Laura Camfield Social Indicators Qualitative research.pdf

Wellbeing Research in Developing Countries: Reviewingthe Role of Qualitative Methods

Laura Camfield Gina Crivello Martin Woodhead

Accepted: 13 August 2008 / Published online: 12 September 2008 Springer Science+Business Media B.V. 2008

Abstract The authors review the contribution of qualitative methods to exploring con-cepts and experiences of wellbeing among children and adults living in developing

countries. They provide examples illustrating the potential of these methods for gaining a

holistic and contextual understanding of peoples perceptions and experiences. Some of

these come from Young Lives, an innovative long-term international research project

investigating the changing nature of child poverty in India, Ethiopia, Peru and Vietnam

(http://www.younglives.org.uk), and others from the Wellbeing in Developing Countries

ESRC research group (WeD), an international, inter-disciplinary project exploring the

social and cultural construction of wellbeing in Bangladesh, Ethiopia, Peru and Thailand

(http://www.welldev.org.uk). The authors show how qualitative methods can be used both

alongside and as part of the development of sensitive and relevant quantitative measures,

and provide some practical and methodological recommendations. They propose that

qualitative approaches are essential in understanding peoples experiences of wellbeing,

both now and in the future. However, the authors caution that while these offer many

benefits, for example, a less structured and hierarchical engagement between researcher

and participant; they require time, energy, and sensitivity. Qualitative methods also work

best when used by trained and experienced researchers working in the local language/s in a

community where some rapport has already been established. Finally, the paper recom-

mends combining data from qualitative and quantitative approaches (e.g. psychological

measures or household surveys) to enhance its explanatory power.

L. Camfield (&)Young Lives, Department of International Development, Queen Elizabeth House, 3 Mansfield Road,Oxford OX1 3TB, UKe-mail: [email protected]

L. CamfieldWellbeing in Developing Countries ESRC Research Group, University of Bath, Bath, UK

G. Crivello M. WoodheadYoung Lives, University of Oxford, Oxford, UK

M. WoodheadChild and Youth Studies Group, The Open University, Milton Keynes, UK

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Soc Indic Res (2009) 90:531DOI 10.1007/s11205-008-9310-z

Keywords Wellbeing Mixed methods Qualitative Developing countries Methodological

1 Introduction

Openness to insights from other disciplines1 has been the hallmark of organizations such as

International Society for Quality of Life Research, reflecting the fluid and multidimen-

sional nature of its object of study. The purpose of this paper is to illustrate through vivid

example the value of qualitative approaches to researchers, policy makers, and practitio-

ners who construct or use social indicators to map quality of life, with the ultimate goal of

enhancing the wellbeing of people in developing countries. It provides a necessarily

selective mapping of the terrain for future exploration and aims to inspire readers to engage

with qualitative approaches to and literatures on wellbeing, even if they do not adopt

qualitative methods. The approaches described in the paper have particular intellectual

histories that we cannot do justice to here; however, this should not prevent a pragmatic

recognition of their potential as a resource within an integrated investigation of quality of

life or wellbeing. For example, the role of participatory methods in understanding, and

possibly even developing indicators of wellbeing is illustrated with studies exploring

understandings of poverty, illbeing, and vulnerability; wellbeing; and resilience.

Concepts of quality of life and wellbeing, which for the purposes of this paper are treated as

synonymous enable engagement with the whole of peoples lives and provide more accurate

representations and measures than approaches that focus explicitly or implicitly on a single

dimension (for example, health or income). However, there are multiple definitions of these

terms that reflect different philosophical traditions, and little consensus, even within disci-

plines. For example, wellbeing can be used to refer to any or all of the following, all of which

have different implications for research or intervention: a subjective experience or state of

being (Diener 1984); the space where wellbeing can or should occur (Sen 1990) or a process

with wellbeing as its goal (Aristotle, 350 BC); and, after Veenhoven (2000), the liveability

of the environment and the life ability of the person. While definitions of wellbeing are

contested (it is tempting to succumb to the authoritative pessimism of Hird that there is no

accepted definition of wellbeing [2003, p. 4]), there are some common understandings.

These were reflected in McAllisters (2005) recent review of the wellbeing literature which

defined wellbeing as more than the absence of illness or pathology [with] subjective (self-assessed) and objective (ascribed) dimensions; it can be measured at the level of individuals

or society; it accounts for elements of life satisfaction that cannot be defined, explained or

primarily influenced by economic growth (ibid, p. 2).

In the context of research in developing countries these subtleties become more

apparenthow do local people understand wellbeing and how do these understandings

vary according to life phase, gender, socio-economic status, etc., within a single com-

munity? How do people pursue what they see as wellbeing or a good life and what trade

offs are they required to make to attain or preserve it? (e.g. between self and household,

present and future) What resources can people draw on in their pursuit of a good life for

themselves, their families, and communities, and what are the political and social barriers?

There is a further question of how far development agencies should take peoples priorities,

1 Two of the three authors trained as anthropologists; two have also engaged extensively with psychologicalmethods and literatures; and all three have conducted multi-disciplinary research with children and adults indeveloping countries.

6 L. Camfield et al.

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values and visions of wellbeing into account to ensure the credibility and legitimacy of

development (Copestake 2007). Additionally, there is growing interest in how public

conceptualizations of wellbeing are constructed (Deneulin and Townsend 2007), especially

in relation to children (Hood 2007).

These concerns are part of a shift within international development and child indicators

research (e.g. Camfield and McGregor 2005; Ben-Arieh 2006) from a deficit view that

focuses on survival, to one that acknowledges peoples resources and agency and pursuit of

wellbeing. The contribution of qualitative approaches to a focus on peoples resources and

agency is that they can encompass areas of peoples lives that are influential and important,

but rarely measured (for example, spirituality and religious practice). More participatory

approaches also challenge the reliance on experts and proxies by taking a subjective

approach to peoples experiences and treating them as researchers as well as subjects. We

propose that exploring understandings and experiences of wellbeing using qualitative

research is valuable in its own right, as the paper illustrates, and also improves the accuracy

of measurement. Qualitative research can make measures more comprehensible and rel-

evant to respondents, provide contextual information to explain particular outcomes, and

most importantly, ensure that the stylised facts such as the a dollar a day metric that

influence international assistance are based on measures of what matters.

The paper begins with a brief introduction to the important but slippery concept of

wellbeing, describing types of wellbeing research that have been undertaken with adults

and children. This is necessarily selective as wellbeing research is a broad category: most

international poverty research claims to be about wellbeing (e.g. Coudouel et al. 2001), and

studies of childrens development are implicitly about their wellbeing. The paper then

introduces qualitative approacheswhat they are and how they can be helpfulbefore

focusing on two overlapping approaches to research: qualitative (for example, ethno-

graphic, participatory) and mixed method, which combines insights from qualitative and

quantitative. We have ordered the paper in this way as a heuristic device; boundaries

between the approaches are blurred on paper and in practice, and there is no grand

narrative. We have also tried to resist the temptation to compare ideal types rather than

messy realities (for example, the lone anthropologist working for 30 years in a single

community versus a team of participatory action researchers interviewing villagers over

the course of a week). A reality check is provided by including some examples from our

own research with the Wellbeing in Developing Countries ESRC research group (WeD), aninternational, inter-disciplinary project exploring the social and cultural construction of

wellbeing in Bangladesh, Ethiopia, Peru and Thailand (McGregor 2007), and Young Lives,an innovative long-term international research project investigating the changing nature of

child poverty in India, Ethiopia, Peru and Vietnam (Young Lives 2008). The paper con-

cludes with some methodological reflections, including a brief summary of the challenges

of different approaches.

1.1 Research on Wellbeing in Developing Countries

Research into wellbeing and subjective experiences in developing countries is growing

rapidly,2 and represents a paradigm shift towards holistic, person-centred, and dynamic

understandings of peoples lives, which are nonetheless embedded in particular socio-

cultural contexts (Boyden 2006; Gough et al. 2007; Camfield, Streuli et al. 2008). Peoples

2 See Gough and McGregor (2007) and studies by Biswas-Diener and Diener (2001, 2006), the InternationalWellbeing Group, Moller, Graham, Rojas, Camfield, etc.

