Lesson 7: ART The KIM methodology Copy

The control of blindness in children is a VISION 2020 priority because the number of ‘blind person-years’ from childhood blindness is second only to cataract.

If VISION 2020 targets for children can be met, the global prevalence of blindness will fall from 7.5 per 10,000 children in 1997 to 4 per 10,000 children by the year 2020.

As you read the following text consider: How could the key informant method (KIM) be used in your setting? Who would be the ideal key informants?

Finding children who are blind
Children who are blind need to be found as early as possible so they can be examined, treated, referred, or rehabilitated. This is crucial if they are to have the best possible chance of proper childhood development, education, and participation in broader social life.

The key informant method is an effective, community-based and participatory approach. It is particularly suited to identifying children who are blind in low- and middle-income countries, where the remoteness of rural communities and poor access to health, education, and rehabilitation services in many areas make most other research methods less effective.

The key informant method was developed and piloted by means of extensive field research in Bangladesh, and it has since been successfully piloted in Ghana and Malawi.

This method can fulfil two very important roles: providing data on the frequency and causes of blindness in children in the community, and finding a large number of children who need services, whether clinical, educational, or rehabilitative.

The method involves using volunteers who know their community well, whether through their occupational or social roles, in order to identify children who are blind.

These volunteers, called key informants, can be health workers, school teachers, non-governmental organisation (NGO) staff, government staff, religious leaders (imams, church leaders, etc.), traditional healers, local journalists, or other people who are actively involved in the social network of the community.

Ideal key informants should be reliable and willing to contribute their time voluntarily. They should also have the opportunity, through their role in the community, to disseminate information to a large number of community members, either directly or indirectly.

Although key informants are volunteers, they need to be motivated and mobilised with a specific objective: in this case, to find blind children. This is the responsibility of the member of the project team known as the community mobiliser.

The community mobiliser stays and works in a defined community for the duration of the project (approximately six weeks) to identify, train, motivate, and mobilise the key informants.

The success of the key informant method relies heavily on the networking, social and communication skills, motivation, and commitment of the community mobiliser.

The method works best when it is conducted in a relatively small, defined geographic or administrative area, ideally a sub-district with a total population of 100,000 to 250,000.

Larger areas can be covered through a phased approach or by using a larger number of community mobilisers. The physical size of the sub-district and the local transport and communication infrastructure should also be taken into account: a community mobiliser should ideally be able to
visit every corner of the sub-district several times during the six weeks he or she will spend there.

During such a six-week period, one community mobiliser, working with 40 key informants who he or she has trained, should be able to identify 60–80 blind children. One community mobiliser can cover eight sub-districts in a year and identify 500 to 600 blind children from a total population of 1–1.5 million.