Home » knowledge sharing

Tag: knowledge sharing

Why Don’t We Talk About This? Why Kenya needs to start talking about mental health

At Be Forward, Africa is our passion. We want to share our passion by bringing to life research and stories from across the continent.

A mental health crisis in Kenya

Africa is facing a mental health crisis. Over the past year, mental health stories have hit the mainstream media headlines, especially in Kenya, the focus of our study.  We wanted to understand what was going on with mental health in Kenya, and to evaluate if the country was indeed facing a crisis.

Research into mental health in Africa has been a neglected priority. Compared to physical diseases, NCDs (Non-Communicable Diseases) have received little research focus; there are still many unknowns where mental health is concerned in Africa.

At Be Forward, we wanted to address this gap and to lay a benchmark for future research by shedding light on mental health in Kenya. How do Kenyans navigate around mental health? What does it mean to them, and how does this impact on their lives? How are changing socio-economic factors impacting on mental health? What impact are global shifts, government, mental health professionals and grassroot advocates having on the mental health agenda?

If the country is facing a crisis, we want to evaluate not only what is being done to address this, but alsogauge if people’s views around mental health were changing (or not). Our research also enables us to identify which challenges and opportunities exist to advancing the mental health agenda in Kenya.

We wanted to primarily understand the average Kenyan’s understanding of mental health. We spoke to members of the general population: men and women, between 20-40 years of age, based in Nairobi, Mombasa and across the Rift Valley, both higher and lower SECs (BC1C2). In order to gather a more comprehensive picture of what was going on in Kenya, we carried out in depth interviews with a range of mental health experts: from radio journalists, to senators, suicidologists to mental health practitioners, as well as recovered mental health patients.

Understanding the stigma around mental health and getting people to open up

We conducted a qualitative general population survey through our online community, providing respondents with a safe and anonymous space in which to explore this sensitive topic. We spoke to more than 80 people either during one-on-ones or in mini groups (3-4 people max). Mini groups were first used to gather general perceptions about mental health; groups were separated by gender, with exception of some deliberate mixed gender groups to allow respondents to exchange and reflect around their mental health experiences. Online research was supplemented by face to face in depth interviews.

We also spoke to people who had recovered from mental health illnesses or had lived an experience with a close family member/friend. For these stories, we used one on ones (face to face or online) to allow them to share their stories privately and in confidence.

To complement the voice of the average Kenyan, we also reached out to numerous stakeholders invested in mental health in Kenya, from policy advisors and politicians, to numerous NGOs or non-profits on the ground. These experts provided us with their knowledge and insight into the mental health landscape in Kenya. In all, 15 stakeholders in Kenya were interviewed. Unanimously, these experts all said the same thing- that there was an urgent need for more research.

Strongly believing that film naturally complements a research report, we produced a short film to accompany the report. This film reflects the title of the report, ‘Why Don’t We Talk About This?’ and illustrates the barriers around mental health and the stigma often faced by those suffering from mental health illness in Kenya. It’s a visual depiction of the current state of mental health in the country.

Whilst our research results are currently qualitative, we are hoping to quantify the hypotheses in 2020 and would value any funding contributions to do so.

Who can benefit from this?

This piece of research provides a robust qualitative baseline that can be used to inform any future research (qualitative and quantitative). This research clearly lays out the population’s thoughts on mental health – a comprehensive ‘U&A’ around the subject. Added to this, our experts have validated and corroborated that the insights uncovered are a true reflection of the current mental health landscape in Kenya.

As far as we know, this is one of the most comprehensive pieces of research that has been undertaken around mental health in Kenya. It’s the first step in a very important journey: that of breaking the silence around mental health in Kenya in order to end the stigma. The research has also recently been used for NGO funding requests.

Help us tell Jackline’s story

In the course of this research we came across many inspiring and tragic mental health stories. One that deeply affected us is that of the death of Jackline Chepngeno, the 14 year old Bomet schoolgirl who tragically took her own life after alleged period shaming by her teacher. Jackline’s story moved us so much, we decided to make a documentary. It’s our first documentary and a huge passion project. We need help to finish it.

If you can spare a little this Christmas, please make a donation on our crowdfunding page. Please help us finish this story!

 

About the Authors: 

Paul Drawbridge, Amélie Truffert and Rhonda Nicholl – Be Forward

Big Data Big Debate: How to handle 5 million plus verbatims in just 2 weeks?

Since the beginning of November 2018 and the start of the Yellow Vest protests, France has experienced a three-fold unprecedented social movement. This mobilisation took place outside any existing organisational framework (i.e. trade unions, political parties or associations). It was also unprecedented in its longevity, as national demonstrations have been held on a weekly basis since Saturday 17th of November 2018, until the European elections in 2019. Last but not least, the multiplicity of channels of expression it used were unknown in France: social networks, the displaying of yellow vests on car windshields, recurring weekly demonstrations, attempts to form a list for the upcoming European elections and so on.

Since the social movement began, it has enjoyed strong public support; it reached 68% in favour ratings in November and December 2018, then dropped to around 58% until the end of January 2019. From February 2019 to present, it stabilised to around 45-48% of support, which is still incredible for a protest that began nine months ago.

Fig. 1

To answer to this protest, President Macron announced in January that a “Grand Débat National” will be held all over the country. A series of town hall-style gatherings were scheduled across France, where citizens could speak to their local mayors about their concerns. During two months, citizens were also allowed to make proposals online at granddebat.fr. Additionally, in March, the government held “regional citizen conferences”, intended to summarise the main findings from the sessions and establish concrete proposals for Macron to consider.

