ACT Consortium Guidance: Qualitative Methods for International Health Intervention Research

Social scientists from the ACT Consortium released this compendium of guidance notes and templates to help international health researchers design, set up, run, analyse and monitor qualitative research in their studies. This is a compendium of the methods used in the qualitative research of the ACT Consortium, which has been developing and evaluating delivery mechanisms in a series of 25 projects to improve artemesinin combination therapy (ACT) access, targeting, safety, and quality in malaria-endemic areas of Africa and Asia. The compendium consists of a series of guidance notes and corresponding templates and examples for designing, setting up, running, analysing, and monitoring qualitative research in international health intervention research. It is underpinned by the Consortium's reflections on the theoretical challenges of applying a meaning-centred approach in a set of projects that were related in a devolved, multi-team approach. The methods presented here are intended to be easily understood by public health audiences, and the authors have incorporated values and languages used in public health research such as systematicity, transparency, and the preference for work by teams over individuals.

The authors ask, "what is it about qualitative methods in particular that make them increasingly in demand today in global health research?" They respond that, first, qualitative research can be valuable for studying meaning: what is important to people based on their knowledge and experience and why, since meaning influences social interactions on an individual and collective level - and these interactions ultimately influence health outcomes. In that sense, qualitative research is humanistic because it focuses on the personal, subjective, and experiential basis of knowledge and practice. It seeks to situate the meaning of particular behaviours and ways of thinking about or doing things in a given context. Secondly, the interpretive and reflexive approach that qualitative research takes can reveal what is important about processes: of social behaviour, interventions, and research methods themselves.

This guidance document covers theory and practical advice on qualitative methods in 5 chapters. Chapter 1 introduces the reader to some of the principles of social science that underlies qualitative research and 3 key stages of intervention design and evaluation which qualitative methods contributed to in the ACT Consortium. In Chapter 2, users will be guided through different qualitative fieldwork methods, including in-depth interviews, focus group discussions (FGDs), and direct observations. Chapter 3 covers some practical issues relating to setting up a qualitative research project alongside or embedded within an intervention. They will find advice on how to set up a research project – from choosing a good team to drafting a protocol. While the entire document is devoted to improving the quality of qualitative research in interventions, in Chapter 4, specific theory and methods for assuring ongoing quality in qualitative research are discussed. The last chapter of the guidance focuses on the interpretation of qualitative data. It outlines different coding and analytic processes, as well as guidance on how to write up qualitative data and synthesise findings in the context of a research consortium. Qualitative research and social science theory terms which may be new to readers are highlighted in blue in the text; their definitions can be found in the Glossary at the beginning of the document. The guidance is accompanied by a protocol template and a set of training tools in PowerPoint presentations and as handouts.

"An outstanding challenge for us has been in writing up qualitative research findings in a meaningful way that goes beyond description of the responses of different participants involved in research activities. Researchers with experience in social theory as well as in the local political and economic contexts that frame the qualitative research carried out appear to be essential for generating research findings that provide a meaningful contribution to questions being asked by both academics and public health practitioners. We recommend, therefore, that in undertaking qualitative research as described in this document, investment is made not only in ensuring a good quality process of field research and data management, but also to employ qualified and experienced social scientists to lead the research and interpretation processes."

This resource was developed by the ACT Consortium, which is funded through a grant from the Bill & Melinda Gates Foundation to the London School of Hygiene & Tropical Medicine.

Click here for the 100-page compendium in PDF format (English).
Click here for the 107-page compendium in PDF format (French).