The second step in Barrier Analysis is to develop the behavior
question. Since we will be comparing people who are Doers and Non-Doers
of the behavior, we need to include a question in the questionnaire
to determine whether the people you interview are now doing or not
doing the behavior (for screening purposes). In our example, you
would probably need to use a short series of questions:
- Are you currently breastfeeding (INFANT’S NAME)?
- Did (INFANT's NAME) have anything to eat or drink apart from
breastmilk during the past day and night?
Define "Doing" the Behavior
Depending upon the populations with which you work, you may wish
to further define what “doing” the behavior really means
or who your target group is. You might bring in considerations of
frequency, for example. If a child is presently exclusively breastfeeding,
but did not always exclusively breastfeed (e.g., she used prelacteal
feeds), is that enough to label the mother as a Doer? This decision
depends on how important full compliance is to achieve your goal.
A Doer could be defined as “currently exclusively breastfeeds
under six months” or as “has always exclusively breastfed
the child under six months.” Again, you make this decision
on how important frequency is to achieving some progress on your
goal. You might also want to focus on a specific set of mothers
(e.g., mothers whose children are at risk due to the mother being
HIV+). This type of refinement is useful sometimes if it supports
your overall objective.
Know Your Target Group
In defining the behavior question you need to know some things about
your target group (audience) before finalizing your study design.
While it is possible to get a general idea of “what proportion
do what” as part of your survey and to then make some of these
decisions after you have already collected data, this leaves you
vulnerable to not having enough in one group of Doers or Non-Doers.
We suggest you figure out more or less if any folks in your target
group do the behavior (e.g., exclusively breastfeed their child
under six months). This can be done by talking to mothers during
a mothers club meeting (for example), through a very quick survey,
or by using existing data (e.g., DHS data1 for the region
of the country where you are working).
When you have trouble finding any Doers, you may decide to:
- study the Non-Doers only without comparing them to Doers, or
- to relax your definition of Doers so as to have a comparison
group (e.g., Doers = mothers who exclusively breastfed for the
first three months of life [rather than the first six months]).
Using the Behavior Question
You will use this question in different ways depending on which
way you decide to do Barrier Analysis: through focus groups or through
individual interviews. If you are using focus groups, you will use
the question when putting together your two focus groups. In one
focus group, you will have people who answered yes to the question,
and in the other you will have people who responded no to the question.
If you are using individual interviews, you will include the question
in your questionnaire as one of the first questions.
1 See www.measuredhs.com.
Questions About Determinants)