The assessment of quality and trustworthiness of a qualitative research is based on a different set of criteria than those used in quantitative studies even though the intended purpose of these criteria is the same. Among the accepted criteria for establishing the trustworthiness of a qualitative study are credibility, transferability, dependability and confirmability (Hansen, 2006; Lincoln and Guba, 1999; Pope and Mays, 2006). In this section, a discussion is given
8 As research authorization was being sought, the organization was known as the National Council for Science
and Technology (NCST).
173 on how each of these criteria for scientific rigour and trustworthiness have been fulfilled within this study.
6.2.1 Credibility
Credibility in qualitative studies is concerned with showing the “truth value” of the findings;
the idea that the findings and interpretations can be shown to correspond to the underlying reality being investigated (Lincoln and Guba, 1999). According to Lincoln and Guba, establishing credibility involves two related steps. The first step is the production of a complete and sufficient account of the varied perceptions of social reality espoused by the social actors. The second step is to avail the reconstructed accounts to the participants (originators of the accounts) for authentication and validation. Credibility requirements can be achievable, broadly speaking, through a thick description of the participants’ accounts and through member checking. The authors of qualitative texts have mentioned a number of undertakings that can enhance the credibility of a qualitative inquiry. These include
“prolonged engagement”, “persistent observation”, “triangulation”, “peer debriefing”,
“negative case analysis”, “referential adequacy”, and “member checking” (Lincoln and Guba, 1999:407). A detailed discussion of these undertakings is beyond the scope of this study, but a short account will suffice to explain how credibility concerns have been addressed.
Peer debriefing, which implies subjecting a study to peer review is one of the mechanisms that was utilized to help realize credibility. Preliminary findings of the study were presented to the teaching staff and postgraduate students at Kenyatta University. This forum provided an opportunity for subjecting the work to a dispassionate and disinterested critique from persons who could objectively evaluate the work. The other way through which truthfulness of the findings have been assured is the concept of triangulation. In the study, the PI was assisted by three research assistants. And even though all the four investigators including the researchers had different personalities and unique ways of carrying out the interviews, the results still pointed to relatively coherent accounts across the cases and sites. Apart from investigators, triangulation also took the form of study sites, sources and methods. Taken together, triangulation helped ascertain the trustworthiness of the findings.
The other criterion according to Lincoln and Guba (1999) relevant for this study is prolonged engagement. Prolonged engagement requires that a researcher spends a good deal of time in the study context and with the participants. One of the goals of prolonged engagement is to equip a researcher with an in-depth understanding of the cultural and social context of his participants. Intimate knowledge of the cultural environment of the study is paramount if an
174 investigator is to understand the meanings of actions, statements and events within the research context. Being a native of this culture, the PI did not need a long time to understand the culture. Similarly, the PI has been involved with HIV activities in that region of the country, has lived in that area for some time and has been involved in research activities in the two research sites in the past. As such, his familiarity with the culture and past involvement with the sites and participants of similar nature provide a basis to believe that prolonged engagement can be demonstrated. Additionally, a one-month preparatory field visit was conducted one year prior to data collection, during which contact was made with the facilities and informal discussions held with a PSC coordinator of one of the sites.
6.2.2 Transferability
The equivalents of transferability in quantitative methods are relevance, applicability or generalizability. The main dimensions of this criterion include the applicability with which the findings of a qualitative research can be used to address some practical problem either of policy or programming (Mays and Pope, 2006). According to Hansen (2006), transferability means that the research process is clearly described in terms of the study sites, sampling procedures, methods of data collection, and the analysis of findings. Such description could help determine whether the findings could be considered relevant to some other situations, and hence the idea of transferability. Transferability is equivalent to replicability in quantitative research.
The other dimension of transferability has to do whether the findings of a particular study can be generalizable to the wider population or whether they can be replicable in similar contexts or with similar target groups in a different setting. This is also linked to the concept of representativeness, whether the sample was representative enough to allow for generalization and replication (Lincoln and Guba, 1999; Mays and Pope, 2006; Pope and Mays, 2006). In this study, the generalizability dimension has been achieved by ensuring that the sample was purposively selected and represented a wide range of participants. The participants included both men and women, young and old, single and married / widowed, rural and urban.
