Abstract
BackgroundIn many parts of the developing world, rural health requires focused policy attention, informed by reliable, representative health data. Yet there is surprisingly little published material to guide health researchers who face the unique set of hurdles associated with conducting field research in remote rural areas.MethodsIn this paper we provide a detailed description of the key challenges encountered during health survey field research carried out in 2010 in a deep rural site in KwaZulu-Natal, South Africa. The aim of the field research was to collect data on the health of children aged 10 to 17 years old, and their primary adult caregivers, as part of a larger national health survey; the research was a collaboration between several South African and foreign universities, South African national government departments, and various NGO partners. In presenting each of the four fieldwork challenges encountered on this site, we describe the initial planning decisions made, the difficulties faced when implementing these in the field, and the adaptive strategies we used to respond to these challenges. We reflect on learnings of potential relevance for the research community.ResultsOur four key fieldwork challenges were scarce research capacity, staff relocation tensions, logistical constraints, and difficulties related to community buy-in. Addressing each of these obstacles required timely assessment of the situation and adaptation of field plans, in collaboration with our local NGO partner. Adaptive strategies included a greater use of local knowledge; the adoption of tribal authority boundaries as the smallest geopolitical units for sampling; a creative developmental approach to capacity building; and planned, on-going engagement with multiple community representatives.ConclusionsWe argue that in order to maintain high scientific standards of research and manage to ‘get the job done’ on the ground, it is necessary to respond to fieldwork challenges that arise as a cohesive team, with timely, locally-relevant, and often creative, solutions. Budgeting sufficient time and project resources for capacity building and community buy-in processes is also essential when working in remote communities unaccustomed to research. Documenting and sharing field experiences can provide valuable information for other researchers planning to conduct fieldwork in similar contexts.
Highlights
In many parts of the developing world, rural health requires focused policy attention, informed by reliable, representative health data
Many rural areas are disproportionately affected by the HIV epidemic [2,3], partly because of AIDS-ill migrants returning to their rural homes to be cared for when they are no longer able to work in the cities [2,4]
We developed a system by which our community guides would ‘scout’ each isigodi in conjunction with our non-governmental organisation (NGO) partner’s local network of home communitybased carers present in that area, before the arrival of the field team; in doing so they familiarised themselves with the area and could subsequently direct interviewers to homes to avoid households being visited multiple times
Summary
In many parts of the developing world, rural health requires focused policy attention, informed by reliable, representative health data. In many parts of the developing world, rural health presents particular challenges that require focused policy attention. Concerns around the status of rural public health have been a motivating factor in the development of partnerships among South African health practitioners and academic departments focusing on rural healtha. In recent years there have been indications that the South African government, as well as other developing country governments, are assigning greater priority to rural health issues [5,6]. Understanding and addressing the particular health needs of rural areas requires, among other things, access to reliable and representative health data specific to these contexts
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