Step 1: Focus group discussions
Focus group discussions (FGDs) were conducted as the first
step in a three-step methodology. The FGDs aimed to:
(i) identify commonly used sources of inpatient care among
poorer populations; and (ii) explore strategies for coping with
the costs of inpatient care, to help develop a list of options for
questions in a hospital exit survey. Three FGDs were conducted
in urban areas and three in rural areas. In Vadodara city, three
different urban slum areas were purposefully selected.
Vadodara slum areas are quite segregated according to the
State of origin of the residents; our FGD groups consisted of
migrants from Uttar Pradesh, Rajasthan and Maharashtra.
Eight to 12 adult respondents (>18 years of age) were included
in each FGD, including both men and women, and only those
who had experienced hospitalization within the previous year
and had migrated to the city within the last 5 years, as recent
migrants were expected to be the most vulnerable to the costs
of health care. In rural areas, three sub-districts (out of 12 in
Vadodara) were randomly selected, and within each sub-district
a poor residential area (usually a ‘para’ or neighbourhood) on
the periphery of a village was purposefully selected. Group size
and inclusion/exclusion criteria were the same as in urban
areas, with the exclusion of the migration criterion.
FGDs were conducted in the Gujarati language by the
Principal Investigator (RJ) and with the permission of respondents,
recorded using a digital video recorder. They were
transcribed in English, and analysed and coded in MS Word.