Academic journal article The Qualitative Report

Combining Causal Model and Focus Group Discussions Experiences Learned from a Socio-Anthropological Research on the Differing Perceptions of Caretakers and Health Professionals on Children's Health (Bolivia/Peru)

Academic journal article The Qualitative Report

Combining Causal Model and Focus Group Discussions Experiences Learned from a Socio-Anthropological Research on the Differing Perceptions of Caretakers and Health Professionals on Children's Health (Bolivia/Peru)

Article excerpt

The paper discusses the utility of constructing causal models in focus groups. This was experienced as a complement to an in-depth ethnographic research on the differing perceptions of caretakers and health professionals on child's growth and development in Peru and Bolivia. The rational, advantages, difficulties and necessary adaptations of combining the two techniques are discussed on the basis of concrete examples. Authors conclude that the building of a causal model in a focus group session can be useful in comparing lay etiologies of diseases as perceived by different categories of caretakers and health professionals and in identifying specific health risks faced by children. Causal model building in a focus group can help renew discussions and participants' interest but its use is only justified when the study concerns the perception of the causality of a given phenomenon (1). Key words: Qualitative Methods, Health Risks, Causality, and Lay Etiologies.

Introduction

The aim of this paper is to present and discuss a specific technique that was used in the socio-anthropological component of a participatory action research project on child growth and development in Peru and Bolivia (1998-2001) (2). The project was conceived to develop and apply a global and integrated approach to promote child health with the participation of the health services, the parents, and other actors of the community (3). One of the basic assumptions of the research was that participation and dialogue between all actors would progressively induce changes in their representations, attitudes, and practices in relation to health and development of children. The overall research encompassed a descriptive analytical phase that was to lead to designing interventions.

For the socio-anthropological component, an in-depth investigation with the use of classical ethnographic techniques (semi-structured interviews, observations) was applied. But a more innovating technique was used: focus group discussions with the support of a causal model building exercise. The objective of this specific exercise was to investigate the causes of child's health and development problems as well as local health risks children face as perceived by different categories of caretakers and health professionals.

The rational, advantages, difficulties, limits and necessary adaptations of combining focus group discussions and causal model building will be discussed on the basis of concrete examples. Before entering this discussion, it is worth briefly describing the objectives, the process, and the techniques used in the socioanthropological research.

The Socio-Anthropological Research

Objectives

The socio-anthropological component studied: (i) the logics and comprehension of child health, growth and development as perceived by caretakers and health personnel; (ii) the relationships between these groups around child care; (iii) the activities considered necessary to support child growth and development; (iv) the factors explaining the differences of knowledge, perceptions and practices related to growth and development of children between caretakers and health personnel; (v) the feeding and socialisation process of children; and (vi) the perception and utilisation of the growth chart (and understanding of growth and development) by the health personnel.

The Research Process

Actual data collection was conducted from September 1998 to April 1999. Field research was conducted in Bolivia in Chavez Rancho in the urban periphery of Cochabamba and in the Amazonian region of Chapare. In Peru, it took place in a marginal suburb of Lima (Independencia) and in a rural village (Choca) located 50 km of the capital city.

The socio-anthropological component permitted to gain insights on indigenous knowledge and perceptions in relation to child health and development, nutrition, local health risks children face, health services, lay etiologies of diseases, health seeking behaviors and associated decision making by the caretakers (4). …

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