Similarly, in the analysis, care was taken to ensure these varying perspectives are represented through the quotations selected. Transferability or relevance has also been ensured by providing a thick description, which gives a detailed elaboration of the experiences of PLHIV with regard to the study objectives and research questions. Based on this thick description, any researcher interested in replicating this study elsewhere or applying its findings to other populations may judge its utility for their specific purposes (Holloway, 2005b; Lincoln and Guba, 1999; Mays and Pope, 2006; Pope and Mays, 2006).
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6.2.3 Dependability
Dependability as a criterion for measuring trustworthiness of a study is seen to correspond to reliability in quantitative studies. Indeed a number of qualitative authors use the term reliability in their works. So for this purpose, the two terms are used interchangeably even though they do not mean the same things (Lincoln and Guba, 1999). The concept of reliability in quantitative research seeks to assure that the research process would produce the same results if conducted by other researchers, or perhaps in different settings by different people.
The concern is with whether the findings are consistent, dependable and accurate (Lincoln and Guba, 1999). Dependability has identical concerns with reliability, as it is interested to establish whether the manner in which the research was conducted is acceptable. In this respect, it seeks to assess the “suitability of methods, and transparency of methods and analysis” (Hansen, 2006). Thus, the decisions that were made including the sampling decisions, the research design decisions, and data collection decisions should be scientifically justifiable.
Because the product is as good as the process, quality assessments determine whether the process is justifiable. The dependability criterion is closely related to the confirmability criterion for if a process is dependable, then it is to a certain level confirmable as the research products (findings, interpretations, conclusions and recommendations) will be seen to be based on sound principles. In this study, dependability is assured by accurate records and availability of source documents (audio recordings, transcripts, field notes, ethical review documentation, the research proposal containing all methodological decisions and records of all choices), which are well kept. All methodological and other decisions have been justified in the report. The PI ensured that all the basic assumptions of the different methods of data collection were met. Sampling was also stratified and was purposive.
The report was written based on triangulation from a multiplicity of sources and methods that included analytical notes made along the course of the study. Therefore, the report has benefitted from exhaustive analytical procedures. An audit trail could ascertain that records of all the processes, the decisions made, and of the entire research process have been kept and can be relied upon to reconstruct the process. Additionally, it can be shown that the report is based on transcripts of interviews, FGDs and KIIs as well as on field notes backed up by a detailed journal (Lincoln and Guba, 1999).
176 Due to time constraints, not all the required steps in ensuring dependability were followed.
For instance, member checks, whereby stakeholders and participants are given a peek preview into the results and interpretations and their opinion sought as to whether these corresponded to their statements was not feasible. However, attempts have been made to ensure that the steps available to the researcher are exhaustively appropriated (Lincoln and Guba, 1999) 6.2.4 Confirmability
Confirmability, on the other hand, is concerned to ascertain that the findings, interpretations and conclusions are based on the data, that they are grounded in the data and not products of the ingenious imaginations of the researcher (Lincoln and Guba, 1999). In this research, the codes used to categorize the responses were based on the objectives of the study and research questions as well as directly from the data collected. As such a balance of both inductive and deductive coding approaches was used. This was to ensure that the codes, and therefore the categories, were informed both by the literature and theory as well as by the data.
In the coding, analysis and write up of the research report, triangulation of methods was used to ensure that the findings reported and interpretations made were derived directly from the data and represented all the possible diversity of responses across all the three methods of data collection (in-depth interviews, FGDs and KIIs). The discussions and conclusions have also been derived from what was said by the participants with theoretical and analytical input of the PI. The data on which the analysis and hence the interpretations and inferences as well as conclusions have been drawn were based on raw transcripts of audio-recordings of interviews, FGDs and KII data, field notes, research journal, analytical and theoretical notes.
These were augmented by other source documents such as ethical review documents, research authorization documents, participants’ records, informed consent forms, and researchers’ field itinerary (Lincoln and Guba, 1999).