List ten non-obvious assumptions about your target customers (or organizations) that you need to validate.

1. The NGOs in the region have the resources to better educate and provide for the communities they operate in.
2. The governmental agencies/departments involved with the crisis are taking it seriously and are not turning a blind eye.
3. The Community Health Workers have enough formal training to be better than the average person and are really able to make some impact instead of being a charade of progress.
4. The NGOs are taking different approaches to their mission depending on the region they are located in.
5. The local governments are recognizing the issue as serious.
6. The federal/national government (politicians, not agencies) is taking the issue seriously and recognize it.
7. Schools are attempting to incorporate basic health measures into their curriculum.
8. Gear, supplies, and transportation are being provided to the Community Health Workers and they are being supported on an institutional level.
9. There are infrastructure projects going on to attempt the reconstruction of the country and facilitate the movement of vital people and supplies.
10. The government is enacting legislation to help promote hospital/medical clinic use for people who normally would not use such resources.

 

2. List ten hypotheses about your project that you need to test during fieldwork.

1. Cultural stigmas against discussing women’s/maternal health related issues are getting better and will not prove to be as big of a barrier as we initially thought.
2. There are serious differences between the tactics used by urban people and those use by rural people to help women have safer deliveries.
3. The urban populations are more likely to trust in western medical practices than the rural populations
4. Sierra Leone does not currently have the infrastructure needed to combat the maternal mortality issue on a wide scale and thus must be investing in its development.
5. The TBAs are a widely used and trusted source for when it comes to delivering in the home and when dealing with issues that arise during delivery.
6. There was less of a “brain drain” than we originally anticipated because the elites in Sierra Leone were already abroad (working or in school) when the civil war and other crisis began.
7. The decentralization efforts by the government have helped to make combatting the crisis easier by giving broader authority to local governments and allowing them to allocate resources more efficiently.
8. The culture of toxic masculinity in the region is especially pronounced and causes the men to be less inclined to seek help for their wives when issues arise and during the pregnancy as they want to be the ones looking after the women.
9. International aid is not as effective as is thought because of bureaucracy and the the ideas we discussed in class about aid being used in extranipus ways where there is no real benefit.
10. The people of sierra Leone are listening to/following the health initiatives because they realize it is better for them individually and as a society.

 

3. What do you think you bring to your team? How has your perception of your own strengths and weaknesses changed over the course of the class? Please be specific.

 

I believe I bring to my team an acute ability to analyze people’s actions and figure out what’s driving them. I think this ability is vitally important for a project such as ours because it allows the team to look past the surface and figure out what an action means in a broader scheme. For instance, take the whole decentralization movement happening in Sierra Leone. At first glance it simply means that the government is relinquishing power back to local authorities. But upon closer inspection the ostensible rational behind their decision might not be altruistic and might be a way to shift responsibility off of an incapable national government onto local communities so that the national government does not have to take the blame for future failures. While this example is only speculation, it still demonstrates how my ability to look for the why in an action can be valuable.

Additionally, I have noticed some other changes in my perceived strengths and weaknesses. For instance, before this project, I never would have considered group communication and organization as a weakness. It had simply never really been applicable before. But now I realize it was an area I was seriously behind in and have been able to make improvements since it was brought to my attention. As far as new strengths go I have noticed I am much better at public speaking than I initially thought. Before I was more reserved and would speak much less in group/public settings. Now however I find that it is much easier for me to do so and I am greatly improving on that front. As we go forward I am going to keep my eye open for new strengths and weaknesses as they have helped me grow in the past and will certainly help in the future.

Ten things to strengthen the next presentation:

 

Going in to the next presentation we have a lot of room for improvement and I am not afraid to admit it. Frankly I see this as a good thing, it means we are able to better think about where exactly we messed up and how we can improve going forward. Firstly, I think the main thing we can improve on is defining our target audience. We simply did not have a very compelling answer this last time around and need to hammer out exactly who we want to reach. Going off that first point the second thing we need to work on is figuring out how we want to distribute our film to our target audience. The channels of delivery are very important and frankly we have never really thought much about it. Thirdly, we need to continue to work on our actual filmmaking skills as we have no real experience and only our advisors know how to do the technical side currently. Another way to strengthen our presentation is to work on our power point coordination as we were off sometimes and were not as prepared to use examples as we should have been. Along a similar vain we also need to better coordinate who is going to be answering which questions because several times throughout the presentation we would get a question and then just look at each other until one of us answered.

The sixth way we can improve our next presentation is by making better use of the graphics and charts we use on the presentation. These are incredibly valuable in explaining just how severe the issue is but we simply did not explain them well, thus limiting their effectiveness. We can also work on the timing of our presentation because near the end it was incredibly rushed as we were crunched for time. The eighth thing we can do is work on controlling our speech patterns during the presentation itself because at times we sounded a little unsure and hesitant which doesn’t help with establishing credibility. We also started working on and have improved another major problem, the fact that we had met with few knowledgeable professionals. Granted, we have turned this around and are scheduled to meet with several soon. Finally, we can also work on the organization of introductory information as the first time around ahd us sort of cramming everything into a few slides and hoping we got it across effectively.

 

Does our work need IRB approval?

 

No, our work should not require IRB approval. This is because we are not conducting research of a sensitive nature and are at most interviewing individuals thus making our research exempt. However, a case might arise where we do wind up needing IRB approval. For instance we could end up wanting to see medical records for women in country to analyze their health relative to women in more developed healthcare systems. In this case we would certainly need IRB approval. Another case where we could require IRB approval would be if we decided to follow and observe people, especially pregnant women, going about their days. We might do this to get a better grasp of the typical life for a community and apply it to the health we observe in the population. Regardless, this type of research would require IRB review. Finally, we could also conduct research about the newborn children and how healthy they are or what the impact of having their mother potentially dying could be. In this case, since we would be working with children, we would require IRB approval.

Logic model:

 

Situation: The maternal death rate in Sierra Leone is the highest in the world

Stakeholders: the public health workers, the TBAs, the mothers, families expecting children, children without mothers, families who lost mothers, the women themselves, the NGOs operating in the region

 

priorities/issues: To decrease the maternal death rate and improve the medical system on the whole, dealing with a culture traditionally hostile to women’s issues, government lacking the resources to fully tackle the issue along with corruption.

 

Inputs: NGO support, government focus on the issue, recent government restructuring which may help focus on the issue (decentralization), the issues are relatively simple but they simply lack the resources required

 

Outputs: Raising awareness about the issue and hope to drive more attention toward it, partner with local groups working on the issue

Assumptions: Our project would be able to reach the audience we need, they would be willing to help, and there is a desire to improve within the country

 

Outcomes/Impact: Making the issue a conscious one in people’s minds and possibly bringing greater investment to the issue indirectly through raised consciousness

 

External factors: Cultural stigma against the discussion of maternal/women’s topics, emphasis on health privacy, language barriers, regional cultural barriers and the wide breadth of cultural practices.