Research methods

Ethnography is a methodology that uses different methods and tools to achieve its aim. In this section, I will talk about how these methods and tools were employed in the data collection process.

2.3.1 In-depth interviews (individual and group)

As explained in the previous sections about the change in philosophical and theoretical frameworks, the nature of interviewing in the study evolved from a

realist to a discursive model. Instead of treating the interview data as a representation of the local reality, it was used to examine, construct and reproduce (later in writings) a discourse. Very frequently, opposing world views were voiced by informants representing different interests. In these cases, opposing views would be checked by alternative data resources, for example documentary materials, observation and/or interviews with a neutral party.

All interviews were conducted in English. An interview guide was developed prior to fieldwork (see Appendix III). There are two types of interviews in the study: in- depth individual interviews and focus group discussions (FGDs). FGDs were conducted only with the students. Looking back, the questions asked in this guide might not reflect the data presented throughout this thesis. This is because of the evolving nature of this research, as I repeatedly talk about in this chapter. Even the list of informants evolved and branched out into non-health or non- education stakeholders such as the media (see section 2.4.1). What eventually was asked in interviews was based on quick analysis, in the field, from the previous interviews (as well as other ethnographic data). Unavoidably this could not be always a systematic process because of the intensity of fieldwork.

Therefore, this process was aided with a constant communication with my supervisory team, including my local supervisor who is a Malawian pharmacist having over 20 years of field experience in the sector19.

Because of the evolving nature of the research, the number of interviews conducted increased from the pre-planned 30 to 120 (with the number of

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My local supervisor, Mr Richman James Mwale, has work experience in various sectors in pharmacy in the country, including community and hospital pharmacy, the professional regulatory body, the ministry, the central medical store, the manufacturing industry and in academia. During fieldwork, I reported my findings to him whenever I gathered enough data for a discussion. Also, he provided me information regarding who I should interview and how I should access these interviewees. The supervision process stopped as soon as I completed my fieldwork. In short, Mr Mwale played an important role in shaping this research though he did not overlook the entire process of the research.

interviewees reaching 145, see Appendix I), by the end of the fieldwork. This posed a huge challenge to transcribing and analysis. All interview recordings were listened to but not all of them were transcribed verbatim. Transcriptions are used in two ways in this thesis: first, in full quotes as evidence to claims made in the thesis; and second, in just one word or one sentence to give a flavour of how the opinions were expressed by the interviewees. In the quotes, words that were emphasised by the interviewee are written in italics; whereas words that were spoken in raised voice are written in capital letters. Meanwhile, some interview recordings are not transcribed because the interviews were conducted as a way to triangulate observation data. Also, many interviews were long, often reaching two or more hours. The reason for having these long interviews was because of the people’s enthusiasm in story-telling. To get the ‘meat’ of the story, I had to wait patiently for the story to ultimately reveal (after enough ice-

breaking conversation was done) and that often meant staying long hours for just one interview. As a result, I had to turn into a highly intuitive, superbly organised20ethnographer to squeeze in as many as 3-4 long interviews in one single day. Despite the labour, I can confidently claim not even one interview was done for the sake of doing it but because I needed to find out certain things from the interview.

2.3.2 Participation observation

Participant observation provides two pathways to understanding the culture: as both an insider (in participant role) and outsider (in observer role). As explained in section 2.1.1, I was often treated as an aid worker in Malawi, even when I

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One important strategy used was establishing rapport before meeting informants face-to-face. By average I emailed each informant twice and made at least one call before the interview. When this failed to get an appointment, I would just show up at informants’ workplace to ask for an appointment. In most cases I was given an appointment within a few days (I encountered none of the so-called ‘African time’ in these cases. Was I being lucky? Perhaps, but I guess African time might most probably be a generalisation!). Negotiating access became much easier and friendlier when I turned up in person than doing it through emails/calls.

declared I was merely a research student. This gave me some insider feel as part of the (aid worker) community in the country. My daily interactions with

different contacts (of various backgrounds, as mentioned in section 2.2.1) gave me glimpses into people’s feelings and opinions about living in Malawi. Ethical and practical constraints (see section 2.2.4) disallowed me to conduct in-depth, micro-level observation of a small circle of the society at a single site. Instead, my observation had more of a macro nature where I was observant of people’s expressed emotions, reactions and concerns. For instance, I made notes of how people displayed guarded behaviour (e.g., by saying ‘please do not tell others that I have xyz’, despite having xyz was entirely legal) of their private lives due to fear of inviting jealousy; or how people disapproved of eating scrambled eggs except for breakfast21(!). These could be mundane, day-to-day interactions that are actually discursive forming. By capturing these moments, I slowly gained understanding about how people think and act, for instance why many were worried about not living up to the ‘British standard’.

There were four types of notes taken: observational (like examples mentioned above), methodological, theoretical and emotional (Gobo, 2008). In

methodological notes, I reflected on the way I collected research data (e.g., whether I had put words in the mouth of the informants because of my personal judgement), whether a different method was needed, and who or what else should be included in the data pool. In theoretical notes, I jotted down some theories I used to explain observational data (e.g., colonial legacies to explain the scrambled egg incident). In emotional notes, I reflected on what I personally felt about what I had witnessed and how that could affect data collection and/or analysis processes (e.g., see 2.2.3). All these notes were written up daily in my field notes and stored in a password protected word document in my computer. Although the notes were not literally separated into four different categories, this categorisation provided a mental checklist for what should go into the field

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Scrambled eggs are traditionally eaten at breakfast in England. However they can be eaten at other times hence it is not an unbreakable rule to have them outside of breakfast hours.

notes. Because they were stored digitally, relevant data can be retrieved easily by using the ‘find’ function in word document, hence saving the work to rearrange the notes should it be handwritten.

2.3.3 Documentary materials

Documentary materials are helpful to differentiate facts from opinions. For example, the arguments between the medical council and pharmacy board regarding doctors having dispensing licenses (see section 4.1.1) needed

clarification from documents containing the Medical Act and the PMPB Act. Most of the documents were available from official websites. However, it was helpful to acquire these from the officials-in-charge, just in case online materials were not updated (in the case of PMPB Act for example, the document online was outdated). Also, it was more convincing to let the officials point out which documents were actually in use, amidst a sea of different information available online.

There were also some documents that could not be retrieved from the public domain, for instance the salary scale of university lecturers. These documents were usually of a confidential nature; hence I was not always successful in collecting them. For instance, I was refused the document showing how funding was allocated to the College of Medicine. However, in some instances, I was told (verbally) what was in the documents, despite having no access to them. In these cases, I have reported this verbal information rather than presenting the figural evidence. For the list of documents I tried accessing, please refer to Appendix IV.