Wellbeing Research in Developing Countries 7

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values, aspirations, and experiences of happiness or unhappiness are now measured

directly within some large surveys of individuals and households (e.g. the World Values

Survey, South African Quality of Life Trends Study) rather than inferred from proxies such

as income (see Graham 2005; Guillen-Royo and Velasco 2009 for reviews of happiness

economics in developing countries). They are also explored in participatory studies that

attempt to identify the pathways to particular outcomes (for example, chronic poverty),

within the constraints of a cross-sectional study, and the perceived possibilities for change

in the future (see Table 4, Appendix 1 for a summary of the key studies). The inclusion of

subjective experiences and meanings is part of a move within international development

and research on poverty from economic to multi-dimensional understandings of peoples

lives.3 This is because the latter improves our understanding of the former (for example,

the role of social norms and relationships in maintaining community savings groups in

Bangladesh [Goetz and Sen Gupta 1996]).

However, even multidimensional understandings of peoples lives still focus on what

they should have or be able to do, rather than what people think and feel about what they

have and do (McGregor 2007), which is an obvious role for subjective measures and

qualitative methods. Multidimensional approaches also fail to acknowledge the interper-

sonal and recursive aspects of wellbeing; for example, the base of shared social and

cultural capital that defines locally defined necessities or what a person needs to partic-

ipate and aspire (Gudeman 2004, p. 9). By this we mean that peoples experiences and

evaluations of their lives are shaped by their perception of their environment and them-

selves, in the context of what they value and aspire to. The rationale for taking wellbeing as

the focus is that it places the person, in their relationships and surroundings, at the centre;

Rojas describes this as engaging with a person of flesh and blood in her circumstance []rather than the wellbeing of an academically constructed agent [2007, p. 261]). Quali-

tative approaches in particular foreground the presence of both the respondent and the

researcher, which highlights the fallibility of all data collection by emphasizing their role

in its co-creation, and encourages reflexivity about the selective process of interpretation

and representation.

Methods to explore wellbeing can be highly contextual, so people are not separated

from their environments, and sensitive to human diversity and its interaction with the

dynamics of power (McGregor 2007; Boyden 2006). The WeD group, for example,

characterizes wellbeing as a state of being with others, where human needs are met,

where one can act meaningfully to pursue ones goals, and where one enjoys a satisfactory

quality of life (2007). Peoples hedonic experiences (for example, pleasure or emotions)

are undeniably important: the New Economics Foundation defines wellbeing as the quality

of peoples experience of their lives (Shah and Marks 2004) and the cognitive psychologist

Kahneman characterizes it as wanting ones current experience to continue (1999).

However, peoples values and aspirations also play a role; in particular their response to

the central question is my life going well, according to the standards that I choose to

use?4 (Diener). White (2007) makes a further valuable distinction between living a goodlife (values and ideals), having a good life (material welfare and standards of living), andlocating ones life (experience and subjectivity).

3 See Sumner 2007 and the literature published by the WIDER research project on measuring humanwellbeing (e.g. McGillivray 2006; McGillivray and Clarke 2006).4 See also the work of philosophers writing on these issues such as Valerie Tiberius, Mark Chekola, andDaniel Haybron.


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As an integrative or umbrella concept, wellbeing provides the opportunity to combine

diverse literatures and methodological approaches to attain a holistic picture of peoples

lives. It enables researchers to explore firstly the way that wellbeing is grounded in and

mediated by social, cultural and political structures and processes. Secondly, the centrality

of relationships to understanding, pursuing, and achieving wellbeing, and finally, the

inevitability of trade-offs and contradictions in this pursuit. In the following section we

briefly outline the role of qualitative and mixed methods approaches in researching

wellbeing and provide examples of their value in studies with both adults and children.

1.2 Methodological Approaches to Wellbeing

We have loosely categorized the approaches to wellbeing discussed in this paper as

qualitative and mixed methods, recognising that even pure quantitative approaches often

contain an element of qualitative work (for example, focus groups or interviews to generate

the items for measures), aside from the qualitative aspects of survey administration

(Olsen and Morgan 2005). Similarly distinctions within the category of qualitative research

relate as much to how researchers choose to position themselves as to any fundamental

difference in ethos or method (for example, the claims made by some participatory

researchers or ethnographers that their research empowers or provides unmediated access

to peoples deepest experiences) (Table 1).

Table 1 Overview of the approaches described in this paper

Approach Distinctive feature Methods Examples

Qualitative,includingethnographicandparticipatoryapproaches

Holistic & flexible, in-depth, usually arisingfrom long-termengagement. Moreparticipatory workinvolves active, if oftenbrief, engagement toinvolve people indescribing, interpreting,and occasionallychanging their reality

Interviews; narratives, e.g.biographical essays oraccounts of illness; lifehistories, participantobservation,predominantly task-basedgroup or individualactivities (e.g. bodymapping, time usediaries)

E.g. understandings of agood life in Cairo(Wikan); concepts ofwellbeing in Bolivia(Calestani 2008) andamong the Cree (Adelson2000); Consultations withthe Poor (Narayan et al.2000); studies of urbanviolence in Columbia &Guatemala (Moser 2003,2004); developing a QoLtoolbox in Madagascar(Farnworth 2004)

Mixed-methods Combines the opportunitiesand challenges offered bydifferent methods andanalytical approaches;increases data validitythrough iteration &triangulation & enablestargeting of findings todifferent audiences

Combination of survey,qualitative, &participatory methods ordata (e.g. householdsurveys & participatorypoverty assessments orlife histories); analysis &presentation usingquantitative & qualitativeapproaches

e.g. WeD, Young Lives,combining ParticipatoryPoverty Assessment &surveys in Uganda(Lawson et al. 2006;McGee 2004) andRwanda (Howe andMckay 2007), combiningsurveys & life histories inBangladesh (Baulch andDavis 2007), structured &open-ended explorationof peoples visions of thegood in South Africa(Clark 2002)


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1.2.1 Qualitative

The sub-section on qualitative methods covers ethnography, and common ethnographic

techniques such as semi-structured interviews and participant observation, and task-based

participatory methods such as drawing. It also discusses the benefits from taking a more

participatory approach, whatever methods are used. Wellbeings location in the disci-

plinary and methodological borderlands makes it a classic object of anthropological

attention (Thin 2005; Corsin-Jimenez 2007). Wilk suggests using ethnography to study

wellbeing in the same way as it is used to study power (and by extension poverty)

where

Unpacking the various meanings of this term has helped make many of us understand

that it is objective and subjective, measurable and experiential aspects are really two

parts of the same whole. The objective reality of the exercise of power cannot be

separated from the beliefs and feelings that motivate, activate, and justify it. Vic-

timisation and empowerment are subjective as well as objective

(1999, p. 93)

Although some anthropologists accuse their discipline of neglecting wellbeing (e.g. Thin

2005; Wilk 2008), much early anthropology, for example, Margaret Meads study of

teenage life in Samoa (1928), is grounded in a powerful critique of modernity, possibly

driven by a romantic vision of the other that relates to the anthropologists own desire to

find an alternative vision of wellbeing (for example, one that draws on the deep

connections to ancestors and community that were considered absent in the West). These

motivations may be familiar to contemporary researchers of quality of life and wellbeing.

Despite applied anthropologys checkered history (e.g. Keesing 1945), it has produced

ethnography: a research methodology that is grounded and flexible, and capable of gen-

erating new and surprising information about the way in which people see the world

(Hammersley and Atkinson 1995). This is even the case when these tacit understandings

(Giddens 1997, p. 169) [are] so profoundly internalised that they cannot be asked aboutdirectly (White and Petitt 2005, p. 26). For example, White and Petitt argue that using

participatory methods to access local perceptions of the good life may not capture the

deepest values of what people consider well-being (for example, a respondents concern

about the state of their eternal soul) as these are beyond the frame of a wellbeing ranking

(ibid). Thin similarly proposes that wellbeing needs to be set in the broader context of

anthropologys concern with moralitywith what it means to be good, to live a good life

and to organize social processes and institutions that facilitate or inhibit virtue and well-

being (2005, pp. 45).

