Maggio, R., Experimental Ethnographies of Early Intervention: The need for an integrated top-down approach, ABSTRACT accepted for conference

Abstract accepted at the workshop on ‘Critical Medical Anthropology Workshop’, Oaxaca, Mexico, 16-20 January 2017

Abstract:

Early interventions in child development and maternal health, according to what is considered to be the “gold standard”, should be conducted alongside a Randomized Controlled Trial tasked with the evaluation of their effectiveness. However, this combination of intervention and research methods features a number of problematic aspects. Questionnaires and surveys are often designed in terms that are not familiar for the research participants; it is difficult to detect changes in practices at the early stages of the intervention when the effects are small; in case the expected changes are not taking place, it is only at later stages of the intervention that quantitative methods will be able to capture the small, slow, or absent change in practices, with considerable costs in terms of time and resources; throughout the intervention, an uncertain number of research participants will leave the study and that will bear negative consequences for the statistical validity of the research findings. This list is only indicative and there are other important complications that it is not possible to recall here due to space limitations. These problems suggest that alternative methodologies should be considered in order to improve the design of the interventions and evaluations.

Ethnography can generate preliminary observations that can be used to design surveys and questionnaires in terms that research participants will find familiar; it can provide stark illustrations of early change in practices at a time when it is still difficult to capture such change with statistical methods; these observations can be used to take redressive action early on rather than wait until significant and meaningful statistics become available; ethnographers can also investigate reasons why research participants might want to drop out, and even reasons why perspective participants might not consent at the recruitment stage. The fact that ethnographies and RCTs are still considered separate and incompatible endeavours does not discourage researchers to experiment with innovative partnerships that integrate these methods, as it is the case of our collaboration between the University of Oxford and University College Dublin. However, collaborations of this kind have limitations that would be avoided if the integration of different methodologies was encouraged by funding agencies, rather than emerging spontaneously from the research experience. A topdown integration of ethnographies and RCT is therefore advisable.