INTRODUCTION TO

QUALITATIVE RESEARCH
Training course in research
methodology and research protocol
development
Geneva 2021

Dr Khalifa Elmusharaf MBBS, PgDip, FRSPH, PHD

Senior Lecturer in Public Health
Director of Public Health Master Programme
School of Medicine – University of Limerick, Ireland
LEARNING OUTCOMES
By the end of the presentation you should be able to:
1. Describe what is qualitative research
2. Demonstrate the differences between Qualitative & Quantitative research
3. Understand the basic concepts of Qualitative studies:
4. Characteristics of qualitative research
1. Bias
2. Triangulation
3. Trustworthiness
CASE STUDY 1
MALARIA
A group of researchers from University of Limerick worked in a village in South
Sudan. They did a survey of villagers and asked them what were the most serious
problems. The villagers said that one of the most serious problems was malaria.

The researchers tested the blood of some of the villagers and found that malaria was
very common. They gave people in the village bed-nets soaked in insecticide and
told them that using the nets would decrease malaria.

The people started using the nets. The research team tested the blood of the people
and found that there was a big reduction in malaria for those people who used the
nets. So they felt the program was successful.
CASE STUDY 1
Later some other researchers came to the village. They found the people no longer
used the nets. They said that they didn’t work.

The villagers were sceptical of outsiders and were less interested in cooperating in
programs to reduce malaria.

Question:
What are possible reasons that the people stopped using the nets?
CASE STUDY 1
THE REAL REASON:
In this case the reason the villagers stopped using the nets was a misunderstanding.
By ‘malaria’ the researchers meant infection with the malaria parasite. But the
villagers meant all fevers. Therefore, although the number of ‘malaria infections’
decreased, the total number of ‘all fevers’ did not change much in the community’s
eyes.
For this reason, they felt the nets did not work against what the community called
‘malaria’ and abandoned using the nets.

Question:
Ask yourself: How could we have discovered the real reason?
QUALITATIVE RESEARCH
Qualitative research is an approach to obtain a lot of in-depth information from
people. The aim is to understand WHY people think and behave the way they do.
Because we spend a lot of time with people to get this information we usually can
only talk with a FEW people.
Qualitative research is a form of social inquiry that focuses on the way people
interpret and make sense of their experiences and the world in which they live, and
understand the social reality of individuals, groups and cultures.
QUALITATIVE RESEARCH
This is different from quantitative methods like surveys and case control studies. In
quantitative research we obtain relatively little detailed information from each
person. This is because with quantitative methods we are interested in describing
WHAT people do (things like how many people have had vaccinations) - without
really wanting details about why the situation is like that. Because we need less time
with people to get this information, we can interview A LOT OF people.

Both qualitative and quantitative methods are important, and whether we use
one or the other depends on what we are trying to learn.
Quantitative approaches are important and solve many type of research
problem. Qualitative research is appropriate for different type of questions.
 DIFFERENCES BETWEEN QUALITATIVE &
QUANTITATIVE RESEARCH
Qualitative Quantitative
1. Aim 1. Exploration of participants’ 1. Search for causal
experiences and life world explanations

2. Understanding, generating theory 2. Testing hypothesis,

from data prediction

3. Exploratory 3. Confirmatory

2. Approach 1. Broad focus 1. Narrow focus

2. Process oriented 2. Product oriented

3. Context – bound 3. Context free

4. Getting close to data 4. In artificial or laboratory

setting
 DIFFERENCES BETWEEN QUALITATIVE &
QUANTITATIVE RESEARCH
Qualitative Quantitative
3. Sample 1. Participants & Informants 1. Respondents

2. Purposive and theoretical sampling 2. Randomised sampling

3. Flexible sampling that develops during 3. Sample frame fixed

research before research starts

4. Data 1. In-depth non-standardised interviews 1. Questionnaire,

collection Standardised interviews
2. Participant observation / fieldwork
2. Tightly structured
3. Documents, photographs, videos observation
 DIFFERENCES BETWEEN QUALITATIVE &
QUANTITATIVE RESEARCH
Qualitative Quantitative
5. Analysis 1. Thematic, constant 1. Statistical analysis
comparative analysis

