Qualitative methods generate rich non-numerical data and are well suited to understanding ‘how, what, and why questions’ or topics that we know very little about. Qualitative methods also allow researchers or programme implementers to understand issues from the perspective and in the language of the community members and key informants. Qualitative methods can be used alone, or combined with quantitative measures for a more robust understanding of your research question(s).
In a pandemic, it is particularly important to listen to communities and actively use their feedback to make programmatic adjustments, as well as bring their voices and opinions to policy- and decision-makers since they may not always have the opportunity to do this directly. Qualitative data can generate important narrative-style information on current needs, fears and perceptions of COVID-19.
Qualitative research can be useful during the following stages of programme implementation:
Prior to programme implementation:
Formative research on behaviour - Formative research is done in advance of programme design and helps “form” programmes, ensuring they are context adapted and effective at addressing the particular needs and priorities of the local population. Formative research normally utilises a range of methods - qualitative and quantitative - to understand current practices, perceptions and the determinants of behaviour (i.e. the factors that enable or prevent a behaviour). It is often repeated during the intervention process to allow for adaptation and learning. Formative research to inform COVID-19 prevention activities involves selecting methods to answer the following types of questions:
How do people feel about COVID-19 and how it is affecting their communities? Do they feel it affects people ‘like them’? Who do they think is most at risk? Are there any measures being done to minimise the risk?
What are current behaviours in the communities (e.g. in relation to handwashing and physical distancing) and what are the specific ways these need to change at the moment?
What factors enable or prevent people from practicing preventive behaviours?
Are there some factors that make it difficult for certain groups to practice the behaviours?
Are there a few individuals or families currently practicing the ‘ideal’ or close to the ideal behaviours? What are they doing and why? Are there any locally available materials to promote the ideal behaviours?
Who within the community is able to effectively influence the behaviour of others?
What are the best ways to reach the population, including marginalised or vulnerable groups within this?
Pre-testing intervention ideas - Prior to rolling out a programme at scale it can be useful to test it among a small group of people. When doing so, qualitative methods can be used to learn about the feasibility and acceptability of the proposed behaviours and the intervention components. Qualitative methods can be developed to explore the following types of questions:
Are the behaviours we are promoting clear and actionable?
Are the behaviours we are promoting feasible to do in your context?
Are the materials we created for the intervention clear to understand?
Might some people in the community misinterpret the materials?
What factors could prevent individuals and communities engaging with the intervention?
What factors could prevent individuals and communities following the recommended actions?
During programme implementation:
Monitoring acceptability and accountability - Throughout programme implementation there should be ways of continuing to learn from populations. This should include selecting methods to answer the following types of questions:
Do people feel that the program is relevant to them and that it meets their needs?
What ideas do people have to improve your program?
Are any unintended consequences (positive or negative) arising because of your program?
How could your program better link to, or support, existing systems?
Are any groups within the population being left out of the programme? What could be done to better involve these groups?
Process evaluations - Qualitative methods can also be used to explore how change did or did not happen at an individual or community level. This should include selecting methods to answer the following types of questions:
What made it easy or difficult to change behaviours?
What could enable or prevent these behaviors from being sustained?
What allowed some individuals or families to change even when others did not?
What changes did the programme lead to in people’s thinking or beliefs?
What changes did the programme lead to in people’s physical environment?
What changes did the programme lead to in people’s social environment?
Feasibility of implementation -
Qualitative methods can also be used with implementation teams to plan or assess the feasibility and logistical aspects of implementing the programme. This should include developing methods to answer the following types of questions:
What within your programme seems to be working really well?
Which aspects of the program are hard to get right?
Are there any aspects of your program that are taking teams longer or shorter than expected?
Are staff members doing things differently than planned? Why?
Have any ethical concerns arisen?
What implementation changes could be made to address some of these challenges?
Are the responsibilities or actions that we are asking communities to do realistic at this time?
Are there other ways that we could be working with communities to facilitate action?
Want to know more about remote quantitative and qualitative approaches for understanding COVID-19 related behaviours and perceptions?
Editor's Note
Authors: Sian White
Review: Julia Rosenbaum, Kondwani Chidziwisano, Sheillah Simiyu, Katrina Charles, Li Ann Ong, Rob Hope
Last update: 10.06.2020