Author: BBC Media Action's Hilina Assefa and Lois Aspinall, originally published on May 17 2017 - How we view our role and relationships within our communities shapes how we behave – with important consequences for development. When widespread, these views constitute ‘social norms’, which people tend to follow because they believe that others do and because they think it’s expected of them. Media Action’s programmes aim to challenge social norms that can lead to people risking their health and reinforce those that support people to make healthier choices.

Donors increasingly want proof that we’re changing norms at scale. But it’s not easy either to define social norms or to identify exactly how media influences desired outcomes, such as children getting vaccinated or mothers going to antenatal check-ups.

These are some of the challenges we face as Media Action’s research team. How do we design research to measure social norms and track whether they’re changing? We came up against this question when evaluating whether our maternal health radio shows had changed social norms in Ethiopia.

We set out to understand whether our programmes had convinced families to prepare for a birth by, for example, saving money and planning how to travel to the hospital. In Ethiopia, preparing for a baby’s arrival typically means planning the important post-birth thanksgiving ceremonies. Women are judged negatively if they don’t put on a good spread but the costs of hosting this celebration mean that there’s less money to get a woman to a facility when the time comes.

We primarily used qualitative methods to understand social norms but we also undertook large-scale surveys to understand how we were shaping social norms at a population level.

To highlight challenges around researching social norms with surveys – and how they might be overcome – here are five common responses heard in the field in Ethiopia: 

1. ‘How would I know what other people think?’

Though intuitive in English, it’s not always obvious in other languages that asking someone ‘what would your neighbour think?’ really means ‘what do you think your neighbour would think?’. Respondents sometimes take the question very literally and reply that they ‘didn’t know the minds of other people’.   

Cognitive interviewing, where interviewees reflect on what they understand by a question, and careful piloting of questions can reveal when something isn’t interpreted as intended. To get the wording of a question right, it’s essential to take the time to test and refine translations into local languages and carefully train field interviewers.

2. ‘Which people?’

When asked about ‘other people in the community’, interviewees often weren’t sure who they were meant to be thinking about. We consequently explained what we meant to respondents, to help them move from an amorphous sense of ‘other people’ to something more meaningful. For example: ‘If you think of five women you know, how many of them would start going for check-ups in the first three months of pregnancy?’  

3. ‘It’s none of my business!’

Our team found people in Amhara (a region in northern Ethiopia where the research took place) to be quite reserved. It’s an area where it seemed to be impolite to speculate on the lives of others, not least to an outsider with a clipboard.

Surveying was as much an art as a science, with interviewer rapport proving to be as important as good survey design.

When it comes to rapport the ordering of questions is important. First of all, you can turn people off a survey by leading with potentially sensitive questions. How willing would you be to tell someone what you earn or weigh when you just met them?

Second, it’s easier to get good answers to tricky questions (like those around social norms) if they’re asked some way into the survey after rapport has been built. But these questions can’t be left too late. People often find talking about things like community dynamics tiring, so you have to broach these topics while people still have enough energy to discuss them.

Finally, it’s important to brief interviewers well so they’re confident of the research aims. They’ll also be better at reassuring participants they’re not trying to probe into their private lives, but rather uncover the practices and perceptions of their community as a whole.

4. ’I don’t know’   

Respondents are often stumped by questions – particularly by those that ask to what extent they agree with a given statement. However, presenting them with a range of simple and concrete options can help elicit answers.

For example, to determine whether respondents believe their community sees something as appropriate or expected, we presented them with options such as: ‘they would think it’s OK’, ‘they would think it’s not OK’ and ‘they wouldn’t care’.

To determine what respondents think people in the community are actually doing, we presented them with choices like ‘none or a few do it’ and ‘almost all do it’.

We found that listing these options helped increase understanding and made the surveys less demanding of participants, resulting in fewer ‘don’t knows’.

5. ‘Let me tell you what happened to me during my last pregnancy…’

When a respondent has to choose from a limited number of options, there’s no way of recording the rich detail someone might provide through sharing their experiences in a more narrative form. Within the context of a survey, personal stories become conundrums (how do I classify this?) rather than goldmines of information. This tension demonstrates why qualitative research remains invaluable.

Illustrating this, we recently used a personal narrative approach to allow mothers to tell us the journey of their pregnancy. Asking questions like ‘Would you say that your story of pregnancy is the same as most of the mothers in your community?’ helped us understand whether or not interviewees were conforming to norms.

We’re continually exploring ways to improve our surveys to pinpoint what social norms are and how they’re changing, always with the aim of truly reflecting people’s perceptions and helping them improve their health.

Hilina Assefa is a Senior Research Officer with BBC Media Action’s Ethiopia team; Lois Aspinall is a Research Manager with the UK office.

 

Click here to access this BBC Media Action Insight blog and related links on their work on health in Ethiopia. 

Image credit: BBC Media Action

Contact:
BBC Media Action
BBC Media Centre, MC3A, 201 Wood Lane
London
W12 7TQ
United Kingdom (UK)
Phone: 44 (0) 20 8008 0001
Fax: 44 (0) 20 8008 5970
Media.action@bbc.co.uk