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This manual is designed for use by anthropologists, social scientists, field nutritionists, and other researchers with a background in qualitative research methods, who are trained in the manual's methods. Managers of national, regional, and local programs have important roles in decisions for the research areas, and will need to designate the research manager.
Since the research manager may come from a range of backgrounds, the procedures included in the manual are explained in detail. The protocol should be carried out by individuals familiar with the cultural setting and conversant in the language spoken in the area.
Since the
research questions concern vitamin A deficiency in the food
system and its effect on nutritional status of infants, children,
and women in the childbearing years, the individual responsible
for data management, data review, and writing of the report
should have suitable background in nutrition.
The individual responsible
for data management and the report should be someone who has a
background in nutrition and expertise in ethnographic procedures.
This individual could possibly be an official in a relevant
agency, who will then recruit a field team leader and two field
assistants. Alternatively, the individual responsible may be the
team leader who will supervise and conduct field work with field
assistants.
Conducting all of the procedures of the protocol within a limited time period will require the full-time participation of three individuals: the field team leader and two field assistants. The availability of two full-time assistants for a six to eight week period, who possess the requisite level of expertise, may vary from place to place. Criteria for selecting assistants depend on the local situation, but the following criteria should be considered:
i. From the same linguistic group as the population under study and familiar with the local culture, particularly the local food culture.
ii. At least a high school education and ideally some college education.
iii. Individuals who are open and personable, nonjudgmental, and sensitive. A key to ethnographic research is that the interviewer demonstrates empathy and displays an interest in the subject matter and the needs of the community.
iv. Individuals who are nonthreatening to the respondents. Therefore, it is important to avoid choosing assistants who are in a position of leadership or authority in the community.
v. Previous experience in interviewing. vi. Have a background in healthcare and/or nutrition and previous word processing/computer experience (this is not essential).
vii. Since the respondents to the structured interviews are primarily women, it may be important to choose female assistants, depending upon the cultural context.
Some examples for selecting field research assistants are given in Appendix 9. The success of the research relies on good interviewing. Therefore, it is critical to identify individuals who are skilled in interviewing or who demonstrate some of the qualities listed above, that would allow them to develop good interviewing techniques. The types of interviews that the assistants will be conducting are as follows:
• Qualitative, open-ended interviews with key informants.
• Open-ended and structured interviews with mother-respondents to carry out procedures eliciting food categories and attributes.
• Open-ended and structured interviews with mother-respondents to collect information on acquisition of vitamin A-rich foods and household consumption patterns.
• Open-ended and structured interviews to gather information on perceptions about the stages of xerophthalmia and treatment sought.
• Open-ended and structured interviews to gather information from market vendors on availability and prices of food.
Since the time allotted for the study is limited, formal training of the field assistants will have to be brief. Much of the training will take place on the job in the community, while the team leader is actually conducting interviews. The assistants should accompany the investigator on key-informant interviews and observe and take notes while the interviews are being administered. After the interviews, the field team leader should review the notes of the field assistants and give individual feedback. During these sessions, information can be taken from the field assistants about their observations during the interview. Team meetings can take place with the field assistants related to field observations and interviewing techniques. The team leader should highlight segments of the interview where probing techniques were used effectively. At the same time, information from interviews can be interpreted and consolidated.
Once the assistants have participated in several key-informant interviews, they can carry out practice interviews. The team leader should accompany each assistant on interviews with local community members. Following the interview, the investigator and the assistant compare notes and discuss the information that was gathered.
The success of the research depends on the relationship established among the project team members. It is vital that the assistants have a full understanding of the goals of the project and essential that they receive the necessary support to conduct the research. Team meetings should be held three to four times weekly to discuss problems, address questions, and give feedback to the field assistants. During these meetings, data can be reviewed and emerging patterns in the data considered.
Good
probing techniques assure the success of open-ended interviewing.
Although it is difficult to determine in advance how much
effective probing the assistants will be able to carry out during
the interviews, the team leader/manager can assess how
successfully these techniques are employed by reviewing field
notes and conducting discussions with the assistants. Abilities
will vary depending upon the assistants' skills and previous
experience. In some cases, it may be prudent to have an assistant
focus only on structured interviews, until further training on
open-ended interviewing is provided.
In most cases, it will be
necessary to use a translator, adding another element that
requires special attention, to the fieldwork. Since the research
is concerned with the local food culture and the meanings the
local population attaches to food, it is critical to get accurate
and literal translations.
The translator must be experienced in providing literal rather than interpretative translations, a mode of translation that is of en difficult to capture. A common problem is that mistranslations occur because the translator is trying to be helpful. The translator must understand that the purpose of the research is to understand the concepts that the community associates with select foods and the treatment of these foods within the local culture. The researcher must emphasize to the translator that translations that are too interpretive can damage the research and therefore, should be avoided at all costs.
