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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

 

Driving Change in Behaviour Management

The Story of Ensuring Equitable Outcomes from Underprivileged Students

It was Monsoon of 2018 when I traveled to the city of Bangalore, India under the Market Research Society of India’s The Community Program (TCP), an initiative designed to give back to the community by offering world-class research and insights to small organisations which work for social causes at grass-root level. The task was unusual but interesting.

Parikrma Foundation is an NGO that strives for the holistic development of underprivileged children empowering them to become valuable contributors to society. It runs 4 schools and 1 junior college in Bangalore. Despite investment in a detailed Behaviour management policy, there was one issue that the NGO had constantly grappled with – Disciplinary Concerns.

Violence and other behavioural traits of underserved children (especially teens) that led to classroom disruption and hampered the growth of all the students. This inherent concern about discipline gave rise to need for a direction – whether or not to change the behaviour management policy? If yes, what should be the change? If not, what should Parikrma do?

This is where the journey began. While the problem looked like a disciplinary concern – to be fixed by rules and policies, I looked at it differently.

I believed that a lot of empathy was needed to understand and address this problem. The study had to be about behaviour and how does one influence it, and not about disciplinary policy and its flaws. Keeping the student as the centre of this journey – their voice and story needed to be captured. My task was to find a mid-way making the outcome relevant to both – students primarily, and the school.

To understand why the students do what they do, a qualitative research approach was apt. However, the techniques had to be minimally intrusive.

The study had 3 phases

PHASE 1: EXPLORATION

Where I set out to explore the problem in detail and left no stone unturned. It began with setting the context right and gaining conceptual clarity about adolescent behaviour. A thorough theoretical review and conversations with developmental psychologists helped in this.

This was followed by in-situ observations at the school to explore and understand what exactly is the behaviour which is labeled as undisciplined or disruptive. Also to pick non-verbal cues and elements that form a part of the school culture. I attended classes and became one of them so that the students could be themselves when with me.

I also interviewed teachers to explore stories and instances of disciplinary issues. Their challenges, their approach to discipline, etc. helped me to develop the next phase, the crux of this entire study, in a robust manner.

PHASE 2: DISCOVERY

Hidden motivations and perceptions are unearthed when the students have freedom to express. And this is exactly what the Interactive workshops we all about.

This was a unique one of its kind technique used for this study. Sessions full of energy, fun and laughter left me with amazing insights that were eye-opening.

Techniques like role-playing their teachers set the students free to express; The Superhero Factory was another exercise where the students were asked to build their own superhero by sketching and making collages, this helped me understand the figures these students look up to and want to project.

PHASE 3: DESIGN

The last part of the study where I took all the findings to some experienced psychologists and senior educators to gain action steps based on their experience.

The most important discovery from this study was – Keeping students at the forefront and dealing with them differently rather than changing rules and policies was what was required for addressing issues at Parikrma.

This broad discovery was then split into small action steps for the NGO based on key insights –

  1. Defining the school environment

“We have simple rules and regulations, we are not their teachers, we are their brothers and sisters that is why they call us Akka and Anna” – Teacher, Parikrma

Compassion is an important aspect of the culture at Parikrma – reflected in every element of the school, be it the pet dog kept at each school or be it addressing teachers as brothers/sisters.

This led to the home vs. school dilemma in students’ mind letting them bring negative behaviour from home into school easily. There was a need to set boundaries.

This was reinforced by introducing elements that make the boundaries clear – like behaviour contract signed between students, parents and the school, reinforced during sessions by psychologists.

  1. Building consistency

“Some teachers are strict and follow the policy as is, some don’t and use their judgment to some extent” – School Head, Parikrma

Inconsistent implementation of the behaviour management policy in action was curbed by knowledge sharing among teachers and giving them different levels of independence in making decisions related to policy implementation.

  1. Creating a positive ecosystem for the students

Crux of this study was the student’s mind – It was discovered that all students had an aspiration to move out of their current underprivileged state, wanted to have a good job and luxuries. What was different in generally well-behaved students was that they could project themselves in a positive way, while the disruptive students had low self-worth and limited projection of positive self-image.

This was reinforced through regular peer-to-peer mentoring, feedback and leadership roles given to disruptive students.

Parikrma Oxygen – a big step of Parikrma based on insights generated through this study. The NGO has invested in a dedicated place on the outskirts of the city which will transport them to another environment, where the students will engage in multiple extracurricular activities and would have the space to express themselves. 

The study seeded different thoughts, elements and action-steps into the “Parikrma Culture” and ways of functioning, marking the beginning of a change and the impact will be seen in the years to come.

About the Author:

Karan Sadashiv Sabnis, Senior Research Manager, Insights Division, Kantar – India

 

The True Added Value of Data Philanthropy

This article is an extract of the “Global Market Research 2018 – An ESOMAR Industry Report”

When talking about market research we usually discuss its commercial applications, such as product testing. Less is known about its contribution to the common good, even though development is a multi-billion sector. We ask several non-profits how data supports them in their powerful, world-improving endeavours – from making invisible street children visible, to tracking the spread of Ebola outbreaks.

Rebecca Lim

Rebecca Lim is Head of Our Better World (OBW), the digital storytelling initiative of the Singapore International Foundation, whose aim is to strengthen mutual understanding between global communities as well as enrich lives and effect positive change. The research that supports this work won an award at this year’s first edition of the ESOMAR Foundation ‘Making a Difference Competition’. Lim stresses the importance of reliable facts. “The data we have from our analytics informs us about what our online audiences are interested in, what they’re clicking on, and it guides us in our storytelling.”

OBW shares stories from non-profits from across Asia in video, photo and text form, to create a bigger awareness of good causes. The goal is to entice people to support them, says Lim. “It’s critical for us to have data, because that gives us insights and helps us get better in how we tell stories and how we get our audiences involved in the different causes.”

When the platform started six years ago, there was no research in digital storytelling for social impact in Asia. Primary research was needed to understand national psyches and uncover drivers of culturally and socially relevant story themes, to better connect with audiences. Only by understanding this, would OBW be able to nurture and grow an online community of action takers.

