Methodology [Review of Kam Pussum Hed (KPH) Clinic]

The Review of KPH was conducted in two phases following consultations and dialogue between KPH Management and SPC. The two-phased approach was beneficial in that it allowed the review exercise to involve a local review team. This was important because it ensured a mechanism for participatory approach and provided a learning opportunity for the local team to participate in programme evaluation. Through the participatory approach, on-going consultations were maintained among team members throughout the process while staff of KPH Clinic also gained a feeling of ownership of the review findings.

The study made use of both quantitative and qualitative data allowing for a rich source of information that complemented each other to form a near complete picture of KPH. Multiple sources of data were also used, including clinic data, peer educators records of work, lists of workshops conducted, interviews with focus groups of different categories, interviews with key informants, exit interviews, and direct observations.

Phase 1

In Phase 1, the key activities included the formulation of the local Review Team, conducting of the evaluation training, development of a plan for data collection, and carrying out data collection using multiple methods. An evaluation training at the outset allowed the Review Team to uniformly understand the evaluation concept, helped them understand the rationale behind the review, the process and the methods used, and to develop a positive image of their participation towards the whole exercise. The 3-day training programme is attached as Annex 1.

During the evaluation training, logistical plans to carry out data collection were developed. Involving the local team ensured active and committed participation of key local personnel, built local capacity in undertaking programme reviews, and instilled a feeling of local ownership in the whole process of the review - from planning, to data analysis, to formulating key findings right up to the presentation of preliminary findings to key stakeholders.

Members of the Review Team included staff of Wan Smolbag and KPH, a clinical nurse midwife from Vila Central Hospital, the RH/FP Coordinator of the Department of Health, and SPC ARH Advisor, Fiji. The list of participants in the Review Team is attached as Annex 2. Phase 1 was undertaken during June 2002 and took 4 weeks to complete.

Phase 2

The key activities under Phase 2 included data coding and analysis, identifying the main findings, drafting the Review Report, and presenting the preliminary findings to a group of stakeholders. These series of tasks were undertaken during 5 – 12 July 2002.

Data Collection Tools

A number of data tools were developed with the Review Team and these were pre-tested during the Evaluation Training. In order to obtain adequate and relevant information under each of the specific objectives above, a combination of data collection tools were used – these included direct interviews, focus group discussions (FGDs), exit interviews, direct observations, and review of clinic-based health service data.

The design of the questionnaire guides evolved from a participatory approach where members of the evaluation team identified the areas where information was required and questions were structured accordingly. Following this, the questionnaire guides were pre-tested by the group.

The schedule for data collection using these tools was also planned collectively by the team. Hence, the plan took into consideration logistical factors that could potentially affect the completion of data collection within the planned timeframe. Following the exercise, a data collection schedule was structured that clearly identified groups by tasks, in terms of who were responsible for collection of which information, from which target groups, living in which communities, and which dates these would take place. At this level of detail, members of the team were clear of the tasks each one was to accomplish either individually or as a group. Having a detailed data collection schedule helped to complete data collection in a timely fashion.

These data collection tools are tabulated in the table on the next page. The table shows that for each of the key programme areas for review, a set of data collection tools were used to collect the relevant information. It also identified which groups were responsible for collecting data under each corresponding programme area.

Questionnaire guides for the different types of interviews and focus group discussions are attached as Annex 3. The data collection schedule is also attached.