Fig. 2

OpinionWay was in charge of analysing the data collected on the online platform granddebat.fr. Two major challenges were faced. First, we had only two-and-a-half weeks following the end of the debate to deliver the results. Second was the huge volume of data, with more than 70 open-ended questions, 1,363,852 contributions and more than 5 million verbatims written by contributors overall.

The government advertised Grand Débat a lot in order to involve the population and increase contributions. The participation curve was unusual, and a peak was reached again during the last week, which we never notice usually for this kind of online consultation. In the end, more than 500,000 citizens contributed to the website regarding at least one issue, with more than 255,000 respondents to open-ended questionnaires.

Fig. 3

There was no demographics on the questionnaire, so it was a challenge to analyse who the contributors actually were. However, we thought it was a decisive point to understand the data better. The only thing we could use was the postal code. We decided to cross this information with census data in order to create maps and revenue indicators, to verify whether the respondent population matched the general French population, as purchasing power was one of the most important issues for the yellow vests. 

To analyse open-ended questions, regarding to the volume of data and the short period to deliver results, we decided to use AI technology. We used a platform to access software dedicated to text analysis. Developed after several years of research around big data technologies, semantics and machine learning, the platform automatically detects and analyses standard text elements (e.g. person, company, concept, event, organisation, location, etc.), and can also integrate project specific vocabulary.

This solution makes it possible to automatically process large quantities of texts to draw quantitative analyses with a qualitative dimension. It also offers data analysis, segmentation and data visualisation capabilities. Particularly suited to the analysis of open questions resulting from the consultations, which can include a very large number of verbatims, this solution proposes many keys of analysis for the open questions, with a finesse that does not have all the tools of textual analysis.

Semantic enrichment consists of recognising different signifying elements in a text. This involves first detecting named entities, which are proper names or very specific common names. It is then necessary to recognise the concepts, which are phrases of several words having a significant interest. At that stage, human intervention was necessary to decide whether the concept was significant in the context of this analysis or not, and eventually to correct it. Validating renamed identified AI concepts, to make sure they were relevant, was a huge undertaking. After every human intervention, we screened data with AI again to make it more efficient, to eliminate statistical noise and to reduce unclassified verbatims.

Then, for each issue, we tried to summarise the main findings, regarding volume and themes discussed by respondents.

In the end, this mode of analysis was conducted under the constraints of rules enacted by the government, as well as under the protection of a college of guarantors, composed of specialists in public debate and data analysis.

Fig. 4

All the data collected was open-access (and is still) to allow all citizen to make their own analyses, which is not usual in our daily business.

Presentation at ESOMAR FUSION event. Madrid, November 2019

About the Author: 

Bruno Jeanbart, Deputy Managing Director at OpinionWay, France.

 

“For every child, every right” – 20 November – Today we celebrate World Children’s Day!

Around the world, children are showing us their strength and leadership advocating for a more sustainable world for all. Let’s build on advances and re-commit to putting children first. For every child, every right.” UN Secretary-General António Guterres

This year’s celebration marks the anniversary of the United Nations’ adoption of the Convention on the Rights of the Child. We can all play an important part in making World Children’s Day relevant for their societies, communities and nations. We, at the ESOMAR Foundation, want to celebrate this special anniversary by offering our readers and followers a few of the many examples of how solutions have been found and impact has been made on the lives of many children around the world with the help of the skills, knowledge and support of the data, research and insights community.

Reducing Child Mortality – A providers, a mother and a powder

Winner of the Most innovative Not-For-Profit case study of the ESOMAR Foundation Making a Difference Competition 2018. “With deep and nuanced understanding of what was driving oral rehydration salt (ORS) uptake, we developed a radically revised theory of how to increase the use of ORS to treat diarrhea in children. Instead of focusing exclusively on RMPs, programs should create demand for ORS by reframing caregivers’ perception of the treatment. This would help RMPs to bridge their “know-do” gap and prescribe ORS with confidence.” This project was carried out by Surgo Foundation in partnership with the Bill & Melinda Gates Foundation and the Clinton Health Access Initiative

Giving the World’s Children

UN0141031 © UNICEFUN0141031LeMoyne

a Voice: A UNICEF case study

Children represent one of the most vulnerable groups in a society. They also represent a society’s future: future decision-makers, leaders, consumers and employees. Despite the progress achieved in numerous areas, children continue to face high distressing situations across the world.

“For 2017 World’s Children Day, UNICEF’s goal was to give the world’s children a voice. The overarching objective was to see the world through their eyes: to hear their perspectives on the most pressing issues affecting children globally and in their home country, to understand their hopes for the world’s children, to hear what they would change if they were in charge. To put results in perspective, we also wanted to understand their world: who they admire (and are influenced by), whether they feel they are being heard and if so by whom and get their opinion on world leaders’ job at addressing children’s issues.This research is an attempt to give children a voice and make the rest of society aware of what children are concerned about, and what changes they would like to see so their opinions are also taken into account in the decisions being made. It is also a reminder to all to make sure we are talking to the right people.”

This research is the product of the collaboration between UNICEFGrey Advertising (the communications agency for the World’s Children Day) and Kantar’s Lightspeed Research: for the technical aspect of the research project.

Awareness of human trafficking risks among vulnerable children and youth in Ukraine

The survey aimed to define the vulnerability and the level of awareness of human trafficking among nine groups of children and youth in Ukraine. The survey covered children in difficult life circumstances and orphans; children from foster families and family-type homes; children displaced from the conflict zone in the East of Ukraine; children with special needs; homeless children; young people detained in penitentiaries; and youth of vocational schools.

