3.5  Assessment methods

Assessing the key sanitation and hygiene aspects of a community requires the use of a number of investigation methods. The main methods (Asefa and Tessema, 2000; Feleke et al., 2003) are listed below:

• Interviews are conversations between the investigator and members of the community, usually on a one-to-one basis. Depending on the information required, different types of interviews and questions can be used, as described in Box 3.1. The interviewer takes notes of the interview or uses a voice recorder. When conducting interviews it is important to gain the interviewee’s consent before starting and to make it clear how the information will be used. Generally, interviewee’s comments should not be used in reports in a way that allows the person to be identified.
• Observation is often combined with interviews. Observation simply means recording what you see or are aware of. For example, while visiting households, interviewers observe the availability and quality of the sanitation and waste facilities, such as the household latrine, solid waste storage and disposal, and handwashing provision. In addition, the interviewer will try and gain a picture of the use of these facilities through observation and discussions. At the same time, the general condition of the housing, water management and food handling can also be observed. There is a risk that the observer will assess the position against their own personal views (a subjective view), so it is important to have a set of standards to be used by all observers to make the assessment as objective (based on things that can be measured or counted and not influenced by personal opinion) as possible. General observations can be made simply by walking around the area and noting the condition of the town. A typical observation sheet to be completed while observing a household is shown in Table 3.1.
• Discussions with the community can provide valuable information about the concerns and health situation of community members that can help to confirm the findings of the interviews and observation (Figure 3.1). For example, one would expect a high incidence of diarrhoea to be reported if an absence of latrines and handwashing facilities had been identified.

Figure 3.1 Community discussions can be useful as part of an assessment process.

• Focus groups can also be useful to find out what people think about a specific issue. A focus group consists of a group of about ten people who represent the community as a whole in terms of age, gender, employment etc. The group is coordinated by one of the team whose role is to introduce the subject and pose a few initial questions. The group then discusses the issue in question while the observer makes notes so that they can produce a summary of the group’s views and ideas. The coordinator should take as little part in the discussions as possible and only intervene if arguments develop or if the discussion strays far from the subject under discussion. An example of an informal all-male ‘focus group’ is shown in Figure 3.2.

Figure 3.2  Focus groups discuss specific issues.

• Questionnaires are another possible assessment method. A questionnaire consists of a set of written questions that is given to a group of people for them to complete. Questionnaires require less input from the investigators than interviews, so it is possible to get the views of a larger number of people. However, there is no opportunity for a ‘conversation’ to develop, so some useful information may be missed. A typical sample questionnaire for use by householders is shown in Table 3.2. The number of questionnaires used is always a compromise. A very large sample means that the results will be more likely to represent the entire community, but a smaller sample size will reduce the costs and the time necessary to deliver, collect and process the questionnaires. As a rule of thumb, at least 15–20 households should be surveyed in each kebele. If householders are not able to complete the questionnaire themselves, it can be used as the basis for structured interviews (see Box 3.1).