2. Content analysis

3. Grounded theory

4. Ethnographic analysis

6. Outcome 1. Story 1. Measurable results

2. Ethnography

3. Theory
 DIFFERENCES BETWEEN QUALITATIVE &
QUANTITATIVE RESEARCH
Qualitative Quantitative
7. Relationship 1. Direct involvement of 1. Limit involvement of
researcher researcher

2. Research relationship 2. Research relation distant

close

8. Rigour 1. Trustworthiness 1. Internal validity

2. Authenticity 2. External validity

3. Typicality 3. Reliability

4. Transferability 4. Generalisability
BASIC CONCEPTS OF
QUALITATIVE STUDIES
 CHARACTERISTICS OF
QUALITATIVE RESEARCH
The primacy of data The theoretical framework is not predetermined but
derives directly from the data
Contextualisation Qualitative is context bound, and researchers must be
context sensitive
Immersion in the settings Researchers immerse themselves in the natural setting of
the people whose thoughts and feelings they wish to
explore
The ‘emic’ perspective Focus on the views of the people involved in the research
and their perceptions, meaning and interpretations
Thick description Describing the location, people within it, visual picture of
the setting, events, verbatim, etc
The research relationship Based on the position of equality
Triangulation Several methods, data collections, investigators
AIMS OF QUALITATIVE
RESEARCHERS
Qualitative researchers
Explore the behaviour, perspectives, feelings and experiences of
people and what lies at the core of their lives

Ethnographers
Focus on culture and customs

Grounded theorist
Investigate social processes and interaction

Phenomenologist
Consider the meanings of experience and describe the life world
BE FLEXIBLE
We need to be FLEXIBLE when carrying out a qualitative study.

There are many methods we can use to achieve the same learning objective.

Also we can ask different kinds of questions to learn the same information.

So, if we find that a method or question we are using isn’t being understood or isn’t working
well, we can change methods or use a different question.

This is unlike a household survey where methods and questions are fixed before we
start collecting data.
BIAS
“Bias means having only part of the truth, but we use the information as if it were
the whole truth”

Since bias is having only part of the truth, we reduce bias by getting more
information.

We get more information by looking at something in different ways.

CASE STUDY 2
THE MOUNTAIN
Think of a mountain. If you were standing in one place looking at a mountain and
tried to describe it, you would only see one side.

So your description would be biased. You would need to stand at different places to be
able to see the whole mountain and really describe all of it.

But even then the description would be biased because you may prefer to describe
some things and not others.
CASE STUDY 2
THE MOUNTAIN

Therefore we should bring in other people and ask them to describe the mountain
also.

But even then the description is biased because we are all looking at the mountain
with the same method, our eyes.

We should use different methods, like using a telescope as well as our own eyes, to
get a more complete description.
CASE STUDY 2
THE MOUNTAIN
But the description is still biased because we are all looking at the mountain at the
same time of year.

Some months there may be snow on the mountain but not at other times, so we
would want to look at different times of the year.

There is a name for reducing bias by using different ways to study the same
thing. It is called TRIANGULATION. We do this, triangulation, in qualitative
studies to describe populations instead of mountains.
TRIANGULATION
Reduce bias by using team members with different experiences and perspectives
Continuously cross-checking information using different methods and types of
informants
 Actively identify bias at the end of each day
 Decide how to manage bias in days ahead

Levels of triangulation
 Data
 Investigators
 Methods
 Information
• From different • Multidisciplinary
groups • Gender
• Insiders / Outsiders
• Different locations

• Different times

Data Investigator
triangulation triangulation

Types of Methodological
Informants triangulation

• women & men

• Within – method (intra
• young & old
– method)
• different ethnic
groups • Between method
• different SES groups (across – method)
TRUSTWORTHINESS
We sometimes say that we trust a person. With this we mean that his behaviour is
predictable in that similar behaviour is expressed at different occasions and we
believe that the person is not lying. A trustworthy person is someone who tells us the
“truth” and dose so consistently.

