One of the main outputs of a SQUEAC assessment is a list of barriers that carers of malnourished children face in accessing treatment at health centres. The assessment also identifies positive factors, or “boosters”, which encourage carers to take their children to health centres for treatment. Surveyors therefore need to undertake a community assessment in order to understand the social, cultural or medical contexts in which the malnourished children live using a variety of qualitative data collection techniques. A more detailed guide on how to conduct a community assessement is available in the Tools section.
The next page, Qualitative Data Analysis, provides guidance and tools on how to organise and analyse the information that is collected.
It is recommended that individual team members have a good understanding of the geographical, sociocultural and linguistic context of the area in which the study will be carried out. We recommend the following points for teams to gain such understanding:
The team itself should also pay special attention to its composition, particularly to gender balance. Assuring a representation of women of at least 30%, aiming for 50%, is a good way of addressing the issue if circumstances allow. Also, the participation of community members and/or health district representatives will not only enrich the collection of data and the interpretation of results but it will also allow for a live transfer of competencies and spur follow-up actions within each party’s limits.
To conduct a community assessment, surveyors need to speak to a number of key informants from the community in and around each service delivery unit within a health district. Bearing in mind that all SDUs will need to be visited within a limited number of days, the activities of the surveyors therefore need to be carefully planned in the days before the start of the survey. It is also important that the enumerators are trained in the various data collection methods.
Preparation before undertaking a community assessment is therefore critical. The following should be considered:
Before a community assessment is launched, a CMAM programme manager needs to organise a comprehensive training on the qualitative data collection, which will permit all data collectors to familiarise themselves with the objectives, methods and tools of the study. The CMN has developed a complete training guideline including recommended activities, introducing the teams to data collection tools and simulating assessments. These guidelines are available in Annex 1 of the Community Assessments Guidelines.
The main methods of qualitative data collection during a community assessment include:
Surveyors should try to go to each SDU in the Health District and, at each, interview or meet with at least four of the following:
Interview guides for different individuals are available in Tools.
Additional qualitative information should be gathered and then compiled when survey teams come together at the end of Stage 1:
Community assessment guidelines
Community assessment training and simulation guide
Community assessment training presentation
Sampling framework and calendar of assessment
Carers of malnourished children
District and NGO representatives
Traditional healers and birth attendants
Health centre observation form
Communication channels matrix template (with explanations)