Appendix 1: Examples of research site selection

Selection of an appropriate research community is a crucial first step in the process of using this manual. The basic aim is to identify a location that is: a) a population with significant vitamin A deficiencies, and b) a community that is typical of a wide area of similar communities. Government planners who sponsor the assessment and the expected intervention program will want information that can be generalized quite widely to other communities.

For example, the pilot study in India was located in a semi-arid region in the state of Andhra Pradesh. Although Andhra Pradesh is sometimes referred to as the Rice Bowl of India because of its fertile regions, there is a large semi-arid region in the state, in which agriculture is not as productive and where problems of vitamin A deficiencies are generally more prevalent. Dr. Pushpamma and her associates reported that "In a recent study assessing the prevalence of vitamin A deficiency...[in the study area] it was found that villages. . had a prevalence of around 4.5% Bitot's spots in preschool children...But during a recent survey (1993) the prevalence of Bitot's spots in preschool children in Sheriguda [the research community] was found to be 4.2%." Describing the ecological situation of the region, they said that "many villages in the Ranga Reddy District in Andhra Pradesh. . . [including the research site]...are dry lands and grow mostly staples such as sorghum (jowar) and pearl millet (bajra) which do not require as much water as rice." They also note that "Sheriguda is one of the typical villages of Ranga Reddy district, where all religion and caste groups are represented in the community."

The village of Sheriguda thus met both of the criteria above: having signs of vitamin A deficiency and being typical of a wide range of villages in the semiarid ecological zone. They also noted that the village is almost 100% Hindu and the caste composition of the village is broadly similar to the usual patterns in that part of India. "Looking at the caste distribution of the village, it was found that about 40% of the families belonged to the...[upper castes], 30% belonged to. . . [lower castes] . . .which includes. . .blacksmiths, carpenters, goldsmiths, shepherds...." The rest of the population consists of Harijan households and a few tribal families. The occupational structure of the village also corresponds to the typical village pattern of the dry region.

The village of Sheriguda also fits well with the other selection criteria: the area has a considerable range of vitamin A-rich foods, whose consumption could be increased; the locality is served by the governmental health structure; and it is accessible by road-about one hour's drive from the researchers' headquarters in Hyderabad (at the National Institute of Nutrition).

If a comprehensive intervention program is planned in an area with important cultural or ecological variations, it may be desirable to conduct data-gathering in two different communities. In testing this manual in northern Peru, the researchers felt that it would be very useful to get information from a rural highland village and also a low-income suburb of the city of Cajamarca. The latter community represents a rapidly growing type of population, in which people are partially cut off from traditional rural, low-cost food sources.

Setting up research in two different communities required additional assistants, but the Team leader was able to serve both sites, as they were only about two hours walking distance from each other. Training of the two research groups, supervision of operations, maintenance of the secretarial support were easily coordinated as all the team members were residents in Cajamarca.