Why Me? Challenges Associated With Recruiting Participants for a Study Focusing on “Wealthy Men”: Reflections From Fieldwork Conducted in Tanzania

Abstract

It is well-known that conducting research with elite groups presents a range of unique methodological challenges including gaining access to and recruiting a demographic group that is underrepresented if not entirely absent from most research. This issue is particularly pronounced when the research topic is sensitive or potentially politicized and conducted in low-income settings in which large wealth inequalities are apparent. Drawing on recent experiences from fieldwork conducted in Tanzania that aimed to explore attitudes toward HIV testing among wealthy men, we reflect on significant challenges in the recruitment process. These included the framing of the research project, the (often unspoken) politicized subtext of the (sensitive) research, the socioeconomic climate, and the navigation of time requirements. Our experiences suggest that a careful consideration of these methodological issues will help researchers recruit elite participants and ensure that data are collected from appropriate samples.

Introduction

Interviewing elites is an important but still uncommon form of research, with most research across the globe focused on the general population and especially those in lower socioeconomic groups (Mikecz, 2012). The term “elites,” while subject to debates on who this term is applied to and the heterogeneity of those classified as “elites,” typically refers to those who are in powerful positions or have high social status (or both), with research focusing on elites including participants such as business leaders (Harvey, 2011), global policy makers (Conti & O’Neil, 2007), political elites (Rivera, Kozyreva, & Sarovskii, 2002), and intellectual elites (Nudzor, 2013). With elite respondents frequently missing from large-scale quantitative surveys, the literature that addresses methodological challenges related to researching elites primarily focuses on qualitative research and specifically methodological issues related to what is known as elite interviewing. While it is necessary to acknowledge the similarities in methodological challenges across both elite interviewing and more generalized interviewing and the requisite good practices that must accompany all high-quality qualitative research (Delaney, 2007), there are a range of methodological issues that are especially prominent when interviewing elites. These can, broadly speaking, be thought of in terms of two distinct but overlapping branches: First, there is a growing body of literature that discusses challenges related to conducting interviews with elite participants that tends to focus on the dynamics of the interview process (Conti & O’Neil, 2007; Harvey, 2011; Lancaster, 2017; Welch, Marschan-Piekkari, Penttinen, & Tahvanainen, 2002), and second, there are a range of issues related to accessing and recruiting elites, informed in part by the literature on elite interviewing (Goldstein, 2002; Harvey, 2011; Lilleker, 2003; Odendahl & Shaw, 2001; Ostrander, 1993) and also other methodological literature that specifically focuses on recruitment (Butera, 2006; Eide & Allen, 2005; Kristensen & Ravn, 2015; Marland & Esselment, 2018; McCormack, Adams, & Anderson, 2013; Rugkåsa & Canvin, 2011; Wigfall, Brannen, Mooney, & Parutis, 2013). This article focuses on the second issue, that of the challenges faced by researchers in gaining access to and recruiting potential elite participants. The issue of recruitment is frequently overlooked in social science research and rarely addressed in research methods handbooks (Butera, 2006; Kristensen & Ravn, 2015). Sections in these handbooks on sampling (one aspect of the recruitment process) can give the impression “that there is a world of people out there waiting to be interviewed; our job as social researchers is to make sure we select the most suitable of these” (Butera, 2006, p. 1263). However, as almost all qualitative researchers will know, this is not necessarily the case, with the recruitment of participants often a time-consuming, difficult, frustrating, and unpredictable process that demands flexibility, creativity, innovation, emotional resilience, and persistence (Kristensen & Ravn, 2015; McCormack et al., 2013; Sixsmith, Boneham, & Goldring, 2003; Thomas, Bloor, & Frankland, 2007; Wigfall et al., 2013). While researchers may prioritize the publication of their findings over discussions of their methods (Rugkåsa & Canvin, 2011), the lack of attention to the recruitment process is surprising given the fact that the quality of the data gathered is heavily reliant on successfully recruiting an appropriate sample of participants (Kristensen & Ravn, 2015). Instead, recruitment is often presented as an unimportant and unproblematic aspect of the research (Wigfall et al., 2013) and is rarely fully unpacked or fully described in research articles (Kristensen & Ravn, 2015).