The International Organization for Migration mission in Ukraine (IOM) implements a variety of human trafficking prevention activities. To improve the existing counter-trafficking practice, it conducted specific surveys on a regular basis to identify the most vulnerable and at-risk populations. Taking into consideration the results of the commissioned survey, IOM supported NGO small-grant projects in every oblast of Ukraine focused on targeted awareness increase and prevention work among the identified key vulnerable groups of children and youth with the highest risks of human trafficking. As a result of these projects, more than 63,000 vulnerable children and youth increased their knowledge of various types of human trafficking and basic rules of safe migration and employment.

The research was commissioned by the International Organization for Migration mission in Ukraine and conducted by GfK Ukraine

Driving the Efforts to Prevent “Stunting” in Indonesia

Stunting is the impaired growth and development of children caused by poor nutrition and repeated infection resulting in their height being two standard deviations below the WHO Standards. Indonesia has a higher incidence of stunting among ASEAN Countries …1 in 3 children. Feedback from the National Nutrition Communication Campaign (NNCC), IMA World Health suggests that we are on the right path … “This research program has made a big contribution to our mission …helped us start right. Stunting is no longer invisible. It’s a mainstream issue backed by the government and local communities. We have no doubt that we will see progressive reduction in stunting.

The government of Indonesia has committed to an integrated National Nutrition Communication Campaign (NNCC) for behavior change targeted at individuals, communities and stakeholders to minimize stunting. To this end, IMA World Health was commissioned by MCA Indonesia to design and implement an effective NNCC resulting in behavior change and lower stunting incidence.

Kantar TNS Indonesia conducted the in-depth study for the understanding of knowledge, beliefs, attitudes and behavior related to mother and child nutrition and stunting – to identify the motivators and deterrents to desired behavior, including the role of different influencers and influences to aid integrated communication strategy development covering message and media/touchpoint strategies.

I am one in a million

How Street Invest  and Big Sofa created a remarkable video: ‘I am One in a Million’ from qualitative research findings – with the objective of changing the public perception of Street Children – to humanise them.

The power of this study lies in the shareable and impactful output film.

Through this research, street children have been able to share their own stories, using in their own voice, in a manner which can be shared with those who have the power to change their lives.

* All the street workers involved were trained in Child Protection and informed consent was gained from the young people who participated in the filming.

 

 

Financial Segmentation in Brazil´s base of the pyramid

Plano CDE is a Brazilian social impact business (B Corp) established in 2009 by a group of economists and anthropologists with extensive knowledge in research, consultancy of social projects and public policies for the base of the pyramid. The Organization has the goal of helping to map and understand the needs of beneficiaries of social programs and public policies to subsidize strategies that improve the lives of these families. We partnered with the Center for Microfinances at FGV University to develop this study for J.P Morgan Foundation.

Brazil has a population of 120 million people living on the base of the pyramid, while eighty million have no access to bank accounts (40% of the population). Studies have shown that improvement in financial inclusion has a strong correlation to wellbeing improvement and vulnerability reduction.

Previous qualitative studies have shown the heterogeneity of this vulnerable population on their demands of financial services: the main goal of this research was to measure this diversity. Our primary objective was to develop a segmentation of financial behavior on the base of the pyramid in Brazil in order to subsidize public policies, financial services and financial education programs on offers better suited for the specific needs of different profiles in the population.

The study was divided into four stages: literature review and questionnaire co-creation, face-to-face quantitative survey, ethnographic immersions, and recommendation workshop with stakeholders in the financial ecosystem. The questionnaire was adapted from previous surveys organized by the Brazilian Central Bank, World Bank, and other pre-tested instruments.

Once data was collected, we learned that 57% of the Brazilian base of the pyramid owned bank accounts – but only 7% used them for more than withdrawing their total salary once a month. Payments were made mostly in cash on lottery houses (which, in Brazil, operate as bank correspondents), and digitalization, notwithstanding the universal ownership of smartphones, did not include financial transactions – only 5% ever paid a utility bill online.

Looking at the aggregate data showed a universal distance of lower-income segment to formal financial institutions. Few have access to formal credit, as previous literature on financial inclusion already predicted. Those who save money on the previous 12 months (27% of this population) did it largely at home, in cash and knowledge of financial concepts is also critically low. Only 20% of the sample correctly answered basic interest-related questions. A relevant segment of 27% refused to try to answer these financial education questions, showing a considerable lack of confidence when dealing with numbers, math, and issues related to money.

With these results in hand, our team formulated a clustering analysis called Grade of Membership (GoM). This method allows for a refined clustering, in which individuals are simply assigned to a group, but are given a grade of similarity to others within a group. The result is a definition of “pure profiles” and other mixed profiles. In our survey, we found three pure types of financial behavior.

Three profiles were found, analyzed, and later visited on ethnographic immersions. The qualitative stage allowed us to understand in depth what psychological traits differentiated the groups. The segments were described as follows:

  1. Conservatives (33% of total combining pure and mixed profiles)

Conservatives are usually older (85% are above 50 y.o.), with lower school attendance (84% never finished Elementary school level). Ethnographic data showed Conservatives were mostly worried about having a “good name”, meaning, they will abstain from consumption lest they generate debt.

“It’s better not the have anything than to be in debt”, one of our interviewees explained. More than 71% don’t have bank accounts, and they generally describe a strong distrust of banks. Extra income, for them, would be directed to tangible assets: home improvements, better groceries for the family.

  1. Disorganized (28% of total combining pure and mixed profiles)

Disorganized are families with younger children (1,6 children per household, on average), and didn’t finish high school (83%). Many are in debt, and half of them do not wish to pay their debt. However, what differentiates them the most is the will to consume even when creating new debt (30%, double that of the total population).

