Participants in this study, who were male and female in-school adolescents (circumcised and uncircumcised males) for the focus groups and selected adult participants (teachers and health service administrators) for key informant interviews, were purposively selected. Carter and Little (2007) posit that qualitative research samples purposively, emphasizing that participants are selected not to be statistically representative of a bigger population, but rather to fulfil an investigative purpose. Honigmann (1982) and Burgess (1984) refer to this type of qualitative
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participant selection as judgemental sampling. However, LeCompte and Priessle (1993) argue that the term criterion based is a better alternative to purposive sampling. This argument is validated by the fact that all sampling (whether quantitative, qualitative or mixed -methods) is essentially purposive (Ritchie, Lewis, & Elam, 2003). However, purposive sampling features the most in the relevant and vast literature on social research.
Perhaps some clarification regarding the term sampling is necessary as this term was borrowed from the quantitative paradigm, and therefore its use in qualitative studies should be explained. The term is loosely used in both qualitative and quantitative approaches to refer to the selection of research participants (Durrheim, 2006; Polkinghorne, 2005). However, others argue that its use in qualitative research often create confusion (Neuman, 2014) because the implication is such that participants are representative. Similarly, Durrheim (2006), although not disapproving the use of the term sampling in qualitative research per se, asserts that its central concept is representativeness and hence, it is largely acceptable in quantitative designs.
Representativeness is considered irrelevant in qualitative studies because the sample is not supposed to be statistically representative (Ritchie et al., 2003; Sarantakos, 2005). Instead, Flick (1998) argues that it is the people’s relevance to the topic of interest rather than representativeness which determines the way suitable participants are selected. However, other researchers such as Miles and Huberman (1994) consider representativeness an indispensable element even in qualitative research. Importantly, participants in the current study were selected based on their relevance to the topic.
Purposive selection of participants is in tandem with the qualitative approach adopted as ideal for this study and its objectives. According to Polkinghorne:
Because the goal of qualitative research is enriching the understanding of an experience, [therefore] it needs to select fertile exemplars of the experience for study.
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Such selections are purposeful and sought out; the selection should not be random or left to chance (2005, p.140).
Therefore, study participants were not only selected because they were conveniently available at the time the researcher wanted to conduct the study, but rather they were chosen because they met certain stipulated characteristics. To be precise, convenient sampling is the most criticised method of selecting participants in qualitative research (Polkinghorne, 2005). Owing to that, the researcher avoided the temptation to use convenience sampling since the intention was to produce quality data that would adequately illuminate the research issue.
To select information-rich cases (Patton, 1990), a priori sampling was used to select participants. This technique involves the stipulation of specific characteristics and structure of selection criteria ahead of the interview (Ulin et al., 2005). To gather rich data, with several layers (multi-layered), detailed and highly nuanced, overall, homogeneous samples were drawn, as suggested by Krueger (1988). Participants for focus group discussions (FGDs) were those circumcised either the medical and cultural way, as well is those who were not (or yet to be) circumcised. The rationale behind the circumcision-based segregation of focus groups was to enhance the process of data elicitation in conducive focus group environments. Because the researcher sought to achieve a diverse mix of participants to elicit multiple perspectives, the uncircumcised, drawn from both traditionally circumcising and non-circumcising cultural backgrounds were also selected. Religious affiliation was also considered, to cater for the main religious groupings, which are Christianity and African Traditional Religion (ATR).
Nevertheless, belonging to a specific focus group was solely based on circumcision status.
Although the individual groups were homogeneous as indicated above, overall the study used heterogeneous samples in the sense that different FGDs with different participant compositions were used. Ritchie, Lewis and Elam (2003) assert that heterogeneous samples are appropriate when the research aims to identify and explore central themes dominant across
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the diversity of cases or people. To align the research with ethical requirements, participants were supposed to be older than 16 years of age. Above all, willingness to participate was a critical criterion; Polkinghorne (2005) emphasizes this requirement. Participants were selected through a snowballing strategy. Snowball sampling or the chain referral technique, as it is alternatively known entails requesting already identified participants to suggest others with special understanding of the topic in question, while at the same time “meet [ing] some important predetermined criterion” (Polkinghorne, 2005, p.141). This strategy was ideal since the topic had personal aspects such as circumcision status. Circumcision status is a personal affair, thus circumcised participants may be regarded as ‘hard-to-reach’ or ‘a hidden population’, making it difficult for a researcher to locate them. Researchers need use skill to arrive at hidden populations (Miller, 2003; Peek & Fothergill, 2009).
In this study, the researcher approached those learners whom teachers knew were culturally circumcised, especially those who use the Zhou or elephant as their totemic symbol.
The researcher then discussed about his study with those learners and requested them to identify and recommend fellow colleagues who were medically circumcised. He would then approach and invite those learners to participant in the study. Once initial prospective participants were identified, the process of recruitment became easy. Learners would identify fellow learners with the stipulated characteristics whom the researcher would approach and invite to participate. Although teachers had some knowledge of those learners who attended health education sessions on VMMC for HIV prevention as part of the recruitment drive, they had limited knowledge of those who finally got circumcised. Despite their limited knowledge, suggestions by teachers also enhanced the initial scouting process.
Therefore, teachers were key informants in this study. An informant in field research is a reliable person that is knowledgeable about the field. The researcher develops a relationship with the key informant (Neuman, 2014). Key informants are an important resource in social
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research because they make the process of recruiting participants relatively easy. Most importantly, they help the researchers to locate hidden or hard-to-reach participants (Peek &
Fothergill, 2009). In the same vein, teachers were very invaluable persons in the process of participant selection.
A total of nine adult participants (five males and four females) were selected to participate in key informant interviews (KII). These were either educators in charge of guidance and counselling or health administrators for a VMMC relevant organisation. The majority (seven) were teachers while two were health administrators at VMMC relevant organisations. Youth participants were learners aged 16 to 19 years3. Circumcision status was considered because the study sought to explore the views of circumcised and non-circumcised adolescent males. Willingness to participate in the study was an important inclusion criterion.