OBW approached Kantar Millward Brown to form a partnership to undertake this primary research. The study into digital audiences demonstrated how different triggers inspire people to act. “In India, for instance, the aspect of social change is most important. People want to be able to play a role in changing a flawed system. Having that insight, we created a video story about child sexual abuse in the country. This started a conversation online and many people approached the non-profit Cactus Foundation with stories about their abuse experiences, including a 70-year old lady. This also resulted in over 1000 volunteer enquiries to the Cactus Foundation. So that was really powerful.”

“We’re all about real stories, especially in this age of fake news, we feel these are all the more relevant.”

With such sensitive topics, it’s crucially important that Our Better World has access to the most reliable data. In case of a dispute or even a denial of social injustice, the organisation can always substantiate its stories by referring to data sets from credible sources. “We’re all about real stories,” stresses Lim. “Especially in this age of fake news, we feel these are all the more relevant.”

Sema Sgaier

Another winner in the ESOMAR Foundation ‘Making a Difference Competition’ 2018 is the Surgo Foundation, a privately funded action tank which partners with organisations and governments to help unlock some of their biggest challenges. “Our key principle is data,” says the foundation’s Co-Founder & Executive Director, Sema Sgaier. She explains that this is a multi-billion sector. Each year over 170 billion dollars is spent to improve the lives of people who live in poverty. This money is spent by multinationals, governments, donors etc. “It’s a pretty data-heavy sector. The question is how this data is being collected and used.”

As an example of smart data use, Sgaier tells about increasing the coverage of vaccines and immunisation to save children’s lives. “Spreading the vaccines is usually quite successful, but what’s lagging is the usage. We’re failing to treat the users as customers of a product because we don’t understand the detailed ecosystem they live in. So we try to close that gap with data and insights that are not traditional in the sector. With these we can design programs that improve the uptake of these services.”

The people whose lives the Surgo Foundation is trying to improve, are what Sgaier describes as populations who are in the dark to the private sector. “For example, many big brand products don’t reach places in rural India. Big manufacturers don’t reach these people through research. So for us, the challenge is to get the data, both on a large scale and on a detailed, deep level.” In order to get the much-needed facts, the foundation has developed its own multi-disciplined teams. It also partners with NGO’s, governments and large suppliers such as Ipsos, who have data collecting teams on the ground, as well as with start-ups who have developed new methodologies. “It really is a collaborative effort,” says Sgaier.

What distinguishes the Surgo Foundation within the non-profit field is its use of private sector-type insights in the public domain. “As an innovation lab, we’re trying to bring methodologies and approaches to the development sector that are not common, and in many ways are unique there. One example would be psycho-behavioural segmentation. In market research it is bread and butter, but in development it is new. In our sector we tend to look at demographics, at age, not at psycho-behavioural profiles. We’re really trying to shift the sector in its approach to thinking about data and how to collect it.”

Hugo Rukavina

Hugo Rukavina is Systems & Information Manager at StreetInvest, a International Development NGO that wants to improve the opportunities and safety of street children around the world. The organisation aims to better inform and positively influence stakeholders through research, data collection and advocacy. “To do this we need to demonstrate the impact of street work on street-connected children,” says Rukavina. “Research and data are key to supporting street-connected children. Without it, we do not know where they are or how best to support them.”

“The absence of this data makes these children invisible.”

Street-connected children exist in every country of the world, yet the lack of systematically collected and disaggregated data means StreetInvest does not know how many there are. “The lack of a standard methodology for counting them results in data which is contested and which lacks credibility. The absence of this data makes these children invisible, which leads to policies not being developed or measures that are ad hoc, temporary or short-term.”

StreetInvest’s headcounting methodology has been recognised as the sector-preferred approach to counting street-connected children, and has been used by a range of partners, including UNICEF. It seeks to provide a standardised, scalable, rights-respecting approach to collecting quantitative data on the number of street-connected children in a specified geographical location, explains Rukavina. “This data can then be disaggregated in by age, gender, disability and activities. The analysis and dissemination of this data is intended to inform the design of policies and programmes which affect street-connected children.”

The numbers have to be absolutely correct. Inaccurate data does not help street-connected children. Wildly inflated numbers can make policy makers and the public believe it’s an unsolvable problem because there is just too many of them in need of support. “Some NGOs may inflate numbers to attract funding, or they are simply based on poor estimates. Underreporting may have the opposite effect: if there is no hard data to show the existence of street-connected children in an area, the authorities can easily dismiss it as a minor issue that doesn’t require intervention.”

Bringing a wide group of stakeholders together, including governments, is one of the positive outcomes of StreetInvest’s headcount, says Rukavina. “It is not just about getting data, the process is also about bringing people and stakeholders together to reach a common understanding of the issues facing street-connected children, and that working with them in a rights-based and child-centred way is the best way to support them.”

Marie Stafford

Marie Stafford is European Director for the Innovation Group, JWT, an in-house futures consultancy that delivers trends, insight and thought leadership to its clients. She’s long been an advocate of businesses sharing their data for the common good. “If we agree that business has a role to play in helping to build a better world, then data philanthropy offers another route to achieving that goal. A lot of important data is held by businesses and organisations can’t get access.”

“Companies have an obligation to help solve social problems and this is an attitude they will bring to the workplace.”

The conversation is growing, she observes. Although she describes data philanthropy as still an emerging field, Stafford does see many signs of it gaining momentum. “Some data suggest that use of the hashtag #dataforgood has gone up by around 68 per cent in the last year. I think participation will definitely grow, but it’s going to take time. Participation is being driven by data scientists themselves, keen to put their skills to positive use outside the day job. Generation Z thinks companies have an obligation to help solve social problems and this is an attitude they will bring to the workplace. Gartner is now predicting that by 2020, employers with a data for good programme will have 20 per cent higher retention rates for data scientists. So it’s going to be a good way to motivate valuable talent.”

“Business has a role to play in helping to build a better world, then data philanthropy offers another route to achieving that goal.”