The literature that does exist on recruitment, or addresses recruitment in passing, includes a discussion of the different ways that participants can be sampled, such as via cold calling, contacting via e-mail or fax, social media, snowballing or through social networks, and the strengths and limitations of these approaches (Butera, 2006; Conti & O’Neil, 2007; Odendahl & Shaw, 2001; Marland & Esselment, 2018; Sixsmith et al., 2003; Thomas et al., 2007; Wigfal et al., 2013), as well as an acknowledgment of the role that luck and opportunism can play. The strategies forwarded to enhance recruitment emphasize the importance of community gatekeepers as a way of accessing hard-to-reach populations (Rugkåsa & Canvin, 2011), as well as, for some communities, the importance of “being seen” or “being known” in the community (Eide & Allen, 2005). Both of these strategies can help to build trust between the researchers and the target group of participants, another key factor when thinking about recruitment (Eide & Allen, 2005). However, gatekeepers can also block, rather than facilitate access, to communities (Wigfall et al., 2013), and in some cases, using gatekeepers can result in a restricted sample (Sixsmith et al., 2003).

Further, success in gaining interviews is often credited to ensuring that potential participants are given a clear and concise overview of the project aims, the sort of questions that might be asked, and why they have been approached (Goldstein, 2002; Harvey, 2011; Lilleker, 2003; Wigfall et al., 2013). One suggested strategy to overcome any reluctance to participate is to accentuate the degree to which the research will benefit from the unique insights that a participant may have (Delaney, 2007). The politicized nature of the research can also influence whether elites agree to participate, especially if research topics are sensitive in nature or may potentially compromise participants or deter them from agreeing to be interviewed (Butera, 2006; Kristensen & Ravn, 2015; Ostrander, 1993). Finally, the practicalities of arranging interviews, being flexible and prepared to wait for a suitable time due to the busy schedules of elites, as well as being upfront about how long interviews may take, are also addressed (Harvey, 2011).

This article extends the literature on accessing and recruiting elites in a low-income setting based on observations from our experience of conducting a qualitative research project in northern Tanzania on attitudes toward HIV testing among wealthy men. This is an important and underresearched topic in the methodological literature given that the literature on elite interviewing that addresses recruitment in passing focuses primarily on studies conducted with business or political elites in higher income countries (with a few exceptions, see Nudzor, 2013; Vorrath, 2013), and the literature that addresses recruitment often focuses on marginalized and/or minority groups (Culley, Hudson, & Rapport, 2007; Rugkåsa & Canvin, 2011; Shelton & Rianon, 2004) though again with some exceptions (see Marland & Esselment, 2018). In particular, we address the challenges of explaining in a persuasive way why elites should participate in our research in a sub-Saharan African context in which little, if any, research is targeted at wealthy men, and when the research topic has a politicized subtext and is on a sensitive and highly stigmatized topic (HIV). We reflect on the importance of the socioeconomic climate in influencing participation rates, as research with elites does not take place in a political vacuum, and also on discussions within the research team about how accurate researchers should be about the length of time interviews may take when inviting participants to take part in the study. Other experiences related to the challenges of recruiting elites in this context are also explored, along with some practical suggestions for researchers undertaking fieldwork of this nature. While the challenges we encountered may also have been due to the sensitive nature of the topic being researched, this in itself is not a rare occurrence, with research with elites frequently addressing sensitive topics. This is an acknowledged but difficult influence to disentangle. However, the authors’ own experiences of conducting research on equally sensitive topics (e.g., sexual behavior related to migration: Deane, Ngalya, Boniface, Bulugu, & Urassa, 2018, and transactional sexual practices: Wamoyi, Fenwick, Urassa, Zaba, & Stones, 2011; Wamoyi, Wight, Plummer, Mshana, & Ross, 2010) in the same region of Tanzania was that the recruitment process was far more challenging with respect to elites than other groups previously researched in this context.