Appendix 6 gives some notes on translation from local to national languages.
It is important to select a translator who is fluent in both the local dialect and a language that the researcher speaks. If the translator is from the area, another consideration is to choose someone who is well-accepted by members of the community. The translator, by presence alone, should not influence the quality of the interview.
Phrases and terms about the signs and symptoms of vitamin A deficiency should be preserved in the native language in the researchers' notes, with a translation.
Even if the translator is experienced, it is important to train him or her. Examples should be used to emphasize the importance of conducting literal translations. Gather a series of examples that underscore the difference between literal and interpretive translations, illustrating the way that interpretation can alter the meaning of the translation, thus misrepresenting the local perspective and affecting the research. Conduct practice sessions during which you review these examples with your translator. Go through the examples asking the translator to identify the differences in the two translations. Through these examples discuss with the translator reasons that it is important to conduct literal translations.
The researchers must emphasize that if the translator is unsure of what the respondent is saying, he or she must probe further to get an accurate understanding. The translator needs to comprehend that the researcher's primary concern is to get authentic information. It may be necessary for the translator to take notes during the interview, particularly if there is terminology that he or she is unfamiliar with, or if long answers are being given.
In order to
gather exact terminology and phrases associated with vitamin
A-rich and other food items, as well as vitamin A deficiency, the
translator should be encouraged to ask questions more than once.
As mentioned above, stress that your primary concern is to
collect information that is representative of the community.
1. Networks and interactions
2. Facilities, equipment, and supplies
In the initial phases of
the research, it will be necessary to spend some time in
reconnaissance with relevant government offices in health and
agriculture at the regional and local levels. This will inform
the necessary officials of the work, and also permit the location
of existing data in published and unpublished reports to complete
the background needed on the historical, ecological, and cultural
setting of community food use at the selected site. (See section
II-B and Appendix 2). Individuals in these regional and local
offices can assist with locating potential research assistants
who have good rapport in the community. They can also help to
locate the closest professional experts to assist with food
identifications and composition needed for the Community Food
System Data Tables.
Interaction with these offices will also help to identify acceptable specific locations for the research to meet requirements for transportation, safety, telecommumications, etc.
The
appropriate permissions and consent for the assessment procedures
need to be obtained from the relevant officials. Appendix 3
discusses some reminders about these and other issues of
data-gathering within communities.
The field team will need a
place to meet for training exercises, discussions, and review of
the research data on a daily basis. This can simply be a room
with desks or tables and chairs, electrical power and lighting,
and a comfortable, ambient environment. Often the team may want
to meet in the evenings after returning from the field. Telephone
communications are helpful among team members or to reach others
associated with the project.
The equipment and supplies needed are:
i. Notebooks, file cards, a game board for the rating exercise, pens and pencils.
ii. Transportation as required.
iii. Hand calculator to calculate percentages and proportions.
iv. Portable computer if available.*
(* Although
data collection has been set up so that a computer is not
necessary, a computer would facilitate data recording and
management of data. See Appendix 12 for information on helpful
computer hardware, software, and skills using microcomputers.)
A. Select key-informants and conduct key-informant interviews
B. Conduct a free list of foods
C. Select key foods
D. Identify food plant and animal species
E. Determine nutrient content of food
F. Select the sample of mother-respondents
G. Manage the data
Selecting Key-Informants
The team leader/manager should work with six to eight key-informants. The most appropriate key-informants for addressing issues related to consumption of vitamin A-rich foods and beliefs about vitamin A deficiency are:
• Mothers of preschool-aged children, or mothers who have raised a number of children within the community.
• Other primary caretakers, such as grandmothers or older siblings who play a key role in the care of the children under six years of age and living in households in the community.
• Fathers of preschool-aged children in the community.
• The local outsider health professional, agricultural extension worker, or vendor, who is knowledgeable about the topics under review.
• Traditional health practitioners.
Depending upon the ethnic variation within the community, it may be important to choose key-informants from different ethnic backgrounds.
A way to identify appropriate key-informants is to ask either local community leaders or government officials with whom you meet during your initial introduction to the community, about people living in the area who may be good sources of information. For example, you may ask, "Do you know of any mothers who are active in the community and who would be willing to talk to me at length about food beliefs and household consumption?" If there is a local health clinic, you may find that the health personnel can help you select mothers who are active within the community and would be available to participate in the research.
Once you have chosen two or three key-informants who are mothers in the community, they can assist in the selection of other community members who fit the criteria listed above and who have appropriate characteristics for interviewing. When individuals are identified, you will need to test their willingness to talk and their ability to respond to questions concerning the topic. You may begin by asking them very broad questions about food within the community. For example, you may say, "How would you describe the standard diet in the area?" Short, terse answers, such as "We only eat millet," and an unwillingness to elaborate when prodded, may indicate a resistance to discuss subjects with strangers to any great length.
