Q2: What Do We Think We Know?

It is likely that you have some knowledge about the programme challenge articulated in Question 1. But some types of knowledge are more valuable than other types. While general knowledge is helpful, a full accounting of the specific challenges facing the intended users of an health service are dependent upon local context and thus require local investigation. Local knowledge — gathered from years of local experience, research and reflection — is of primary value.

This phase is about composing learning goals starting with what we know and think we know —  the local knowledge that already exists among you, your team members and your programme. Because this likely is not the first time your team has engaged in the process of investigating and responding to challenges facing users, it is helpful to begin the process by methodically reflecting upon your existing knowledge.

Reviewing existing knowledge and recognizing assumptions before we define our learning goals insures against duplicating past efforts that didn’t succeed and avoids overlooking areas of exploration if their past conclusions are based on insubstantial evidence.

Q2 | 2a

Assemble Existing Knowledge

Assembling the available information on the current challenge can be an overwhelming task. Instead of casting too wide a net, we encourage you to collate only those pieces of information that fall into one of the three categories of ‘existing knowledge’:

Knowledge about the programme challenge: It is possible that your team is aware of, and experienced with, the situation.

Knowledge about past efforts: Gather lessons from past efforts, such as what has worked and what has not — and, most importantly, why.

Knowledge about the user-group: It is possible that some outside group your own programme has already conducted formative research about the population in question.

Q2 | 2b

Recognise Assumptions

Assembling and examining existing knowledge are prerequisites to what we think is the most important step: recognizing our assumptions. In any situation where we are asked to solve a problem, we bring along implicit and explicit assumptions — about the population we are serving and the challenges they are facing. This is an opportunity to discuss assumptions prior to problem-solving.

Tool #3

Assumption Catalogue


Use this tool to document existing assumptions about the challenge, past efforts, and the user-group in question. It includes a short-list of general assumptions that span contexts and communities.

Tool #4

Journey to Immunization


Use the Journey to Immunization model to think about what areas need the most attention and what we can learn at each stage.

Q2 | 2c

Compose Learning Goals

The gap between the change we are supporting in the community (the objective statement) and what we know and think we know from past research (assumptions) leaves us with what we still need to figure out. These questions that need additional research become our learning goals.

Do we know how decisions are made? Do we know everything about the prioritized user-group’s motivations, perceptions, and trade-offs? Using the Journey to Immunization model, think about what areas need the most attention, and what we can learn at each stage. Reference your Assumption Catalogue to further investigate the questions that need to be answered.

While the model follows a caregiver journey to immunization, consider the journey of the health-care provider as well, since both work in equal parts toward the goal of immunization. What must they know and prepare? What cost and efforts must they make to be present both physically and mentally?

Tool #3

Field Notes Map


During research, each step will yield distinct outputs — your “Field Notes.” This tool gives you a framework in which to capture them.