Research TrainingText Book

Research Training Text Book Training for young people to conduct qualitative research on young people’s sexuality and youth friendly SRH services

This textbook is part of the RNG/IPPF research training for young people (for conducting qualitative research on youth sexuality and youth friendly services). In the textbook you will find the relevant topics that correspond to the sessions in the training. Some of the topics during the training might be a little complicated and hard to understand at first. Don’t worry! We developed this textbook so that you can read up on these topics whenever you feel the need to refresh your memory or boost your knowledge.

We wish you a pleasant training!

Reading for Day 1: Introduction and FGD with research team

Time 9.00 – 10.30 10.30 11.00 11.45 12.30 13.30

– – – – –

11.00 11.45 12.30 13.30 17.30

Sessions Energizer to facilitate introduction of all persons present Welcome by MA representative Break Explanation of research training: Why are we here?

Conceptualising Sexuality Lunch FGD on young people’s sexuality and youth friendly clinics

Introduction to the research

This research project has been commissioned by the International Planned Parenthood Federation (IPPF); it is part of a programme that seeks to improve the quality of and access to Youth Friendly Services in various IPPF partner countries. In order to realize this, IPPF asked the international department of the Rutgers Nisso Group (Youth Incentives) to conduct participatory research in two countries (Bangladesh and Malawi) that focuses on the sexuality and sexual behaviour of young people, and how the services of the Member Association (MA) can be improved according to this behaviour. The research is participatory because it actually makes use of young people (you!) as researchers. There are many advantages to youth participation in research, but also some risks; these will all be explained in more detail during the training. For now we would like to familiarize you more with the objectives of the research, the main research question and some of the main concepts used within the research.

Health professionals often define (young) people’s sexuality purely from a physical health perspective, ignoring other important aspects such as pleasure and mental health. This has led to an emphasis on the dangers of sex and an assumption that information on STI/HIV, condoms and risk awareness should lead to safer sexual behaviour. However, in doing so health professionals tend to neglect the fact that young people also find pleasure and fun in sexual relationships, and that there are cultural, situational, mental, physical and relational factors that influence and sometimes prescribe the sexual choices that people make. Therefore, young people’s needs and wishes relating to information, advice and services might go beyond the scope of physical health into the domain of social relationships, spirituality and sexual well‐being.

Research Objectives and Goals

This research aims to get insight into adolescent sexuality issues and factors that influence the uptake of services by adolescents, taking the experiences, ideas and opinions of adolescents as a central point of focus.

The main objective of this research, based on these insights, is to formulate recommendations for increasing uptake of SRH services by adolescents.

In addition to this main objective, an important goal of the research project is to build young people’s capacity to conduct qualitative research, and, through the research process, to explore and build new forms of partnerships between young people, MA staff and community stakeholders that will continue after the end of the research within the MA’s intervention projects and service provision.

By actively involving MA staff and community stakeholders, the research project aimed to increase reflection on the influence of norms, values, opinions, knowledge, skills and attitudes of staff on the quality of their services to young people, to increase acceptance of young people’s sexuality, and to increase support for youth participation within SRHR‐related research and interventions. Therefore, this report will also pay attention to analysing the research process. In addition to this report, a separate report will be drafted by RNG that describes more specifically the methodology and ethics for youth participation in research. The main objective of the research is to provide recommendations for MA’s on how to improve the quality of and access to youth friendly services in order to increase the level of uptake by young people.

Research Questions

Central research question What do young people need and what do they want from SRH services in order to match their sexual realities and needs and enable them to enjoy sexual wellbeing?

Main sub-questions 1. What are priority sexuality issues: Need and Demand?

The uptake of services depends on the need and demand for these services. For instance, if adolescents are not sexually active, their need and demand for contraceptive or VCT services will be low. Therefore relevant questions in this respect are:   

What kind of services do young people need?

What kind of services do young people want?

What kinds of services are offered to them?

2. What are the major barriers (and enabling factors) to youth friendly services: (Awareness, Access and Quality)?

Even if services match the needs of adolescents and demand of adolescents, adolescents will not make use of them if they are unaware that these services exist for them. In order to investigate the reason for low uptake of services by adolescents, it is therefore important to ask questions relating to awareness, access and quality:    

Are adolescents aware that there are YFS available to them where they can go with their SRH issues?

Are the YFS effectively attracting adolescents to come to their static services or actively reaching adolescents by offering mobile/outreach services?

Are YFS considered to be acceptable and affordable by adolescents?

Do the YFS have welcoming, non-judgmental, non-discriminatory, motivated and skilled staff?



Do the service providers have an adequate supportive organizational and management system in order for them to deliver good quality services?

Key Concepts within this Research

Sexuality

Sexuality is a concept that entails much more than sexual intercourse alone. According to the World Health Organization (WHO), the following definition is used to explain the concept of sexuality:

“Sexuality is a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviours, practices, roles and relationships. While sexuality can include all of these dimensions, not all of them are always experienced or expressed. Sexuality is influenced by the interaction of biological, psychological, social, economic, political, cultural, ethical, legal, historical, religious and spiritual factors.”

During the training we will look at this concept in more detail.

Sexual Realities and Needs

This research focuses on the subjective (own) experiences of young people with regards to sex, sexuality, sexual relationships and services. The research also makes use of the term ‘realities’ of young people, these realities point towards any problems (socio‐economic) the informants may face in their lives, and how this may be related to their sexuality. It also points towards any aspects of their lives that are affected by (or worth mentioning) in relation to sex and sexuality. As sexual reproductive health service providers we need to be aware that young people do not have sex to prevent unintended pregnancies, sexually transmitted infections or HIV but that they have sex for various reasons including love, intimacy, curiosity, (peer) pressure or economic reasons. Therefore this research will explore whether young people experience sex and, how they experience their sexuality in the context of their surroundings (community, family, friends, school, etc) i.e. are they able to talk about sex openly, if so with whom, and with whom can they not discuss it, and why.

This brings us to the ‘needs’ of young people: the sexual ‘needs’ of young people encompasses their sexual behaviour, sexual desires and preferences, and translates this into their needs in terms of sexual reproductive health services. It is crucial that the services provided to young people encourage awareness and understanding of safe sex and a sex‐positive approach in order to prevent unwanted diseases, pregnancies and other problems relating to (negative) sexual behaviour. The research will therefore make an explorative investigation into the sexual behaviour of young people, and will make recommendations for the improvement of SRH services based on this information

Sexual Well‐being

To be sexually healthy, does not only mean absence from diseases / physical problems / pain i.e. good functioning of the physical body alone. It also means absence of concerns, fears and emotional pain. It means enjoyment and safety in sex and sexuality, physically and mentally. In our research, we use the term sexual well‐being for this.