Stafford adds that consumers also rate ‘good’ companies higher. “Data philanthropy is just one way in which companies can demonstrate those values and pursue a social mission, and they have a big role to play in its future.” In a recent study JWT conducted on sustainability, 89 per cent of people across the UK, USA, China and Australia said they wanted to know more about companies’ efforts in the space. “I think in the contexts where it is appropriate and relevant, brands could involve consumers in the process, by actively eliciting their support for data sharing, even if this goes beyond the current legal requirements. At the end of the day data is generated by people, so it’s their data. It’s only right that they should also be able to take some credit for any positive impact.”

Good examples

Marie Stafford believes companies already hold data that can be put to work for good. She lists examples of data philanthropy:

  • IBM has a programme that connects its scientists with NGOs and academics.
  • DataKind is an organisation with global chapters that can match data scientists and analysts with causes that need help.
  • UPS donated handheld parcel-tracking devices that were used to help distribute supplies to refugees in Mauritanian camps.
  • Vodafone shares anonymised smartphone data with the Ghanaian government on human population movements, in order to track the spread of Ebola outbreaks.
  • Waze shared data on traffic flows to help academics tackle air pollution in Mexico City.
  • US food safety officers have used consumer review data from Yelp to help them prioritise their inspections.
  • Syngenta shared agricultural efficiency data gathered from more than 3,000 farms.
  • Intel and Google have been helping the National Center for Missing and Endangered Children track down trafficked children more rapidly through visual recognition and artificial intelligence.

 

Ghislain Mukuna

Ghislain Mukuna is Program Manager of the ADMIRE project, Catholic Relief Services (CRS) in the Democratic Republic of Congo. All around the world, CRS is using new technologies to understand and visualize data. “This helps us extract practical information that can lead to improved programming, expanded impact, and better insights on different issues,” says Mukuna. He gives an example: CRS’ data from DRC shows that girls miss more school days than boys. “Better menstrual hygiene management could help address this problem, but we found that inadequate infrastructure, lack of equipment and knowledge are obstacles to better menstrual hygiene management, whether at school or at home.”

Mukuna feels there’s a good chance the community can break the taboo around menstruation if the issue becomes part of the discussions in the community. “This remains a hypothesis, because the pilot hasn’t yet taken place, but we would like to test approaches that would improve knowledge about puberty and menstruation by facilitating communication between adolescents and their parents on taboo subjects.” Indeed, studies in the DRC have demonstrated that parents are adolescents’ main sources of information on menstruation.

At CRS they are optimistic that this pilot will lead to a high impact, given the positive response of the community to the results of this research. “Working together, we believe we can change the current menstrual hygiene management situation in communities.” The exchange of information is crucial, adds Mukuna. “We want to share insights like this one with CRS staff, partners and other stakeholders to leverage lessons learned and draw the public’s attention to an issue so we can work together to create a better world.”

Originally published in “Global Market Research 2018 – An ESOMAR Industry Report”

 

 

 

Breaking the Silence: Uncovering the Truth about Gender-Based Violence in Mongolia

Violence against women is a global problem that crosses cultural, geographic, religious, social and economic lines. It is one of the most prevalent forms of human rights violations, and it deprives women of their right to live fulfilling social, economic and political lives. Violence against women causes a myriad of physical and mental health issues that span generations, and in some extreme cases, it can result in the loss of life.

Understanding the magnitude and trends of violence against women, as well as its root causes and consequences, is key to effectively addressing the problem at the individual, community and national levels. However, up until recently, very little was known about the actual prevalence and patterns of violence against women, especially domestic violence, in Mongolia. For the longest time, authorities depended only on the number of reported cases of domestic violence to estimate its prevalence in the country. But in most societies, including Mongolia, domestic violence is still surrounded by stigma and many incorrect notions, and so many cases go unreported.

To address this crucial gap in information, the United Nations Population Fund (UNFPA) in Mongolia, together with the national government and the Swiss Agency for Development and Cooperation (SDC), initiated the first ever nationwide study on gender-based violence (GBV) in the country. This is an important first step in a comprehensive four-year endeavor to combat GBV in Mongolia by strengthening national capacity for GBV prevention and response. With this study, policies and projects addressing GBV can be planned, developed, implemented, monitored and evaluated based on accurate data.

The nationwide study uncovered a multitude of issues and information on GBV in Mongolia, including the prevalence, forms, causes, risk factors, and effects of GBV. The study combined quantitative data based on the methodology developed by the World Health Organization for their Study on Violence Against Women, together with qualitative data based on methodologies used in other countries. While these borrowed methodologies and survey instruments were revised according to the nuances of Mongolian culture and context, adopting internationally used methodologies allowed for international comparisons and a solid substantiation of the indicators and targets of the Sustainable Development Goals.

Given the ambitious scale of the project, UNFPA deemed it fit for the Mongolian National Statistics Office (NSO) to implement and manage the study. After all, as a government agency, their resources are already available for mobilization throughout the country. UNFPA provided extensive technical support to NSO, bringing in experts both from the UNFPA Mongolia office as well as its Asia-Pacific Regional Office. These experts guided NSO every step of the way – from developing the survey and planning its execution to enumerator training, from data analysis to report writing.

For the quantitative component of the study, a population-based household survey covering all 21 provinces of Mongolia and 9 districts of the capital city of Ulaanbaatar was implemented from May to June 2017. A total of 7,920 women (98% response rate) aged 15 to 64 years old were selected using a multi-stage sampling strategy to take part in face-to-face interviews for the survey. They represent all women aged 15-64 years old in Mongolia.

UNFPA and NSO also took extra measures to ensure that these women spoke candidly so that the study may accurately represent the true GBV situation in the country. The interviewers, who were all women, underwent an intensive three-week training to learn to collect information in a safe and sensitive way. The interviewers also referred to the study as “Women’s Health and Life Experience” to protect the interviewees and to encourage participation especially among households where GBV takes place.

To supplement the quantitative data, UNFPA and NSO added a qualitative component that is unique to Mongolia’s GBV study. A third-party research consulting firm was engaged to conduct a battery of qualitative methods to explain and validate the numerical results and to uncover details about the experiences of Mongolians in a way that the quantitative survey could not. Overall, 87 in-depth interviews, 59 key informant interviews, and 64 focus group discussions were conducted among not only women, but also the LGBTQI community, men, the elderly, and people with disabilities.

