Overcoming challenges in the field: Lessons learnt from a community-based study on noncommunicable diseases in an urban underprivileged area of Bangalore city

ABSTRACT Introduction: Unique challenges are faced while conducting surveys, facility, and community-based activities for the control of noncommunicable diseases (NCDs) among the urban underprivileged. Objectives: The objective of this study was to describe the challenges faced by field staff in carrying out NCD-related activities in an urban underprivileged area. Materials and Methods: A qualitative study was conducted among the field staff working for an NCD project in an underprivileged area near a medical college in Bengaluru. A group discussion followed by the construction of a loose bubble plot was done to identify the challenges faced by the staff in conducting community-based NCD activities and survey. The principles of the loose bubble plot were used to reflect the frequency, magnitude, and modifiability of the issues faced. Solutions for identified problems were discussed. Results: The challenges faced were categorized as survey-related, personal, and training related. Challenges perceived to be of great magnitude and occurring at high frequency were, unavailability of the working population during the day, participants not consenting, poor hygiene of participants, unclean surroundings, female staff maintaining menstrual hygiene, and accessing toilet facility on the field. The challenges of lesser magnitude and occurring less frequently were problems faced while using the app and calculating portion size during dietary recall. The main training-related challenge was scheduling a day convenient for the Urban Primary Health Center staff. Community resources were identified for overcoming the challenges. Conclusion: We identified unique and various sets of challenges faced by field staff while conducting community-based NCD activities. Prior planning, good communication, problem-solving skills, and engagement with local community leaders would help address such challenges in the field.