Sexual Rights & Rights‐Based Approach

A rights‐based approach recognizes individuals as ‘rights‐holders’, which implies that others are ‘duty‐bearers’. Duty bearers (governments, organisations and institutions) are obligated to respect, protect and fulfil human rights. Rights holders are entitled to demand their own rights from duty bearers, but they also have to respect the rights of others. This approach emphasizes the participation of individuals and communities in decision‐making processes that shape policies and programmes that affect them. These are the basic principles of the RAP approach promoted by the international department of the Rutgers Nisso Groep, which originate from what has come to be known as the ‘Dutch approach’. The basic principles of the Dutch approach include the right to good information, a healthy sex life and the right to be who you want to be.

In order to determine if young people’s sexual rights are being respected, protected, facilitated and fulfilled within the context of service provision by the MA, IPPF has composed 10 main sexual rights (young) people have. Service providers are meant to dedicate their work to ensuring that these clients’ rights are met. We need to investigate if young people feel that they are seen as sexual beings and that their needs and feelings are being taken seriously.

IPPF’s Sexual Rights Declaration:

Note: Freedom from, based on – see article 1 below.

Article 1: Right to Equality Equal protection under the law and freedom from all forms of discrimination based on sex, sexuality or gender

The right to equality is closely related to the principle of equity. Equality is when everyone receives the exact same treatment, quantity, or quality of something. However, in most societies, certain groups of people are treated less favourably because of personal characteristics, which create different levels of advantage and disadvantage. Therefore, offering identical treatment, quantities or qualities to everyone does not translate into equal experiences for all people. Equity is a principle that recognizes the diversities among people and how

specific conditions or characteristics (e.g. sex, gender, age, religion, etc.) affect each person’s capacity to fulfil his or her rights.

Article 2: Right to Participation For all persons, regardless of sex, sexuality or gender

Everyone has the right to actively and freely participate in all aspects of human life. All young people are political beings. This means that all young people, including those under age (either 16 or 18, depending on the country), married and non‐married young people, young people living with HIV, young people living with disabilities, young migrants and young people of all sexual orientations and gender identities have the right to meaningfully participate in decision‐making that affects their lives and to influence changes in their societies.

Article 3: Right to Life, Liberty and Security of the person and bodily integrity Children and young people must have special protection from all forms of exploitation and harm, especially sexual exploitation, child prostitution, trafficking, forced sexual activity, and being used in pornographic performances or materials. Harmful traditional practices, such as female genital mutilation and child marriage, must be addressed to fulfil all young people’s sexual rights.

Article 4: Right to Privacy All young people have the right to privacy and to make autonomous decisions about their sexuality privately.

All young people also have the right to decide if, when, how and with whom to share information about their sexual choices without forceful interference from other people.

Article 5: Right to personal autonomy and recognition before the Law All young people have the right to decide freely on all matters related to their sexuality and to fully experience their sexuality and gender in a pleasurable way. Everyone has the right to do so while being recognized as an individual before the law.

Article 6: Right to Freedom of thought, opinion and expression, the right to association All young people have the right to express their thoughts, opinions, needs and desires related to sexuality without limitations based on dominant cultural beliefs or political ideologies. All young people have the right to explore their sexualities and should be able to have dreams and fantasies, and voluntarily express their sexuality without fear, shame or guilt, while respecting other people’s rights. This should occur in a non‐ discriminatory environment that respects the evolving capacities of young people.

Article 7: Right to Health and to the benefits of scientific progress Every young person has the right to enjoy the highest attainable standard of physical and mental health and well‐being, including sexual and reproductive health and the underlying factors that contribute to health.

Young people also have the right to be protected from all factors that lead to poor health status.

Article 8: Right to education and information All young people have the right to education and information, including comprehensive, gender‐sensitive and rights‐based sexuality education. All young people have the right to access accurate, easy to understand information and education about sexuality, sexual health, reproductive health, sexual rights and reproductive rights in order to make decisions freely and with informed consent.

Article 9: Right to choose Whether or not to marry and to found and plan a family, and to decide whether or not, how and when, to have children.

Article 10: Right to Accountability and redress Governments must respect, protect and fulfil all sexual rights for young people. Respect means not interfering directly or indirectly with young people’s enjoyment of their rights. Protect means taking measures to prevent

others from interfering with young people’s human rights. Fulfil means adopting laws, policies and programmes that enable young people to fully realize their sexual rights.

Sex Positive Approach

Sexual behaviour is not always a bad thing, however, young people who engage in sexual behaviour at or before 15 years of age are less likely to use a condom during intercourse and are more likely to report having more than one sexual partner. Such risky sexual behaviour can have negative outcomes such as early pregnancies and sexually transmitted infections (STIs), including HIV/AIDS. But rather than using ‘risk factor model’ ‐ which focuses on prevention through abstinence – this research focuses on a ‘sex‐positive’ model emphasized in the Sexual Rights Declaration and RNG’s RAP approach. A sex‐positive approach focuses on promoting an environment in which young people are encouraged to communicate about their needs related to sexual health and well‐being in order to prevent risky behaviour. A sex‐positive approach encourages young people and adults to discuss sex‐related issues, in order to raise awareness and go beyond the status‐quo of taboos and all the negativities that occur as a result of it. A sex‐positive approach is closely related to the rights‐based approach in that it recognizes (young) people as agents of change, and encourages them to make positive and independent decisions.

RAP Approach

The RAP approach is integrated in all aspects of Youth Incentives’ work. RAP stands for: Rights‐based, Acceptance of young people’s sexuality and Participation of young people.

Rights:  To be yourself  To know  To protect yourself, to be protected  To have good health care  To be involved

Acceptance:  Young people are sexual beings  Sexual orientation  Gender equity  Talking about sexuality

Participation:  of young people at all levels and in the entire process.

Emic perspective: what is at stake for young people?

There are two central focus topics for this research: on the one hand the realities, experiences and perceptions of adolescents and on the other hand whether the services available to them match these realities and perceptions. The research therefore makes use of an ‘insiders’ perspective, or ‘emic’ perspective 1 , that gives a better understanding of the meaning behind the decisions, behaviour, experiences and perceptions of the actor, in this case young people. Such an approach is necessary to understand the sexuality of groups of young people and whether and how SRH services can better be managed to serve the realities and needs of the clients.

Youth Friendly Services

The International Planned Parenthood Federation (IPPF) believes that SRHR are a human right, and it fully subscribes to the United Nations Convention on the Rights of the Child (CRC 1989), which is a departure point for providing access to high quality services for all young people. These services are referred to with the term Youth Friendly Services (YFS). According to IPPF’s International Medical Advisory Panel youth friendly services are described as follows:

They are able to effectively attract adolescents, responsively meet their needs, and succeed in retaining these young clients for continuing care. Youth friendly services should offer a wide range of sexual and reproductive health services relevant to adolescents’ needs. While not always possible, attempts should be made to identify and provide the most needed sexual and reproductive health services, including sexually transmitted infection/HIV services, at the same clinic. These services should include sexual and reproductive health counselling, contraceptive counselling and provision (including emergency contraception), sexually transmitted infection/HIV prevention, counselling and testing, treatment and care, prenatal and post‐partum care, sexual abuse counselling, relationship counselling, and safe abortion and abortion related services (IPPF 2008b: 4)

Quality of services

Good quality services are those that meet the demands of the target group. In order to determine whether the quality is good, or whether the services are accessible, this research makes use of the emic (subjective) interpretation of young people. Hence, young people will indicate whether the services are of good quality by expressing whether these meet their realities and needs.

