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  • Title: Family planning field research projects: balancing internal against external validity.
    Author: Fisher AA, Carlaw RW.
    Journal: Stud Fam Plann; 1983 Jan; 14(1):3-8. PubMed ID: 6836662.
    Abstract:
    This report discusses the experience of a two-year family planning and maternal/child health project in Nepal. Although the project was planned as an experimental field research endeavor, a series of unanticipated events repeatedly compromised the internal validity of the project and forced design changes. While unexpected events are common in the history of most field projects, they present the research evaluator with the fundamental dilemma of trying to maintain a high degree of internal validity without sacrificing external validity. Rigid research designs with tight control over the introduction and measurement of experimental variables may serve to increase internal validity but they may also create an atypical and artificial situation that fails to mirror real field conditions and thus threatens external validity. This report discusses the experience of a 2-year family planning and maternal/child health project in Nepal. Although the project was planned as an experimental field research endeavor, a series of unanticipated events repeatedly compromised the internal validity of the project and forced design changes. While unexpected events are common in the history of most field projects, they present the research evaluator with the fundamental dilemma of trying to maintain a high degree of internal validity without sacrificing external validity. Rigid research designs with tight control over the introduction and measurement of experimental variables may serve to increase internal validity but they may also create an atypical and artificial situation that fails to mirror real field conditions and thus threatens external validity. Goals of this project, which ran from 1976 to 1978 in the Gorkha and Dhanusha district, were to: 1) test a new field based, experimental model of training for Nepal; 2) compare the work performance of panchayat (community) based workers against a similar category of clinic based workers; and 3) evaluate the effect, if any, that these workers had on the family planning knowledge and contraceptive practice of currently married women. The area had previously been included in a KAP survey (family planning knowledge, attitude, and practice). Evaluation methods were to include collection of service statistics for panchayat and clinic workers, and comparison of data from the KAP survey with current family planning knowledge, attitudes and practices for each worker's area, collected by personal interviews and panels of currently married women. Unanticipated events effecting the evaluation included: 1) selection of panchayats too remote or not coinciding with KAP sampled panchayats; 2) lack of full staffing; 3) 2 sterilization camps held during the project period; 4) some panchayat workers began to work in clinic worker areas; and 5) salary payments were stopped for 2 months. Instead of a quantitative outcome evaluation, the project problems resulted in a process evaluation for a service delivery field demonstration. The project showed that decentralized mobile units using local panchayat workers could perform well without constant supervision in remote areas.
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