Ethnographic methods provide what the interpretive anthropologist Geertz characterizes

as thick description which attempts as far as possible to provide an insiders perspective

on peoples understandings and actions (our own constructions of other peoples con-

structions of what they and their compatriots are up to [1973, p. 9]). The illustration

Geertz gives of thick description is the difference between a blink and a wink; one is

an involuntary twitch, while the other can be a conspiratorial signal to a friend, or even a

parody of that signal to confuse an observer. The physical movement is identical but each

has a distinct meaning (as anyone unfortunate enough to have had the first taken for the

second knows [Geertz 1973, p. 6]), which varies between different contexts and cultural

systems. Geertz provides an example of thick description from his own research when he

was an involuntary participant in a police raid on the village cockfight, which gave him an

experiential understanding of one of the main components of Balinese wellbeing:


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Getting caught, or almost caught, in a vice raid is perhaps not a very generalizable

recipe for achieving that mysterious necessity of anthropological field work, rapport,

but for me it worked very well. It led to a sudden and unusually complete acceptance

into a society extremely difficult for outsiders to penetrate. It gave me the kind of

immediate, inside view grasp of an aspect of peasant mentality that anthropolo-

gists not fortunate enough to flee headlong with their subjects from armed authorities

normally do not get. And, perhaps most important of all [] it put me very quicklyon to a combination of emotional explosion, status war, and philosophical drama of

central significance to the society whose inner nature I desired to understand

Geertz (1973, p. 416)

Geertzs description illustrates the potential of ethnography for understanding how people

conceptualise wellbeing, how this changes over time and in response to particular

experiences, and what sacrifices people are prepared to make in its pursuit.5 As peoples

meanings are often deeply buried-Bourdieu describes how what is essential goes without

saying because it comes without saying (1977, p. 167)it may be necessary to

supplement direct questions about wellbeing with participant observation, and listen to

respondents speaking in their own terms, rather than in the slightly artificial context of an

interview or participatory exercise. The examples given in the paper illustrate the potential

of ethnography as a method for studying wellbeing; for example, exploring local

understandings of wellbeing (e.g. Calestani 2008), collecting detailed information on the

experiences of people living in poverty using longitudinal ethnography (e.g. Wikan

1985), and contextualizing understandings of peoples lives and livelihoods (e.g. Reynolds

1991). While a rich and holistic understanding can be gained through ethnography or

longitudinal qualitative research, reassuringly even a single interview can provide insight

into what someone means by quality of life or wellbeing, as described in the section on

mixed methods. This is especially so in the context of responding to a measure of

wellbeing, as described in Section 2.2.

The conventional distinction between participatory and qualitative and ethnographic

methods is an artificial one as participatory methods are obviously a subgroup of quali-

tative methods, and many qualitative and ethnographic studies of childrens wellbeing use

group or task-based activities (e.g. Punch 1998). Ethnography can also encompass the

altered researcher/researched relationship (for example, the anthropological classic

Reflections on fieldwork in Morocco [Rabinow 1997]), where participants have some

role in setting the agendas of the research, the course of data collection, and/or analysis and

presentation of results. Conversely, so-called participatory methods encompass many

degrees of participation, as illustrated by Harts ladder of child participation (1992), which

moves from child-initiated and directed to manipulation. Participatory research on

poverty is distinct from mainstream economic approaches in its emphasis on experiential

aspects of poverty such as being respected, having meaningful choices, and being able to

preserve ones dignity (e.g. Brock 1999). As in all qualitative research, participatory

studies aim to be experience-near, but they also aim to create a space for people to share

and reflect upon their experiences and to conduct research that generates valuable out-

comes for participants, policy makers, and practitioners. Good participatory work can

widen the lens to include aspects of peoples lives that are often overlooked in purely

quantitative studies such as companionship, everyday pleasures, and sources of meaning

5 The acceptance tale that Geertz recounts can also be seen as an example of the anthropological rhetoriccritiqued by Clifford and Marcus (1986).


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that enable them to sustain their wellbeing in insecure and resource-poor environments

(Laderchi 2001; White and Pettit 2005; Camfield and McGregor 2005). The process of

collective discussion and decision is seen as a good in itself, which can also spur col-

lective action (e.g. the Participatory Learning and Action approaches advocated by Reason

and Bradbury 2000), for example, the Childrens Forums in Vietnam carried out as part of

Young Lives (Pham and Jones 2005).Participatory research has become increasingly popular during the past twenty years,

evidenced by the mainstreaming of Participatory Poverty Assessments in the 1990s (e.g.

Norton et al. 2001) and the World Bank funded Consultations with the Poor study(Narayan and Walton 2000, 2002; Narayan et al. 2000), although its integration or

co-option into the mainstream has attracted some criticism (e.g. Cooke and Kothari 2001;

White 1996). The main claims made by participatory methodologies is that they more

closely reflect respondents worldviews than traditional, scientific approaches by (i)

recognizing the contextual, subjective and non-material dimensions of human experience,

(ii) illustrating the complex dynamics behind poverty and well-being, and (iii) draw[ing]

out culture, location and social group-specific understandings of the dimensions of well-

being (White and Pettit 2005, p. 13). For example, White and Pettit (ibid) cite two

volumes of practitioner reflections on participatory methods, which note their value in

identifying improved quality of life according to local standards (Cornwall and Pratt

2002), and capturing local perspectives (Cornwall et al. 2001).

Connecting with participants understandings is even more important for studies of

childrens wellbeing (as explored in Sects. 2.3 and 2.4) because childrens interests and

priorities may differ and even at times conflict with those of adults (Qvortrup 1994; Prout

and James 1997; Woodhead and Faulkner 2008). Childrens participation in analysis as

well as data gathering can increase the reliability of the research (Kirk and Miller 1986 and

Kefalyew 1996, p. 204, both cited in Ben-Arieh 2005) and may also help diminish the

ethical problem of imbalanced power relationships between researcher and researched at

the point of data collection and interpretation (Morrow and Richards 1996, p. 100). Hill

(1997) and Thomas and OKane (2000) provide several examples of how to involve

children during the data collection process, for example, by selecting methods that enable

them to control the form and content of the discussion, interviewing children on more than

one occasion, working in small groups to aid collective interpretation, or having a few

peer analysts draw out important messages from other childrens accounts.

Participation is assumed to enhance childrens subjective wellbeing in the short-term

through the act of participating in the research, and in the long-term as a means of

improving the accuracy of data collected to inform child-related policy making. Doing

research with children rather than on children enables researchers to engage critically withtheir own assumptions about childrens capabilities and about the nature of a good

childhood, and create spaces where alternative voices can be heard. However, participatory

research with children involves more than simply using participatory techniques as no

method is inherently participatory (White 1996; Morrow and Richards 1996) and

research methodologies need to be flexible to communicate appropriately with different

respondents and respond to changing contexts and emergent findings. Visual and inter-

active methods may be helpful, especially with younger children, to allow all participants

to engage in generating and reflecting on their data (Crivello et al. 2008). Nevertheless,

drawing, speaking confidently in front of a group, or talking with adults are culture specific

skills which children acquire gradually.


