1. OVERVIEW OF QUALITATIVE METHODS Violet Kimani SCHOOL OF PUBLIC HEALTH MAANZONI

2. Objectives Provide Overview of Methodology Highlight distinction between Qualitative and Quantitative methods List the various Methods

3. Qualitative methods Qualitative research methods Developed in the social sciences to investigate social and cultural phenomena Complement Quantitative methods Qualitative data sources include: observation, FGDs, Key Informant interviews, In-depth interviews & the researcher’s impressions

4. Distinction between Qualitative and quantitative data Descriptive Non-numeric Small numbers How, why questions Internal validity Low on intracultural variation Contextual understanding Numeric Quantification/statistical analysis Large numbers What Questions Replicable/generalizatio n External validity/reliability High on intracultural variation

5. Formulation of a research problem: Qualitative Approach The study is often exploratory- Knowing that a problem exists but knowing little about its characteristics or possible causes: -Who is affected? -Why them? -How do the affected people behave? -What do they know, believe, think about the problem?

6. Areas of Focus Examples: Why women use/not use contraceptives Why some women deliver in health institutions & others at home Why some illness are ignored Explanations for care seeking behaviour

7. Exploratory Approaches Provides insight into a problem by investigating peoples views on the problem; interpretation and finding solutions Local concepts of describing the problem Local perception of causation & treatment Participatory research- engage the community Move from known to unknown Shared decision making processes

8. Data Collection- Qualitative Approaches Discussions/Participatory Engage the researcher more Format- unstructured instruments/Guides

9. Types of Qualitative approaches Key Informant Interviews In-depth Interviews Focus Group Discussions Observations Narratives:- reported often verbatim as case studies Visuals

10. Who is a Key Informant? An “informed”/Expert person (DMS, MOH, PHO, Nutritionist, programme manager, Community leader etc) on the subject Based on training, status in the community and level of exposure to community issues/concerns Provide expert opinion Provides an overview of the issue at hand - the magnitude of the problem

11. Key informant interview Prepare a detailed guide- covering the broad issues of the study Adjust according to level & position of the informant in the organization or project Tentative conclusions & or recommendations and what needs to be done in terms of cost, feasibility.

12. Why Key Informant interviews? Knowledgeable and have an objective eye for the communities/organizations they represent Fast hand detailed information used to corroborate with other qualitative and quantitative approaches Factual e.g. policy issues

13. In-depth Interview (IDI) Collection of detailed information from an individual, client, patient A detailed guide is prepared to elicit required data more detailed Conducted one to one Also referred to as Semi structured Interviews (SSI)

14. Participants in-depth interviews A person representing the problem or affected by the problem, e.g. Expectant mother- experience with a given service Caregiver(s)- skills and working environment- what is the experience and what needs to be done In-depth interview quite close to case narratives Narrative is factual personal story/evidence information

15. Focus Group Discussions Homogenous group e.g. ( ANC mothers; Orphans; HIV Clients; Youth etc. desegregated by gender & age ) Common problem for discussion Participants 6-10 in number Ideal time 60- 90 minutes Moderator and note taker

16. Areas covered/applied Provision and use of health services Experience with the services- quality of care Access to health services Barriers to service utilization What is to be done to improve services What barriers can be removed & by who

17. A narrative Involves an individual participant Performs well for patient with chronic condition May refer to livelihoods (poverty assessment- Kwale) Purpose is to enlist participation of the client Information is experiential and incisive Sometimes provokes deep emotions

18. Narratives A lead statement is adequate: What has been your experience with this illness? Examples: Patient in terminal stages of ca Widow(er) living with HIV Married woman experiencing infertility Orphan and OVC

19. Observation Observation is a primary method of data collection. It can be part of qualitative as well as quantitative research ( i.e. lab experiments) Researcher may or may not have direct contact or communication with people whose behaviour is being observed

20. Advantages of Qualitative Methods Detailed & focused information Can be documented verbatim ( with permission) Ideas on programming and project implementation (esp. from KII) Changes/adjustments in service delivery

21. Conclusion Validation: Conduct several qualitative interviews on an issue using various tools Qualitative methods Complement quantitative methods Examples?