Selected methods

The research design, focusing on data collection in Ghana and informed by the results of the phenomenological review in the UK, incorporated a wide range of participatory methods. The research was designed based upon the results of the phenomenological review, and new literature, which located these findings in the context of existing theory, informed this design.

The design process was iterative whereby the results of the phenomenological review were analysed over several stages to inform the design of the research for Ghana, considering the findings of the interviews in the UK as they gradually emerged. Reflections on the research design for Ghana were made in the research diary and through dialogue with supervisors. The methods which were intended to be used to collect data in Ghana were maintained as planned. Data in Ghana was collected with two cohorts, PM and menopausal women, and environmental health professionals. PM and menopausal women were eligible to participate if they were in the appropriate age range to discuss PM issues, and were from the communities in which the research was conducted. PM and menopausal women participated in oral history interviews, using semi-structured interviews as a tool to do so, participatory mapping, questionnaires, and PhotoVoice. The data from these tools were complemented by ethnographic observations made by the researcher. This data from the different tools was triangulated to present the picture of the WASH needs of PM women in Ghana. As planned, the second cohort, environmental health professionals, participated in the vignette method.

Figure 3.5 illustrates the outcomes of the final research process which was eventually deployed to research the WASH needs of PM women.

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Figure 3.5: Outcomes of the research design

119 Table 3.6 outlines why each method was ultimately chosen and how they contributed to the research, and the limitations which needed to be catered for.

Methods Contribution to data collection Limitations Oral history

• Challenging to organise and conduct

• Language barrier as researcher does not speak Ga or Twi

• Facilitates discussion of WASH needs between women on a taboo topic

• Reveals spatial issues for PM women which were otherwise less obvious Questionnaires • Identifies topics for discussion in the

oral history interviews

• Illustrates WASH context for PM women

• Time-consuming

• Language barrier means medical terms about PM on questionnaires difficult to translate

PhotoVoice • Illustrates tangible infrastructural issues for engineers to address, rather than social issues

• Enables women to show issues faced in private spaces such as toilets where other people will not see them

• Raises community level WASH needs from the perspective of PM women

• Training and building confidence in women to use the camera is time-consuming, restricting sample sizes

Ethnography • Triangulates women’s narratives with community settings using visual

Vignette method • Communicates the findings from PM women to environmental health

• Presenting a wide range of topics to discuss can overwhelm and confuse

Table 3.6: Contribution to data by method

120 3.7.2 Outcomes of research design

The methods selected for the research sought to ensure bias and error risks were eliminated, that the findings were valid and accurate, and that the research was rigorous, credible and trustworthy. The contributions of each method to answering the research questions are outlined specifically in Chapter 5. As per Chambers’ (2017) markers of error, issues of power, interests and motivation, mindsets, ego, misleading data, extrapolating out of context, behaviours and experiences and repetitive confirmation bias (Section 3.3.2.5) were collectively considered in the research design, as part of maintaining validity. This research sought to ensure validity by using a feminist perspective, which argues for accepting women’s narratives as the truth (Harding, 1987). Women were placed at the centre of the research and were listened to, and their voices were accepted as the truth. Yet, validity issues may arise according to the way in which the research was conducted by the researcher, according to, for example, how questions may be phrased when collecting data. Another aspect of ensuring validity would have been to ask all the participants to read through their transcripts. Yet this was not possible due to time constraints overall due to how long it takes to transcribe an interview, the language barriers posed in the research and the practical elements of returning to meet each participant for a read through and verification of the data. A research diary was a means to record the decision trail for the research, and the analysis of this trail formed the basis of this chapter, and ensured reliability and consistency. The rigorous approach taken in this study is demonstrated through this chapter, outlining the theoretical background, plan for the research, the design, and the eventual outcomes of the methods used.

There were some elements of bias in this study within the design as per Chambers’ (2006a) principles (see Section 3.3.2.5), the effect of which was sought to be minimised. Bias in the initial stages lay in the fact that the research objectives were set through data collected from the UK (see Section 3.9 and 3.10). The main stage of data collection was conducted in one country (Ghana), in only two communities, which had a specific degree of access to WASH, and only in urban areas and not rural areas, therefore there was some spatial bias. In Ghana, there was person bias. In one community, La, all the women interviewed were menopausal rather than perimenopausal, it was not possible to gather data on current WASH issues for PM women in that community, and women were reflecting back on past experiences. The main data collection phase in Ghana was only conducted in one season so there was seasonal

121 bias, and it was not possible to see the impact of seasonality on WASH provision through ethnography, however piloting was done in a different season, but this data was not included in the final report. The data relied on the women relaying their experiences of WASH across the seasons. There was diplomatic bias in one mapping session; menstruation was not discussed because of local taboos. Professional bias lay in the fact that the researcher has a training in geography and not in engineering. It was, therefore, difficult to judge whether solutions being shared by environmental health professionals were trustworthy and could be taken on board on face value. Finally, security bias was present, and this dictated the choice of doing research in the UK and in Ghana, because they were deemed to be safe.

Trustworthiness in the research was measured through credibility, transferability, dependability and confirmability. In terms of credibility, it was important to take the women’s narratives as the truth in line with the feminist approach. Yet, the perspective from the environmental health professionals was challenging to analyse as the truth due to professional bias; the researcher could not judge the credibility of the discussions with these professionals about engineering solutions because of her academic training in geography. This research was conducted in the UK and in one low-income country and in only two urban communities. The transferability of these results is applicable to urban low-income communities with a similar level of WASH facilities, but a gap remains in terms of exploring the rural context and other low-income countries and the findings do not reflect these contexts. The methods in Ghana ensure dependability as they were tested for a pilot in August during the wet season and then implemented in the dry season. The research has sought to maintain objectivity and reduced the impact of the researcher’s values on the process through confirmability, but her feminist positionality had a degree of influence in the process, even though this study lends itself to feminist approaches.