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1.2.2 Mixed Method

The sub-section on mixed methods distinguishes between different approaches to com-

bining methods (for example, the timing of the qualitative input), and describes the role of

qualitative techniques in drafting, piloting, and validating measures of wellbeing. Well-

being is a truly hybrid concept because it is both objective and subjective and these

aspects cannot be separated or reduced to each other (Wilk 1999). For this reason Wilk

recommends mixing qualitative and quantitative methods as any indicator no matter

how clever, is going to miss an essential quality of what needs to be measured. There is no

alternative but to combine measurements with assessments of what the measures mean to

the people being measured (1999, p. 93). Both quantitative and qualitative methods

provide answers on the nature and extent of wellbeing that can be used separately to

validate each others findings (triangulation) or brought together to deepen insights and

possibly raise new questions. Mixed methods research6 is defined as the combined use of

both quantitative and qualitative methodologies within the same study in order to address a

single research question (Hewson in Jupp 2006, p. 179). However, this simple definition

obscures the challenges involved in reconciling the different values, goals, epistemologies,

and analytical approaches held by different disciplines (see Olsen 2006; Bevan 2007b). For

example, Brannen describes how

Quantitative researchers have seen qualitative researchers as too context specific,

their samples as unrepresentative and their claims about their work as unwarranted

that is judged from the vantage point of statistical generalisation. For their part

qualitative researchers view quantitative research as overly simplistic, decontextu-

alised, reductionist in terms of its generalisations, and failing to capture the meanings

that actors attach to their lives and circumstances

(2005, p. 7, op. cit. Jones and Sumner 2008)

Disputes continue even within mixed methods research, for example, Bevan (2005) makes

a further distinction between Q-squared (called after the conference series of the same

name, see www.q-squared.ca/) and Q-integrated approaches as she contends that only the

latter is genuinely integrated. According to Bevan, while Q-squared approaches collect

and analyse data separately and bring it together to answer specific research questions, Q-

integrated approaches entail cross-disciplinary research using a range of research instru-

ments to produce different types of data that can be analyzed both quantitatively and

qualitatively. An example of Q-integration is the research on subjective wellbeing by the

WeD team in Ethiopia (Bevan 2007a, June) which reported aggregate responses to mea-

sures of wellbeing (Woodcock 2007) and also used individual responses in household case-

studies alongside qualitative data (Lavers 2008; Pankhurst 2006).

Mixed methods approaches sequence the input from qualitative and quantitative

methods in different ways, depending on whether they are combining methods to

increase understanding, initiate new research questions, create complementary insights,

or highlight contradictions for future exploration (Brannen 2005, pp. 1214). For

example, qualitative methods like semi-structured interviews, focus groups, and even

ethnography (Ware et al. 2003) are often used to generate item content for measures of

6 Cresswell (2003) and Brannen (2005), provide a useful overview of this area, and Carvalho and White(1997), Kanbur (2003), and Jones and Sumner (2008) explore the potential of these methods in relation tostudies of poverty and childrens wellbeing respectively.


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subjective health, which can be an important component of wellbeing. Cognitive inter-

views are used to understand more about how people respond to these measures

(Barofsky 1996), both with established measures (e.g. Mallinson 2002), and as part of

pre-testing (e.g. Bowden et al. 2002), and qualitative methods can be used in the vali-

dation of subjective measures, as they shift the focus from the measure to the respondent

by aiming to assess the accuracy with which a measure has represented their worldview

(Paterson and Britten 2003). Examples of cognitive interviewing and qualitative vali-

dation are given in Sect. 2.1.

2 Examples of Qualitative and Mixed Methods Approaches to Wellbeing

Section 2 illustrates the value of the approaches described above in exploring wellbeing

with both adults and children. Sections 2.1 and 2.2 provides examples of studies with

adults using qualitative (ethnographic and participatory methods) and mixed methods

(participatory numbers (Chambers 2003), validating measures of wellbeing, and inte-

grating qualitative and quantitative data). Sections 2.3 and 2.4 provides similar examples

from studies with children using qualitative (ethnographic and participatory methods) and

mixed methods (developing indicators or measures and integrating qualitative and quan-

titative data).

2.1 Studies with Adults Using Qualitative Methods

In this section we use Wikans longitudinal ethnography of a poor community in Cairo as

an example of an ethnographic approach to wellbeing. This method has a long history as

Oscar Lewis conducted similar studies with families in rural Mexico (1959) and Puerto-

Rican families in New York (1966), which informed his theory on the culture of poverty

(1966). Wikan (1985) carried out fieldwork with 17 families (100 individuals) from a small

neighborhood in Cairo, which she visited regularly for 13 years (19691982), four of

which were spent living with one of the participating families. Her sample was selected

through natural networks of friendship and amity to help her develop a rapport and

observe her respondents in their natural surroundings. Her main finding was that while the

expert judgment is that standards of living are in decline,

In terms of their own values the poor argue that they dress better, have better health,

better entertainment, more and better education, more employment opportunities,

better chances for savings and investments, less need than before for borrowing, and

much, much more in the way of prestigious consumer goods. And they celebrate the

feast [Eid]

(1985, p. 8)

Wikan notes the effects on peoples wellbeing of a change in their self conception from

seeing themselves as poor and shameful to experiencing increased self-esteem from having

a better style of living. This expresses itself in new clothes, which enable nearly all

families to celebrate the feast days, household equipment, and most importantly television.

Television not only provides a focal point by attracting husbands and sons who previously

hung out in cafes, but is also pleasurable as the entertainment introduced in such lives by

Egyptian TV comedy and soap opera genuinely changes the level of living (1985, p. 12).

She maintains that as goods have accumulated, so have all family members self-pride.

Whereas previously men were too ashamed of their homes to bring acquaintances there,


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they now have items to show off with pride (1985, p. 24). Wikan assert that the

importance of appearances in Egyptian society mean that material acquisitions play a

significant role in increasing self-esteem and argues therefore for their inclusion in

international measures of standards of living (noting also that standard measures such as

housing have little relevance in this context, due to the tenure system and positive attitudes

towards overcrowding). In addition to providing an alternative perspective on its

constituents, Wikan gives a detailed account of peoples dogged pursuit of wellbeing

(mak[ing] swift use of marginal improvements in opportunities and circumstances

(1985, p. 23), and unpacks issues of intra-household allocation (for example, how

employed daughters are more beneficial than sons for their mothers wellbeing because

they feel obliged to share their income).

Corsin-Jimenez (2007, pp. 12), in his edited collection on the anthropology of well-

being, uses Evans-Pritchards evocative description of the Nuer of the southern Sudan as

an illustration of how ethnography can contribute to our understanding of wellbeing

through extraordinarily rich descriptions of the social and political forms of life

[which] provide an alternative route into the political and theoretical imagination ofwellbeing. For example, Evans-Pritchard defines wellbeing for the Nuer as that in which

a family possesses several lactating cows, for then the children are well nourished and

there is a surplus that can be devoted to cheese making and entertaining guests (1940, p.

21, in Corsin-Jimenez, op. cit.). Ethnographies can overcome a common criticism of

wellbeing research as individualistic and politically nave (e.g. Sointu 2005; James 2007)

by providing socially and politically embedded accounts of wellbeing. James (2007, pp.

2021) criticizes the current rhetoric of wellbeing for a fastidiously modern and a his-

torical presumption about how individuals ought to fare in life and suggests that it is

absurd to look for wellbeing in contexts such as Sudanese refugee camps in Ethiopia

where a communitys historical sense of purpose has been evacuatedwhere people are

told and slowly come to realize, that they will never return to their old ways of liveli-

hoods. Calestani (2008, this issue) similarly explores potential contradictions between

individual and collective definitions of the good life in the Bolivian plateau, and Adelson

(2000) notes how for the Whapmagoosti Cree wellbeing or being alive well is inex-

tricably linked to the life of their community (if the land is not healthy then how can we

be? [2000, p. 3]). Contributors to Corsin-Jimenezs edited collection (2007) continue to

emphasise the social and political dimension of wellbeing by tackling subjects such as the

depoliticizing effect of international health and literacy programs in Nepal (Harper and

Maddox) and changing concepts of wellbeing (mad ife) among the Fuyuge in Papua NewGuinea in response to increased pressure from international mining companies and a

modernizing state (Hirsch).