It is important to work with key-informants who are nonjudgmental and sensitive to differences within the community. In other words, you need to identify individuals who are highly aware of what goes on in the community and interact with a range of community members from different backgrounds. When choosing key-informants, keep in mind that these individuals are representing the perspective of the general community on food use.
Procedures for Key-Informant Interviewing: Principles of Open-Ended Interviews
Key-informant interviews will be conducted throughout the duration of the research design and data will be collected in the form of written field notes. The interviewer should record as much as possible during the key-informant interviews, in the informant's exact or near-exact words. Words, phrases and whole sentences should be written down as they were stated.
Note taking is an important element in the interview process. Remember that you are looking for vocabulary and local terms that may allow you to capture important insights into the local culture and belief system. When such terms are mentioned, insure that you have an accurate understanding by probing for specific examples or illustrations. You may say, "What do you mean by ?" or "Could you give me an example of where is found in this community?"
Often interviewers find that taking good notes requires time, leading to brief pauses while the interview is being conducted. While the notes are being recorded, the interviewer may feel that these short interruptions cause some discomfort for both the interviewer and the key-informant. If this occurs, explain once again to the informant that what they have said is important and in order to capture the information you need to write it down in its entirety. It is also important to remember that as the interviewers and the key-informants become more familiar with one another, these short periods of silence will become less noticeable. Furthermore, with time the interviewer will become more adept at note-taking. Always keep in mind that when trying to capture the local belief system and gathering data on health and nutrition concepts (see emic in Glossary, Appendix 13) that it is critical to get information in the words of the key-informants.
During the interview you may also find the body language or the hand motions of the key-informant to be significant. If this is the case, record observations that you have identified as important.
You may find that the information you gather from the key-informants may vary according to the location and the timing of the interview. For instance, when talking about food, it may be useful to carry out interviews with the key-informants in settings where the foods are purchased or gathered, such as in the market or during a visit to the local garden. Another possibility is visiting other women in their compounds with the key-informant. Conducting the interview while the informant is preparing a meal may also enable the interviewer to elicit different and pertinent information. As you become more familiar with your informants and the activities in which they are involved, explore the possibility of conducting the interview in different settings that may enhance the interview or allow you to expand upon the information gathered.
Key-informants
should also be consulted for the testing of protocols used with
the mother-respondents noted in section II-C-6. Discussing the
procedures and conducting exercises with the informants will help
the researcher determine what revisions and modifications need to
be made so that the research instrument is appropriate for the
community under study. You may want to choose two or three of
your best informants to test the research procedures. Once you
have administered the exercises ask for advice on how to modify
the procedures so that they are appropriate for the local
audience. Get suggestions about specific terms or phrases and
whether there are ways to make the questions more clear.
1. Creating the List
2. Expanding the list through observation
3. Analyzing the free list data
i. To collect an initial list of foods eaten in the area, begin by administering the task with Type I informants. Start by asking the informants to name all of the foods they consume, and use Form 1.1 to record responses for each individual interview.
You may want to begin by saying, "People in this area eat quite a lot of different foods. Can you list for me the different kinds of foods that are eaten?"
ii. Once you have collected a list of foods, you should find out what foods are eaten during other times of the year. Most likely, the staple foods will not vary, but the list of vitamin A-rich foods can differ significantly depending upon the time of year.
You may begin by saying, "Now that it is (current season), there seems to be quite a lot of (common seasonal food) available. Are there any foods (or other foods) that are not available now that people eat in (season)?"
If you find that the informant does not respond with precision, you may want to use more concrete situations.
For example, you may say, "Pretend that it is (name a season or time of year). Can you tell me what foods are eaten during this time of year? How does the produce differ from the foods you have just described to me? Are there any foods in particular that are abundant during that season which you cannot find in the area now?"
iii. When the informant stops, you can continue probing for further information. Use the data you have gathered during the initial interviews with Type I informants as background information for probing to identify additional foods with Type II informants. The types of questions to ask may include the following:
a. "Many of the foods on the list seem to be foods people eat every day. Are there some foods that people eat less often?"
b. "In some places people like to eat food from the forest or food that grows wild. Are there any foods like that around here? Are there any foods that people don't like to eat, but you could eat them if you were very hungry, or when food is scarce?"Once you have recorded the response, you may continue by saying, "Once again, try to think of food grown in the wild which is available at different times of the year."
c. "Are there any plants that people use when they are sick? That they use for making teas or special dishes to help them get well?"
d. "What about food for babies and small children? Have you already given me the names of all the foods that are eaten primarily by them? How do they differ according to the season or time or year?"