Quality includes respecting confidentiality, giving choices and raising awareness on rights. Quality also goes beyond the service delivery setting to include community acceptance of adolescent sexual and reproductive health. In addition, demand‐driven services contribute to quality by responding to the realities of young people lives.

1 ‘Emic’ perspective is an anthropological concept deriving from a research orientation that argues that data are best interpreted, understood, valued and judged in terms of the cultural framework and categories of the people who are studied instead of the cultural framework and categories of the researcher or research funder (Van der Geest & Reis 2002).

Access to Services

In this research the (lack of) access to SRH services by young people is analysed from the subject realities and perspectives of young people. The lack of access to services is usually correlated with other socio‐economic and cultural aspects of an individual’s life within quantitative studies. For this research a qualitative evaluation of ‘access’ will be used, which determines any barriers the individual may face in making use of a particular SRH service from the perspective of the individual.

These can be external barriers i.e. cultural, economic or social, but they could also be personal i.e. fear, embarrassment, or simply a lack of knowledge on behalf of the individual. Young people will be asked whether they make use of SRH services, and to describe any factors that may impede the process of making use of them.

Adolescents and Young People

This research makes a distinction between young people and adolescents. ‘Young people’ are defined in this research as those between 10‐24 years. This category, together with the service providers, engulfs the whole spectrum of our research. We use the category ‘adolescent’ to indicate a specific group of young people, namely those between 12‐18 years. Adolescence for many young people is the period in which sexual initiation takes place; however it is not unusual to observe sexual behaviour between 10 and 11 year olds. The term adolescent is often used to depict a particular stage of mental and physical development, often referred to by the term ‘puberty’. Puberty can be defined as the hormone‐driven stage of sexual maturation. Socially seen, this stage covers the period of transition between childhood and adulthood (referred to by the term adolescence). The boundaries of when this stage or period starts and ends are not clear‐cut and depend on the social context. In this research ‘children’ are defined as people less than 10 years of age.

It is important to realise any differences between groups of young people, as it will influence what kind of services these different groups need and want, and we expect differences to be seen in the sexual realities and needs of different ages of young people. Therefore, distinctions between different ages within the category ‘young people’ will be made according to relevant findings.

However, due to the qualitative nature of this research, we do not intend to make any generalisations concerning age groups.

Stakeholders

Stakeholders are individuals, groups of people or organisations that have a direct or indirect interest in the outcome of a project. For this research stakeholders are individuals, groups of people and people within organisations that have an interest in the sexual well‐being of young people. Think of elders, parents, religious leaders, community leaders, school teachers and service providers, etc.

Reading for Day 2: Research Methodology

Time 9.00 – 9.15 9.15 – 10.30 10.30 – 11.00 11.00 – 12.30 12.30 – 13.30 13.30 – 15.00 15.00 – 15.30 15.30 – 17.30

Sessions Energizer Continuation of FGD / Session on what makes services youth friendly Break What is research? Introduction to Research Methodology Lunch Brainstorm Interview Techniques & Exercise ‘interviewing the facilitator’ Break Practicing Interview Techniques: Role play exercise

What is Research?

Research can be defined as:

A study or investigation aiming to gain new information or reach a new understanding about a certain topic.

Research is an organized and systematic way of finding answers to questions.  An ‘organized and systematic way’ means using data collection methods.  The information that helps you to find an answer to your question is called data.  The source that provides you with the data is called data source. If this source is a person, this person is called an informant.  The process that leads to answering your question is called data analysis.

But in order to find answers, you first need a clear and focused research question. This is always the first step in all research. The formulation of a research question will help you:

 To focus the data collection (narrowing it down to the essentials);  To avoid collection of data that are not strictly necessary for understanding and solving the problem you have identified;  To plan and organize the data collection in clearly‐defined parts or phases.

Quantitative research: To collect quantitative data, you have to ask closed‐ended questions, so that the answers can be categorized and counted. Questionnaires and service statistics are examples of quantitative research.

Quantitative Data: This is information expressed in terms of measurable numeric values. Examples are data from surveys or information that is expressed through attaching a certain value to something (e.g., on a scale from 0‐10) so that it can be counted. Quantitative data is useful if you want to know how general or common something is.

Advantage: It does not matter too much who conducts the research and does not depend much on research skills. And it gives you a good overview of things that count for a big group of people.

Disadvantage: Not in‐depth, no opportunity to ask for explanations and if topic is sensitive (e.g. sexual behaviour), then there is a high chance that respondents will write down something different than their actual behaviour or opinions.

Qualitative Research: This involves collecting qualitative data and you have to ask open‐ended questions, e.g. questions that start with why and how. Interviews and FGD’s are examples of qualitative research, but also case studies, essays, diaries, films/documentaries, etc. Data can also be collected through observations, if that helps the researcher to understand something better.

Qualitative Data: This is information in the form of descriptions that cannot be written in numbers. Examples are feelings, meanings, experiences, attitudes and beliefs. Qualitative data is gathered in order to understand something, like (sexual) behaviour and the reasons why and how something happens.

Advantage: Is detailed information that helps you to understand something. If it is carried out well, the information is more trustworthy compared to quantitative data and therefore this method is preferable when investigating sensitive themes like sexuality.

Disadvantage: It is more difficult to carry out well, because you need good research skills. What kind of data the researcher collects depends on what kind of questions he/she asks and how he/she asks the questions, the setting and whether he/she has ‘rapport’ with the informant, etc. Also, the data is collected with less informants and therefore less representative for a bigger group.

Research Methods

A research method is the method used to collect information. There are many ways to get information. The most common research methods are: literature searches, talking to people, focus groups, personal interviews, telephone surveys, mail surveys, email surveys, and internet surveys. Below is an overview of the pros and cons of the different research methods.

Method

Pros

Cons

Questionnaire/Survey Large-scale, generalizable, can Measurable numeric values, examine correlations (whether one variable has a relationship with so can be counted. another variable). Seen as more scientific/objective (results the same no matter who conducts the data collection).

Desirability bias, only literate informants need to know if everyone understands the question the same way.

Cannot investigate in-depth (reasons, explanations, meanings).

Reports, texts, statistics, Already available, desk work. literature, etc.

Called ‘secondary data’

Might not be exactly the data that you are looking for. Data might be biased/not reliable.

Sometimes a lot of work.

Method

Pros

Cons

Participant observation For example observe (and note down): How men and women interact in a pub, How teachers teach sexuality education in a school, How service providers respond to young unmarried clients in a clinic.

Direct observation of behaviour in natural setting (no reasoning/justification by informant).

Researcher is ‘undercover’.

Better able to include factors you might not have thought of beforehand.

Time-consuming, much work to transcribe and analyse notes.

Ethical questions might arise as informants are not informed/have not given their consent.

Interview Data in form of description of feelings, meanings, attitudes, reasons.