“I’m very relaxed with money” is a typical self-description heard on the ethnographic immersions. Their financial decisions are seldom planned – most think it’s not worth thinking too much ahead since emergencies invariably arrive.

  1. Planned (27% of total combining pure and mixed profiles)

This profile has similar education levels as the disorganized, yet they manage to have better financial education and are able to consume and save. “I cannot buy a product made for an upper class” summarizes how Planners deal with their consumption habits: noting what fits their tight budget.

Up to 58% of them were able to save money on the previous year, although commonly at home. The extra income would go to savings accounts – more common in the public, which is 91% bancarized.

These findings were shared in a co-creation workshop including the ecosystem of financial inclusion (Central Bank, major financial institutions, Fintechs, NGOs and Academia). Stakeholders at this meeting recommended solutions for each of the profiles identified. Whilst there was a challenge of finding the Planned profile with current credit scoring algorithms, institutions also needed to learn how to better direct financial literacy solutions to the Disorganized, and more secure payment means to Conservatives. Co-created recommendations can be summarized in the table below

 

Disorganized Planned Conservatives
Drivers Indulgencies, family well-being Build assets Safety and stability
Fears No giving better conditions to their families To lose what they have conquered To default
Relationship to network Highly dependent on their network of friends for credit Individual mindset – will not borrow or lend money Protects the family and depends on working-age children
Why save money To be prepared for small emergencies To conquer new assets To have a less worrying future

 

The results were presented at Brazilian Central Bank Financial Inclusion Conference and other important forums of the theme and subsidized new financial instruments and financial education programs more suited for the different profiles of the base of the pyramid´s population.

 

About the Authors: 

Mauricio de Almeida Prado, Executive Director Plano CDE

 

Safe Village Programs – Preventing Child Trafficking in Rural India

My Choices Foundation is a Hyderabad-based NGO dedicated to ending violence, abuse, and exploitation of women and girls in India. They address two prevalent forms of gender-based violence – domestic violence and child trafficking – through Operation PeaceMaker and Operation Red Alert.

Operation PeaceMaker works in Telangana through thousands of empowered community women, legal teams, programs to empower young girls and encourage men to become allies in ending gender based violence. Operation Red Alert works in rural India to prevent child trafficking through a prevention-based program.

There are between 3 – 20 million commercial sex workers in India. To understand the behaviours we want to end, comprehensive research was required on what drives decisions to:

  • force girls/women into trafficking
  • make men willing to pay for sex

The aim of the research was to understand these contextual factors and the roles of specific emotions and behaviours that enable these decisions. The objective of the research was to apply learnings from cognitive neuroscience and behavioural economics to understand and influence the behaviour of at-risk families and men who buy sex. This reflected a gap in terms of the current understanding of issues.

This research was conducted with the aim of preventing trafficking by sensitising, alerting and empowering at-risk families in source areas, and to stem the demand by changing the behaviour and attitudes of men at destination areas. Key considerations during the research were to ensure that the findings and insights can easily be extrapolated into applicable interventions on the ground.

Our idea of justice is summed up in this: “Pulling drowning people out of a river is compassion. Walking upstream to find the reasons they are falling in, is justice.” My Choices Foundation decided to start with research and commissioned Mumbai-based Final Mile Consulting to conduct this research paper, which won the 2016 ESOMAR Excellence Award.

The first stage of research comprised of field visits to develop an understanding of the context, through direct interactions with at-risk families, stakeholders, migrant workers, influencers and decision making environments.

Due to social stigma attached to the issue, these conversations alone could not reveal the full picture, therefore interviews and discussions were conducted with NGOs, government agencies and stakeholders involved in different aspects of trafficking – prevention, protection and prosecution. Learning from various programs deployed and prior research conducted was also a part of the research methodology and the key output of these stages was a set of hypotheses for understanding and changing behaviour.

This research used EthnoLab™, a FinalMile proprietary research technique that involved a game that simulated the real-world context of the participants to solicit real-world reactions and behaviours. This game was the medium through which context, emotions, and mental models that influence the behaviour of at-risk families and urban clientele were studied. This was followed by an interview session designed to elicit emotions and was a crucial element in gathering insights and information about personal experiences and perceptions of trafficking and purchasing sex.

The main achievement of the research is the development of the Safe Village Program (SVP), designed to help people at all literacy levels in villages understand human trafficking and collectively prevent it from ever occurring in their villages.

Aimed at targeting intervention, Operation Red Alert (ORA) of My Choices Foundation partnered with Quantium Analytics to build a tool based on multiple sets of data to map villages highly prone to trafficking. Using this data, we conduct two-day SVPs in high-risk villages in 8 states in India: Andhra Pradesh, Bihar, Jharkhand, Karnataka, Maharashtra, Telangana, West Bengal and Rajasthan.

To initiate discussions on trafficking amongst children, we created a comic book translated into the vernacular language. To ensure children have retained the message, we scripted a skit on a family experiencing trafficking, which the children re-enact. It is customized to local cultural beliefs and easily resonates with the audience to be more effective.

Members of the village are given the Red Alert helpline (1800 419 8588) which responds to cases of human trafficking. Furthermore, ORA appoints volunteers called Nodal Teachers who watch over vulnerable children and reiterates the message of being alert; and Rakshaks to report urgent cases back to ORA and partnering organizations – thus ensuring the sustainability of the program.

The impact of this research on anti-trafficking NGOs is identifiable through our network of 90+ partnering NGOs which traverses state borders, i.e. a network specialized in its local geographies. In 2019, our first Anti-Trafficking Forum which brought together our NGO partners in India, Bangladesh and Nepal facilitated cooperation amongst organizations committed to ending cross-border trafficking.