Keep in mind as you are going
through this procedure that some items that are an
important part of the diet may not be recognized as food
in the area. For example, when conducting this procedure
in West Africa, people neglected to mention those foods
that are used to make a sauce. Since the researcher knew
that certain food items included in the sauce are rich in
vitamin A (such as green leafy vegetables) and other
foods such as oil are critical to the absorption of
vitamin A, she used probing techniques to get the
additional information. |
This initial list will not give you an exhaustive inventory, but will allow you to create a working inventory of food names and categories. It may also illustrate the importance of the various food items and give you some ideas about the frequency with which they are consumed.
iv. Use the list of foods developed during the first interviews to establish a more comprehensive list. Keep a running list of foods that are added, after each interview. At the same time, keep a list of attributes (adjectives) mentioned when your Type 11 or key-informants are describing these foods. Be aware of the order in which the foods are listed and look for patterns. Keep in mind that the items that are mentioned first and by more informants are likely to be important in some respects. At the same time, remember that the order may also reflect the time of year during which the interview was conducted. With the use of probing techniques, you should be able to ascertain which foods, particularly vitamin A-rich foods, are important at other times of the year.
For example, you may conduct
the interview at a time when mangoes are not available.
But, once you have administered the interview and have
probed for seasonal variation, you may discover that
mangoes are plentiful during three months of the year and
are then eaten on a daily basis by preschool-aged
children. The daily consumption of a rich vitamin A
source such as mangoes could not only ensure a healthy
vitamin A status for children during these months but
could allow for adequate vitamin A storage to sustain
children for loser months. Certainly, in this case,
mangoes should be included on the list of key foods. |
In addition to obtaining
the food lists through verbal exchange, observe the food with
key-informants. For example, it may be possible to suggest to a
particularly friendly and relaxed informant that he or she go
with you to the market so they can show you some of the foods
firsthand. A walk through home gardens is also a useful way to
obtain some food terms and provides an opportunity to observe the
types of food grown in home gardens. A visit to the surrounding
bush area with children who forage for wild food may give useful
information. During these tours, it would be advisable to once
again probe for food found in the market and gardens at other
times of the year. With some Type 11 informants it may also be
possible to observe household food stores, which can lead to
further useful discussion about food availability.
Depending on what part of the world you are in, it may be important to spend some time with your key informants at home observing food purchasing and food-related activities at the household level. Home visits will allow you to observe household practices that may guide your research, including food preparation and preservation, consumption patterns, and sanitation practices. Additionally, certain food may not be sold in the market or in local stores but may be sold by vendors traveling from household to household. Conducting household observations will also give you an opportunity to observe firsthand those wild foods that are collected and consumed by members of the household, but may not necessarily be marketed in the area.
During the
interview, write the names of the food items as people list them
and note all comments about food. You can record the list of food
directly on Form 1.1 or transfer the data to the form after the
exercise is conducted. Also, record other information you think
may be important. It is critical that the interview be written up
in detail, either by hand or on the computer, as soon as possible
following the interview. Write out phrases and terms precisely as
they were articulated and avoid making interpretations.
i. If you did not use the form during the interview, transfer the terms to the data collection Form 1.1 with the name of the informant(s) who was (were) interviewed.
It is important that the free list be carefully and accurately recorded. It is often an advantage to tape record the interview so that you can check pronunciation of terms with which you may not be familiar. However, the use of a tape recorder can also be difficult, particularly in a first interview with a local community member, so you will need to use judgment about when and whom to tape.
By the time you have completed this exercise you will probably have an extensive list of foods. This list will be used as part of the criteria in choosing the key list of vitamin A-rich and staple foods. You will not want to restrict or reduce the list of foods until you have completed a round of free listing exercises with all Type I and Type II informants.
ii. Form 1.2 is used to tabulate the number of times each food was mentioned. Go through Form 1.1, beginning with the first food mentioned on the list. For each food item, count the number of informants who mentioned the food. Write the name of the food item in the left hand column on Form 1.2 and the total number of times it was listed in the right hand column. Be sure to include the number of informants interviewed at the top of the page.
iii. Using Form 1.3, arrange the food items in order, beginning with the items mentioned most frequency. Remember that the research team members will make use of this list when making final decisions regarding the selection of the twenty-five to thirty key foods. On the right side of the form, record attributes or special qualities mentioned.
iv. All items mentioned in the free list should also be entered in the Community Food System Data Tables on separate Food Data Sheets.In addition to the food items that you have assembled on this list, you will be able to use other information from these interviews to develop some initial hypotheses about local beliefs and practices concerning staple and vitamin A-rich food. For example, while conducting the free list Type II informants may offer information regarding qualities they associate with particular food items. As mentioned previously, the order in which the food is listed may be of importance to the research. You should also take note of those food items that are widely consumed and which constitute a significant component of the population's diet, but which took much probing to elicit.
In order to get a different
perspective, conduct the exercise with primary
school-aged children. Children in primary school may
bring a different dimension to the food list. |