Examples: stories of change exit interviews  consult/counselling

Personal! Allows in-depth studying of why & how, understanding what is at stake for the person studied instead of what is at stake for the NGO/donor. Good method to assess impact, whether your activity or intervention has changed anything and on which levels.

Good for illustrating other (quantitative) data.

Good for assessing behaviour that does not conform to the norm.

Rapport and trust needed Time-consuming Researcher bias (researcher ‘colours’ the data) – data depends on skills and rapport of researcher, and on setting/location.

Focus group discussion (FGD) Examples:  It is better to ask the opinion of women about male behaviour in an allfemale group.  Debate between boys and girls on responsibility/ condom use, etc.

Sometimes easier to talk ‘as a group’ compared to as an individual (group safety, group agency). Good for assessing norms, what is expected and how it is judged. Good for debates.

Good for checking inconsistencies, contradictions. Good for checking if something is valid for a larger group.

Because of the group setting, there is conformity of less assertive people to the opinion of ‘leaders’ in the group. Therefore normative data. Composition and setting of group can influence the data you collect, you should reflect on this.

Case study For example to understand:  Why someone becomes a sex worker, drug addict, engages in multiple relationships,  How sexual violence comes into existence, what contexts facilitate this,  How courtship/partner selection works (for example in relation to negotiation of condoms).

Focus on one case. Gain in-depth understanding of complex issues.

Personal story can be more appealing than statistics.

Illustration/explanation of other data.

Limited applicability to other situations/people. Timeconsuming, much work to transcribe and analyse notes.

Role-play Examples:  Courtship,  ‘Temptations’, reasons to engage in sex, reasons to drop out of school, role parents, peers, partners.

Projective method: does not necessarily reveal personal experiences. Therefore useful for collecting information on sensitive issues. Good way to show complexity and what happens in social interactions, also including consensus of group. Can be tool for advocacy/ awareness-raising.

Difficult to analyse, best way is to record on film and literally transcribe. Sometimes exaggerations. Some people may be too shy to perform/act.

Essays/diaries E.g. ‘sex’ diaries, essays on personal stories, experiences.

Good for collecting very personal information, for instance on sexual practices/condom use/first-time sex/sexual violence or harassment/gender inequality.

Difficult to analyse. Not always reliable as information might be biased through desirability or shame.

Much work for informant.

Pictures/film As part of case study and/or participant observation.

As data recording tool during interviews, FGDs.

Gives impression, personalizes, can show feelings/emotions, reach wider audience – advocacy tool.

Play back to fill in memory gaps, to allow second opinion on interpretation. To encourage others to discuss issue.

Literal transcription, so less researcher bias.

Multi-interpretable. A lot of work to literally transcribe, code and analyse the data.

‘Overacting’, exaggerations or shyness because of camera.

Not anonymous.

Drawings/mapping E.g. on being approached, unsafe places, understanding of the body.

Ice breaker for difficult topics, entry point for discussion, especially useful for shy/young people. Good for mapping ‘unsafe’ places (e.g., in the village). Good for examining ‘explanatory models’ relating to the body, health and sickness.

Difficult to interpret/analyse.

Has to be followed by an interview or discussion where the informant can explain the drawing or map.

Reading for Day 3: Interview Techniques

Time 9.00 – 9.15 9.15 – 9.45 9.45 – 10.30 10.30 11.00 11.30 12.30 13.30 15.00 15.30 16.30

– – – – – – – –

11.00 11.30 12.30 13.30 15.00 15.30 16.30 17.30

Sessions Energizer Evaluation of day 1 and 2 Interview techniques: Entry points and probing (after short summary techniques discussed on day 2) Break How to prepare an interview Preparing interview with service provider(s) Lunch Conduct interview with service provider(s) Break Summary of and reflection on what we learned Tour and explanation of the Youth Friendly Service in Dowa

Creating a conducive environment for an interview

What is necessary to encourage people to open up and honestly express their experiences and opinions? Remember, people often do not want to say anything negative because they want you to like them. Or they are embarrassed or ashamed to talk about something personal, or about issues relating to sex and sexuality. A core interview technique is to create a conducive (or enabling) environment for making the informant(s) feel at ease to talk openly and honestly about sex and sexuality.

There are some tips on how to create such an environment:  Create a comfortable and private setting.  Introduce yourself and the research properly.  Try to build rapport and show respect.  Address sensitive topics in a sensitive way.  Use open‐ended questions and avoid leading questions.

Anonymity = ensuring that no one will be able to find out who the person was that provided this particular information.

Confidentiality = ensuring that the personal information that the informant provides will not be shared with others if the informant does not want to, or that the information will be shared, but the informant be kept anonymous, so that no one can relate the personal information to this particular informant.

Consent = permission that the informant gives to ask him/her questions and to use this information for the research/M&E, but this permission needs to be based on informed choice. So the informant needs to know what he or she is giving permission for. That is why we call it informed consent.

 Don’t judge (make the informant trust you and open up to you).  Power disparity  Listen  Show genuine interest  Don’t interrupt  Be ethical  Be clear  Use correct tone of voice  Show empathy  Summarize main points

Examples of closed and open‐ended questions

Closed-ended question

Open-ended question

Did you go to the supermarket yesterday?

What did you do yesterday?

Is the service provider friendly?

Can you tell me about your visit to the clinic/service?

Should sex before marriage be allowed?

What do you think about sex before marriage?

Was the research training good?

How did you experience the research training?

Advantages of open questions Open questions generally begin with “why”, “what”, or “how”. Open questions can get a person to open up.

They are good for getting all kinds of free information you did not ask for. Once a person opens up you will be able to use that information to your advantage.

Disadvantages of open questions Open questions are intended to make people talk, but they cannot guarantee that. For example you could ask someone “what did they do yesterday” and they could answer “oh nothing really”. This is an important point to make regarding communication and negotiation skills in general. People do not always react the way you want them to, so you should always be prepared to use different communication skills and be quick on your feet (spontaneous and thinking ahead).

Advantages of closed questions Closed questions are useful for drawing a conversation to a close. You can use closed questions to narrow the focus of a conversation, and eventually steer that person into making a conclusion or definite commitment.

Closed question are also useful to fish for interesting topics, or to find out which topics the respondent is more willing to talk about.

Leading questions A leading question is one that alters or influences the way a person perceives a fact or event. A good example is an experiment where people were asked a series of questions after watching a car accident film.

One group was asked how fast the cars were going when they crashed into each other. Another group was asked how fast the cars were going when they hit each other. The last group was asked how fast the cars were going when they made contact.

The researchers found that the first group estimated 60 km an hour, the second group estimated 50 km an hour, and the last group mentioned 30 km an hour. So just changing the question influenced how fast people thought the cars were moving. Another interesting example is when they were asked whether they saw the broken headlight; people were three times more likely to respond “yes” than when they were asked whether they saw a broken headlight. In fact there was no broken headlight! This leading question altered their memory and caused them to recall something that didn’t even happen. This is how powerful leading questions can be.

Identifying entry points and probing opportunities

Entry points = answers, remarks or information that the informant is giving you that provide you with an opportunity to ask more ‘in‐depth’ questions to find out more.