The interaction between global and local dimensions of wellbeing was also captured by

Farnsworths work with smallholder organic farmers in Madagascar (2004), which aimed

to develop a simple and flexible QoL toolkit for use by local researchers. The methods

needed to be specific enough to produce unique meanings in particular situations, and

universal enough to speak to other stakeholders (for example, the German consumers at the

other end of the organic supply chain). She also felt the methods should be dynamic as well

as grounded as wellbeing is a process of becoming rather than a state. Farnsworths

approach has obvious value as a way of fully understanding local peoples realities before

developing a measure, and is quicker than the long-term ethnographic engagement

described in the earlier part of this section.


123

2.2 Studies with Adults Using Mixed Methods

More recently participatory research has been used in developing countries in con-

junction with household surveys (for example, Participatory Poverty Assessments), or as

a means of generating quantitative data (e.g. Barahona and Levy 2003). Community

wealth and more recently wellbeing rankings are often used in the initial stages of

participatory research as they provide valuable insights into how local people define

wellbeing and the referents they use when asked to make judgments about their own

lives (e.g. Seeley et al. 1995; Chadwick et al. 1995). According Van Campenhout (2007),

the advantage of wellbeing ranking over conventional poverty indicators in developing

countries is that they (i) use local conceptions of poverty and wellbeing that acknowl-

edge the complexity of rural settings (Scoones et al. 1995), (ii) include intangible

elements such as status, bargaining power, and access to support networks, and (iii) are

less vulnerable to individual biases (for example, underestimating current consumption to

increase the chance of receiving development assistance in the future). They also

acknowledge inequalities in household distribution that affect the wellbeing of household

members; for example, Van Campenhout noted that the major contribution of girls and

women in fetching firewood and water were captured by participatory methods, but not

by poverty indicators.

Findings from qualitative studies emphasise the importance of paying attention to

peoples subjective wellbeing or QoL, and qualitative methods have an additional role in

interrogating these constructs and improving their measurement. Within WeD subjective

QoL was explored both qualitatively (Camfield 2006) and quantitatively (e.g. Woodcock

et al. 2007). The WeD definition of QoL as the outcome of the gap between peoples

goals and perceived resources, in the context of their environment, culture, values, and

experiences (Camfield et al. 2006) was developed through a combination of literature

review and exploratory research in the WeD sites7 to identify dimensions of QoL and test a

range of methods. The definition builds on the World Health Organisations work on cross-

cultural quality of life measurement (WHOQOL group 1995) by highlighting the interplay

between peoples conceptions of their goals and satisfaction with their achievement, given

their material and social circumstances. It shows the additional influence of gap theories

such as Calman (1984), Michalos (1985), and Ruta et al. (1994). During the exploratory

research, WeD used the Global Person Generated Index8 (GPGI) as this represented the

best operationalisation of the WeD definition. However, WeD subsequently developed an

individualized measure of weighted goal attainment (the WeDQoL) where the level of

satisfaction with a goal reported by the respondent is weighted by how important they

perceived this goal to be. This is assumed to be a more accurate proxy for subjective

7 WeDs exploratory research took place in rural, peri-urban, and urban sites in Bangladesh, Ethiopia,Thailand and Peru. The average sample size for the countries was 360 (range 314419) and age and genderwere used as the key breaking variables, followed by religion or ethnicity. The fieldwork used qualitativeand quantitative methods, including semi-structured interviews, focus groups, the Global Person GeneratedIndex and the Satisfaction with Life Scale, all of which had been piloted in similar WeD sites.8 The Global Person Generated Index (GPGI) is an individualised QoL measure that uses a mix of open-ended questions, scoring, and points allocation to establish peoples satisfaction with the areas of life that aremost important to them. It was developed in 1994, revised four years later to broaden the focus from health-related QoL to QoL itself, and piloted in Ethiopia, Thailand, and Bangladesh in 2004 (Ruta et al. 1994,2004; Ruta 1998)


123

wellbeing. The WeDQoL bridges the gap between the ideographic approach of the GPGI

and nomothetic (abstract or universal) approach of international measures such as the

WHOQOL. By developing and validating a questionnaire with a common format and

additional items that reflected the priorities of people in particular countries (for example,

having metta-karuna for others in Thailand; see http://www.bath.ac.uk/econ-dev/wellbeing/

research/methods-toobox/qol-toolbox.htm), it was possible to not only integrate subjective

and objective data (for example, the Index of Needs Deprivation and total household

expenditure, Camfield and Guillen-Royo 2009), but also to relate the subjective data to

qualitative case study material for both individuals (Lavers 2008) and groups (Camfield,

Guillen-Royo et al. 2008).

Cognitive interviewing is rarely part of the process of developing a subjective measure

in developing countries, although arguably even more important due to the acknowledged

problems of these measures outside their original context (Camfield 2004). Bowden and

Fox-Rushbys development of the KENQOL (Bowden et al. 2001, 2002; Fox-Rushby et al.

2003, Fox-Rushby and Bowden 2003; Nzioka et al. 2001) is an example of good practice

as it involved first identifying the local concepts of health that the scale was based upon

through extensive qualitative research and long-term participant observation, and then

rigorously pre-testing the measure using six separate methods to ensure that it was cap-

turing the self-perceived and locally defined health of people in Makueni district,

Kenya (Bowden et al. 2002). Qualitative methods can also be used as part of validating a

measure, for example, Camfield and Ruta (2007) compared the content of the GPGI (Ruta

1998; Ruta et al. 1994) and in-depth semi-structured interviews as part of the validation of

the versions that were administered in Ethiopia, Bangladesh, and Thailand during the WeD

exploratory quality of life research (see also Martin 2007). This was a disconcerting

exercise as more than half of the cases analysed found minor discrepancies between the

GPGI and the interview, which related to the overall score, the relative weights in one area,

or basic errors of comprehension. Some discrepancies can be attributed to interviewer

competence; for example, Bangladesh had almost twice as many successfully completed

GPGIs as Thailand. However, there were some patterns: in Bangladesh the discrepancies

related to areas that were abstract, or personal, and thus difficult to capture in a few words

(e.g. own boredom and lack of fulfillment) while in Thailand they mainly related to

debt. This suggests that people will talk about different things in the more relaxed context

of a semi-structured interview, not merely topics that are abstract, or idiosyncratic (i.e.

important to them, but not important), but also ones that are potentially shameful. The

impression is reinforced in Table 2, which compares the GPGI scores for importance and

satisfaction given by a 73 year old man from rural Ethiopia with his responses in the

accompanying semi-structured interview. His overall score was low but positive (63 per-

cent), however, his description of his current situation was I am living a dead life, and

I want to die [] I am living a life that is horrible and very bad/worst, which suggests amuch lower score. Similar discrepancies can be seen in Table 2 between the weights given

to areas and the number of times they were mentioned, and between the score for satis-

faction and his verbal evaluations. This type of exercise underlines the need for caution in

interpreting both quantitative and qualitative data outside the contexts in which they were

collected. Since the respondent also said he wanted to die because he had no farming

implements, this may be a manner of speaking that relates to his age, location, or religion,

and would mean something quite different in the mouth of another respondent. It highlights

the value of thick description, or at least having local anthropologists or historians at hand

to resolve these puzzles (Table 2).


123

2.3 Studies with Children Using Qualitative Methods

Ethnographic approaches have been used in studies of childhood wellbeing, with the

obvious proviso that it is less easy for an adult researcher to be a participant observer, or

blend into the background. For example, Punch (1998) used a mixture of semi-participant

observation, informal interviews and task-based methods to investigate how children

negotiate their independence as they grow up in rural Bolivia. Corsaro and Molinari (2005)

conducted a seven-year longitudinal ethnography of a group of Italian childrens transition

from pre-school to middle school, which sets the unique opportunities offered by the

Northern Italian school system in an international context and reflects on the potential

threat from Italys changing political climate. Nonetheless, the authors are careful not to

diminish childrens agency, and show how peer-to-peer social interactions are as salient to

their educational development as support from parents and teachers, and create effective

rites of passage that maintain childrens wellbeing. Reynolds (1991) undertook a detailed

study of childrens time use in the Middle Zambezi Valley that used case studies of

precarious rural livelihoods to illustrate the impact of large-scale development projects

such as dams and game parks on peoples well-being. By intensively studying the activities

of 24 children her research provides an excellent example of how small facts speak to big

issues (Geertz 1973, p. 23), namely the impact of market-driven development strategies

on the wellbeing of rural populations. It is also a good example of mixing methods as

interviews and observations were combined with extracts from childrens diaries and

secondary data from district records.