Combining the qualitative and quantitative methodologies produced a study with robust results that were analyzed in a more comprehensive and nuanced way. The study revealed the prevalence of the five forms of violence against women – physical, sexual, emotional, and economic violence as well as controlling behaviors – perpetrated by both partners and non-partners. The data was segregated by age group, province, urbanity, educational level, employment status, and partnership status. Additionally, the study also looked into the specific kind of violent acts per type of violence, as well as the underlying toxic beliefs and attitudes toward gender and relationships that contributed to the prevalence of GBV.

With the publication of the nationwide study, a communications campaign was launched to raise awareness about these statistics; the results were published in both English and Mongolian, multimedia content was produced, events were staged, and the raw data was made available to the public for free for their own analysis.

However, the numbers revealed by the study were staggering that conversations were forced among stakeholders. The survey showed that that more than half (57.9%) of Mongolian women experienced one or more forms of violence in their lifetime, and one in every three (31.2%) experience sexual or physical violence in their lifetime. More worrying still is that more often than not, the abuse is committed by their partner. These numbers were much higher than expected, and both government officials and the general public alike were forced to pay attention to what used to be the silent suffering of many. Longtime advocates of gender equality and the fight against GBV finally had the right data that can be used not only to create more relevant and better targeted initiatives, but also to persuade stakeholders, especially the national government, to invest resources in combating GBV.

Guided by the results of the study, UNFPA Mongolia, together with the national government and the SDC, was able to pinpoint ten locations for One Stop Service Centers, i.e., establishments that provide survivors of GBV with accommodations as well as health, psychological, legal, counselling, and protection services. These locations were chosen primarily on the basis of highest GBV prevalence rates compared to the national average, but with consideration given to geographical and population balance.

The high prevalence rates revealed by the study coupled with the tireless advocacy work of UNFPA and civil society actors convinced provincial authorities to invest financial and human resources toward GBV prevention and response in their territories. In 2018, 560 million Mongolian Tugriks (approx. USD 210,000) was invested by provincial governments toward the construction and operations of these One Stop Service Centers. This amount is almost double the amount spent by the Mongolian government in the last five years combined.

Beyond these initiatives, the results also proved useful for UNFPA and its implementing partners for behavior change campaigns. The data segregation allowed UNFPA and the Government of Mongolia to identify the most vulnerable demographics to target, while identification of the root causes of GBV guided the development of relevant and data-driven messages, particularly for campaigns that sought to educate the public about life skills and healthy relationship behaviors that can help them avoid and escape GBV.

With all the initiatives spurred toward combating GBV in Mongolia since the release of the landmark nationwide GBV study, its important role in the advocacy work to raise awareness and garner stakeholder support cannot be ignored. In fact, UNFPA is working closely with NSO and other key government ministries to amend the National Statistics Law to include the regular conduct of a nationwide GBV survey to better guide and monitor the work put into combating GBV in Mongolia in the coming years. Mongolia may still have a long way to go in the path toward eradicating GBV, but with reliable data, innovative solutions, and the untiring advocacy of many, there is surely hope that someday, we may have a violence-free society where the rights of women, children and men are respected and protected.

 

Making a Difference Competition: Empowering Digital Storytelling for Good

Winner of the Best international NFP case study of our Making a Difference Competition. This project was carried out by Kantar Millward Brown Singapore on behalf of Our Better World / Singapore International Foundation

“This simple and impactful case study is set for making a tremendous difference across all NFPs globally”

Six years ago, Our Better World (OBW) was created as the digital storytelling initiative of the Singapore International Foundation. This was the result of the opportunity that arose from the sweet spot of these three trends:

  • A media landscape filled with negative news or mindless entertainment
  • Ground-up non-profits/social enterprises doing great work but relatively unknown to the public
  • People feeling passive about giving back and not knowing how they can help

Telling stories of people doing good in Asia, to inspire the online audience to take action, became the mission of OBW.

The initial years of OBW saw proof of concept when non-profits/social enterprises attributed part of their growth to the stories OBW told. However, the team believed that greater success could be unlocked through deeper understanding of the online audience.

In Asia, there was no research in digital storytelling for social impact. Unlike in the US, where research is funded by large philanthropic organisations which believe in using media for good, the concept was ahead of its time in Asia.

Primary research was needed to understand national psyches and uncover drivers of culturally and socially relevant story themes, to better connect with audiences across Asia. Only by understanding this, would OBW be able to nurture and grow an online community of action takers. OBW approached Kantar to form a partnership to undertake this primary research.

Given the lack of such research in the region, Kantar designed the qualitative research to be both wide and deep. A dual approach was developed: personal interaction on the ground, combined with the wide reach of digital – deployed in Singapore, Malaysia, Indonesia, India and the Philippines.

Face-to-face interviews gave researchers insight on meaningful, emotionally-charged experiences among participants. Digital forums created spaces for dispersed OBW community members to gather and freely voice, evaluate and develop ideas, and tap into their hearts and minds.

This approach fused exploratory, evaluative and projective perspectives in the analysis, enabling not just an understanding of current realities and their contexts, but also the building of deeper insights for future strategies.

The research analysis decoded what “contributing to social causes” means for people, based on two attitudinal anchors: a personal, deeply emotional and social experience, and an antidote to an unsympathetic world. Furthermore, a spectrum of motivations in social contribution was identified – ranging from a desire to change (e.g. overturn atrocities) to a desire to enhance (e.g. improve lives and communities).

Building on this, the insights helped to construct the defining characteristics of meaningful stories by market and the role digital can play to influence attitudes. In brief, the construct looks like this:

  • India: Social change – the desire to confront a flawed system, where storytelling themes revolve around changing social inequalities; the role of digital being sensitisation
  • Malaysia: Social preservation – the desire to uphold ethics in the midst of social decline, where storytelling themes revolve around values and ethics that inspire a sense of nostalgia; the role of digital being a reminder
  • Philippines and Indonesia: Social cohesion – the desire to improve communities, where storytelling themes revolve around initiatives that positively impact communities; the role of digital being to garner support
  • Singapore: Social welfare – the desire to improve the lives of others, where storytelling themes revolve around individual actions and initiatives that improve the lives of others; the role of digital being amplification

In addition to the construct, a trigger to action was identified – the most effective stories were ones that evoked a combination of complex and intense emotions.