Since 2016, ORA has reached over 3,400 SVPs through our research based anti-trafficking program, and we are getting closer to increasing awareness on trafficking to ensure that all children are safe from human trafficking.

About the Authors: 

My Choices Foundation is a Hyderabad-based NGO that works to give women and girls in India the choices to live lives free from violence, abuse and exploitation.

 

BREAKING THE CYCLE – Increasing uptake of HIV testing, prevention and treatment among young men in South Africa

In South Africa, adolescent girls and young women make up around 2/3rds of new HIV infections yet men account for slightly more than half of AIDS deaths. 

Whilst women are infected at a greater rate, the AIDS deaths do not follow the same linear pattern which suggests men often find out about their HIV status later (when iller) or do not take treatment compared to their female counterparts.

Population Services International (PSI) is a global NGO that implements social marketing programs on behalf of International Development donors in the healthcare sector. PSI works closely with private and public sector funders to bring life-saving products, clinical services and behavior change communications to empower the world’s most vulnerable populations to live healthier lives.

The Bill and  Melinda Gates Foundation approached PSI to understand the reasons which prevent some men from engaging with HIV services and design interventions to help better support these men. The primary objectives were to understand how to encourage men to test for their status more regularly, and how to ensure that positive men link to treatment within 30 days.

PSI partners with Ipsos, a global market research company and Matchboxology, a South African design firm to research and design interventions.

The long term intended recipients of the research results and interventions are the health delivery partners in South Africa who have been consulted throughout.

Understanding South Africa’s young men

The study started by framing the wider context of men’s lives and how HIV fits within it. To do this, researchers used an ethnographic approach in which trained moderators spent up to 1 day with 18 different men living in high-risk areas of South Africa to understand what daily life is like.

Following this, researchers spoke to 58 men using a semi-structured qualitative ‘journey to vaccination’ discussion guide, to understand men’s experience of HIV services and identify drop-out points.

Using both of these qualitative inputs, a questionnaire was designed, and 2000 men were surveyed. The analysis segmented men according to their underlying attitudes and behaviors, to tailor messages and interventions for harder to reach groups of men.

The research team worked closely with PSI and Matchboxology to ensure insights were well understood and humanized to design against. They did this using a number of methods such as bringing actors to play the roles of the different segments, and the use of video/ verbatim from the qualitative.

Matchboxology then used the segmentation to recruit men from 2 identified challenging segments and brought them to a co-design workshop. Together, the men and designer’s prototypes interventions to pilot in the field. This will be the next step of the process.

Increasing the uptake of HIV testing

Whilst specific interventions are being designed and tested, the insights alone have greatly advanced thinking behind how to approach young men in South Africa. Previously, men were thought to be stubborn and indifferent, but what the research highlighted is that the young men were scared and vulnerable but rigid gender norms prevented them from being able to share such emotions.

This has meant that rather than using fear-based communications, to try and scare men into testing (which is counter-intuitive), healthcare programmers should find other ways to engage with men. Men tend to see HIV as a death of life as he knows it, even though widely available HIV medicine means HIV is no longer a death sentence. For men living in tough conditions, testing for HIV does not represent a release, it only represents more stress.

As a healthcare providing community, we are actively looking to find ways to reframe testing as a positive and reduce the perceived burden of a positive diagnosis and this research has helped us make a major shift in how we think about men’s attitudes towards HIV.

About the Authors: 

Ipsos:

Sunny Sharma

James Bell

Melissa Levy

Jemma Reast

PSI:

Nina Hasen

Shawn Malone

Identifying nudges for the growth of women in Rajasthan, India

The story of an enigmatic woman across a state border

In July 2018, we set out across to the state of Rajasthan, miles away from Mumbai, the concrete jungle. After a three-hour road journey from the main city, we reached Bhap, a little-known village in Western Rajasthan.  It is home to approximately 10,000 people of which only 4000 are women (Census, 2011).

We were here to undertake an assignment under the banner of ‘The Community Program’ (TCP) by the Market Research Society of India (MRSI).

The TCP is MR industry-funded program for young researchers to give back to the community by providing research and insights to not-for-profits that cannot typically afford it. [Other excellent case studies from TCP are Driving Change in Behaviour Management and Government Policies for the Disabled vs. Ground Reality].

The assignment was for Women Serve, a not-for-profit, operating out of Western Rajasthan, India. The NGO has been working towards advancing the status of women in six different villages specifically in the district of Paholdi.

The brief was simple – the organization was looking to establish a community park which would provide a safe place for women to improve the quality of their life and that of their family by learning various skills. This community park would also serve as a medium for women to exchange ideas and grow personally.

An answer to the key questions – Would a community park be welcomed by women and what would be the possible triggers and barriers to participate?– would then serve as a template for action for other villages where Women Serve would run the program.

When we got down to our ‘drawing board’, we realized that for Women Serve to make the right decisions about various interventions, it was essential for us to look at the woman in Bhap through a holistic lens.

This comprehensive lens was used throughout the designing and execution phases of the study. Thus, we broke up our research objectives into the following

  1. Identify the needs and motivations of women
  2. Identify their deep-rooted belief and aspirations
  3. Identify activities that she could engage in at the community park

Furthermore, our study was designed in the following way:

In our one week in the village, we did 30 qualitative interactions – a mix of group discussions as well as one on one interactions.  We also gave shape to a quantitative questionnaire, right on the field – basis our learnings from the interactions – and performed 130 interviews representing all layers of the society in the village.