There are many good examples of international participatory studies9 (e.g. Ungar 2003),

which address the related concept of childhood resilience (often defined as maintaining

subjective and psychosocial wellbeing in adverse circumstances, e.g. Masten 2001). For

example:

Day-in-a-life (Gillen et al. 2007, http://dayinthelife.open.ac.uk/index.cfm), whichfilmed five days in the lives of 30-month olds in Peru, Italy, Canada, Thailand, and the

UK to explore cultural differences in development and learning in early childhood

Table 2 Comparison of quantitative and qualitative data on the subjective experiences of an Ethiopianrespondent

GPGI area Quantitative data Qualitative data

Wealth,poverty,& assets

Score 2 of 6, 30% weight, mentioned [20times

It is good to die rather than to live in poverty. Iam very poor

Education Score 4 out of 6, 30% weight, mentionedindirectly twice

I am not skilful, knowledgeable, and sociablebecause of my poor living condition

Labour/work

Score 4 of 6, 20% weight, mentioned 16times

I am not benefiting from my life because noreturn from my work

Health Score 6 out of 6, 10% weight I am getting physically weak and old

Peace Score 6 out of 6, 10% weight, mentioned 5times, but not in relation to the currentregime

This day I am not happy with any thing butduring the Haile Selassie regime I was happywith life

9 See also Johnson et al. (1995) on environmental resources in Nepal; Woodhead (1998, 1999, 2001) onchild labour; Ennew and Plateau (2004) on physical punishment; and Boyden and De Berry (2004) onreintegrating child combatants.


123

International Resilience Project (Ungar and Liebenberg 2005, www.resilienceproject.org), which examined how young people grow up well in 14 challenging environ-

ments, despite exposure to what local informants characterized as atypical levels of risk,

using culturally appropriate methods such as talking circles, and

Negotiating resilience study, which applied the day-in-a-life methodology to the livesof 1315 year olds in matched sites in Canada, China, India, South Africa and Thailand

who are making successful transitions between two (and possibly more) culturally

distinct worlds (Didowsky, pers. comm.)

All these studies seek relatively unmediated access to childrens perspectives and expe-

riences (for example, by using video diaries), and involve children and/or significant adults

from their families and communities in interpreting the data. For example, teenage par-

ticipants in Negotiating Resilience are asked to discuss both their own video tape and atape from a child of the same gender in a paired research site and reflect on any similarities

or differences (e.g. Saskatoon in Canada and Cape Town in South Africa were paired as

both contain young people in ethnically-based informal settlements). This encourages

participants to interrogate their own ideas about what constitutes wellbeing, in the context

of examples from another country where similar challenges are responded to in a very

different way.

As discussed earlier in the paper, a key finding from participatory research with adults

in developing countries is that the quality of interactions and relationships matter as much

to peoples wellbeing as the quality of their assets. This is especially true of family and

community relationships which are both intrinsically and instrumentally valuable (Devine

et al. 2007) and have positive and negative dimensions (Wood 2003). Johnston (2006)

generated similar data with children when she used participatory poverty trees in a

collective exploration of childrens ideas about the causes (roots) and outcomes (fruits)

of poverty. For example, Johnston found that the quality of family relationships featured in

childrens definitions of poverty, and having parents who were absent or still very young

was identified as one of the causes of poverty. Incidentally, the similarity of responses to

questions about poverty and wellbeing in developing countries seems to support Jones and

Sumners premise that the distinction between the two concepts is perhaps overdrawn

(2008). It suggests that the concepts may be linked in the minds of both researchers and

respondents through a positive/negatively connoted dualism [of] well-being/poverty

(Neff and Olsen 2007, p. 12), in the same way that when people are asked to describe the

experience of wellbeing, they invariably list the resources required to attain it.

Fattore et al. (2007) also used group dialogues, combined with individual interviews and

self-directed task-oriented projects (for example, keeping a visual journal) to understand

what Australian children (aged eight to 15) saw as positive well-being. The goal of the

study was to identify new or important indicators to monitor the well-being of Australian

children, for example, feeling valued and secure in relationships, being a moral actor in

relation to oneself and others, and being able to make choices and exert influence in

everyday situations. Young Lives similarly used participatory methods to explore childrenswellbeing (Crivello et al. 2008) through group exercises and individual interviews with

children and adults, which built on their previous participation in the group exercise. The

exercises produced voluminous data on important components of wellbeing during pilot-

ing, especially from older children and caregivers, and showed surprising regularity across

respondents and contexts (for example, community focus groups vs. individual interviews).

Key themes that emerged in all countries were the importance of family support, education

and recreation, good social relationships, and good behavior. The inclusion of good


123

behavior may relate both to its role in facilitating smooth social relationships, and prob-

lems in the translation of wellbeing, which often gave it a strong moral tone. Common

indicators of illlbeing were also predominantly social and respondents even described

material indicators such as dirty clothes or irregular meals as reflecting a lack of care and

support (Table 3).

As an illustration of the potential of this approach, we describe a wellbeing exercise

conducted with boys aged 1113 in Addis Ababa, Ethiopia (October, 2007). The example

underlines the importance of comprehensive note taking as the most surprising insights

came during the discussions of each childs presentation (described below). According to

the researchers notes, the first child to present (a 12 year old boy) was an orphan. He

emphasised that a child that is doing well has both parents. He has a house with many

rooms, CD [player], and TV. He has a good variety of food prepared for him by his parents.

The child goes to entertaining places with his parents. He goes to a school that has a field

and equipment for kids to play on such as a shertete (slide), jiwajiwe (swing), and merry-go-round. The school is not far [from his home], it has good classrooms and clean toilets

for boys and girls separately; and it also has a library. The presenter characterised a boy

who is not doing well as having no parents and living alone. The roof of his house has

holes so during the rainy season, water goes into the house and as a result the boy gets sad

and cries. He doesnt go to school and does not have any food to eat because his parents are

dead.

The other participants raised a number of questions about the boy who was doing badly,

for example, why isnt he helped by relatives or neighbours? (answer: people do not get

close to him because he has dirty clothes), why cant he do paid work such as shoe

shining? (answer: there is no-one to buy the boy polish for the shoe shining), why cant

he get help from an NGO? [Non Governmental Organisation] (answer: no-one gets close

to him so he doesnt have any access [] no-one can prove his problems to the Kebele[local authority] or NGOs). One participant observed that the child who was doing well

didnt have a school bag to carry his books, which seemed incongruous, but the presenter

responded does living well means being rich? No, living well does not mean being rich.

The two most important indicators for wellbeing ranked by the participants were getting a

good education, because education is key to achieving wellbeing, and having a good

family that can advise the children. Getting a balanced diet was only slightly less

important because if a boy does not get a balanced diet he would not understand what he

learns. The four indicators of illbeing generated during this exercise (being an orphan,

lacking family support or proper follow-up, leaving school, and bad behaviour) were

considered equally important and interlinked, for example, leaving school led to bad

behaviour as a child who does not learn will finally be a thief. The participants were also

asked how the situation of the child who had the worst life could be improved. Apart from

one mention of basic needs, their responses centred around relationships (advice and moral

education, receiving care and support from family, having positive role models and

avoiding bad boys, and good relationships with family and neighbours) and the childs

own agency (studying and working hard, being obedient, sensitive to others needs, and

disciplined) (Wellbeing exercise, October 2007).