Overall, this framework connected consumer motivations with storytelling, and provided OBW a much-needed formula for defining authenticity and meaning for impactful storytelling, spanning the production of videos to social media copy. The following examples highlight how research helped to meet this objective.

  1. India: Post research, OBW told a story about child sexual abuse, calling for social change and action, which saw 1,020 volunteer enquiries. This was a significant jump in impact compared to a pre-research story about animals, that, whilst heart-warming, lacked strong call for change, and resulted in only 105 volunteer sign-ups.
  2. Singapore: Post research, OBW told a story about a volunteer group helping to provide gowns for babies who pass away prematurely, garnering over 340 volunteer enquiries for the cause. The story focused on how volunteer actions have helped bereaved parents. A previous story which called for volunteers for a hospice, but angled on what the volunteers did, resulted only in 24 additional volunteers for the organisation.

Research has helped empower OBW with confidence and a stronger base for compelling impact storytelling. The impact from applying the insights is increasingly evident.

Beyond OBW, the findings are also applicable for non-profits/social enterprises in Asia. Organisations can use the insights to craft their own strategic communications to cater to different audience motivations, to drive more impact.

OBW wants to play a catalytic role in spearheading research, applying insights for best-in-class digital storytelling for social good in Asia. What has been accomplished so far serves as a strong foundation for new partnerships and support, and OBW is now seeking further research investment to be made in this fast-evolving digital space. Not only would OBW apply fresh insights for better impact outcomes, it would also share them with the relevant sectors, contributing towards the media playing its role as a force for good.

About the Authors:

Making a Difference Competition: Reducing Child Mortality – A provider, a mother and a powder

Winner of the Most innovative NFP case study of our Making a Difference Competition. This project was carried out by Surgo Foundation in partnership with the Bill & Melinda Gates Foundation and the Clinton Health Access Initiative

“Huge potential impact in India and internationally where diarrhea kills large numbers. This is a really excellent, thorough and innovative and effective piece of research”

Diarrhea is the second leading cause of death among children worldwide. It kills mainly by causing dehydration. Fortunately, a simple, cheap, and scalable solution exists – the use of oral rehydration salts (ORS). Yet India sees more than 200,000 diarrheal-related deaths every year. Its most populous state, Uttar Pradesh (UP), accounts for a substantial portion of these.  ORS is available and relatively inexpensive in UP, but surveys showed that only 30% of children with diarrhea in the state were treated with ORS. Why were children not receiving this potentially lifesaving medicine?

In Uttar Pradesh, India, 84% of caregivers of children with diarrhea seek care from rural medical practitioner (RMPs) – informal community providers who often lack medical training. Several organizations trying to tackle this problem hypothesized that improving RMPs’ access to ORS and informing them about best practices for treating diarrhea would significantly improve the uptake and use of the treatment. A statewide program was begun to provide ORS directly to RMPs at prices that would improve their profit margins. This was combined with training RMPs on how to prescribe the treatment properly. However, after three years of investment, levels of ORS use among children had not improved. Surgo Foundation began working on the project with the aim of answering the ‘why’ – why ORS uptake was so low? Did families and providers understand the benefits of ORS treatment? Did RMPs have sufficient access to the drug to prescribe it? What else could be driving the low uptake of this critical drug?

In the first phase of our work, Surgo analyzed and integrated insights from several surveys, including a state-wide, large-scale quantitative survey of caregivers and a “mystery client” survey. This enabled us to map and understand the ORS treatment “cascade” – each step along the child’s path from having diarrhea to visiting an RMP, being correctly diagnosed, receiving ORS, and using the treatment. Our goal was to see where the largest drop-offs occurred on the path to ORS use.

The phase 1 research found that RMPs had ample access to ORS in the open market, which meant that the direct retailing of the product by NGOs was not filling the previously hypothesized gap. Surgo also identified a stark “know-do gap” among RMPs when it came to dispensing ORS to children with diarrhea. Around 80% of the RMPs knew they should use ORS, yet only 20% of children with diarrhea received ORS directly from RMPs. In essence, even though a majority of RMPs knew ORS was the right treatment, they weren’t prescribing it. These findings showed that the theoretical underpinning of the original project was not correct – lack of access to ORS and a knowledge gap among RMPs were NOT the main barriers to ORS use.

In phase 2, we undertook ethnographic research with RMPs and their mentors, and with caregivers, to better understand the “why” of low ORS uptake. We aimed to capture their views, practices, motivations, and treatment decisions. Our research allowed us to develop hypotheses on the mental models, beliefs, and emotions of both RMPs and caregivers. We found that caregivers judged the effectiveness of a treatment by how quickly it provided relief to the child. This led them to prefer antibiotics, which relieve symptoms even though they do not treat the diarrheal condition. Caregivers also held strong beliefs about the efficacy of medicines based on what form they came in: powders were seen as least effective, pills, syrups, and injections as better, and intravenous drips as best of all. In sum, because ORS was a powder, caregivers didn’t perceive it as an effective treatment.

These insights provided Surgo with a basis for our phase 3 research, in which a specially designed decision-making game incorporating behavioral-science concepts was used to identify and test the factors driving RMPs’ treatment decisions. We found that the behavior of RMPs was determined by a trade-off among three considerations: economic insecurity, the desire to make money, and the desire to provide the right treatment. Since people were unable to pay large sums to RMPs, there was fierce competition among RMPs to get as many patients as possible, and to retain their loyalty. This was where economic insecurity and the wish to make money came into conflict with prescribing the best treatment. In an effort to appear “expert” and meet caregiver expectations (and thereby retain their business), many RMPs focused on providing immediate relief for the symptoms of diarrhea. This meant prescribing IV fluids, injectables, and antibiotics – and avoiding ORS, even though this was in fact the correct treatment.