For e.g. several communities i.e. castes inhabit the village – a reality that became prominent once we were on the ground. It was critical for us to get a representative response – since one’s caste dictates the way of living in the village. For instance, the higher one is in the caste ladder, the more likely one is to receive education. These are dimensions could have been easily missed had we not spent the time with the villagers.

Due to our holistic and dynamic approach, we were able to observe nuances that otherwise one would possibly skip on. For example, all our qualitative interactions happened at the woman’s house – giving us the opportunity to observe her home life and her interaction with her family members. For instance, we were able to pick up on her hesitation to admit her TV viewing patterns in front of her in-laws and husband.

We also met with influencers in the village – the head of the village (Sarpanch) as well as the hostel warden to understand the workings of the village from a third person’s perspective.

Our study provided us with key insights that gave the organization some new directions and helped make some reiterations on directions they wanted to take.

 

It is important to note that the stakeholders of the NGO live in big cities and the key sponsor is in USA.  Our research brought to life the context that otherwise would have been difficult for the NGO.

The Bhap woman since her birth is a burden to her family. Thus, being married off in her childhood – sometimes even at birth. Education is out of the question. Her life is spent catering to the needs of her family, within the four walls.

Given this social context, she lacked the self-confidence to even step out of the house, much less dream. Dreams and aspirations are words that did not seem to belong in their dictionary.

In her complex reality, her only solace is engaging in the activity of sewing. The activity is so deep rooted in her life that one can find evidence of it when one visits homes in Bhap – you will often find them displaying their work to visitors.

The impact of the activity was one of our key learnings from the study. Along with cultural rootedness, it also allowed her to work from the comfort of her own home. Moreover, most women saw it as a possible source of income. One of them said to us, “My neighbor is uneducated like me. But she knows stitching so she earns 3000 a month”. Thus, this was an avenue for her to increase her confidence and help her stand on her own two feet (financial independence) in the truest sense.

Moreover, through our quantitative learnings, we found that this activity as part of the community park was highly endorsed by women for the above reasons and more – it was an activity that was acceptable in the community and no one would raise any questions if she left her house to pursue and excel at this activity.

Knowledge sharing sessions as part of the community park was another action step for the organization. After a day’s work women are often seen visiting each other. This opportunity could be utilized to share stories and learn new skills.

Thus, the study provided key nudges that would push the boundaries slowly and steadily for the women of Bhap and go a long way in making sure that Women Serve is able to make dreams and aspirations a reality for the coming generation.

 

About the Authors:  Niyati Taggarsi, Research Executive, Ormax Consultants, India

(The study was done in collaboration with Madhur Mohan, Research Manager – Kantar)

Government Policies for the Disabled vs. the Ground Reality

The Equals, unlike other NGOs, is an organization which focuses on advocacy issues related to people with disabilities. They function as a facilitator between the government and people with disabilities by making them aware about the policies while understanding the challenges faced in their day to day lives to help the government in developing policies customized to their needs.

In 2016, The Disabilities Act was revised to enable more equality for the differently abled. Among the other reforms, two major changes include – recognition of new categories of disabilities and, revisions in policies to ensure inclusiveness. It was two years since the enactment of the new policies and Equals wanted to assess the impact of the changes in policy by evaluating the extent of awareness of the Disabilities Act among the differently abled and their experience about exclusiveness and discrimination.

The research was delivered pro bono to Equals, under the banner of The Community Program (TCP) of the Market Research Society of India (MRSI). The TCP is MR industry funded, with mentoring and research time, volunteered by research practitioners with an objective to make professional research accessible to NGOs that cannot typically afford it.

This study was conducted by me, Divya Meenakshy, a volunteer researcher from Brandscapes Worldwide. I conducted Qualitative interviews among the people with disabilities/guardians and NGOs supporting the cause.  The first set of interviews was with people with different disabilities to assess their level of awareness while the second set of interactions was with the NGO managers to understand their perceptions and solution directions that they perceived as important in the current scenario.

One NGO manager

I used Qualitative (In-depth interviews) because:

–    It helped with meeting people in their comfort zone considering the sensitivity of the topic and make the respondent comfortable emotionally to be able to talk to me

–    Each disability is different, and hence the approach to them had to be different. This was only possible through a qualitative exercise.

The center chosen was Mumbai, Maharashtra State, as it has one of the highest numbers of disabled in India and usually, a large city like Mumbai is where most legislations are generally first implemented.

The research helped in qualifying areas that Equals need to focus on the bring about the desired change along with a professional report that would help Equals to have a fact-based conversation with the policy makers and implementers.

The research focus on three key areas of policy, namely Medical, Education and Employment  and these were assessed for awareness, accessibility and actionability – Aware  of the policy and the change introduced;  Able to Access all the information related to policy/scheme and finally, If they were able to see it come to Action  for themselves in their interactions.

Through this research, it was found that awareness was not an issue but accessing  and exercising the policies by the disabled was the major concern.

For example, in education, “Right to education” is known to all. However, when it comes to actual implementation – infrastructure isn’t disable-friendly and learning aids are not easily available which in turn hampers their learning process.

The clear direction was to focus on not just the policy but work towards creating infrastructure, for example learning aids for the differently abled to be made available at educational institutions. It was understood that across all three areas of policy researched, limited and accessible information sources and inadequate infrastructure were impediments to policy implementation.

Organizations like Equals help in bridging the gap between the disabled groups and the government.  Through this research, Equals and in turn the government would be able to identify the challenges at ground level and thus define actions that are fit to purpose. It is a long way before we become a society that creates equitable opportunities for the differently abled.

An eye-opening fact which I’ve discovered during the research is that while newer buildings require by law ramps for wheelchairs, and are provided in newer shopping malls or other institutions, they are not constructed according to the measurements for a wheel-chair to access!  I personally would not have known this to be a challenge as this seemed to be an area where the implementation rates of policy were high.

