Presentation by Silvia Alonso, Sokerya Seng, Nguyen Ngoc Thuy and Jeff Gilbert at the First African Regional Conference of the International Association on Ecology and Health (Africa 2013 Ecohealth), Grand-Bassam, Côte d'Ivoire, 1-5 October 2013.

1. Conférence internationale Africa 2013 sur l’Ecosanté
Combining apples and oranges?
Synthesizing quantitative and qualitative
data from EcoZD studies
Silvia Alonso1, Seng Sokerya2, Nguyen Ngoc Thuy3 and Jeff Gilbert1
1. International Livestock Research
Institute, ILRI
2. Centre for Agriculture & Livestock
Development Cambodia (CelAgrid),
Phnom Penh, Cambodia
3. Nong Lam University, Ho Chi Minh,
Vietnam

2. Conférence internationale Africa 2013 sur l’Ecosanté
Combining apples and oranges? Synthesizing quantitative and
qualitative data from EcoZD studies
• EcoHealth research:
• Multidisciplinarity
• Holistic approaches
• Participation
• …
• EcoZD – all this to be applied to investigation
of a zoonotic disease transmission problem
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Quickly said…
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Combining apples and oranges? Synthesizing quantitative and
qualitative data from EcoZD studies
Qualitative research:
Participatory rural appraisals (PRA)
Focus group discussions (FGD)
Quantitative research:
Observational studies
Randomized clinical trials
…but…
Summary
report
Statistical
analysis

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• Mixed method research
“… intentionally integrate or combine quantitative and qualitative data to
maximize the strengths of each, to answer questions that are
inadequately answered by one approach.” (Ozawa and Pongpirul, 2013)
“… it allows researchers to view problems from multiple perspectives,
contextualize information, develop a more complete understanding of a
problem, triangulate results, quantify hard‐to‐measure constructs,
provide illustrations of context for trends, examine processes/experiences
along with outcomes and capture a macro picture of a system.”
(Ozawa and Pongpirul, 2013)
Increasing literature ‐ mixed methods as a distinct research approach
EcoHealth to engage and contribute!!!
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Combining apples and oranges? Synthesizing quantitative and
qualitative data from EcoZD studies

5. Conférence internationale Africa 2013 sur l’Ecosanté
• What do mixed methods contribute?:
• Complementarity – one type of data illustrates/explains
findings on the other
• Development – one type of data informs the use of the
other method
• Initiation – identify areas of incongruence to generate
new insights / research questions
• Expansion – each method suited to explore different
aspect of a research question
• Triangulation – corroborate findings
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Combining apples and oranges? Synthesizing quantitative and
qualitative data from EcoZD studies

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Livestock keeping and acute diarrhea in
Cambodia
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Combining apples and oranges? Synthesizing quantitative and
qualitative data from EcoZD studies
2 Provinces
4 Districts
8 villages
Quantitative methods
(questionnaire and biological sampling)
Evidence and investigate risk factors
for zoonotic transmission
Qualitative methods (PRA and FGD)
capture socio‐economic aspects linked
to disease occurrence and spread
Numerical
output report
Summary of
observations

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Combining apples and oranges? Synthesizing quantitative and
qualitative data from EcoZD studies
Quantitative methods
(questionnaire and biological sampling)
400 Households reporting diarrhea in past 2
weeks
Questionnaire on household characteristics,
food consumption and hygiene practices
Fecal samples – diarrhea cases
Fecal samples ‐ cattle/pig/chicken
Tests: Salmonella spp, E. coli 0157, Shigella
spp, Plesiomonas, Aeromonas, Vibrio spp
Qualitative methods (PRA and FGD)
In each village:
Village layout (map)
4‐5 villagers interviewed
Household layout
Seasonal calendar: production, water
availability and illness
Livelihood mapping
Wealth ranking

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Combining apples and oranges? Synthesizing quantitative and
qualitative data from EcoZD studies
Biological samples:
• Human cases - Shigella spp and E. coli 0157 (most isolations in high
bloody diarrhea incidence areas)
• Animals – E. coli 0157 and Salmonella spp (only in high bloody
diarrhea incidence areas)
• No correlation with pathogen presence in household animals
Questionnaire:
• Animal raising practices similar across study sites
• Risk factor analysis: suggests raising animals / pig-cattle consumption
are NOT risk factors. Duck/fish consumption potential RF.
• Eating sick animals, vegetables, use surface/lake water

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Combining apples and oranges? Synthesizing quantitative and
qualitative data from EcoZD studies
Participatory rural appraisal:
• Sickness - Vegetables and not-boiled water. Food other than
from animals!!
• Farmers did not consume meat from their animals! (market).
• Obvious HH distribution in village associated with wealth.
• Different animal raising practices according to season - not
captured in the QUANTI study.
• Chemicals – mentioned often, neglected in QUANTI study.

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• Help make sense of “hard to explain” quantitative findings
• Captures complexity
• Help design the research question
– Water identified as potential important source (QUALI) – QUANTI to explore more in detail
– Identifying the problem
– Get acquainted with the context
• Inform participants about study
• Guide design of intervention/control strategies
• Good complement of small studies
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Combining apples and oranges? Synthesizing quantitative and
qualitative data from EcoZD studies

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CONCLUDING REMARKS:
• EcoHealth researchers need to expand interest/skills
on mixed methods (formal approaches)
• Need to acknowledge the reason why qualitative and
quantitative research methods are needed
• choose the method that suit best, maybe you don’t
need mixed methods!!!
• If needed: incorporate explicitly in project DESIGN:
• how to do, how to analysis, how to integrate data
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Combining apples and oranges? Synthesizing quantitative and
qualitative data from EcoZD studies

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