The second step in Barrier Analysis is to develop the behavior question. Since we will be comparing people who are Doers and Non-Doers of the behavior, we need to include a question in the questionnaire to determine whether the people you interview are now doing or not doing the behavior (for screening purposes). In our example, you would probably need to use a short series of questions:

• Are you currently breastfeeding (INFANT’S NAME)?
• Did (INFANT's NAME) have anything to eat or drink apart from breastmilk during the past day and night?

Define "Doing" the Behavior
Depending upon the populations with which you work, you may wish to further define what “doing” the behavior really means or who your target group is. You might bring in considerations of frequency, for example. If a child is presently exclusively breastfeeding, but did not always exclusively breastfeed (e.g., she used prelacteal feeds), is that enough to label the mother as a Doer? This decision depends on how important full compliance is to achieve your goal. A Doer could be defined as “currently exclusively breastfeeds under six months” or as “has always exclusively breastfed the child under six months.” Again, you make this decision on how important frequency is to achieving some progress on your goal. You might also want to focus on a specific set of mothers (e.g., mothers whose children are at risk due to the mother being HIV+). This type of refinement is useful sometimes if it supports your overall objective.

Know Your Target Group
In defining the behavior question you need to know some things about your target group (audience) before finalizing your study design. While it is possible to get a general idea of “what proportion do what” as part of your survey and to then make some of these decisions after you have already collected data, this leaves you vulnerable to not having enough in one group of Doers or Non-Doers. We suggest you figure out more or less if any folks in your target group do the behavior (e.g., exclusively breastfeed their child under six months). This can be done by talking to mothers during a mothers club meeting (for example), through a very quick survey, or by using existing data (e.g., DHS data¹ for the region of the country where you are working).

When you have trouble finding any Doers, you may decide to:

• study the Non-Doers only without comparing them to Doers, or
• to relax your definition of Doers so as to have a comparison group (e.g., Doers = mothers who exclusively breastfed for the first three months of life [rather than the first six months]).

Using the Behavior Question
You will use this question in different ways depending on which way you decide to do Barrier Analysis: through focus groups or through individual interviews. If you are using focus groups, you will use the question when putting together your two focus groups. In one focus group, you will have people who answered yes to the question, and in the other you will have people who responded no to the question. If you are using individual interviews, you will include the question in your questionnaire as one of the first questions.

¹ See www.measuredhs.com.

Next (Developing Questions About Determinants)