These reflections are of particular importance due to the extremely limited discussion of research with elites in the sub-Saharan African context, in part a reflection of the fact that the vast majority of research conducted in this context focuses on developmental issues relating to poverty, including health challenges such as HIV which are invariably viewed (rightly or wrongly) as intimately related to poverty. Further, with the research gaze beginning to turn to emergent middle classes (Mercer, 2014), who along with elites may not be as obliging as the African poor in terms of research participation, this is a timely contribution that may be of interest to those conducting research with a range of demographic groups. Access and recruitment challenges and how they are addressed also influence who does and who does not participate and thus ultimately the quality of data collected.

Project Overview

The research project in question primarily aimed to explore attitudes toward HIV testing among wealthy men in Tanzania. It was developed on the basis of data from Demographic Health Surveys (DHS) conducted across a range of sub-Saharan African countries, in which a range of HIV-related indicators (including HIV prevalence and HIV testing behaviors) are presented by wealth quintile, using an asset-based measurement approach to wealth. Despite assumptions that the wealthy are more likely to test for HIV in sub-Saharan African countries, the data showed that there are still significant numbers of wealthy men who have not. In Tanzania, the latest DHS data show that 40% of men in the wealthiest quintile report having never tested for HIV (The Tanzania Commission for AIDS [TACAIDS], Zanzibar AIDS Commission [ZAC], National Bureau of Statistics [NBS], Office of the Chief Government Statistician [OCGS], & ICF International 2013 , 2013). Further, HIV prevalence among men is highest among the wealthiest quintile in Tanzania (4.9% in the highest wealth quintile compared to 3.1% in the lowest wealth quintile), emphasizing the need to address this issue if the Joint United Nations Programme on HIV/AIDS 90–90–90 targets (by 2020, 90% of people living with HIV know their status, 90% of people diagnosed with HIV are on sustained antiretroviral therapy, and 90% of all people receiving antiretroviral therapy will have viral suppression) are to be achieved (UNAIDS, 2014). This demographic (wealthy men) is largely (if not entirely) absent from HIV research and policymaking, with the response to the epidemic viewed through a poverty lens (Long & Deane, 2015), despite epidemiological evidence that suggests this is problematic (Mishra et al., 2007; Parkhurst, 2010).

Fieldwork was conducted in Mwanza city, Tanzania, in February and March 2017, and was comprised of 23 semistructured interviews with the owners or regional managers of key public sector institutions and prominent businesses within the city. This sample was chosen to serve two related purposes. Firstly, due to the exploratory and qualitative nature of the research, it would mean that the research team could be confident that the participants would definitely be classified in the highest wealth quintile using the standard DHS asset index approach to classifying wealth, and thus it would not be necessary to quantify or measure potential participant’s wealth. To some extent, the methodological challenges of measuring wealth thus elicited the narrowing down of our target sample from the wealthiest 20% (which in reality includes a wide range of income levels) to a focus on elites. Secondly, by choosing to focus on larger scale public institutions and businesses, it would also be possible to explore a secondary research theme related to the economic impact of the HIV epidemic on businesses and public institutions, and how these different organizations respond to mitigate or avoid any potential negative impacts (see Deane, Stevano, & Johnston, 2019). This second theme played a crucial role when structuring the flow of the interviews as it was used as an introductory section before participants were asked about their attitudes toward HIV testing (and also HIV testing practices) within their peer group and their own attitudes and practices, potentially more sensitive themes that were best addressed after the interviewer had warmed up participants and had a chance to establish rapport.

