CHAPTER THREE
3. RESEARCH DESIGN AND METHODOLOGY
3.3 Data collection techniques
Varkevisser et al (1993) noted that research can combine a number of data collection techniques through a process termed triangulation. In this study, triangulation helped to show how the different methods of data collection, that is, in-depth interviews, self-administered questionnaires and Focus Group Discussions supported or contradicted one another. Through triangulation, the different methods used to study the same phenomena have the effect of balancing each other out to give a more realistic and truthful account of results. Kennedy (2009:3) states that „the problem with relying on just one method is to do with bias.‟ He argues that using mixed methods is useful in that it captures more detail and also minimizes the effects of bias by ensuring a balanced research study. Bailey-Beckett and Turner (2009:3) agree with the above views on triangulation when they state that different methods when used for gathering data „complement and verify one another.‟
Through triangulation, the data collection methods mentioned below complemented each other to reflect the respondents‟ perceptions. The mixed methods in this study were used in the form of using different data collection methods and also through the collection of data from different sources. Both qualitative and quantitative research techniques were used to maximize the quality of the data to be collected. The qualitative research techniques produced information that was recorded in a narrative form while the quantitative research techniques provided data that could be counted and expressed numerically in a table or chart.
3.3.1 Primary sources of data 3.3.1.1 Interviews
Kvale (1996:14) defines interviews as “ … an interchange of views between two or more people on a topic of mutual interest, ...” Boyce and Neale (2006:1) regard interviews as “a qualitative research technique that involves conducting intensive individual interviews with a small number of respondents to explore their perspectives on a particular idea, program, or situation.” As a data collection tool, interviews involve a systematic pattern of talking and listening between the interviewer and the interviewee to enable the former to collect research data from the latter. A commonly quoted advantage of the interview over other data collection techniques such as mail surveys is that the interview provides the interviewer the opportunity to probe or ask the interviewee to elaborate on issues as necessary.
Data collection in this study was done through direct in-depth interviews of patients and health workers.
Through interviewing, selected stakeholders were orally questioned to elicit information that clarified the area under study. The interviews were a combination of two types, one with a high degree of flexibility (unstructured) with open-ended questions where an interview schedule was used and the other being less flexible (structured) in that there was a list of questions with fixed responses where the investigator was more confident about the expected answers. One of the advantages of using interviews for collecting information was that they allowed for the clarification of questions during the question and response sessions.
Self-administered questionnaires
Self-administered questionnaires are a data collection technique that involve the collection of data through questionnaires, with the questionnaire filled in by the respondent in the absence of the investigator. Some of the generally recognised benefits of using self-administered questionnaires are that they have the potential to reach a large number of would-be respondents and, in the process, guaranteeing the anonymity of the respondent. Self-administered questionnaires have also been known to be helpful in collecting data from a large number of respondents in a relatively cost effective way with reduced interviewer bias. One of the notable disadvantages of self-administered questionnaires is that the investigator has no control over who actually completes the questionnaire. Self-administered questionnaires have also been criticised for their often low response rates. Williams (2003:9) notes that studies indicate that self-administered questionnaires may have a response rate that is reduced by up to 20% compared to an interviewer-based survey, with a “ ... response rate of 75% ... considered to be extremely good.”
Although this data collection technique has been criticised in some circles for its limitations in capturing forms of information such as emotions or feelings and the difficulty of telling how truthful respondents were being, self-administered questionnaires were used to collect data from conveniently selected policy makers in the Ministry of Health due to the difficulty of meeting the officers personally to interview them, because of their busy schedules. The questionnaires were personally delivered to the secretaries of the policy makers in the Ministry.
3.3.1.2 Focus Group Discussions
Gibbs (1997:1) describes Focus Group Discussions (FGDs) as group research involving “organised discussion with a selected group of individuals to gain information about their views and experiences of a topic.” Morgan (cited in Gibbs, 1997:1) notes that although focus groups are a form of group interviewing, a distinction can be made between the two in that group interviewing involves interviewing a number of people simultaneously, with emphasis placed on questions and responses between the researcher and participants whereas focus groups are reliant on the interaction within the group guided by topics supplied by the researcher. The discussions and comments made by the participants are based on their personal experiences. Morgan and Krueger (cited in Gibbs, 1997:2) note that focus groups are particularly useful in, among other instances, situations where there are power differences between the participants and decision makers or professionals. The focus groups were selected for use in this study because the health sector has the potential for exhibiting power differences, with health professionals often wielding more power than their clients due to their medically based knowledge.
Six FGDs were conducted and they facilitated the discussion of the perceptions that the selected groups of people or stakeholders had on the quality of health services provided by the health institutions nearest to them. The investigator guided the discussions so as to arrive at a decision with wider participation of the group members. The use of FDGs was selected because it was useful in gathering the views and recording the attitude and opinions of the community representatives on the quality of health services provided by the health institutions nearest to them.
Purposive or convenience sampling was used to select the group members from the vicinity of the sampled hospitals, excluding people in positions of power or authority. The participation of the group members helped in the formulation of strategies for change regarding the provision of health services.
The familiarity of the investigator with the local conditions, that is, the cultural practices, religious beliefs and power structure helped in the selection of the participants for more meaningful group discussions.
Each group, with members who were within the same age ranges, had a minimum of eight and a maximum of twelve participants. The discussions were mainly based on open-ended questions covering a written list of themes. The questions allowed the participants to express their thoughts and feelings based on their specific situations. Questions that gave a “yes” and “no” answer were kept to a minimum. (see Annex 4 for discussion guide).