Assessing Safe Motherhood in the Community: A Guide to Formative ResearchTool Name:Assessing Safe Motherhood in the Community: A Guide to Formative Research Origin / Source: MotherCare/JSI; Nancy Nachbar, Carol Baume, Anjou Parekh; Technical area:Maternal and newborn health To Tool: http://www.mothercare.jsi.com/website/internet/homepage/cd_manual/index.htm Basic Description: Manual that provides tools for the design of formative research on community aspect of Safe Motherhood. Provides the essential information investigators need to plan and develop their own data collection protocols and carry out the study. Country Applications: Can be used in any country in which Safe Motherhood activities are or will be taking place. Language(s) Available: English (in hard copy and electronically) Full manual available electronically at: http://www.mothercare.jsi.com/website/internet/homepage/cd_manual/index.htm Purpose: Needs assessment and formative evaluation research: guidance on conducting a Safe Motherhood community assessment. Technical Scope/Purpose: Since Safe Motherhood can cover a wide range of topics, this manual is intended to provide the tools necessary for designing formative research that meets specific project needs. This manual, which contains 4 modules, is intended for researchers with experience in qualitative data collection methods, but who may not have background in Safe Motherhood. Design: Qualitative in approach: specifics of design largely at the researcher's discretion, most likely using a small purposive sample drawn from the community, and including families, health workers, and others. Method: Various qualitative techniques, with "complications narratives" as the centerpiece. Other possible techniques include but are not limited to individual interviews; focus group discussions; taxonomies, body and community mapping; and structured techniques such as free listing, pile sorting, and ratings/rankings. Frequency of Administration: Depends on context and program: especially useful in planning phase of program, but can be conducted sporadically as part of ongoing program monitoring, and evaluation activities. Key Users of the Information: Primary users: researchers, Safe Motherhood program planners and managers, health officials Secondary users: Cooperating agencies, donor organizations, NGOs/PVOs. Objectives and Scope of the Tool: General Objective:
Scope of the Tool: This guide does the following:
The focus of the manual is on conducting research that will assess knowledge, behavior, attitudes, and perceptions related to maternal and newborn health and survival. The four modules cover a range of topics: Module 1 (maternal): Prevention issues and normal care; response to complications Module 2 (neonatal): Prevention issues and normal care; response to complications Module 3 (community description): Demographic, geographic, social and economic contexts; infrastructure; health resources Module 4 (communications): Literacy levels, sources of information/networks, influentials, communication channels The manual uses the Pathway to Survival as the theoretical basis for the design, conduct, and analysis of Safe Motherhood research at the community level. The Pathway consists of the following steps, all leading to maternal and newborn survival: Step 0: Prevention Step 1: Problem recognition Step 2: Decision to seek care Step 3: Access to care Step 4: Quality of care Key Indicators: Key "indicators" are not specified since this manual focuses on qualitative approaches, however, key topic areas are highlighted. Tool Design: Since this is not a standardized data collection instrument, there is no fixed design or methodology. However, the manual provides guidance on design issues in the following ways:
Implementation and Training: This manual is intended for use by researchers who are experienced in qualitative methods and who will lead the Safe Motherhood community assessment. Technical assistance in research design, implementation, or data analysis may be required if researchers have limited experience. Engagement of program managers in translation of findings to intervention strategies is strongly suggested. Research Team: The research team should be composed of persons with complementary areas of expertise, such as social science, qualitative research in health promotion, clinical medicine, and community work. Teams of 3-6 persons are usually optimal. It is strongly recommended that the research team includes a secretary skilled in word processing, who can enter data onto a computer, as it is collected. Training: Data collectors will generally require training on Safe Motherhood as a topic area as well as on the specific data collection protocols developed from this guide. (This manual provides the necessary background information on Safe Motherhood that should be shared during training.) The duration of training will vary, depending on the scope of the research and number of data collection techniques included in the protocol. Training specifics are not discussed in the manual, as it is assumed that users w ill have experience in conducting such training. Implementation of field work: The length of time required for fieldwork will vary, depending on the scope of research and the geographic area(s) in which data collection will occur. At the end of each day in the field, time should be allotted for a daily analysis session with the entire team. The daily analysis session should cover: what was learned/findings; emerging issues or topics that warrant investigation but perhaps were not covered in the original protocol; how these findings compare to those in other communities already covered by the research. The major outcomes and decisions stemming from these sessions should be recorded. Manuals and Guidelines: The entire "tool" is a manual, providing guidance on the design and conduct of community-level Safe Motherhood formative research. Data Processing and Analysis: Data processing: At the end of each day of fieldwork, data should be checked, and gaps filled in as necessary. Data should be entered daily, not saved until the end of fieldwork. Analysis: Textual data should be coded in a way that allows examination of data according to the Pathway to Survival. A primary objective is to identify problem areas within each step of the Pathway, and to identify the weakest component(s) of the Pathway. The ensuing program intervention, would then target these areas. Further guidance on data analysis and display is provided in the manual. Reporting and Dissemination of Results: The research report should use the Pathway to Survival as an organizational tool and should contain not only findings, but also recommendations for programmatic intervention. Program managers, health officials, and members of the research team can and should be engaged in the translation of study findings into concrete programmatic recommendations. Cost:This manual is available at no cost on the Web at the address given above. The scope of the research can be as large or as small as program budgets permit. A full research protocol, conducted in multiple sites may require donor funding. A focused research protocol, can be conducted with very minimal funding that covers the cost of fielding the 3-6 person research team, their transportation, and necessary preparation and analysis time. Contact Person: |