The good thing about entry points is that you do not have to introduce a topic or question, but that you make use of something the informant has said. An entry point is inviting you to ask more personal questions. Entry points can be followed by probing questions.

Probing questions = questions about motivation, opinion, reasons, beliefs, feelings – often they are ‘why’ questions.

Probing questions help you to get in‐depth information. Often you can ask more than one probing question after one entry point, or you can ask the same probing question but in different ways. For example: “ Why / How?”, “Can you explain?”, “How does that work?”, “ Can you give an example?” “How does that make you feel?”, “What is your experience with this?”, “What do you think of this?”, etc. Sometimes you can repeat a sentence the informant says in a questioning manner instead of asking a ‘why’ question. For example: “You said you think he does not want to use condoms?”

Preparing For Interviews

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2.

3.

4.

5.

6.

Formulate a research question Formulate sub-questions Prepare the order of the questions Prepare your introduction Prepare yourself Organize logistics

Before you start conducting interviews, you first have to make some preparations. There are six steps you should take to prepare yourself for the interviews.

1 Formulate a research question

The first thing you should do is to formulate a research question: What do you exactly want to know?

On level of research: “What do young people need (or what do they want) from sexual reproductive health services in order to match their sexual realities, needs and fulfil their sexual rights?”

However, this is too broad, and an informant won’t understand what you want to know. For interviews you will have to focus on a small part (topic) and formulate it into language that informants will understand.

On level of individual interviews / FGD’s: E.g. “What are the experiences of this person with regard to his/her visit to the YFS clinic?”

E.g. “What are the problems this person is encountering, relating to sexuality and/or sexual relationships?”

2 Formulate sub‐questions

If you have formulated your main question, the second step is to divide your main question into themes and then formulate sub‐questions.

Split up in two topics (sub questions):  What are young people’s sexual realities and needs, what problems do they have that services should help them with?  Do young people think the services that are there are adequately helping them with these problems? Why/how (not)?

These themes/questions can be subdivided even further (optional: small brainstorm).

It is good to prepare a question list for your interview, to provide you with focus and inspiration during the interview. However, try to avoid being pinned down to the questions on the list. Be prepared to take a different path of questioning if during the interview this turns out to be interesting, logical or necessary. Make use of the entry points that come up during the interview. You can always come back to your question list.

Remember that people would rather talk about good things than bad things. Therefore it is important that you always include questions that inquire about more negative things, as people might not voluntarily share this information with you. You may have to encourage them. This is an important tactic!

3 Prepare the order in which you want to ask the various questions.

Start with general – non–threatening – questions about the person you are interviewing (e.g. age, background). Then proceed to more personal questions about the context of the issue you want to discuss. It is useful to think of indirect ways or topics that can lead you to more sensitive themes

4 Prepare your introduction

In your introduction, you will explain to the informant:  who you are,

   

what the research is about, how you are going to guarantee anonymity and confidentiality, how you are going to use the information given by him/her and why you need his/her informed consent, that the informant can withdraw his/her participation in the research at any point during the interview or research process and without having to give an explanation.

5

Prepare yourself

Be prepared for the questions the informants might ask you. In principle you can prepare yourself for this by imagining being asked the questions that you pose. So how would you yourself answer your own questions?

The informant might expect you to have knowledge on these themes and might ask for your advice or opinions.

It is good to be prepared for this. But do not volunteer such information; remember it should be the informant who does the talking, not you!

6 Organize logistics

This will become important after the research training. The main rule that a professional researcher has to obey is to ensure that you don’t make things inconvenient for your informant. This means that you should always try your utmost best not to keep your informants waiting on you.

Reading for Day 4: Personal reflection & Research Ethics

Time 9.00 – 9.15 9.15 – 9.45 9.45 – 10.30 10.30 – 11.00 11.00 – 11.45 11.45 – 12.30 12.30 – 13.30 13.30 – 15.00 15.00 – 15.30 15.30 – 17.30

Sessions Energizer Summary and evaluation of day 3 Carrousel game: Exploring own boundaries and values Break Analysis of Carrousel game Research ethics, what does it mean?

Lunch Ethical cases and discussion on consent Break Ethical protocols and asking for informed consent exercise

Research Ethics

For this research, we have a set of guiding ethical principles. These principles are derived from the universal human rights, the convention of the rights of the child and the sexual rights declaration of IPPF:

 ‘Primum non nocere’: First do no harm.  The guarantee of confidentiality and anonymity (the right to privacy).  Complete and correct information about the research purpose, process and potential consequences, on which the potential participant can base a meaningful consent (the right to information, the right to consent).  The right of all people, including adolescents and young people to participate in matters that concern them (the right to participate).  The right to freely and responsibly decide the number, spacing and timing of their children, to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health, for all people, including children and young people (sexual rights declaration).  To continuously monitor and reflect on our ethical conduct and the participants’ wellbeing.  To refer in the case of questions for help.  Not to abuse our power as a researcher: adhere to the International Save the Children Alliance Child Protection Policy: where it states children, we read children and adolescents (0 – 18 years).

All members of the research team are obliged to follow these principles to the best of their abilities. If participants or informants ask questions relating to sex and sexuality, we oblige ourselves to provide them with correct and complete information, following the sexual rights declaration – or refer them to the person best capable of doing so. If participants or informants approach us with questions for help, e.g. in case of trauma, we oblige ourselves to refer this person to a competent professional or institution that can deliver this help.

Guidelines for not harming the informant

-

Confidentiality and anonymity; informed consent and right to withdraw (even if this means you cannot use the data.

This is why it is so important to guarantee confidentiality and anonymity and to ask for informed consent and the right to withdraw – so that your informant can calculate his/her chances of getting harmed.

-

Not to judge, monitor wellbeing and reaction to your questions Attitude of professional researcher: never judge! This not only prevents your informants from feeling bad, it will also improve the quality of your data as they will be more open and honest with you. If you notice a person is not feeling comfortable, try asking different questions or less personal questions or ask the person about his/her comfort with the questions.

-

Refer person to professional in case of trauma/question for help Example of trauma? What could we do when we encounter somebody with such a story and asks for your help?  Do not offer to help yourself but refer to a professional who has been trained to deal with such cases! In this case: FPAB counsellors. Or first discuss with the Coordinator.

-

Never abuse your position as a researcher Can you think of ways that a researcher can abuse his/her power that would harm another person (e.g. intimidation, receiving money, sexual abuse, blackmail with personal information)? Not abusing your position or power as a researcher is something you have to promise, if you want to become a serious and professional researcher. Such a promise is sometimes called a vow (e.g. the president of the USA when he assumes office or a medical doctor when he/she receives his/her diploma). A vow is like making a promise to God and to yourself.

The pros and cons of asking parental consent Pros -

Parents have the right to know about any significant activity of their underage teens.

Could open up discussion about sexuality and create a good bond between parents and child.

Parents could learn to take their children seriously as they will be respondents of scientific research.

It could create awareness amongst parents and stimulate the use of health facilities by both parents and child.