With this deep and nuanced understanding of what was driving 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. We recommended a portfolio of new interventions, including:

  • Targeted media campaigns to shift the paradigm of ORS so that it was not seen as a treatment, but rather as immediate care
  • Mass marketing of ORS to create demand among caregivers of infants and children
  • Phasing out direct retailing of ORS to RMPs (this led to significant cost-savings)
  • Interventions to increase RMPs’ sense of economic security

Collectively, these strategies led to an increase in ORS uptake in UP from 30% to 50% in under two years. Our approach to getting a deep and nuance understanding of the ‘why’ before jumping into solutions has significant implications for diarrheal treatment and child mortality programs globally.

This program was implemented in partnership with the Bill & Melinda Gates Foundation, which funded the ORS delivery program in UP, and the Clinton Health Access Initiative, which implemented it. The study was designed, led, and analyzed by Surgo Foundation. We thank Ipsos and Final Mile for their contributions to the research.

About the Author:

 

Making a Difference Competition: Menstrual Hygiene Management Study in DRC

Winner of the Best local/domestic NFP case study of our Making a Difference Competition. This project was carried out by Forcier Consulting on behalf of Catholic Relief Services D.R. Congo.

 

“This very important piece of research is something that could make a real difference to half the population.”

Every month girls face an additional barrier to education: their period. For Forcier, studying the relationship between menstruation and education means more than just attempting to understand absenteeism. Our goal was to provide strong field-based evidence to NGOs, the DRC government and all actors in the health and sanitation field. We believe that good research must go far beyond simple statistics, which is why we always chose to adopt a holistic approach to data collection and analysis, which in this case includes extensive research surrounding community attitudes, beliefs, and hard to see implications. In 2017, Catholic Relief Services selected Forcier to accomplish one of the largest studies on knowledge, attitudes, environment, and practices regarding menstruation in the Democratic Republic of the Congo (DRC). The overall objective was to determine whether menstrual management practices have an impact on school absenteeism for girls, and to evaluate how the Congolese government’s “Healthy Schools and Villages” program, supported by UNICEF, can contribute in improving menstrual hygiene management. Data was collected by local Forcier enumerators in the provinces of Kinshasa and Haut-Katanga, as well as in camps for internally displaced persons in North-Kivu, thereby allowing for an analysis in urban, rural, and emergency contexts.  In the province of Kinshasa and Haut-Katanga, both respondents living in areas impacted by the “Healthy Villages and Schools” program and respondents not living in these areas were interviewed, and, in all three provinces, both girls in school and out of school were interviewed. The results of this study will help NGOs, the Congolese government and UNICEF adapt their interventions so as to better respond to the menstrual hygiene needs of girls and women in the country.

Forcier put forth a holistically designed mixed-methods approach for this research. In order to garner a broad understanding of the different barriers menstrual hygiene can represent for women, it was essential to collect information from the various groups of people who can influence how girls and women manage their menses. Forcier conducted 2601 quantitative surveys with 10 to 17 year old girls and their female guardians and 1022 quantitative surveys conducted with 10 to 17 year old boys. Forcier in addition, uses qualitative interviews to obtain contextual details and experiences of people with opinions that can shed light on hard to see implications. Qualitative interviews were conducted through the use of focus group discussions. 60 Focus Group discussions were conducted with girls, fathers of girls, teachers, community leaders and health practitioners. To ask questions to 10 to 15 year old girls in camps for displaced persons, an especially vulnerable population, child psychiatrists used dice game to make them more comfortable discussing these issues and to overcome taboos about menses. Analysis was conducted by triangulating the quantitative and qualitative data collected, as well as information garnered through a thorough literature review.  The research was designed to allow for findings to be presented for the individual provinces in which data was collected as well as the country as a whole.

The research, made up of 3623 quantitative interviews and 60 Focus Groups, identified the main obstacles preventing girls in the DRC from meeting their menstrual hygiene needs.  Girls are unable to adequately manage their menstrual hygiene because of a lack of sufficient knowledge and understanding of menstruation in the country. Whether village leaders, educators, parents, or the girls themselves, many members of Congolese society are not properly informed on the causes of the menstrual cycle nor, critically, how to teach girls to manage their menses in a safe, private, and healthy manner.  This is largely the result of a substantial taboo that surrounds menstruation, in part consequence of a conservative social order that associates the menstrual cycle with girls’ sexuality, and which impedes open discussion with girls both before, during, and after menstruation first begins.  Additionally, poor infrastructure, especially in villages and schools – in particular, a lack of clean, girls-only and private bathrooms – prevents girls from adequately taking care of themselves when they have their menses. A lack of available and affordable tampons or sanitary napkins further complicates girls’ ability to ensure their menstrual hygiene, and adds to their fear of being seen in public at these times. As a result, girls often stay at home when they have their menses – sometimes days at a time – forgoing their usual activities, including sports, church, and, most crucially, school, for fear of being “discovered” and “shamed” by members of their community.

The findings of this study are vital because they will allow Catholic Relief Services and other organizations working on hygiene, education and gender issues to better tackle the specific challenges that girls face in living in a healthy way and in receiving an education.  Indeed, this research on menstrual hygiene management is one of the first of its kind, on a too often overlooked aspect of development that is crucial to understand for the sake of empowering women. In particular, this research will help the Congolese government, along with UNICEF, reinforce the “Healthy Villages and Schools” program that seeks to improve sanitary and hygienic conditions in thousands of villages and schools across the country, including in camps for internally displaced persons, by highlighting the need to raise awareness on menstrual hygiene, improve infrastructure and make available sanitary napkins. This will, in turn, allow girls to live more comfortable, healthy lives and live up to their true potential.

About the Author:

 

Giving the World’s Children a Voice: A UNICEF case study

The need was to bring children’s needs to the world’s attention by letting children speak for themselves.

Every year on the 20th of November, UNICEF celebrates the adoption of the Convention on the Rights of the Child through World’s Children Day. This is a very special day for UNICEF when the organization strives to get the world’s attention on the suffering millions of children across the globe experience and the criticalness of fighting for the rights of every child.

