Mishler (1986) defines an interview as a type of communication between the researcher and the interviewee. “Questioning and answering are ways that are grounded in and depend on culturally shared and often tacit assumptions about how to express and understand beliefs, experiences, feelings and intentions” (ibid: 7). Interviews are very common form of data collection method (Hancock and Algozzine, 2006) and done “with a purpose” (Kahn and Cannell 1957:149). They are one of the most significant data collection methods (Yin, 2003). Interviews are an essential part of case study evidence (Remenyi et al., 1998) and may be structured, semi-structured or unstructured.
Semi-structured interviews were particularly well suited for this case study research. They enabled the researcher to explore issues as they arise, whilst providing an initial framework for areas for discussion. Gorman and Clayton (2005) highlight that semi-structured interviews facilitate an immediate response to a question, allow both parties to explore the meaning of the questions and answers, resolve any ambiguities and can provide a friendly emphasis to data collection. They enable researchers to ask predetermined but flexibly worded questions, the answers to which provide tentative answers to the research questions (Hancock and Algozzine, 2006).
In this study, in-depth interviews were employed to get information from key informants about brain drain in the Malawi health sector. A key feature of in-depth interviews was their depth of focus on the individual. In this research, they provided an opportunity for detailed investigation of each person's personal perspective, for in-depth understanding of the personal context within which the research phenomenon is located, and for very detailed subject coverage (Ritchie and Lewis, 2003). An exploratory descriptive design helps understand the topic under- study from the populations involved perspective since they are able to talk about their personal feelings, opinions and experiences (Ulin et al., 2004). For the reason that this study was looking at determinants of brain drain of registered nurses in Malawi, semi-structured interview was relevant because it enabled the interviewer to ask the same questions. The advantage of this form of interview according to Bryman and Bell (2007) is flexibility, as questions can be adjusted although the interviewer follows the planned questions. The material collected during the in-depth interviews forms the basis for determining the attributes and attribute levels (Coast and Horrocks, 2007).
Interviewing is a key data collection method and very central to the study as Richards (1996) pinpoints that, it provides information not recorded elsewhere, or not yet available (if ever) for public release. According to Gubrium and Holstein (2002), interviewing is where both
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interviewer and interviewee are seen as actively and unavoidably engaged in the interactional co-construction of the interviews content. Fontana and Frey (2000) state that people live in an interview society, in a society whose members seem to believe that interviews generate useful information about lived experience and its meaning.Interviewing cannot begin until decisions are made about who to interview and what questions to ask (May, 2002). While asking questions, as stated by Hancock and Algozzine (2006), interviews in this study were used in order to get an in-depth understanding of the brain drain issues in Malawi health sector. Legard et al. (2003) point out that, when probes and other interview techniques are used this way, the researcher can achieve depth of answers in terms of penetration, exploration and explanation. The researcher asked open-ended questions by avoiding yes/no questions, leading questions, or multiple-part questions. Key informant interviews in this research were conducted with respondents representing stakeholders.
Eighteen nurses three from each sampled government hospital in Malawi participated in the study. The sample also included nine key informants altogether namely six key informants from hospitals, one Christian Health Association of Malawi (CHAM) official, one Nurses and Midwives Council of Malawi (NMCM) official and one Ministry of Health Headquarters official.
An in-depth interview is preferred as Miller and Glassner (1997) argue that information about the social world is achievable through in-depth interviewing. The personal interviews in this study were administered using open-ended semi-structured interview guides. Yin (2003) suggests that when doing case study interviews, the researcher should ensure that they obtain rich information during conversation with interviewees. Hence, they should design “friendly and non-threatening questions in their open-ended interviews” (Yin, 2003:90). All the interview guides were developed in English because the participants were well conversant with the language. An interview guide is used to ensure that all the interviews are focused on the same research questions. In addition, they provides the subject area to help the interviewer deliver questions focused on a particular subject. As such, the researcher has the flexibility to create a conversation on a specific subject area based on the research assumptions (Crabtree and Miller, 1999). Interview guide was used to give enough latitude and flexibility to the respondents to explain issues under study. Aberbach and Rockman (2002:674) highlight that in semi-structured interviews, interview subjects ‘do not like being put in the straightjacket of closed ended questions [but] they prefer to articulate their views, explaining why they think what they think’. Probes to bring out narratives critical to brain drain issues followed this. The use of semi-structured interview was necessary because some issues very important to the study that could be overlooked by the researcher were captured.
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For ethical reasons, all the interviewees were assured that their responses would be treated in the strictest confidence and that the researcher would not make individuals identifiable attributes. Douglas (1985) refers to this type of interviewing as creative interviewing and states that to achieve thick descriptions of data and depth, the interviewer must establish a climate for mutual disclosure. Dunbar et al. (2002) concur with Douglas by stating that in most interview situations, emphasis in research is disproportionately placed on researchers obtaining information from respondents. The interviewer must constantly engage with the narrator by listening attentively and empathetically to evoke further narration of experiences (Rosenthal, 1995). A researcher should remember that time spent talking to the interviewee would be better spent listening to the interviewee. In other words, the researcher should limit his comments as much as possible to allow more time for the interviewee to offer his perspectives (Hancock and Algozzine, 2006).
The participants’ decision to participate in this research was voluntary. A digital voice recorder was used to record the interviews and notes were written on a note pad. However, before audio recording, the researcher obtained the participants permission. The advantages of audio recording are that the interviewer can re-listen to the interview, allow direct quotes to be used and allows the interviewer to concentrate on questioning and listening (Saunders et al., 2012). Each interview session took an average of one and a half hours at the interviewees’ organisation premises. Transcription began within two days to ensure timely familiarisation with the data.
3.7.1.1.1 Recruitment of Respondents for Semi-structured Interviews
Semi-structured interview has a known structure with a room to adjust the questions to determine their order and presentation (Sarantakos, 2005). A researcher should identify key participants in the situation whose knowledge and opinions may provide important insights regarding research questions (Hancock and Algozzine, 2006; Silverman, 2002).
This study adapted purposive sampling technique. Purposive sampling also called Judgement sampling is a sample where individuals are selected with a specific purpose in mind, such that as their likelihood of representing best practice in a particular issue (Remenyi et al., 1998). For the actual selection of the respondents in purposive sampling, the procedure is to establish contact with a key person, or highly placed manager, [in order] to take his or her help in identifying the right persons (Ghauri and Gronhaug (2002). In this study, the selection of the nurses was done with the assistance of Chief Nursing Officers and Administrators. This was critical in order to maximise what we can learn (Stake, 1995) as it enables the selection of
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information rich cases for in-depth analysis related to the central issues being studied (CEMCA, 2002).