Both child and researcher will not feel they are being ‘secretive’ about the research.

-

It may encourage parents to take the sexual health of their child seriously, and may reduce the barrier to using health services (therefore contributing to the overall goal of the research).

Creates transparency.

Cons -

Quality of data could be jeopardized due to fear of the child i.e. their parents finding out the content of the discussion.

Could create a selection bias.

Usually, parental permission articulates what most agree represents the ‘best interests of the child’. However, this is often not the case (look at cases of child abuse, neglecting the law, etc).

If the parents don’t fully understand the goal of the research, they may be inclined to refuse participation.

Participation rates could decline significantly Acquiring parental consent may be time consuming (and cost money) and delay the research process.

Children’s fear of parents finding out they are sexually active.

Parents might get involved and ask the child what kind of questions they were asked (may cause shame and force the child to lie).

It is a violation of the child’s right to privacy.

Parents may feel that allowing their child to participate in research about sex would encourage their child to have sex.

Parents may feel that their children do not know anything about sex and so shouldn’t be involved in such research.

Parents may force a child to participate due to material benefits they think they might acquire through participation.

Parents may be illiterate and not be able to understand why such research is of importance.

It may be very hard to reach the parents due to practical reasons such as infrastructure.

Parents may expect something in return for letting their child participate in the research.

If something were to happen (sexually) to the child after the research, the parents may blame the research for it.

Asking for parental consent may deter the child completely from participation, even if they originally wanted to participate.

PROTOCOL IN CASE OF ETHICAL PROBLEMS, ADVERSE EVENTS OR ILLEGAL ACTIVITIES In the case of ethical problems, adverse conditions, illegal activities or difficult situations, the researcher has to strictly follow these steps (see also code of conduct): In the case where the informant has particular problems relating to sexuality, sexual activity, sexual relationships, etc, or is suffering from abuse or force and tells you about this: 1. Always suggest that the informant should talk to a service provider or counsellor from FPAM in order to receive professional advice or help.

If the informant asks for your personal advice: 2. You should not give advice yourself. You are not a professional and if your advice is wrong, it might cause extra problems. Offer to seek the help of a professional.

If the informant refuses to go to a professional, or faces problems because of his/her participation in the research: 3. Always consult with the research coordinator regarding the nature of the problem and possible solutions; never try to solve the problem yourself.

4. Tell the respondent you will consult the research coordinator regarding the problem. If the informant mentions that he/she does not want other people to be informed: ensure them that their identity will be kept absolutely confidential. If they still don’t want you to consult the coordinator, explain that you are unable to help unless you do this.

5. In the case where the informant refuses help from a professional due to lack of money available to travel to the service provider, tell the informant that these costs will be paid by the research project. Or you can suggest making an appointment with a service provider at a place of the informant’s choosing.

In case of legal issues, abuse or need for further reference, the FPAM protocols and network will be followed and used.

INFORMED CONSENT FORM The following form will be used and carefully followed by the researchers when they ask for informed consent from potential informants and/or their parents/guardians. The form will be further adapted during the research training and translated into the local language. If the informant is literate, he/she will be offered the form for reading and signing.

When asking consent from the parent(s)/guardian(s): use the words in italics and between brackets.

Introduction Hello, my name is ____________ . I work as a researcher for FPAM. I would like to ask you if you want to (/will allow your child to) help us with our research. But before you answer, I want to explain to you exactly what the research is about, so you fully understand why we need your (son/daughter’s) help. If I say something you don’t understand or cannot follow, you may stop me so I can explain it better. Is that okay?

I work as a researcher for FPAM. FPAM is an organisation that offers services and information to people, including young people, about sexual and reproductive health and rights. This includes information about sexuality and reproduction. (Check if informants or parents know what sexuality is, give the following information): Sexuality involves things that have to do with: -

changes you experience when growing up/during adolescence/puberty (give an example of your own experiences), relationships between boys and girls, like feeling attracted to someone, falling in love, the behaviour of people as a result of this, including sexual activity, consequences of sexual activity, like pregnancy, having children, STI’s, HIV/AIDS, etc.

FPAM provides services for young people and adults that can help them in cases of problems related to sexuality and reproduction. For instance, they provide you with contraceptives that help to prevent pregnancy and diseases; tests for pregnancy; tests for STI’s and HIV/AIDS and counselling when you have questions or problems.

Do you understand?

Do you have any questions so far?

Research purpose and use of data Like all young people, young people in Malawi have questions, concerns, curiosities and sometimes problems relating to sexuality and sexual relationships. It is therefore important that young people can go to services like the one that FPAM offers. Yet many young people do not use the services. We are conducting research, or a study, to find out what discourages young people to go to SRH services, or what encourages them to go. In order to find out, we

will interview young people about their concerns, questions and experiences relating to sexuality and what they think of such services. We hope this information can help us to make the services better, so that more young people will use them if they want to.

If you want to help us with this research, by (allowing your child to participate/) participating in the focus group discussion or in the interview, your (or that of your child) information will help us to give recommendations to FPAM and other organisations that provide SRH services to young people (in Malawi and the rest of the world) on how to improve services.

Do you understand?

Do you have any questions so far?

Informant’s rights: anonymity, confidentiality, right to withdraw, right to full information If you choose (your child chooses) to help us, we promise that what you say (or he/she says) will stay between us. We will write down what you have said (your child has said), but we will not write down who has said this, so that nobody will know. It is important for us to hear the truth, even if it makes us feel uncomfortable. That is why we are making this promise, so that you and the others feel free to talk to us. If you do not (your son/daughter does not) want to share particular information, because you are in a group or because you feel uncomfortable, you do (he/she does) not have to, or you (he/she) can tell us outside the group in a one to one interview. If you feel (he/she feels) uncomfortable and you want (he/she wants) to leave, you (he/she) can do that at any time during the discussion or interview, without having to explain to us why. If you have (he/she has) any questions, you are free to ask them and we will answer. If we do not know the answer, we will ask for help from our senior researcher.

If you have any questions concerning this study please contact Dr. Alister C. Munthali on 0888822004 or email amunthali@sdnp.org.mw or Dr. Charles Mwansambo of the National Health Sciences Research Committee on 0888826446.

Do you understand?

Do you have any questions so far?

Individual question for participation in the research Do you want to help us with this research, by participating (allowing your child to participate) in the focus group discussion and/or individual interview?

If yes, you can sign here:_____________________________________

Signature of the researcher:___________________________________

PROTOCOL FOR ETHICAL CONDUCT PROTOCOL FOR ETHICAL CONDUCT FOR RESEARCHERS PARTICIPATING IN THE RESEARCH “Do they match? Young people’s realities and needs relating to sexuality and youth friendly service provision” Hereby, I, _____________________________________ declare to abide to the following ethical principles and conduct in a way that is in line with the following principles: General principles:   

 

  

‘Primum non nocere’: First do no harm.

The guarantee of confidentiality and anonymity (the right to privacy).

Complete and correct information about the research purpose, process and potential consequences, on which the potential participant can base meaningful consent (the right to information, the right to consent).

