Rapid Assessment Procedures (RAP) to Improve the Household Management of Diarrhea



Elizabeth Herman and Margaret Bentley

The Johns Hopkins School of Hygiene and Public Health Department of International Health


Published by International Nutrition Foundation for Developing Countries (INFDC), Boston, MA, USA.

(c) Copyright 1993. All rights reserved.

The digitalization of this publication was made possible by a grant from the Nestlé Foundation




Part I. Overview

1. What is RAP?
2. How does RAP differ from KAP?
3. Who should use this manual?
4. How to use this manual
5. What is needed?

Key points

Part II. Background

1. Diarrhea case management
2. Oral rehydration and feeding
3. Appropriate referral

Key Points

4. The cultural context of diarrhea

Locally recognized types
Perceived causes
Actions taken
Relationship with other childhood diseases
Significant characteristics
Relationships among beliefs
Key Points


Part III. Field Guide

Step 1. Meet CDD program or project personnel

1. Identify CDD advisors
2. Ask questions about the program or project
3. Identify information needs
4. Explain ethnographic research
5. Discuss the scope and plan of the research
6. Develop a medical referral plan
7. Arrange further working sessions

Step 2. Prepare the study

1. Brief the field workers
2. Prepare a list of priority questions
3. Review existing information
4. Prepare interview guide(s)
5. Train the field workers

Step 3. Collect basic information

1. Approach the community
2. "Map" the community
3. Identify key informants
4. Conduct unstructured interviews
5. Check Lists
6. Organize the information
7. Summarize belief system "pieces"

Step 4. Understand the belief system

1. Conduct card sorting with key informants
2.Take detailed case histories
3. Test decision models
4. Summarize relationships

Step 5. Identify possible approaches

1.Make lists of beliefs and practices
3. Review findings and possible approaches with CDD advisors
4. Develop a list of additional questions

Step. 6 Assess and improve the approaches

1. Select key informants for additional questioning
2. Use appropriate methods to obtain additional information
3. Explore possible images and proverbs
4. Revise your assessment of possible approaches to promote AHM
5. Choose the most useful approaches

Part IV. Options for applying the results

Option 1. Test the generalizability of the results and recommendations through additional ethnographic studies
Option 2. Test the generalizability of the results and recommendations through a structured interview format

1. Select questions for the structured interview
2. Plan and conduct a structured interview

Option 3. Test the generalizability of the results and recommendations through focus group discussions
Option 4. Develop and pretest messages and materials

1. Draft scripts to present the approaches
2. Present the scripts to small groups of caregivers
3. Develop illustrations for the scripts

Annex A. Summary of research findings and recommendations: South Sumatra, Indonesia

1. Information obtained from unstructured key informant interviews
2. Key Informant interviews on focused topics
3. Possible approaches to promote AHM
4. Development and administration of the structured interview
5. Choice of a recommended approach
6. Choice of an educational image