FHI - Rapid Ethnograpic Guide Intro

Introduction

This guide introduces and provides simple advice on rapid ethnographic approaches. It is accompanied by a separate ethnographic question guide.

Rapid ethnographic assessment arose from a recognition that intensive techniques such as observation, key informant interviews and group discussions enable researchers to explore social issues in depth and to identify factors and relationships that may not be understood through quantitative survey. Quantitative surveys alone provide a decontextualised treatment of a community. Rapid ethnographic assessment seeks to make ethnographic data promptly available to programme managers. Rapid ethnographic assessment is judged by its ability to provide a rapid, broad overview of a community or sub-culture and by its ability to generate insights which inform or modify programme design or delivery. Rapid anthropological assessment is particularly useful in understanding sub-cultures with heightened vulnerability to HIV, such as gay males, injecting drug users or sex workers. Rapid anthropological surveys are increasingly combined with quantitative surveys and the results from the different approaches are used to triangulate and validate each other.

Key informant interviews

Key informants are experienced people with direct, expert knowledge of the subject you are studying. If there were a completely reliable way of finding key informants, assessment would be much quicker and simpler, as we could skip many other aspects of the assessment. Unfortunately, there is not. All we can do is offer some suggestions that may be of help in identifying good key informants.

There are logical reasons why certain people should have expert knowledge in certain areas. Logically, some of the following should have expert knowledge of commercial sex: experienced sex workers, especially informal leaders, experienced clients, management, security, reception and bar personnel in lodges and bars where sex work is common, doctors or nurses who frequently treat sex workers, traditional healers who provide services to sex workers, community-based distributors of family planning services, social workers who work with sex workers, members of women's groups and rape centres, police, though their comments should be interpreted cautiously, church workers, especially those with activities in areas where sex workers live, journalists who have reported on sex work, men in occupational categories where visits to prostitutes are frequent, including the uniformed services and transport workers; community leaders, especially in small, cohesive, established communities.

Within these groups, we ask people who the experts are. For example, when talking to sex workers, we ask them who their informal leaders or most experienced and knowledgeable members are. Similarly, we ask medical workers, journalists, social workers which of their colleagues work frequently with sex workers. People identified repeatedly as experts by different people may be promising key informants.

We usually talk repeatedly to key informants and once to other interviewees. However, we try to probe potential key informants to make sure they really are experts before we accept them as key informants and invest time interviewing them. When probing, we look for a long record of involvement, direct, personal experience and comments rich in situational and contextual detail and examples. We are wary of informants whose comments are limited to generalities. If our informant's reply is satisfactory, we proceed; if not, we politely thank them and tactfully discontinue the conversation.

We follow certain principles when doing key informant interviews. These include:

We begin with truly exploratory, flexible, open-ended questions
We never tell people they are wrong, give nonverbal clues or offer value judgments
We share our own experiences (without disclosing strong views) if doing so relaxes informants
We never move to a new topic until we have completely explored the topic under discussion
At first, our questions are open-ended and flexible and we pursue all unanticipated, but important, issues that arise
We make very brief notes on each informant's comments
We interpret and summarize the key informant interviews, perhaps using the following steps. First, we make a list, partly for intervention purposes, of all the areas, categories of places, addresses, days and times where risky sexual activity occurs. Second, we produce a summary, in point form, of the key points made by each key informant. Third, we make a summary, also in point form, of the separate key informant summaries. We divide our summary into areas of major and limited agreement and consider possible explanations for inconsistencies.

How do we know whether the information we get is reliable? There is no foolproof way, but we can do the following:

We can be attentive to internal inconsistencies in the comments of key informants and explore these inconsistencies in a reassuring way.
If some conclusions seem questionable, we try and determine whether an informant has drawn them from a single, memorable incident.
We ask ourselves whether the key informant's experience qualifies them to make a statement whose reliability seems uncertain.
We consider carefully whether the attitude the informant holds towards sex work may have influenced particular answers.
We compare answers of different key informants, looking for contradictions and points of consistency in the comments of different key informants.
We compare the information gathered from key informants with that yielded by other methods.

Observation

Next, we rely upon observation. To begin an observation, we re-acquaint ourselves with our maps and keeping it firmly in mind, go to bars, streets and suburbs where risky sexual activity is common. We go unobtrusively and mingle casually. We can learn a lot, in a bar, for example, by buying drinks for sex workers, clients, or bar workers, discussing sexual relationships and observing what is happening around us

Depth Interviews

The next step is to begin open-ended, depth interviews with target group members, using many of the same principles discussed above, for key informant interviews. As noted earlier, key informants are experts about other peoples' lives, while depth informants are experts about their own lives. We usually interview key informants several times and depth informants once.

Focus Groups

Focus groups or group interviews, which are discussed below, may form part of an overall ethnographic assessment, or they may be used on their own.

Triangulation

When different methods of collecting data are used and agreement yielded by the different methods is compared, this is called triangulation. Triangulation is an important way of verifying the accuracy of information. To triangulate data, we take the major conclusions gathered from different data collection methods and compare them for areas of agreement and disagreement. Where discrepancies arise, it is important to look for forms of evidence that help us to decide where the truth may lie. It is also important to suggest possible explanations for discrepancies.

Rapid Ethnographic Questions

Overview

What groups appear to contribute most to the spread of sexually transmitted infections? What is the supporting evidence?
Which sexual practices appear to contribute most to the spread of sexually transmitted infections? What is the supporting evidence?
Which groups have the greatest number of sexual partners and why?
Who are the most sexually active groups having sex with and why?
Where do people find new sexual partners? Why do they choose these places to find new sexual partners?

