A Discussion of the Reliability of Measures of Hygiene Behaviours: The Case of the Health Behaviour Intervention Project, Lima, Peru
This paper discusses the use of qualitative and quantitative methods to eliminate systematic sources of error in quantitative measurement of hygiene behaviours in the Health Behaviour Intervention project in Lima, Peru. The authors argue that the combination of methodologies can give public health better data for the design and implementation of interventions to prevent disease. In relation to qualitative methods, the paper discusses the reliability of structured observation data for health intervention studies. It presents background on structured observation in Lima, reliability of measure across observers and over time, and preliminary significant associations between behaviours and diarrhoeal disease.
The Centre for Tropical Disease Research Medical School at the University of Guerrero, Mexico has been developing the Sentinel Survey process since 1985. Community-based Sentinel Surveys are a tool for developing dialogue among families, local leaders, district health services and regional and national level health planners about health risks (00). They are based on the premise that through careful, inexpensive measurement, dialogue and using the perspective of the family health possibilities can be changed (02). The video focuses on a village survey (one of 43 sentinel sites in Guerrero) which investigated family practices that might increase the risk of parasites and diarrhoea (10). All households in the village were surveyed by local health workers. Blood, faeces and saliva tests were processed quickly and the data fed back to the community (14). A preliminary risk analysis of common practices such as using contaminated water to wash vegetables or keeping pigs in the yard was also carried out by health staff in the field using laptop computers (15). The results were distributed to the community the next day and demonstrated to the community that by changing certain practices their families' health could be improved (15.30). The information gathered can be shared with other district health authorities, as well as with regional and national level bodies. It can also be used as the basis for dialogue with relevant sectors such as the water or education authorities (23).
New agricultural technologies are often inappropriate to the needs of small farmers because scientists lack information about their needs and objectives. The IPRA method is a set of procedures which has been developed to put technology designers in regular contact with small farmers so they can better exchange information which will orient research to real needs. Farmers and scientists learn from each other and work together to identify problems, plan experiments and evaluate solutions. The aim is to mobilise the expertise and resourcefulness of small farmers so they can be active partners in agricultural research. The DVD demonstrates the various stages of the IPRA method as carried out in a village in rural Colombia. During first contacts with the villagers a rapport was established as the researchers attempted to carry out routine village tasks (09). Diagnostic meetings were then held for farmers to discuss common problems and the scope for improvement (10). When the farmers priorities had been established the researchers suggested new plant varieties, fertilisers and other components. The various options were considered for testing by the farmers (13). The farmers and researchers agreed on the components of the field trials and the same trial was conducted on several farms to obtain comparative results (14). The standing crop and the harvest were assessed by the farmers (17), and their families participated in evaluating samples of the products for flavour, quality and texture (18).