A presentation from the 2014 Annual Results and Impact Evaluation Workshop for RBF, held in Buenos Aires, Argentina.

1. 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 LTH R ESU LTS IN NOVATION TRUS T FU N D

2. 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?

3. 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)

4. Challenge of diverse target audience!

5. Why do
qualitative
research?

6. 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

7. What is
qualitative
research?

8. 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

9. 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

10. Qualitative
research in
designing and
implementing RBF

11. Systems function lens
5
WHO - 2007"

12. 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"

14. 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

15. Challenges
and working to
overcome them

16. 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

17. 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)

18. Thank You
WWW.RBFHEALTH.ORG | WWW.FACEBOOK.COM/RBFHEALTH | @RBFHEALTH