UNICEF, United Nations agency for the protection and advancement of Children’s rights, works to improve the lives of children and their families.

See the world through children’s eyes

UNICEF’s daily work typically involves adults exchanging with other adults about children’s issues. Despite being UNICEF’s ultimate stakeholders, children are rarely part of those conversations. 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 the product of the collaboration between UNICEF, Grey Advertising (the communications agency for the World’s Children Day) and Kantar’s Lightspeed Research: for the technical aspect of the research project.

Methodologies used during the research

UNICEF and Lightspeed agreed on adopting a quantitative approach in the shape of an ad-hoc survey among children and teens aged 9 – 18 in 14 countries. This was the most adequate methodology given our goal of getting reliable quantified data on children’s views and opinions. Considering UNICEF’s global mandate, the aim was to run the study in as many countries as possible within the available budget, to ensure the widest geographical coverage and to include a mix of developed and developing countries. The study was complex on many levels, agreeing on the adequate sample age bracket, capturing responses from 12,950 respondents, utilizing translations to include their local language and following all ethical standards and ESOMAR’s guidelines on conducting research among children. To help capture spontaneous reactions and give children their own voice, open and closed-ended questions were utilized.

We utilized descriptive statistical analysis to obtain children’s views to help paint a picture of the world through their eyes. The analysis was mainly kept at total eligible sample due to the lack of substantial differences identified through analysis of demographic sub-groups. Verbatim responses were left in raw format and used to get compelling quotes to bring the figures to life.

What about if you were in charge of your country. What would you do differently to improve the lives of people your age?

“Make sure children all have healthcare, access to good food and education.” – USA

“I would not steal. I would teach sports and add more classes at school.” – BRAZIL

“I will take immediate actions for girls’ safety.” – INDIA

“I would make more schools where they give all children breakfast, where the teachers would not be absent, and teach them well and love them, and take good care of them.” – MEXICO

Results were analyzed at country and multi-country level given the goal to relay the children’s voice into media at country and global-levels. Finally, we brought external perspectives to the analysis, e.g. comparing children’s perception versus reality to adults.

Impact

The research provided a multi-country perspective, across both developed and developing countries, on children’s concerns for themselves and for children across the world, their hopes, and their views on world leaders, but also on how they live their lives: what they do outside school or the personalities they admire.

The verbatim to the open-ended questions also provided some very poignant statements from children in their own words, about what they would do if they were in charge, and issues they would address if they had a “super power”.

I like to get the magic pencil. Everything I draw will come true.

I will draw food and schools and teachers for children.”

a child in India on the superpower they wish they had to improve the lives of children

The findings fed into press releases, media headlines and communications material that were shared and used at global and national level. The survey formed a key part of UNICEF’s media activity around World Children’s Day, which during the first 48 hours of launch garnered a high volume of mentions in online media outlets.

The research improved the existing practice

It is often felt, at least at headquarters level, that for an organization whose mandate revolves around children, UNICEF does not listen directly to children enough and does not consult with them enough in the organization’s decisions. Traditional thinking suggested that since it takes adults to help children, it is adults’ opinion that mattered.

The study was a reminder that UNICEF does not carry out opinion surveys among children often, and that the findings from such work are both highly valuable and compelling.

Also, the decision to make ‘Access to quality education’ a focus of UNICEF’s advocacy in 2018, initially came from the survey findings which highlighted that this was one of the issues children cared most about.

Relevant for society

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.

UN0146396 © UNICEFUN0146396Dejongh

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.

 

About the Author:

Benjamin Riondel, Consumer Insights Manager, UNICEF, Switzerland

Girl-Friendly Toilets

Qualitative Insights to the Benefit of Female Students in Public Secondary Schools

 

Kankali Secondary School (KSS) in Naikap, Nepal, is high up on the west side of Kathmandu valley in a very poor area. Started in 1982, its young Headmaster, Bishnu Paneru has helped build KSS into a high achieving Public Community School, with almost 400 students. KSS is now regarded as a model school in Kathmandu Valley. It also functioned as a support hub for the community after the earthquake in April 2015.

The non-profit Association Luxembourg-Nepal (ALN), started to support the Kankali Secondary School in the 1990’s. Inspired by their work, André Linden, a retired Market Research Director from Soremartec (Ferrero) and ESOMAR member, who studied at Heidelberg University with Claudine Hengesch, the President of ALN, started to sponsor the KSS students, and the school itself from 1993.

In 2013 Kankali Secondary School faced a decline in the number of students. The Nepalese newspapers were reporting an “unhealthy competition” in the Nepalese education system due to commercially-oriented Private schools. To be able to understand better the situation and find ways to support KSS, André Linden commissioned research with Simon Patterson and his team at QRi Consulting.

A three-stage methodology was adopted:

  1. Desk Research. QRi conducted Desk Research sourcing relevant reports from UNESCO, World Bank, UN Development Programme, USAID, and education conference papers. The findings were written into a 120-page draft report; “Understanding the Nepalese education system today – Looking for sustainable opportunities for development of Kankali Secondary School in Kathmandu Valley”.
  2. Qualitative field trip inspired by cultural anthropology. Simon and André organized a visit to Kathmandu in March 2014 to see for themselves the differences in quality standards, in all respects, between Private and Public schools. Together with a group of Headmasters, they visited 9 schools, including KSS, and conducted interviews with the Directors of each school. In addition, a meeting was held with the District Education Officer (DEO) of Kathmandu, during which the draft report was reviewed. Everything was documented with video, audio recording, and photographs.
  3. Field Analysis and Report. Once back, QRi completed the report, integrating the findings from the field trip, all the input received in Nepal, as well as input from Associate Professor Martha Cardell (Edinburgh University), whose papers on the subject had been recommended by the DEO, and who, during a subsequent mail exchange, underlined its importance for the community.

In July 2014, the final report was sent to all participants and stakeholders.

The Desk Research confirmed to Headmaster Paneru and his colleagues the value and importance of Public Community Schools. It also highlighted that boys’ education is given priority by the Nepalese Society. Boys tend to be sent to Private schools (at high cost), and girls, by default, are sent to Public schools in Nepal.