The research team for this project was comprised of one researcher (Kevin Deane) from the United Kingdom and three researchers from Tanzania (Joyce Wamoyi, Samwel Mgunga, and John Changalucha). The project began as a collaboration between Kevin and Joyce, with John providing strategic guidance and institutional support, and Samwel recruited as a graduate research assistant. All interviews were conducted by Samwel in Swahili with the other authors not present. This approach (see Deane & Stevano, 2016, for a full review of the strenghts and weaknesses of this approach) reflected the potentially sensitive topic under discussion and, in light of the linguistic limitations of one of the authors (Kevin), ensured that interviews could flow without the continuous interruptions necessitated if this had been done using Samwel or other authors as interpreters (Pitchforth & Van Teijlingen, 2005). Usually, the interviews were conducted in the participant’s workplace according to their convenience.

Ethical clearance was granted by the Medical Research Coordinating Committee of the National Institute for Medical Research, Tanzania (NIMR) and also by the University of Northampton (UK) Ethics Committee. Further, written permission to conduct the fieldwork was obtained from relevant community leaders and all participants gave informed consent prior to starting the interview.

Recruitment Approach

Potential participants were initially identified through initial brainstorming sessions with the research team and other contacts within the host research institution. This included a discussion about the most important sectors in Mwanza (e.g., manufacturing, construction, wholesale and retail trade, transportation and storage, accommodation and food services, information and communication, financial and insurance activities, and professional scientific and technical activities; United Nations Department of Economic and Social Affairs, 2008), businesses that would likely be locally owned compared to businesses that would be managed on a regional basis but owned either by pan-Tanzanian or International firms, and the key public institutions that employ large numbers of workers. This list served as a starting point for approaching potential participants, though it was added to as the fieldwork progressed. Participants were contacted in a range of ways, such as through personal networks of the research community in Tanzania, the personal networks of friends of the research community, institutional relationships (local public financial institutions or private sector firms that had engaged commercially with the host research institution), snowballing through participants, and turning up unannounced at business and institutional premises. Prior to fieldwork, the project team hoped to recruit a “project champion” from the elite community to help with invitations, but this did not end up happening, necessitating the range of different ways that potential participants were contacted. This combination of different recruitment strategies is not uncommon in research that is focused on hard-to-reach populations.

There seemed to be no discernible pattern in terms of which methods were most successful, despite prior expectations that using local elite networks would prove to be the most fruitful way of recruiting participants. This serves to emphasize the many interlinked and complex challenges that the project encountered in accessing and recruiting from this demographic group. In some cases, turning up unannounced sometimes yielded immediate results, highlighting the need to be opportunistic and ready to do interviews on the spot. In other cases, potential participants who we were put in touch with through contacts at our institution and thus were confident of interviewing did not end up agreeing to participate or continued to put us off until the research team recognized the subtext to these delays. To some extent, getting interviews done on the spot may offer a more fruitful approach to recruiting elites, as once appointments are made, they can become “movable,” and thus interviews often end up not happening. There were also discussions within the team about the role that the age of Samwel (26) had when inviting potential participants who were all older (and in some cases significantly older) than him. To this end, the project was supported by the NIMR Human Resources (HR) manager, who was more senior in age and also status, who accompanied the research team for some selected introductions. Again, while this tactic worked, there were still potential participants who did not respond to this and a number of situations where Samwel was perfectly able to secure their agreement to participate. The multiple ways through which we contacted participants confirmed that there is no clear science to recruiting elites, with “extensive preparation, homework, creativity on the part of the researcher, as well as the right credentials and contacts, not to mention a little luck” (Conti & O’Neil, 2007, p. 70) all necessary components of a successful sampling strategy.

The final sample of 23 successfully interviewed elites was comprised of 9 business owners, 7 regional/zonal managers of private sector companies, and 7 public institution regional/zonal managers. It is suspected, based on the different positions of participants, visits to businesses premises, and differences in the number of business operations owned by different businessmen, that our sample included individuals with a range of income and asset levels, in reality ranging from those who may be considered as upper middle income to those who were among the wealthiest individuals in the city, reflecting the large disparities in wealth even among those in the upper echelons of Tanzanian society. With two exceptions, participants were typically aged between 35 and 60 years. Initially, the project intended to conduct 25 interviews, and thus we were two interviews short of our target. A total of 36 potential participants were contacted during the fieldwork, reflecting a participation rate of approximately 64%.