The right of all people, including adolescents and young people to participate in matters that concern them (the right to participate).

The right to freely and responsibly decide the number, spacing and timing of their children, to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health, for all people, including children and young people (sexual rights declaration).

To continuously monitor and reflect on our ethical conduct and the participants’ wellbeing.

To refer in cases of questions for help.

Not to abuse our power as a researcher: adhere to the International Save the Children Alliance Child Protection Policy. Where it states children, we read children and adolescents (0 – 18 years) (see other side).

Signed on the

__________________ (date)

At

__________________ (place)

By

__________________ (name)

___________________ (signature)

Reading for Day 5: Adapting the research to the country context Time 9.00 – 9.15 9.15 – 9.45 9.45 – 10:45 10:45 – 11:00 11:00 – 11:30 11.30 – 13:00 13:00 – 14:00 14.00 – 16:00 16:00 – 17:00

Sessions Energizer Summary / Review of first week and short evaluation (of day 4) Working out research topics and questions Break Defining key concepts preparing FGD questions for the field & division of tasks in FGD Lunch FGD with adolescent clients in the field Prepare presentations of findings for day 6

Defining Key Concepts

Before you start the research, you need to define what you exactly mean by the major concepts/terms/topics that you use in your research. This is important so that others can understand what you mean, but also for yourself. For example, if you want to do research with adolescents, then you have to think about what you mean by adolescents. Which ages? Which characteristics? What defines an adolescent? What is the difference between children, young people and adults?

This is an important step in focussing more on your research.

Another example is SRHR. This is a term we often use in our field, but sometimes we ourselves do not exactly understand what is meant.

On day 1 this conceptualisation of sexuality will be considered and on day 2 YFS. Can you remember how we explained sexuality? Has it to do with sexual well-being, sexual rights? YFS?  Recap on sexual well-being. It is important that you can explain what you mean by these concepts, as you will have to explain it to your informants as well. 

Practice defining these concepts in the local language.



Can you identify and define other key concepts of the research that we want to carry out? o o o o o o o o

Youth Adolescents Sex Sexuality Youth Friendly Services Quality Access Sexual Realities / Needs / Problems

o o o

Sexual and Reproductive Rights Stakeholders Etc.

GUIDELINES, INTERVIEW QUESTION LIST Semi-structured and open questions for FGD and individual interviews This document serves as a guideline. During the research training the questions below will be adapted to fit to the local Malawian context and priority issues and will be translated into the local language.

Introduction When you approach one or more individuals for participation in group discussions or in-depth interviews, carefully follow the protocol for informed consent. Each FGD and individual interview will begin with an explanation of the research outline and research goals, also explaining what the data will be used for. After the research outline has been explained, the informant will be ensured that all of the information given is strictly confidential. Once the informant has understood the confidential terms and conditions, their consent will be asked for participation in the research. The informant will also be told that he or she could choose to refrain from the interview or FGD at any time - no reasons will be asked.

For FGD’s: Pose the questions underneath in a general way (e.g. ask about ‘young people’ in general, ‘peers’ or ‘friends’), so that people do not feel they have to disclose personal information or experiences if they do not want to. In in-depth interviews try to ask the questions in a more personal way to persuade your informant to open up about his or her own experiences.

Step 1 Opening: creating a comfortable environment for the informant Begin by smiling and asking everyone if they feel comfortable being here …

By following the informed consent protocol, you have introduced the topic of sexuality. Check with the informants that they understand what sexuality means (if they do not, clarify). 

Do you know what sexuality is?

Informants can brainstorm and give their ideas (which may create entry points: “So you experience that too?”)

Step 2 Explanation of what sexuality is Then you will give the following answer: Sexuality = Things that have to do with:  changes you experience when growing up/during adolescence/puberty (give an example of your own experiences),  relationships between boys and girls, like feeling attracted to someone, falling in love,  concerns we may have or things we are curious about at this age.

Emphasise that sexuality can include sexual activity, but is not restricted to this. So people who are not sexually active are still sexual beings! This should also put the informants at ease as it means that talking about sexuality does not necessarily mean that you are sexually active, or that participation in the research is only for those who are sexually active.

Step 3

Break the ice: Brainstorm about changes experienced during adolescence

 What kind of changes do girls/boys/you experience when growing up?  Physical changes - What did that do to you / how does that make you feel?

- How do others/boys/girls/parents respond to these changes?

How about feelings or interests in the opposite sex, has that changed?

Do boys/girls get more interested in/curious about the opposite sex?  Yes, attraction/falling in love/flirting/courtship/dating/desire/arousal.

The answers that the informants might give will provide entry points. Follow these entry points to ask about their experiences, curiosities and fears!

If they are shy and answer: No, no interest/feelings: - When do boys/girls develop feelings for girls/boys? How do they develop feelings?

- What happens if a boy or girl develops feelings or feels attracted before e.g. marriage?

- Use examples: So you have never felt attracted to …. (name of film star or famous person).

Step 4   

Probing into the personal experiences of the informant’s fears/concerns Have you ever felt attracted to someone?

What do you feel/think when you feel attracted?

What does that do to your body?  Feelings of desire Direct question: “Do boys/girls/you feel like wanting to have sex?  Masturbation (follow entry point to concerns, issues, etc.)  Follow entry points into root causes of those fears and concerns: What are the main concerns/fears, where do they come from, what are the consequences i.e. what happens when they experience this, what do they do?

 What do boys/girls do with these feelings/interests?  Falling in love/expressing feelings/interests  Courtship/Dating: Describe what happens during dating/where do you go, what do you do? Can you kiss/touch? Why not? What are the consequences?  Fears/concerns/sexual power/restrictions of parents (follow entry points!)

What happens next?  Probing into sexual relationships o Did you ever have a boyfriend/girlfriend?  If not, ask about peers, when do most boys and girls start getting involved?

Reasons? Reasons not to? o How long did the relationship last? o Did other people know about it? (Why not?) o Were you ever unsure or did you ever have questions or fears due to this relationship? o Who did you discuss this with? Where did you try to find information to get answers? o What did you do to prevent pregnancy/STI’s (including HIV)?

o Did you discuss prevention with your partner? (Why not? How? How did your partner react/How would he/she react if you tried to discuss this?) o Did you ever regret anything? (Question further about feeling forced). o Did you ever go for information/help to YFS? Why not? What was it like?

Would you ever go there? When/for what?

If the informant does not go into his/her own experiences, probe into the experiences of their peers or friends: Step 5 Probing into curiosities and sexual behaviour 

At our age, what do you see? Do boys and girls fall in love with/feel attracted to/have particular curiosities about each other? o What happens?  Dating? o How about you? o Ask about love relationships: Have they ever been in love? What is love?

Step 6 Probing into sources of information about sexuality 

How did you learn about puberty/sexuality/sex? o Sources of information, o Initiation rituals (ask about experiences, the info/instructions received, would they recommend it to others?), o Where do you go if you have questions relating to sexuality/sex? (Ask about magazines, pornography, stories, etc). o Who do you discuss these issues with? Parents? Teachers? Siblings? Aunts?

