An Epidemic in the Field? Rapid Assessment Procedures and Health research

This paper reviews the development of various methods designed to quickly and accurately generate relevant social information pertaining to health and disease control. It examines the use of knowledge, attitudes and practice (KAP) surveys, community diagnosis, RRA, rapid epidemiological assessments (REA), and rapid assessment procedures (RAP) using anthropological methods. It is cautioned that KAP surveys may be inadequate to document behaviours or to explain social opinions, and that data require validation through triangulation. Often it has been used as a simple questionnaire without pretesting. Community diagnosis emphasises the participatory nature of research, using local researchers, flexible design and a mix of qualitative and quantitative methods. Community diagnosis is contrasted with other techniques (PRA, PALM, RRA). Both RRA and REA are characterised by "quick forays into the field". RAP using anthropological methods receives particular attention, given the lack of trained social scientists to work with disease control programmes and ministries of health and in light of the need for social science input into the development of health policies and programmes. The various techniques are assessed in terms of scope and methods. The discussion of RAP focuses on issues relating to professional competence (e.g. use of RAP by biomedical researchers), representativeness, reliability and validity of data (e.g. short time period of study). Ways in which to maximise the benefit of valid data are presented (e.g. triangulation). The paper also refers to many limitations (e.g. brief training, use of manuals, personal ability and dangers of rushing) of RAP applications and transfer.