Ethical Considerations and Procedures

According to Streubert and Carpenter (2011:62) ethics in social research refers to what is proper and improper in the conduct of scientific inquiry. Therefore ethical issues that were considered in this qualitative research included the following: protection of the rights of the institution, informed consent, confidentiality/anonymity/privacy and potential harm.

3.2.5.1. Protecting the rights of the institution

Protecting the rights of the institution is considered an important ethical issue, therefore in order to adhere to that, ethical clearance for the study was obtained from the Higher Degrees Committee of the Department of Health Studies, at the University of South Africa before commencement of the study (see Annexure A). In addition, permission to carry out this research study was obtained from the Zimbabwe Ministry of Health represented by the Chief Executive Officer (CEO) of the central hospital, where the study was undertaken (see Annexure B).

3.2.5.2. Informed consent

The researcher provided key information about the study to potential research participants and obtained verbal consent expressing their interest to participate in the study. The researcher set up appointments with potential participants where necessary in order to get informed consent. According to Moule and Goodman (2014:63) informed consent refers to the process of gaining agreement from an individual to participate in a research study, based on having been given all relevant information, in a manner that is appropriate for that individual, about what participation means, with particular reference to possible harms and benefits as well as the inclusion criteria. In addition the consent should be informed and be purely voluntary. This implies that the research participants should give consent after assimilation of essential information. Clients were provided with a detailed written consent form which was read by the client and or was read and explained to those not able to read in lay terminology. The written consent was in two national languages: Ndebele and English (see Annexure C). Furthermore the researcher provided an opportunity to answer questions and concerns raised by participants. Thereafter the researcher obtained a signed written consent from each research

participant. The research participants were also informed that they had a right to withdraw from the study at any time if they so wished without even giving the reason and that is not going to affect their care

3.2.5.3. Confidentiality, Anonymity and Privacy

Below is an outline of how this principle of confidentiality, anonymity and privacy was maintained.

3.2.5.3.1. Confidentiality

Confidentiality, according to Babbie (2010:67) refers to the researcher’s responsibility of making sure that the information obtained during the course of the study is not divulged to any other person without the permission from the study participants. Therefore it was explained to research participants that information would not be shared without their permission. Participants were also informed that because of the nature of the research, during the data analysis stage other researchers may read the raw data in order to establish confirmability of the findings. However, the participants were assured that the confidentiality would be maintained throughout. The participants were also informed that in the interest of maintaining confidentiality the raw data, the taped interviews and transcriptions would be locked in a cupboard in the researcher’s office to be disposed of properly after a minimum of two years.

3.2.5.3.2. Anonymity

Grove, Burn and Gray (2013:172) state that anonymity exists if research participants’ identity cannot be linked with individual responses. In the context of this study, the research participants were informed that their individual identities would not be disclosed in the research findings. Therefore the researcher made use of pseudonyms in transcripts. Interview tapes were stored in a locked cupboard as indicated above(under confidentiality), stored separately from participants’ contact details. This process ensured that there were no details that made the client identifiable.

3.2.5.3.3. Privacy

According to Grove et al (2013:169) privacy refers to an individual’s right to determine the time, extent and circumstances under which personal information can be shared or withheld from others. In a bid to maintain privacy, in this study interviews were conducted in separate consultation/counselling rooms in the hospital. In addition to this, the

participants were allowed to discuss issues that they felt comfortable to talk about and the researcher only asked information that was relevant for the study.

3.2.5.4. Non-maleficence

Rees (2011:103) discussing the concept of non-maleficence posits that the researcher has an obligation to protect the rights and welfare of research participants. According to Babbie (2010:71) this principle refers to the researcher’s responsibility and duty to avoid, prevent or minimise harm to research subjects. In this study, the researcher was sensitive to asking questions that are triggering emotions. Questions were asked in a non- discriminatory manner. However, in instances where emotions or psychological distresses were triggered as the participants described their experiences, they were referred to the counsellors or to the clinical psychologist within the hospital.

3.2.5.5. Beneficence

Moule and Goodman (2014:57) indicate that the ethical principle of beneficence refers to maximising benefits versus risks in a study and preventing any harm. In this study there were no direct individual benefits to the study participants. Therefore this aspect was explained to the participants prior to the commencement of the study. It was further explained to the study participants that a significant potential benefit would be the development and refinement of knowledge that would accrue from the study and benefit HIV positive PMTCT clients accessing the PMTCT services. Direct benefits could include referral to other service providers and information giving and further counselling if there was need.