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Focus groups or group interviews are a useful addition to other ethnographic methods described above. Focus groups involve gathering a group of people to discuss an important problem thoroughly. A group leader guides the discussion, using a series of carefully chosen questions. Individual depth interviews tend to be preferable to focus groups for examining very personal, sensitive or complex issues and focus groups tend to be more suitable than depth interviews for producing ideas, examining group interaction and its effects, developing and testing educational materials and refining health services. However, the following brief comments and suggestions may be useful in conducting focus group type assessments. Suggestions When conducting assessments, focus groups may be conducted in many different groups, including: sex workers; clients; truckers; soldiers; migrant workers; agricultural workers; mine/oil workers; traders; and youth-in- and out-of-school. It is usually easier if focus group participants are fairly similar in age, sex, education, socioeconomic background, occupation and fluency in the language used in the focus group, but this may be waived if a discussion between a broad cross-section of the community is desired. It is usually important to be careful when mixing people of different status. In many places, especially among such groups as the uniformed services, health workers or teachers, it is difficult to speak freely amongst superiors. The ideal group size is 8-10 people. This gives everybody a chance to talk and permits a sufficient range of contributors. The number should seldom be below 6 or above 12. It is hard to give firm guidelines concerning the number of focus groups one should hold. However, a rough rule of thumb is to hold at least two focus groups with each specific group and to continue holding focus groups until no new information emerges. Before holding a focus group, it is important to decide the objective of the focus group. For example, a focus group in the early stage of an intervention may be concerned primarily with the social and sexual context of HIV risk. Focus groups held when an intervention is well established may examine participants' responses to intervention services and programme adjustments needed. However, some themes are likely to be consistently important throughout a programme. These include how to remove barriers to condom use and how to improve the accessibility, acceptability and uptake of STI services. When the objective is clear, one prepares a question guide. This guide must not be too long or the focus group will be rushed and superficial. In general, about 10-12 questions are sufficient. The group setting is important. It should be accessible, private, quiet and unintimidating. It should also be large enough to seat 8-12 people in a circle, because this makes it harder for anyone to dominate the discussion. The group leader should sit in the circle with everyone else and avoid standing in front of the group or doing anything else that suggests higher status. The group leader then introduces himself or herself and the reporter, the purpose of the meeting, the other participants and the ground rules. Figure 5 presents a sample introduction. Hereafter, the focus group stands or falls by the group leader. If the group is tense, s/he should first put them at ease with a relaxing manner and innocuous questions. S/he should not seem judgmental or domineering and should convey warmth, enthusiasm and interest. S/he must encourage everyone to participate and quietly control dominant participants. When the focus group is over, the leader should invite concluding comments, thank the group collectively, noting how helpful they have been and citing specific insights they have provided, then thank them individually and say goodbye. The data are then analyzed and a report is written. To analyze the data, the following steps may be helpful:
Focus Group Questions Introduction Good morning/afternoon/evening. My name is _______ and I work for _______. We are studying ways of improving health and other services. As part of our studies, we've asked you here to discuss the problems that communities face. Our discussion should last for about _______ minutes. I will be helping to guide the discussion and make sure everybody has a chance to speak. This is my friend_______. S/he will be making notes during the discussion so that we do not forget any of the points discussed. Although s/he will be recording the points raised, s/he will not write down any names, so whatever you say will be confidential. Please remember, you are the experts and we are here to learn from you. Please don't tell us what you think we might want to hear. Tell us your views, whatever they are. Before we go further, we should all introduce ourselves. Please tell us your name and where you live. Now we have introduced ourselves, let me explain the ground-rules. They are very simple. Please don't interrupt anyone and try to give everyone a chance to speak. Are there other rules we would like to add? Questions
Illustrative Example Introduction A series of focus group discussions, complemented by other ethnographic approaches, were conducted among truckers, sex workers in Zimbabwe, yielding the following insights. Community Perceptions Truckers have unenviable reputations. Truckers complained people were reluctant to let their daughters marry truckers and indeed, community members admitted that they discouraged their daughters from marrying truckers. Trucking and Sex Work Trucking and sex work are closely interwoven. In many towns, informal brothels are situated by drivers' hostels and women living in them say their clientele are predominantly drivers. Sex workers wait outside hostels, depots and bars and hotels patronized by drivers. Drivers prefer hotels frequented by prostitutes and hotel managers in small highway centres encourage sex workers in order to attract truckers. Sex workers like truckers as clients for several reasons. They say they are usually tired and undemanding. They also have cash from unauthorised passengers and informal smuggling. International drivers have foreign currency. Sex workers often exchange sex for free transport. In some highway stops, sex workers are the only source of accommodation. Provision of food and shelter are closely linked to sexual services. Drivers also say it is cheaper to sleep with a sex worker than to stay in a hotel. Girlfriends In addition to sex workers, many truckers have girlfriends in several places. Sometimes, a woman is girlfriend to several truckers. Truckers' Lives Focus groups also offered insights into why trucking is linked to commercial sex. Drivers spoke movingly of the monotony and loneliness of their work, of the strain it imposes on marriage and family life, of interminable, hot days and long, dark evenings on highways, of spartan, drab hostels or truck cabins and of the "anti-community" environments, of depots, road stops or hostels dominated by males. One spoke wearily of only hearing adult males voices. Notwithstanding boredom and loneliness, a climate of sexual bravado exists, with drivers saying it is impossible to refrain from sex. Health Issues Truckers report numerous health hazards besides AIDS, including malaria and cholera. Many truckers kept their wives in rural homes because it is uneconomical to maintain family accommodation in town when they were away so much. Truckers believe their wives are also unfaithful. |
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