Chapter 3 Qualitative Part 1: Focus Group Discussions and Key Informant Interviews

In this first of three chapters summarizing Project RISE qualitative data streams we focus on the focus group discussions (FGDs) and the key informant interviews (KIIs) (the following two chapters present our ethnographically derived qualitative and our interviewing the interviewers data, respectively). We present searchable tables for an extensive list of perinatal rituals and biomedical practices and for perinatal food choice. The information from these discussions was used to shape the quantitative surveys and some key themes were explored further in the following ethnographically-derived chapter. Here there is strong support for a key finding - that the overwhelming majority of perinatal rituals are motivated to promote health or reduce harm to the baby and mother.

A multitude of causal relationships linking certain behaviors to outcomes is presented, many of which are echoed in later data streams. Most rituals are essentially health-neutral with respect to biomedical concerns. Most rituals and behaviors are inter-connected. We find that biomedical and traditional views often co-exist and evidence of perceived tension or conflict is fairly rare. ASHAs and Mothers have very similar personal health practices (another theme echoed in later chapters). Analysis of this qualitative dataset raises a question about the degree to which ASHA’s see themselves as persuaders or as culture-change agents. It seems likely that this endeavor is over-shadowed by a direct emphasis on services. We also find evidence supporting the notion that even though a commonly viewed strength of CHW programs in general is that they are members of the communities they serve, ASHAs are nonetheless seen as ‘outside the home’ whereas more traditional influencers, Dais especially, are ‘inside the home.’