Sex Workers

Are there sex workers in the site?
What is the public perception of sex workers?
What places on the site have the highest numbers of sex workers?
What hours do sex workers work?
Where do sex workers work from? Are they stable or transient?
Are sex workers local or from outside the site?
What different categories of sex workers are there? Do sex workers work from their homes, streets, or bars/nightclubs? What is the relative proportion in each site?
Do sex workers cross borders to find clients?
Are the sex workers controlled by pimps or are they freelance?
How many partners a week do sex workers have?
What do they charge per session?
What do they charge per night?
Do sex workers report sexually transmitted infections?
Where do they go for treatment if they have a sexually transmitted infection?
What relationships exist between the police and sex workers?
Do sex workers use condoms?
What factors assist or inhibit their condom use?

Clients

Who are the major clients of sex workers?
What are the occupations and backgrounds of these clients?
Are the clients local or from outside the site?
What places in the site have the highest numbers of clients?
Where do clients find sex workers?
What do clients pay per short session?
What do clients pay per night?
Do clients report sexually transmitted infections?
Where do they go for treatment if they have a sexually transmitted infection?
Do clients use condoms?
What factors assist and inhibit their condom use?

Men with Multiple Partners

Are there other men who are NOT formal clients and who may have several sexual partners?
Who are these men?
Where are they found?
What sexual partnerships do they have and what risks are associated with these sexual relationships?
Do these men have sexually transmitted infections?
Where do they go for treatment if they have sexually transmitted infections?
Do these men use condoms?
What factors assist or inhibit their condom use?

Low-Income Women

Are there other low-income women who are NOT formal sex workers and who may have several sexual partners?
Who are these women?
Where are they found?
What sexual partnerships do they have and what risks are associated with these sexual relationships?
Do these women have sexually transmitted infections?
Where do they go for treatment if they have sexually transmitted infections?
Do low-income women use condoms?
What factors assist or inhibit their condom use?

Informal Traders

Are there informal traders on the site?
Are these informal traders local?
Do they cross the border frequently? Why? How often?
How many informal traders are there, where are they found, and what do they trade?
Does their trading work put them at risk for sexually transmitted infections (including HIV/AIDS)? How does their trading work put them at risk?
What sexual partners do the informal traders have and what risks are associated with these sexual relationships?
Do the informal traders have sexually transmitted infections?
Where do the informal traders go if they have sexually transmitted infections?
Do informal traders use condoms?
What factors assist or inhibit their condom use?

Truckers

Do truck drivers stop over at the site? If so, how long do they normally stay there?
What places do the truckers frequent most on the site?
What is the reputation of the truckers that stop over or spend the night at the site?
Do truck drivers sleep with sex workers on the site or do they have local girlfriends or both?
What do truck drivers think of sex workers or local girls that stay on the site?
Where do truck drivers find sex workers?
How much do truck drivers pay per session or per night?
Do truckers report sexually transmitted infections?
Where do they go if they have a sexually transmitted infection?
Do truckers use condoms?
What factors assist or inhibit their condom use?

Migrant Labourers

Are there migrant labourers passing through this site?
Where are they from? Are they national or international migrants?
What types of migrant laborers are there?
What are the social and economic characteristics of the migrants?
What do they do and why are they travelling through the site?
Do the migrants have sexual relationships with local people?
What categories of local people do the migrant workers have sexual relationships?
Where does the sex take place and where do the migrants find their partners?
Do the migrant laborers have sex with sex workers and if so, where?
Do migrants report sexually transmitted infections?
Where do the migrants go if they have sexually transmitted infections?
Do migrant laborers use condoms?
What factors assist and inhibit their condom use?

Spouses of Migrants

Are there spouses of migrant laborers on the site?
Where are they from? Are they national or international spouses?
What economic activities are these spouses involved in?
What is known about the sexual relationships of these spouses while their migrant laborer partners are away?
Who do the spouses have sexual relationships with?
Do spouses of migrants report sexually transmitted infections?
Where do they go for treatment if they have sexually transmitted infections?
Do the spouses of migrant workers use condoms with their husbands?
What factors assist and inhibit their use of condoms with their husbands?
Do the spouses of migrant laborers use condoms with sexual partners other than their husbands?
What factors assist and inhibit their condom use with these extra - marital partners?

Youth

Who are youth having sex with? What different categories are youth having sex with? Why are youth having sex with each category? Romance? Pleasure? Status? Essential item gifts? Luxury item gifts? Money?
Are youth having sex with older partners?
Are youth having sex with other target groups? What are these groups?
What are the most risky sexual relationships the youth are having?
Where do the youth find sexual partners?
Is there sexual coercion? With whom? What forms does it take?
Do youth report sexually transmitted infections?
Where do they go for treatment if they have sexually transmitted infections?
How do youth report being treated at the places they seek treatment from?
Do youth use condoms?
What factors assist and inhibit their condom use?

Community Organization

What informal community associations do people belong to? Possible examples include ethnic or neighbourhood associations, child minding groups, cooperatives, savings clubs, traders' associations, market associations, burial societies, sports clubs, cultural groups? Which are the largest and most active and why?
What different community associations do adult men, adult women, young men, young women and other groups of special interest, such as sex workers, belong to?
Which groups are most likely to belong to associations? Which groups are least likely to belong to associations?
What influences, potentially positive and negative, do associations have on members' behaviour?
Where, when and how often do associations meet? What activities do they do?
What opportunities are there to introduce AIDS prevention and care activities into existing community associations? How can such activities best be introduced and what problems may be faced?

Summary

How would you summarize the major sexual risk factors on the site?
Which groups have the most sexual partners?
What sexual relationships have the most STI/HIV risk?
What factors make sexual behaviour in this site different to sexual behaviour in other sites?
What are the top priority HIV prevention activities and why?

Rapid Ethnographic Guide