Download - Annual Results and Impact Evaluation Workshop for RBF - Day Five - Qualitative Learning on RBF
Qualitative learning on RBF 29 March 2014 RBF Workshop, Buenos Aires, Argentina
Kent Ranson | Senior Economist (Health), HRITF Shun Mabuchi| Health Specialist, Africa Region
H E A LT H R E S U LT S I N N O VAT I O N T R U S T F U N D
Learning objectives
• Why do qualitative research? • What is qualitative research? • How can qualitative research be used in
designing and implementing RBF? • What are some of the challenges of
using qualitative research?
Structure of session
• Presentation (20 mins) • Role play (25 mins) • RBF challenge in Nigeria
o Presentation (5 mins) o Small group discussion (30 mins) o Synthesis and large group discussion (20 mins) o What was actually done (10 mins)
Why do qualitative research?
• Studying processes: the aim is to explain (e.g. an intervention’s apparent success, or otherwise) rather than merely describe
• “Behind every quantity there is a quality” (Sobo 2009)
• Studying meaning: what is important to people and why? o Influences social interactions and
ultimately health outcomes
What is qualitative research?
• Explores and understands (interprets) the social world through participants’ and their own perspectives
• Focusses on actors, understanding their varying perspectives, relationships and decisions
• Is attentive to social and political context
What is qualitative research? (cont’d)
• Emphasizes the ‘software’ of health systems: ideas and interests, norms and values, relationships and power
• Follows distinct criteria for rigour o Reflexivity: A continuous process of reflection on
research and activities undertaken to collect and interpret data
Social construction / complexity lens
• Policy and systems shaped by politics, culture, discourse
• Decisions diffused through system • Problems (and solutions) are related to
understanding complexity • Human ‘software’ critical to health
systems performance Kabir Sheikh et al - 2011"
Stages to which qualitative research can contribute
Intervention stage Qualitative research contribution Formative research - Understand the target problem and context of the
intervention - Choose and refine intervention design - Baseline data to compare with data collected later
Process evaluation - Ongoing as the trial / intervention is implemented - Is it going as planned? - May look at quality, intervention delivery, intervention
receipt, reach (barriers to participation), context - Can contribute to changes during the trial as well as to
an understanding of effect
Outcome evaluation - Changes in health worker and community perception and behaviour, acceptability of intervention components
- Intended and unintended consequences
Challenges to overcome
• Timelines vs. rigour / exertion • Problems of capacity • Quality control • Ethical issues • Biomedical science dominance: among
researchers, editors, others o Fighting the perception that findings are biased,
common sense, or offer little value relative to cost
Building HRITF qualitative research portfolio
Intervention stage Qualitative research contribution Formative research - e.g. research feeding into intervention design in the
Gambia
Process evaluation - e.g. case studies ongoing in: - Cameroon - Central African Republic - Nigeria - Zimbabwe
Outcome evaluation - e.g. In Kenya, explaining differential performance across outcome indicators
- in Nigeria, explaining differential performance across health centres (exercise)