2.4 Studies with Children Using Mixed Methods

Developing wellbeing indicators based on childrens experiences and perspectives is ben-

eficial from an analytical as well as an ethical perspective as children are usually the best

source of information on their daily activities (Ben-Arieh 2005). They can also provide


123

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123

reliable information on other aspects of their lives and children as young as seven can

engage with abstract concepts such as children and human rights (Melton and Limber

1992). For this reason the Psychosocial Working Group (http://www.forcedmigration.

org/psychosocial/PWGinfo.htm) used child-focused qualitative methods to develop a cul-

turally appropriate measure of psychosocial wellbeing for use in post-conflict Afghanistan

(2005). Davis et al. (2003) initiated the process by combining intensive participatory

methods with children (the Childrens Ideas Project) and focus groups with parents and

grandparents to learn how war-affected children in Kabul experience and understand their

situations. Wellbeing was understood by respondents in four separate senses: as an ideal, as

hoped-for achievements, as a standard for the important things in childrens lives, and as

the qualities that children should develop (ibid, p7), and was centered on the local concept

of Tarbia which refers to childrens manners and the quality of their relationships withothers. A second study two years later (PWG 2005) developed and administered a 23-item

questionnaire based on Davis et al.s findings, which was used with children and adults to

assess the effect on psychosocial wellbeing of three types of intervention (psychosocial,

water, or a combination of psychosocial and water) and was combined with qualitative and

participatory research and a sub-study on means of coping. The value of a mixed methods

approach is illustrated by the fact that the quantitative and qualitative research presented

contrasting results. Both considered the combined intervention the best, but the quantitative

measure rated water only as almost as effective as the combined and psychosocial only

as ineffective, while the qualitative results supported the value of both. For example,

children said that the psychosocial intervention helped them communicate with parents and

reduced beatings by teachers. The qualitative results also highlighted the gendered nature of

risk and coping and enabled exploration of the differences between the sites identified in the

quantitative results, which were hypothesized to relate to their internal cohesion and level of

initiative in helping children.

Another example of combining qualitative and quantitative comes from Young Liveswhere econometric analyses of panel data from Ethiopia demonstrate that children who lost

one or both parents early on are not only resilient, but may have better cognitive and

educational outcomes than their peers (Himaz and Camfield 2009). This surprising finding

challenges the homogeneity of the administrative category orphans and other vulnerable

children (Meintjes and Giese 2006) and draws attention to the importance of timing in

predicting the effects of key events. Young Lives integrated data set enables the processesbehind it to be explored with descriptive statistics and qualitative case studies using data

from multiple sources (see Crivello et al. 2008).

3 Conclusion

While the authors perspective on mixing methods can be summarized as whats the

alternative? it would be unwise to ignore the challenges this involves, especially on

international collaborative projects. Some methodological cautions with using qualitative

methods in studying wellbeing in developing countries include their lack of credibility with

certain audiences (for example, local policy makers) who may be more familiar with

aggregate statistics. It can be difficult to find local researchers and translators with qual-

itative experience, due to the absence of qualitative research infrastructure in developing

countries, and consequently data collection is costly. Even qualitative researchers who

speak the local language/s cannot participate in every research interaction during a large

scale project, which means interpreting some field data second-hand. This is a challenge


123

even when the data is transcribed and accompanied with detailed field notes. A further

potential loss of meaning occurs from working through an interpreter or with translated

data, which means that is difficult to share qualitative data through data archives. Finally,

qualitative approaches generate an enormous amount of data for analysis and even with

qualitative data analysis software it is hard to share analysis across the team and ensure

transparency and accountability in the conclusions drawn.

More participatory work presents further challenges and some authors have expressed

discomfort with its recent entry into the mainstream, emphasizing that participatory

methods can also be top-down and extractive. Other concerns are that the emphasis on

community consensus rather than individual priorities may provide cultural context at the

expense of individual experience, emphasise public goods over private (e.g. services rather

than family relationships), or marginalize minority interests. There is often a pronounced

framing effect from its link to development practice, and starting from poverty may

miss the opportunity to understand peoples lives in their own terms. Finally, there are

great variations in the quality of participatory research and the extent of participation that

are not always apparent from the project reports. The challenges described in relation to

qualitative methods also affect studies using mixed methods where researchers have to

overcome unhelpful dichotomies (for example, between hard and soft data), intellec-

tual-stereotyping, and disciplinary conflicts, which are often exacerbated by institutional

structures. Finding researchers with a sufficiently broad skill-set is also challenging

(especially in the study countries); as is the meaningful combination of data in analysis

when the data collection was underpinned by different epistemologies. The need to

evaluate and reconcile findings from different methods also necessitates a common means

of establishing validity, which may require more inclusive criteria (see Sumner and Jones,

this issue).

The examples provided in the paper demonstrate the value of qualitative research in its

own terms, despite the above challenges, but have they answered the more pressing

questions of what researchers more familiar with quantitative methods can learn from

qualitative approaches, and how they can use them in their work? We advocate a pragmatic

approach that engages on three levels:

(i) with qualitative literatureethnographies, social history, reportage, novelsto gain a

fuller understanding of peoples contexts and influences;

(ii) with the skills and knowledge of multi-disciplinary teams, which involves

understanding and respecting the world view of other researchers as well as

respondents; and

(iii) with qualitative methods, which used strategically can both enrich and improve the

accuracy of quantitative data.

For example, if a researcher wanted to adapt a measure of childrens subjective wellbeing

for use in schools in Addis Ababa, a good place to start might be Poluhas detailed

ethnography of the Ethiopian school system (2004), or Tekolas research on the experi-

ences of children in Addis Ababa (2008), or findings from any of the cross-sectional and

longitudinal studies that have worked in this area (e.g. Young Lives, WeD). The measurewould need to reflect the different competencies and experiences of school-aged children

and the characteristics of the setting where it was administered. It would need thorough

pre-testing to ensure the validity of the content and method of measurement, and it might

be prudent to check conceptual validity (Herdman et al. 1998) through exploratory qual-

itative work. Cognitive debriefing would be helpful and might throw up unanticipated

problems, which would be resolved through discussion with key informants and local or


123

country-specific researchers who could set responses in their cultural context. Finally,

when interpreting the data it might be useful to complement it with other sources,

especially qualitative sources, so that the dynamics, complexity, contradictions, and

diversity of peoples positions can be understood in a nuanced way. It is likely that

personal and family health, community involvement, and cultural capital may all con-

tribute to well-being and that transport, insecurity, vulnerability and family worries may all

contribute to ill-being [] but these are each in turn construed differently from place toplace and from time to time (Neff and Olsen 2007, p. 18).

Acknowledgements The authors thank the participants in WeD and Young Lives research, as well as thecountry researchers who generated much of the data referenced in this paper. Elaine Chase providedinvaluable comments on an earlier draft of the paper. In relation to WeD, the support of the UK Economicand Social Research Council (ESRC) is gratefully acknowledged. Young Lives is funded by the UKDepartment for International Development (DFID) and based on a collaborative partnership between theUniversity of Oxford, Save the Children UK, The Open University, UK, and a series of prominent nationalresearch and policy institutes in the four study countries.