My hope is that through this research work we have enabled Equals to have a conversation with stakeholders on the need for creating not just the policy but to work towards making it accessible and actionable at an everyday level.   I hope too that the MRSI through TCP will initiate more similar work in the coming years and drive change for the society one step at a time.

This research for Equals is one small step in the right direction.

About the Author:

Divya Meenakshy, Manager Insights, Insights Division, Bradscapes Worldwide

 

Cracking the Gender Code. A 20-year longitudinal study in 6 months

Why are there so few women in computing? Jobs are plentiful – demand exceeds supply – and they pay well. Simple, right? Girls don’t like computers.

But that’s rubbish. At primary school age, girls and boys have similar interest levels. It’s at secondary school that their interest declines relative to boys.

Girls Who Code (GWC), a US-based NGO, asked Accenture Research to investigate this conundrum – and to suggest how they might help solve it.

In an ideal world, we would have conducted a longitudinal study, tracking a group of girls from birth to college. But we didn’t have 20 years; we had about 6 months.

Ultimately, we needed to build a quantitative model; Girls Who Code wanted to understand what interventions would make a difference – and what impact they would have on the pipeline of women into computing.

Phase 1: Identifying the problem

However, before even beginning to think about questionnaire design, we needed to understand the mindset of girls – and their wider ecosystem of support (e.g., parents, teachers, friends).

But who knows what goes on inside a teenager’s head? Sure, we’ve all been teenagers. Some of you might today be parents/carers for teenagers. But can any of us, hand on heart, say they understand what teenagers think and feel? Do we understand the language they use? And the relationship these digital natives have with ubiquitous technology?

We also needed to consider how best to tap into insights from different groups: A traditional focus group might be intimidating for younger girls – and we needed to get their parents onboard for legal as well as research reasons. And how could we tap into the energy and natural curiosity of high-school girls?

We turned to PSB for help, and through extensive desk research and brainstorming sessions, settled on a ‘Community Case Study’ approach. Mimicking the life-journey that makes or breaks a girl’s interest in computing we not only needed to speak to girls of different ages, but also to other life stakeholders who shape a teenager’s development. This of course meant that we needed to tailor our methodology to each audience we spoke to: Ethnographic ‘kitchen-table’ discussions with primary school girls, their friends and their parents; fun conflict or ‘swing’ groups with high-school girls to learn the language they use to advocate a career in computing; classic focus groups with coding students and young professionals to better understand the life stories behind their decision in favour of computing.

And, given the huge role of societal factors, we wanted to follow an anthropologist-like approach by selecting two contrasting cities, Atlanta and New York, in which we spoke with more than 150 people.

Phase 2: Framing the solution

We used the language and insights from the case studies to build an online quantitative survey which was answered by ~9000 individuals drawn from the same groups as the community case studies.

We combined this survey data with labour force statistics into a model to identify the factors that most influence girls’ decisions to pursue computing further at each stage of their educational journey.

The model allowed us to show how the proportion of women could rise from 24% to 39% by acting on the most positively influential factors – and was also used to calculate the associated $299 billion uplift in women’s earnings.

Pleasingly, the barriers we identified in the community case studies were very strongly evidenced during the subsequent quantitative analysis. The need to spark interest at middle school; sustain interest at high school; and inspire interest in college, were all suggested by the qual – then proved by the quant.

The research within “Cracking the Gender Code” has supported the work of GWC by helping the organization tell the story of the gender gap in tech and make the case for interventions earlier in the academic pipeline.

The report has been used by GWC to rally support to programmes which have reached 185,000 girls across the United States. GWC founder and CEO Reshma Saujani said: “In order to create a more equitable tech industry, we have to understand the extent of the problem – how many girls and women are participating in the field, when they drop out of tech, and why. The research within the Accenture and Girls Who Code report “Cracking the Gender Code” has been invaluable as we work to rally support for our programs, for solutions to closing the gender gap in tech.”

Read the full report.

 

About the authors

Dominic King is a Senior Principal at Accenture Research. Accenture Research is a team of ~300 researchers and analysts across 23 countries. It shapes trends and creates data-driven insights about the most pressing issues global organizations face.

Brita Cooper is a Project Manager at PSB. With roots in innovative political campaign strategy, today PSB are a full-service research insights agency engaging blue-chip organizations across all sectors.

Successful parenting – Harnessing aspirations to save lives in rural India

India, one of the world’s fastest-growing economies, still loses 300,000 young lives each year to pneumonia and diarrhea, diseases that we have the tools to prevent. If practiced together, handwashing with soap at key occasions (HWWS) and complete immunization, two of the most cost-effective child survival interventions, could significantly reduce under 5 mortality. Lifebuoy, Unilever’s leading health soap brand and Gavi, the Vaccine Alliance, an innovative public-private partnership working to immunise children in the world’s poorest countries, came together to design an integrated communication platform called ‘Safal Shuruaat’. Translated as ‘Successful Beginning’, the program harnesses parents’ aspirations for their child’s success to help mobilise parents to handwash with soap at key occasions, immunize their children and other key parenting behaviours. The program aims to achieve sustained behaviour change in handwashing with soap and immunization under the ‘aspirational’ umbrella of successful parenting as a communication platform to save lives of young children and help them reach a better potential while intervening in the first 2 years: bringing down the under 5 mortality rates. Safal Shuruaat is being implemented by a consortium led by GroupM, with Kantar as the research partner responsible for monitoring and evaluation.

