The purpose of this document is to systematically critique the qualitative research design and the process that has been undertaken by the researcher. The objective of this inquiry is to understand if the kind of research undertaken is the best possible method for inquiring into the research question.
In the study which we are exploring, authored by Matima et al, the research method is a qualitative inquiry using interview-style questions. The interviews that are conducted consist of only open-ended questions. To understand the access of public health facilities for patients with multiple morbidities, samples were drawn from two public clinics. Ten patients and six healthcare workers were interviewed and their responses were recorded and transcribed.
The qualitative inquiry into health access and assessing the success of institutional structure on patient ease is an emerging field, but since qualitative research methods leave little space for gathering data from a large group of people, it runs the risk of being biased.
In this particular research, sample size was small because of the paucity of sample sizes, but it was explained that this was done because of limited resources. Rolfe et al (2018), commenting on the usage of qualitative methods for public health research, argue that representation is key when engaging in this particular research. Furthermore, an important aspect to expand upon is a categorial inquiry into the socio-cultural environment in which the research is taking place. The methodology description does not provide a description of the case study area and the socio-cultural characteristics which may influence the viewpoints of the interviewee.
Al-Busaidi (2008) argues that the usage of qualitative methods in studying healthcare affords the researcher to encompass what quantitative methods may miss. However, one of the advantages of qualitative research, as Al-Busaidi points out, is that it may examine social factors like belief and culture; this very aspect was not delved upon in the research objectives.
In addition to that, the research question could have benefited more from the inclusion of some close ended questions in the questionnaire as well. Close ended-questions serve as a guide to direct the researcher towards the kind of questions that the researcher can ask the interviewer to get the most viable answers.
Lastly, an inherent quality of the interview method of research is that it is subject to internal biases caused by human errors (Patton, 1980). A preliminary quantitative research should’ve accompanied the research in order to guide the interview away from biases. Consequentially, analysis becomes trickier in the interpretation of this data. Another aspect of analysis that needs to be considered here is language. Since the interviews were all done in a foreign language and an interpreter was needed to translate the interviews, chances are that some of the data may literally be lost in translation. Because qualitative approach is generally inductive in nature, the gap which is caused when the interviewee says something and it is subtly changed by the translator while relaying it, the interviewing method, in this particular case, could cause some significant loss of important data (Murphy et al, 1998).
The purpose of this thematic analysis is to insightfully look at the interviews provided and isolate themes and patterns from the data that is given there. The section hopes to isolate some common patterns with regards to the interviewee’s responses and come to a conclusion regarding the researcher’s aims and if the interview achieved it or not.
A common theme across the response of both the interviewees is the complaint about long wait time, either when availing the services of a healthcare worker or while buying medicines. Respondent number P6 expresses this in the very beginning, that they have to wait in the pharmacy and then in the diabetes clinic. Respondent number P4 relays that he comes during the weekend to avoid the rush, but upon asking in greater detail, the second participant expresses that his solitary complaint with the health centre he visits is the waiting time. From the response of both the participants, it becomes obvious that the waiting time problem is a problem which emerges from poor management on the part of the health centre and not necessarily the doctors or nurses themselves.
In terms of the medical advice that the respondents avail, the attitude towards the advice is contrasting. Both participants receive similar advice about consuming healthy foods, vegetables and fruits, but Participant P6 reveals that it is not economically viable to always afford fresh, healthy foods. Participant P6 remarks that the difficulty in keeping sugar levels healthy is also because she is provider for her children and health officials are unable to provide her with solutions with regards to prioritising her health over the wellbeing of her family. That is not the case with Participant P4 as he finds it easier to control his diabetes and take his medication.
Special emphasis must be given to the issue of HIV treatment and the patient’s perception. Both participants receive medication and health advice with regards to HIV and both the participants are satisfied with the treatment that they get from the clinic. Participant P6 is content with her present health condition with regards to HIV and Participant P4 has expressed that the healthcare worker’s have provided him with information which would help him live healthy with HIV and diabetes.
The general attitude of the participants seem heavily dependent on the support system they rely on for the purpose when they are undergoing treatment. Both participants reveal that they have financial troubles and find it hard to maintain a healthy lifestyle on limited financial means. However, their friends and family are their support system and they have adapted to the life they live in and the ramifications of the diseases they have.
The interview was done to get a patient-centred perspective on the public health centres in Khayelitsha in Cape Town, South Africa. While the scope remains for further research in this area, the conclusions that can be drawn from the thematic analysis are largely indicative of the fact that because of the nature of the diseases and the relative deprivation, patients need close attention at a personal level. This conclusion is in tune with van Olmen et al’s (2012) findings which postulates the same things. Additionally, the participant’s dissatisfaction with the health centres’s advice for healthy living but failure to provide economic means to actually realised that goal is also reflected in Manne-Goehler et al’s (2019) findings that relate that innovation needs to take place in technological aspects of treatment by healthcare workers in South Africa in order to effectively treat the patients, especially in the rural areas of South Africa.
The interviews and thematic analysis suggests that while patient care in the region has not been able to give specific attention to each patient, the patients are all advised well on the ramifications of the diseases that they have and are advised carefully about how they can live healthier and prolong their life irrespective of their health conditions. A bigger sample size has the potential to reveal greater aspects of this particular research question.
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