The field trip enabled us to understand in concrete terms the competition that Public schools were experiencing. We also heard first-hand the high potential of the female students. At a debriefing with the headmasters, everybody agreed “Girls are the hidden treasure of Nepal’s Public secondary schools”.

Whilst visiting one particular Public school the issue of girls’ safety and attendance came up. Then, as the discussion developed, we became aware that the girls’ toilets were rather basic, and the Headmaster disclosed that the girls had in fact been increasingly complaining about them. The existing toilets were only able to facilitate communal urination, with no cabins and no privacy. Defecation had to be done in the woods (part of the general Open Defecation problem in the region).  The poor facilities also meant that girls tended to stay home during their monthly cycle, thus missing classes.

Old Girl’s Toilets in Janabikas Secondary School, March 2014

This issue had not emerged through the desk research and had not been openly discussed before. This moment of truth had been made possible by the atmosphere of openness and trust that we encouraged as we toured the schools with the Headmasters, in a research setting.

Actions and Outcomes

The key difference this research made in human terms was the building of Girl-Friendly Toilets first at KSS’s sister school, Janabikas Secondary School, in 2015, then at KSS in 2017.

New Girl-Friendly Toilets in Janabikas Secondary School, 2015

The Girl-Friendly Toilets have increased morale and self-respect amongst the female students, as well as increasing attendance of classes. One headmaster wrote: “The facility of Girl-Friendly Toilets has given the school pride for all the students, staff, stakeholders and the community.”

 Another impact of this innovative research, resulting in the building of Girl-Friendly Toilets in two Secondary Schools in Kathmandu Valley, is that two other Luxembourg NGO’s active in the region have asked ALN for detailed information, studying it as a model for their own school projects.

We believe this case to be a significant example of where Qualitative Research has really made a difference relevant for society and NGO’s.

About the Authors:

Simon Patterson, Founder & CEO, QRI Consulting

André Linden, retired Market Research Director from Soremartec (Ferrero)

Umbrella of Hope

St. Jude Child-care centres (SJ), established in 2006, provides free accommodation and holistic support for needy families travelling for their children’s cancer treatment to metropolitan hospitals in India. Lumière conducted two research studies for SJ in 2010 and 2011.

SJ was on the threshold of expansion and needed to assess how their vision could be expanded while keeping the core intact. There was a need to evaluate project operations and efficiency in the three centers in Parel and in Kharghar, to bring maximum benefit to the children and families. Lumière conducted in-depth interviews with all stakeholders for a 360 degree feedback, and provided SJ a situation analysis with suggestions on expansion of services and new initiatives to better serve the beneficiary families. The initial study provided an insight into how families perceived SJ. It helped SJ arrive at the core essence which gave SJ the confidence to replicate the model across geographical boundaries. Venturing out of Parel and testing the first ex-Mumbai pilot, Kharghar, gave SJ the confidence to build a road map for scaling the vision.

A 360-degree research approach

Qualitative research methodology was used for the strategic social research projects for Parel (2010) and Kharghar (2011) centers. Our project team led by Deepa Soman visited all centers under consideration and used a combination of techniques, one-on-one interviews with founder, COO and center managers, family interviews, ethnographic observations. The sample included a mix of families by demographics, to cover children of different age of child, new/ returnee child, place of origin, parents’ profession. A 360-degree research approach was used to allow for in-center ethnographic observations (family units, community kitchen, dining area, washing and common areas), family interviews and focus group discussions. The moderator brought great sensitivity given the context (kids with cancer), build rapport, trust and comfort with the families and children, as many belonged to rural and disadvantaged societies. Multiple visits to the centers helped build familiarity and bridge distance with respondents. Focus group discussions were groups of 15 people. They were inclusive, long and more like ‘sharing circles’ than a focus group discussion. It included a mix of cohorts to optimize interactions. Notes taken from the interactions were used for analysis and report preparation. We used the brand key framework and archetype theory to arrive at the SJ core.

Outcomes

SJ sought to anticipate the challenges to scale with questions on whether to extend outside Mumbai, or have more centers within the city, disease focus on cancer or to consider diseases like heart and tuberculosis. The output helped arrive at core values and confidence that the core was robust and replicable. The strong, stable, committed leadership team was equipped to strategize and execute their road map for growth.

In 2006 SJ served 159 families through 3 centers, in the vicinity of the top cancer hospital in the country, Tata Memorial Hospital. The SJ team gained more confidence after setting up the center ex- Mumbai in the ACTREC facility of Tata Memorial Hospital. Unlike Parel centers which had the advantage of constant monitoring, visits, and guidance for smooth working, the Kharghar pilot was remote working. Lessons learned from stabilizing Kharghar centers were used to expand to other cities. This study provided a tipping point in the expansion strategy of SJ.

The SJ model was created for cancer care with the vision, ‘Every child coming to the city for treatment should have a SJ home to stay’. SJ grew in other cities, with centers in Kolkata (2012), Delhi (2013) and Hyderabad and Jaipur (2014).

Lumière conducted a baseline study in 2013 as part of a donor management requirement for funds utilization. This was a formal audit that used methodology of observation, documentation reviews on issue and usage, as well as traditional methods of face-to-face interviews of center staff. Building robust donor management systems is key to expansion.

In 2014 technology and process audits was conducted to identify the situation analysis, identify gaps and success process and technology improvement to enable ramp up. Post the study inputs, MIS systems have improved and offer real time feedback and proactive issue identification and resolution. Currently in phase I, staff across the country is trained to update MIS with patient information. Daily reports are generated through MIS.

Today in 2018

SJ operates 35 functional centers pan-India in 6 locations with on-going expansion. 2648 new families were admitted at SJ since 2009. SJ has opened centers in Vellore in 2018, and Guwahati will commence later this year. SJ caters to pediatric cancer patients with chances of survival. The support systems for families includes counselling for patients and families, art-based therapy, yoga, education, skill development for parents. An impact study of 60 families who went back home showed adopting healthy practices leading to an improvement in children’s response to treatment.

About the Author:

Deepa Soman, Managing Director, Lumière, India