Grandparents?

Step 7 Ask about Youth Friendly Services, Youth Centre and FPAM 

Have you ever heard about the youth centre/YFS/FPAM/Family Planning? o If yes, can you tell me what it is/what they do? o If no, explain you can go there for sexuality issues/concerns/problems. o What kind of issues/concerns do you think young people go there for? o Reasons to go/not to go: - Logistical reasons (money/waiting time/travel time/waiting room).

- Stigma to go there as unmarried young person.

- Attitudes of staff.

- Ideas about services provided.

- Ideas about the chances of being helped/your problem being solved when going to YFS.

Final step

Closing the interview

At the end of the interview or FGD, thank the informant for his or her time. Ask them whether they have any questions, or if there is anything they are not clear about. Reassure them about confidentiality. Compensate them for their time and reimburse their travel expenses if they have any. Offer them drinks or snacks if this is appropriate.

HAND OUT FOR PREPARATION OF FGD IN THE FIELD (1) Main research question (major objective of the FGD: What do we want to find out?):

Relevant topics:

Sub-questions:

HAND OUT FOR PREPARATION OF FGD IN THE FIELD (2) Division of tasks: Facilitator(s): person(s) who will ask the questions

Data recorder: person who will make notes on the contents

Observers: persons who will make notes on the ‘form’ (process)

Questions to ask during observation of the FGDs: 

Do participants openly share?



Are they at ease?



What barriers can be observed?



What topics or questions are more difficult to discuss?



What makes them feel at ease?

Evaluator(s): Person(s) who will briefly interview two or three random FGD participants after the FGD on their opinion of the discussion.

Questions to ask during evaluation of the FGDs: 

What did you think of the FGD?



Did you feel comfortable/free to share your opinion?



Did you understand the reason for this FGD?

Questions the observers and evaluators have to answer

The observers have to summarize their answers to the following questions for the presentation: o o o o o

Did participants openly share?

Were they at ease?

What barriers were observed?

What topics or questions were more difficult to discuss?

What made them feel at ease?

The evaluators have to summarize the answers to the following questions for the presentation: o o o o

What did the participants think of the FGD? Did they feel comfortable/free to share their opinion?

Did they understand the reason for the FGD? Any issues regarding ethics?

Reading for Day 6: Presenting Findings & Reflecting on the Quality of Data

Time 9.00 – 10.30 10.30 – 11:15 11.15 – 11.45 11.45 – 12.30 12.30 – 13.30 13.30 – 14.30 14.30 - 15.00 15.00 – 16.00 16.00 – 17.00

Sessions Preparation of presentation on findings Presentation group 1 Break Presentation group 2 Lunch Feedback on FGD findings and process: How to order & analyze data (according to topics).

Drawing good conclusions Reflection on quality of data Note-taking exercise

Steps for drawing a good conclusion

A good conclusion: 

Gives an answer to the question, and a short explanation of why and how.



Is logical (the relationship between cause and effect is clear).



Is complete and reflexive: It includes a focus on the positive as well as the negative.

It includes information on what is not found (e.g. no stories of safer sex).

 -



Is based on strong arguments which in turn are based on sufficient and truthful data.

If not, or if weak, the conclusion should include a reflection on the limitations of the research and the validity and reliability of the data, or the conclusion is preceded by such a reflection.

Includes recommendations, or is followed by a paragraph that formulates recommendations.

Steps to check validity and reliability of data

Steps to check validity and reliability of your data: 1

How much consensus is there on a particular topic or explanation?

2

Which topics did I collect conflicting data on?

3

Does the answer/conclusion count for boys and girls?

4

Are the data based on the informants own observations, experiences, or is it hearsay?

5

What do you think of the overall ‘honesty’ of the informants (with regard to specific topics)?

6 7

Are the main findings and conclusions verified with some informants?

Would the answers be different if you had been male/female, older/younger, had interviewed the informants in a different setting (e.g. in their homes instead of the clinic)?

Steps to take after finalizing the interview 

Introduction

We have focused on preparing and conducting an interview, but there are also steps to take after you have done the interview. 

Instructions on steps to take after finalizing the interview. Illustrate the steps (ask the participants) using the example of the service provider interview on day 3.

When you have finished the interview, it is advisable to work out your notes immediately, or as soon as possible, so that the information is still fresh in your mind and you can still read/understand your notes!

Write down on top of the report sheet:  the date  name of the informant if you have it – if not, think of an alias  age  gender and  location.

Then write down:  The main questions with the main answers (in a summary).  Your main impressions: What did you find most remarkable or interesting (for example something that is new to you, that you did not expect, that conflicted with information from others, or confirmed what others have said).

  

Your own ideas and thoughts (e.g. explanations, hypotheses, ideas, conclusions).

How the interview went: one thing you want to do different/better next time.

Your impression of the ‘trustworthiness’ of the information you have collected.

Reflection on Quality of data

INFORMANT: Do you feel the informant was honest with you?

 Would h/she have told you something different in another setting / situation?

(The kind of answers the researcher collects depend on the setting in which the questions are asked: in a group, in a one‐on‐one interview, at home, in the street, at the market, in school, etc.).

 Are the data based on the informants’ own observations, experiences, or is it something they heard form someone else? Make sure you note this.

 How do you assess the overall ‘honesty’ of the informants (with regard to specific topics)?

RESEARCHER (yourself): Do you think the informant would have said something different if you were a girl/boy, older/younger? Or if you were friends with this person?

Bias is a term used to describe a situation in which something has influenced the outcome (e.g. data, results) and the outcome is therefore less trustworthy.

The researcher is the main instrument for collecting data. The answers that you collect depend on  What kind of questions you ask and how you ask them,  Your ‘rapport’ with the informant,  Your experience as a researcher (skills),  Your interpretations: Unlike a film documentary, you write down the things that you think are important, or the way you understood it. This can be different from what someone else would have written down (e.g. somebody from another country, somebody with different skills or a different ‘rapport’ with the informant). This is not a bad thing, but it is important to think about how you influence or ‘colour’ the data. And it is important to explain this to the people who read your research data.

There are a few tricks that you can use to make your findings more objective and to check the trustworthiness of your data:

Tricks:

TRIANGULATION: Use different methods to collect data on the same topic or question, and see how the answers that you get differ. E.g. see what people answer you in a personal interview versus what they say in a FGD. Compare the data that you have collected on a certain topic or question with that of the other researchers.

Compare the information that you have received from different persons.

VERIFICATION: Check if the answers are the same for boys and girls.

Check your main findings and conclusions with some ‘key‐informants’, people whom you think are honest with you and have a good deal of knowledge or experience.

 Conflicting info:

if you find conflicting information, you have to investigate the reasons for this conflict, until you have an explanation.

 The more consensus there is on a topic, the more valid the answer is.

Thinking about how you and the setting could possibly have influenced your data is called REFLECTION. Reflection will help you to formulate new questions for the following interviews and bring focus, efficiency and quality to the data collection. Answering the above questions directly after the interview or FGD will later help you with ordering and analysing your data.