-to-face interviews included an open-ended ‘why’ question. Twenty clients were contacted for follow-up via telephone.		 A convenience sample of 9 service delivery sites (6 in Kenya and 3 in Nigeria) was selected based on client volume for family planning services, representation of both static and outreach clinics, and willingness to participate.
The NPS question on likeliness to recommend services was inserted into an existing client profile survey.
Clients were surveyed via face-to-face interviews as they exited family planning services.		 A convenience sample of 3 clinics was selected based on proximity to the capital, client volume, and willingness to participate.
Volunteer youth peer promoters directed clients exiting the clinic to kiosks set up with tablets that were connected to an online survey in DHIS 2.
Clients chose to complete the survey by themselves on the tablet, with assistance from a youth promoter using the tablet, or by themselves using a paper-based survey.
Variables included in NPS survey

  • Consent to participate

  • Clinic name

  • Interviewer name

  • Approach:

    • ∘ Interview: 49%

    • ∘ Drop box: 51%

  • Scale:

    • ∘ Emoji faces: 49%

    • ∘ Numerical: 51%

  • Consent to follow-up: 96%

  • Likeliness to recommend services: mean 9.096

  • Why (interviews only)

  • Consent to participate

  • Country:

    • ∘ Nigeria: 44%

    • ∘ Kenya: 56%

  • Service delivery channel:

    • ∘ Static: 48%

    • ∘ Outreach: 52%

  • Service delivery site name

  • Interviewer name

  • Gender: 96% female

  • Age: mean 30.9 years

  • Family planning method received

  • Source of last method used

  • Method category:

    • ∘ Long-acting or permanent method: 35%

    • ∘ Short-acting reversible method: 65%

  • Family planning use profile:

    • ∘ Adopter (first time or lapsed): 27%

    • ∘ Provider continuer: 34%

    • ∘ Provider changer: 39%

  • Reason for changing provider and/or method

  • Likeliness to recommend services: mean 8.45

  • Consent to participate

  • Clinic name

  • Administration method:

    • ∘ Paper-based: 9%

    • ∘ Self-administered on tablet: 42%

    • ∘ Youth promoter-assisted on tablet: 49%

  • Age: mean 34.5 years

  • Gender: 89% female

  • Type of service

  • Likeliness to recommend services: mean 9.39

  • What could be improved

Abbreviations: DHIS 2, District Health Information System 2; NPS, Net Promoter Score.