What then, is trustworthy research?

How can we judge what findings are worth believing?

Several criteria have been established within both quantitative and qualitative
research to judge their trustworthiness or rigor:
FOUR CRITERIA FOR
ASSESSING
TRUSTWORTHINESS
Question asked Issue Qualitative Quantitative
1. Have we really measured what we set out Truth value Credibility Internal validity
to measure

2. How applicable are our result to other Applicability Transferability External validity
subjects and other context

3. Would our findings be repeated if our Consistency Dependability Reliability

research were replicated in the same context
with the same subject

4. To what extend are our findings affected by Neutrality Conformability Objectivity

personal interest and biases
1) TRUTH VALUE:
CREDIBILITY
The ability of the study to capture what the research really aimed
at studying, meaning that the result are not simply the product of
research design errors, misunderstandings, or influence of
unknown factors.

= Internal validity in quant

HOW CAN WE IMPROVE THE
CREDIBILITY OF A STUDY?
1. Prolonged Engagement (Stay in the field until data saturation occurs.)
1. counters distortions from researcher's impact on the context
2. limits researcher biases
3. compensates for effects of unusual or seasonal events

2. Persistent Observations (Consistently pursue interpretations in different

ways in conjunction with a process of constant and tentative analysis.
Look for multiple influences. Search for what counts and what doesn't
count)
3. Triangulation (The best way to elicit the various and divergent
constructions of reality that exist within the context of a study is to collect
information about different events and relationships from different points
of view.)
 ask different questions
 seek different sources
 utilize different methods

4. Referential adequacy (What materials are available to document your

findings? Video tape provides a good record but it can be obtrusive.)
5. Peer Debriefing (This is done with a similar status colleague (not with a
junior or senior peer) who is outside the context of the study and who has a
general understanding of the nature of the study and with whom you can
review perceptions, insights, and analyses.)
tests working hypotheses
helps develop next step

6. Negative case analysis: involves the conscious search for data that don’t fit
the current working hypothesis, within existing data as well as in planned
data collection.
7. Member Checks : is an activity that entails brining back the results to the
members of the studied group. At different levels:
 Transcripts
 Preliminary report

corrects errors
provides additional information
puts respondent on record
assesses the overall adequacy of the data in addition to individual data
points
2) APPLICABILITY:
TRANSFERABILITY
 Thick Description
Because transferability is a naturalistic study depends on similarities between sending and
receiving contexts, the researcher collects sufficiently detailed descriptions of data in context
and reports them with sufficient detail and precision to allow judgments about transferability
to be made by the reader.

Purposive Sampling
In contrast to random sampling that is usually done in a traditional study to gain a
representative picture through aggregated qualities, naturalistic research seeks to maximize the
range of specific information that can be obtained from and about that context by purposely
selecting locations and informants that differ.
3) CONSISTENCY:
DEPENDABILITY
An inquiry must also provide its audience with evidence that if it were
replicated with the same or similar respondents (subjects) in the same (or a
similar) context, its finding would be repeated

Increasing Dependability
To enable readers of the research report to develop a thorough understanding
of the methods and their effectiveness, the text should include sections
devoted to:
The research design and its implementation, describing what was planned
and executed on a strategic level;

The operational detail of data gathering, addressing the minutiae of what

was done in the field;

Reflective appraisal of the project, evaluating the effectiveness of the

process of inquiry undertaken.
4) NEUTRALITY:
CONFIRMABILITY
To what extend are our findings affected by personal interest and biases

This is the degree to which the findings are the product of the focus of
the inquiry and not of the biases of the researcher.)

Confirmability Audit Trail

An adequate trail should be left to enable the auditor to determine if the
conclusions, interpretations, and recommendations can be traced to their
sources and if they are supported by the inquiry
An example of a qualitative study
http://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-0973-1