The researcher participates in/observes the natural setting over an extended period of time: Systematic observation of verbal and non-verbal actual behaviour in which trained observers use a structured recording form. Data is collected by observing, interviewing, note taking and/or journaling. The researcher develops a relationship with the participants, which may affect the data collected.

Tool: Participant observation checklist

Example: Semi-structured direct observation will be carried out in selected facilities to assess and compare the behaviour of health staff towards patients who are not members of the revised schemes in at least two facilities in each study county, such as one township or commune health centre and one county or district general hospital. In this setting the observer can participate in the interaction between the health staff and the patients and can act as part of the health providers’ team or as a client to the health providers.

The researcher does not participate in any activity in the natural setting. Data is collected by observing, note-taking and/or journaling. The researcher does not develop a relationship with the participants and therefore cannot explore further issues in relation to observations made unless this approach is complemented with a follow up.

Tool: Participant observation checklist

Example: The same study setting as the example above, but this time the observer does not participate in the interaction between health staff and the patients. He or she will independently observe the encounters.

Detailed descriptions of events, actions, behaviours, people and objects in a natural setting. Field observations are written in the form of field notes.

Tool: Transect walk checklist

Example: To understand the day-to-day activities, practices, and interactions in a village, a researcher walks through the village cross-sectionally and observes villagers activities, structures of houses, buildings, and interactions among villagers.

A purposeful conversation directed to the participant by the researcher. The researcher will typically develop an interview guide beforehand. The researcher encourages the participant to talk in-depth, prompting more detail whenever possible without leading the participant to specific answers. Interviews are often recorded and transcribed. The average length of an interview is one hour (or less).

Tool: In-depth interview guide

Example: In-depth individual interviews with: People suffering from ‘catastrophic illnesses’, including both members and non-members of revised schemes and those who have used and not used the services; health policy-makers at national and local levels; and rural health insurance scheme managers.

Written or printed records of past events (e.g. letters, anecdotal notes, diaries). Material objects and symbols of a current or past event, groups, organizations, or a person that can reveal social processes, meaning, and value (e.g. diplomas, awards, papers, logos etc.).

Tool: Checklist or other criteria to review documents

Example: Analysis of printed posters, commercials etc. to understand values, messages and meanings for targeted audiences.

Media that captures the daily life of an individual, group or event under study. Can be captured and viewed repeatedly to record behaviours.

Tool: Checklist and/or criteria to review that media

Example: Review photographs taken by community members showing the areas of public health need in their community.

A 1–2 hour discussion, guided by a trained moderator, in which 6 to 10 similar respondents (e.g. by age, gender, social status) focus on a list of defined topics. The discussion, designed to reveal beliefs, opinions and motives, should take place in an informal setting. Data collection may be enhanced by the interaction among participants.

Tool: FGD topic guide

Example: Focus group discussions using participatory techniques with: members and non-members of the revised schemes (including different age, gender and socioeconomic groups); and health service providers at county/district levels and below, including general practitioners/primary care providers, preventive service providers, and out-patient and in-patient providers.