A successful start

‘Safal Shuruaat’ has been implemented in an initial two pilot districts in Uttar Pradesh, India.  Further scale-up in 12 additional districts is planned for the second half of 2019. The program takes parents of children under 2 years on an engaging journey through a series of village events, home visits, and a group encounter at the rural childcare centres and school.

The overall research design, provides 360-degree support to program implementation, with multiple components set out with the following objectives:

  • Formative: To understand the status quo and build a hypothesis that could be tested and utilized to inform initial program design and strategy.
  • Concurrent Monitoring (initial two pilot districts):To track key indicators on handwashing and immunization in synergy with the pilot intervention roll-out, and provide strategic inputs for course correction through learning, preparing the program for scale up.
  • Impact Evaluation: To estimate the effectiveness and impact of the program on the knowledge, attitudes, intents and practices around handwashing and immunization by comparing treatment and control groups (pre-and post-intervention) in the scale-up phase.
  • Sustainability Measurement: To capture behaviour regression and relapse to understand the intervention’s contribution to sustained behaviour change.
  • Documenting and Dissemination: To capture and record ‘positive deviance’, capturing insightful stories and creating a strong learning & sharing culture with internal as well as external stakeholders.

The Formative research formative research included 800 face to face CAPI assisted quantitative surveys with parents of under 2 years, along with 70 qualitative activities with key influencers and enablers, including extended family members, village heads, and field-level workers. Findings showed that parents broadly considered children’s health issues to be beyond their span of control and an unavoidable part of their life. Childcare practices were mostly governed by prevalent social beliefs, norms and rituals, which potentially contributed to the low uptake of suggested practices, even though promoted by front line health workers.

Concurrent monitoring was undertaken for a period of 10 months across 108 villages. Six monitoring touch points took place before and after program visits; each program visit covering progressive modules on HWWS, immunization and parenting. In a sample of about 4000 respondents engaged during the monitoring, a longitudinal panel sample of 320 households was followed to enable a deeper dive into handwashing behaviours.

The first round of concurrent monitoring (MV0) set up a baseline for knowledge, attitudes and practice indicators on HWWS, immunization as well as relevance of these in being a successful parent.

The incidence of handwashing post defecation was as low as 13% at the baseline and showed a rise of 53% within 6 months (MV4 after 3 program visits). The high engagement strategy, including the use of engaging audio-visual aides, managed to target other handwashing occasions as well. The incidence of handwashing with soap by the mothers before breastfeeding a child rose from 2.7% to 14.8 percent. In terms of the proportions, the percentage of people never washing hands post defecation dropped from 86.1 to 29.3 percent. These trends were similar for cross-sectional as well as the longitudinal panel participants.

The Mother and Child Protection Card (MCP Card) is an essential tool[1]designed to inform and educate the mother and family on different aspects of maternal and childcare, linking maternal and childcare into a continuum of care[2]. The program stresses the importance of using the MCP card and keeping it safe. Monitoring at MV4 showed an increase of 12 percentage points from the baseline (85.2%).  The compliance for three priority vaccines – Rotavirus, Measles Rubella and Pentavalent – relevant for children under the age of 2, grew by 45%[3], 35% and 20% points respectively.

Several social and religious constraints also act as barriers to immunisation uptake. Breaking down misunderstandings and finding a way to leverage or transform social norms becomes critical if we are to increase the uptake of vaccines.

Finally, the parenting component, which was the foundation of the integrated communication platform was also monitored. Awareness of key parenting behaviours, including the understanding of the need to bond with the child, ensure adequate nutrition and maintain hygiene behaviours increased by 18%, 23% and 11% points respectively. With respect to washing own hands with soap and getting the child immunized positive trends with a 2% rise in vaccination and 11% in handwashing was reported as actions to be a good parent.

The data was analysed to examine differences in the cohort exposed to specific program visits with access to assets distributed vis-à-vis the others. The proportion of people, who received the handwashing station always washing hands with soap post defecation was 10% higher than who did not receive. Similarly, the more exposures to the program visits the higher the proportion of ‘always washing hands with soap post defecation’. An immunization calendar was given to parents to facilitate reminders around immunization dates. The ones who received the calendar showed 12%-point higher compliance for pentavalent vaccine, 11% points higher for rotavirus vaccine and 15% points higher compliance for measles-rubella vaccine as compared to the cohort that did not receive it.

This project has been a rich learning experience for each of the stakeholders and the 360-degree research component has played a critical role from strategizing and creative design right through to implementation and monitoring. At the end of the 3-year program Safal Shuruaat will have reached 5000 villages and a minimum of 300,000 households with children under 2 years.

[1]Developed by the Ministry of Women and Child Development and the Ministry of Health & Family Welfare, Government of India.

[2]Implemented through the Integrated Child Development Services (ICDS) scheme of Ministry of Women and Child Development and the National Health Mission (NHM) of the Ministry of Health & Family Welfare (MoHFW)

[3]Rotavirus was introduced during the period of the programme so the increase of 45% is measured between MV1 and MV4

 

About the Authors:

Pallavi Dhall, Director- Research Services, Kantar

Esha Sheth, Sr. Global Brand Manager, Lifebuoy Social Mission, Hindustan Unilever

Susan Mackay, Technical Lead, Demand Generation, Gavi, the Vaccine Alliance

Surya AV, CEO-South Asia, Public Division, Kantar

Smita Singh, Senior Director, Groupm Media India (Pvt). Ltd.

Carol Szeto, Senior Country Manager, Gavi, the Vaccine Alliance

Abhishek Singh, Senior Director, Groupm  Media India (Pvt). Ltd.

Pradakshana Kaul, Assistant Manager, Lifebuoy social mission, Hindustan Unilever