Appendix 1

Table 4 Comparison of the characteristics of wellbeing, illbeing, and poverty found by selected partici-patory studies in rural and urban communities in developing countries (Camfield 2006)

WeDa

Bangladesh, Ethiopia,Thailand, Peru

Moore et al. 1998South Asia

Consultations with thePoor 2000b

Over 50 developingcountries

Brock 1999c

12 developingcountries

Infrastructure and services

Basic infrastructure Govt.and NGO services

Security (civil peace, aphysically safe andsecure environment,personal physicalsecurity, lawfulnessand access to justice,security in old age,confidence in thefuture)

Clean environmentBasic infrastructure and

servicesCommunity relationshipsNeighbourhood violence

Home

Good house (e.g. water andelectricity, furniture)

Secure access tohousing (urban)

Quality of homeDomestic violence

Economic security/Material wellbeing

Economic stability/needsatisfaction throughlivestock and farming and/or business activities andemployment

Land and other assets

Land/assetsDiverse sources of

incomeType of job (urban)Food sufficiencyHousehold

structure (e.g.adult malelabour)

Material wellbeing:having enough

(food, assets, work)

Access to employmentWork and working

conditionsMoney and assetsLandAccess to natural

resourcesFood securityResilience in response to

seasonality and shocks


123

Table 4 continued

WeDa

Bangladesh, Ethiopia,Thailand, Peru

Moore et al. 1998South Asia

Consultations with thePoor 2000b

Over 50 developingcountries

Brock 1999c

12 developingcountries

Education and Health (physical and mental)

Health (self and children)Education (self and children)

Education Bodily wellbeing: beingand appearing well(health, appearances,physical environment)

Psychological wellbeing(peace of mind,happiness, harmony,including a spirituallife and religiousobservance)

HealthPeace of mind

Respect

RespectGood appearance

Respect and acceptancefrom others

Freedom from responsibility, independence

Independence (specificperiods and relationships)

Freedom of choice andaction

Having choices; not beingin relationships ofdependency

Feeling able to act andhave some control overthe outcome

Family relationships, community relationships

Relationships within thehousehold and extendedfamily

Having a partnerChildrens physical, socio-

economic and moralwellbeing

Social wellbeing (beingable to care for, bringup, marry and settlechildren, peace,harmony, goodrelations in the family/community)

a The WeD data in the tables has been compiled from the country reports of the exploratory phase,supplemented by re-analysis of translations of the original interviews. They represent the most commonresponses, determined by qualitative and quantitative analyses and for ease of comparison, they have beengrouped into the categories of Family and Community relationships (also friendship, sociability, goodcharacter/ behaviour, preserves social harmony, helping/ supporting each other, participating in communitydevelopment), Economic security/ material wellbeing, Education, Health (physical and mental), Freedomfrom responsibility, independence, Achievements, Respect, Access to infrastructure and services, Home, andReligion, which appeared in the original country reportsb The Consultations with the Poor (Narayan and Walton 2000; Narayan et al. 2000) identified economic(risk and vulnerability) and non-economic (empowerment and participation) dimensions to wellbeing.Sources of wellbeing were grouped under five domains, Material, Physical, Security, Freedom of choice andaction, and Social wellbeing, which partially reflect the structure of international measures of wellbeing suchas the Personal Wellbeing Index (Cummins et al. 2001)c Brocks review (1999) foregrounds the experiential aspects of poverty which impact on peoples agencyand mobility; for example, fear, insecurity, dependence, shame, hopelessness, and powerlessness. Partici-pants recounted not feeling accepted or respected by others, and feeling powerless in front of officials.Changes in their environment or bodies that seemed to be beyond their control made them feel vulnerableand reduced their confidence and agency


123

References

Adelson, N. (2000). Being alive well: Health and the politics of cree well-being. Toronto: University ofToronto Press.

Aristotle. (350 BC). Nicomachean ethics (T. Irwin, 1985, Trans.). Indianapolis: Hackett PublishingCompany.

Barahona, C., & Levy, S. (2003). How to generate statistics and influence policy using participatorymethods in research: Reflections on work in Malawi 19992002. Working paper no. 212. Brighton:Institute of Development Studies.

Barofsky, I. (1996). Cognitive aspects of QoL assessment. In B. Spilker (Ed.), QOL and pharmacoeco-nomics in clinical trials (pp. 107116). Philadelphia: Lippincott-Raven.

Baulch, B., & Davis, P. (2007). Poverty dynamics and life trajectories in rural Bangladesh. Q-Squaredworking paper no. 42. Toronto: Centre for International Studies, University of Toronto.

Ben-Arieh, A. (2005). Where are the children? Childrens role in measuring and monitoring their well-being. Social Indicators Research, 74, 573596.

Ben-Arieh, A. (2006). Measuring and monitoring the well-being of young children around the world.Background paper prepared for the Education for All Global Monitoring Report 2007. Strong foun-dations: Early childhood care and education.

Bevan, P. (2005). Studying multi-dimensional poverty in Ethiopia: Towards a Q-integrated approach.Q-Squared working paper no. 15. Toronto: Centre for International Studies, University of Toronto.

Bevan, P. (2007a, June). Cultural constructions of wellbeing in rural Ethiopia: An investigation ofcompeting local models. Paper Presented at the Wellbeing in International Development Conference,Bath.

Bevan, P. (2007b). Researching wellbeing across the disciplines: Some key intellectual problems and waysforward. In I. Gough & J. A. McGregor (Eds.), Well-being in developing countries: From theory toresearch, Cambridge: Cambridge University Press. Also available as WeD working paper no. 25. Bath:Wellbeing in Developing Countries (WeD) Research Group.

Biswas-Diener, R., & Diener, E. (2001). Making the best of a bad situation: Satisfaction in the slums ofCalcutta. Social Indicators Research, 55, 329352.

Biswas-Diener, R., & Diener, E. (2006). The subjective well-being of the homeless, and lessons for hap-piness. Social Indicators Research, 76, 185205.

Bourdieu, P. (1977). Outline of a theory of practice. Cambridge: Cambridge University Press.Bowden, A., Fox-Rushby, J., Nyandieka, L., & Kangeri, J. W. (2001). The reliability and validity of a new

generic measure of health related quality of life for use amongst the Kamba of Kenya. Quality of LifeResearch, 10, 261. (Abstract).

Bowden, A., Fox-Rushby, J., Nyandieka, L., & Wanjau, J. (2002). Methods for pre-testing and pilotingsurvey questions: Illustrations from the KENQOL survey of HR-QoL. Health Policy and Planning, 17,322330.

Boyden, J. (2006). Young lives conceptual framework. Retrieved November 1, 2007 from Young Liveswebsite, www.younglives.org.uk/pdf/other-country-publications/docu01-conceptual-framework.pdf.

Boyden, J., & de Berry, J. (Eds.). (2004). Children and youth on the front line: Ethnography, armed conflictand displacement. Oxford: Berghahn Books.

Brannen, J. (2005). Mixed methods research: A discussion paper. ESRC National Centre for ResearchMethods (NCRM) methods review paper. Southampton: NCRM.

Brock, K. (1999). Its not only wealth that matterits peace mind too: A review of participatory work onpoverty and illbeing. Paper for Global synthesis workshop, Consultations with the poor. World Bank,Washington, DC. Retrieved from www.worldbank.org/poverty/voices/reports.

Calestani, M. (2008). An anthropology of well-being: Local perspectives and cultural constructions inBolivian Plateau. Unpublished PhD thesis.

Calman, K. C. (1984). Quality of life in cancer patientsan hypothesis. Journal of Medical Ethics, 10,124127.

Camfield, L. (2004). Measuring SWB in developing countries. In W. Glatzer, S. Von Below, &M. Stoffregen (Eds.), Challenges for the quality of life in contemporary societies. Netherlands: KluwerAcademic Publishers.

Camfield, L. (2006). Why and how of understanding subjective wellbeing: Exploratory work by the WeDgroup in four developing countries. WeD working paper 26. Bath: Wellbeing in Developing Countries(WeD) Research Group.

Camfield, L., & Guillen-Royo, M. (2009). Wants, needs, satisfactions. In J. A. McGregor & I. Gough (Eds.),Development as the pursuit of human wellbeing. Cambridge University Press.


123

Camfield, L., Guillen-Royo, M., & Velasco, J. (2008). Does needs satisfaction matter for psychologicalwellbeing and happiness in developing countries: A comparative study of Bangladesh and Thailand.Social Science and Medicine, special issue.

Camfield, L., & McGregor, J. A. (2005). Resilience and wellbeing in developing countries. In M. Ungar(Ed.), Handbook for working with children and youth pathways to resilience across cultures andcontexts. CA: Sage.

Camfield, L., McGregor, J. A., & Yamamoto, J. (2006). Quality of life and its relationship to wellbeing.Unpublished paper, Wellbeing in Developing Countries (WeD) Research Group, University of Bath.

Camfield, L., & Ruta, D. (2007). Tran

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