A Critique of KAP Studies and Some Suggestions for Their Improvement

The KAP tradition emerged from the historical need to measure the extent to which overt hostility to the idea and organization of family planning services existed. As growing numbers of countries have implemented family planning programs without arousing widespread and active opposition however the importance of this role has diminished. The usefulness of KAP studies now depends on their contribution to the evaluation and guidance of existing programs. Although this fact is clearly recognized (Berelson 1966 ch. 51) there has been a surprising reluctance to modify and refine KAP methodology for these purposes. Perhaps the great emphasis placed on international comparability and standardization while providing much needed support for inexperienced researchers has helped to create and perpetuate an inadequate orthodoxy of research design. Improvements to the KAP approach have also been impeded by the domination of the demographic component in the questionnaire. Knowledge of fertility marital and infant mortality patterns provides an essential background for strategy and evaluation. But measurement of these factors by comprehensive pregnancy histories has been accompanied in many instances by relative neglect of KAP elements more directly related to social action. (excerpt)