Challenges and Lessons Learned

Why Me?

The most prominent challenge faced during the recruitment phase was explaining the project to potential participants, and being clear about why we wanted to talk to them specifically. In most cases, potential participants, not necessarily used to being approached by researchers in this context, frequently wanted to know why we had chosen to invite them (and not other members of Tanzanian society), and in general asked many questions and made us work hard to convince them that this was something they should make time for. It was abundantly clear that, reflecting prior themes in the literature, a good and concise explanation of the project aims, and what the outcomes or benefits from the project would be, and more importantly why we had chosen to sample them, were of the utmost importance when gaining a successful interview (Lilleker, 2003). However, this was not as straightforward as we initially presumed.

Our first issue related to the project documentation and the study title that had been reproduced from the formal ethical approval we had received from the Medical Research Coordinating Committee, Tanzania. Before we could start our fieldwork, we also had to gain approval from all the relevant authorities in the study setting. At each stage, the project title “exploring attitudes toward HIV testing among wealthy men” was reproduced on the official paperwork. However, during the translation of the consent forms and information sheets, the research team reflected on how to “label” the sample we were after. Concerns were raised that if we used the project title and explained to potential participants that we wanted to speak to them because they were “wealthy,” this label (being wealthy) could be viewed as some sort of accusation or lead to questions (and suspicions) as to how we knew they were wealthy (or not). While wealth is intertwined with social status and power, it is not necessarily something that is always explicitly acknowledged in this context rather displayed in other forms such as conspicuous consumption and tacit influence. Therefore, on the consent form and information sheet, the project title was tweaked to read “businessmen/public sector directors/managers” rather than “wealthy men,” and it was explained to potential participants that we approached them because they met that criteria and were “influential community members.” This to some extent ensured that the issue of wealth was not directly touched upon during the invitation process, though this was not the case when potential participants asked to see the formal paperwork from the Regional Medical Officer or District Medical Officer, which did not happen very often. However, in cases where they did, the focus of the research on the wealthy was more obvious. In retrospect, more thought could have been given to the project title at the stage of applying for funding or ethical clearance as once the project has been submitted, the title is reproduced in official documentation and can either dissuade participation or at least make the recruitment process uncomfortable.

Alongside this (re)presentation of the project as targeting influential community members, another strategy was to emphasize the secondary project aim allowing us to explain that we wanted to talk to them as they were a business owner or business/institutional regional manager who was responsible for employing a certain number of people and that we would like to talk to them about the impact the HIV epidemic has had on their business or organization. This enabled us to further circumvent (or so we thought!) the need to be explicit about the fact we wanted to talk to them because they were wealthy. However, one unintended consequence of framing the project in this way was that a number of zonal or regional managers of private firms, and indeed some business owners, said that they were not really the right people to comment on this and tried to pass us on to their HR department who would be able to give us the “data.” Clearly, this was at odds with what the project sought to investigate, but the design of the research and this approach to recruitment lead to numerous discussions about why we wanted to speak to them and not their HR department and was a point of contention throughout the project. Other deflective tactics were also used by potential participants to downplay their role in the organization or what they might have to say about the themes we wanted to discuss.

In response to this issue (and the challenges related to the socioeconomic climate discussed below), the project team agreed to focus more on the health aspect of the project, rather than the business impact, explaining that there was evidence from national surveys (TACAIDS, et al., 2013) that significant numbers of people like them (again leaving the wealth issue out of it) did not take HIV tests and that we wanted to understand the barriers people like them faced to help design interventions or policies to encourage more uptake of HIV testing services. On the face of it, this seems fairly unproblematic. However, it is unclear how persuasive this tactic was, or indeed how authentic this came across as. This is in part because, as noted above, health issues are almost entirely related to poverty in the sub-Saharan African context, and thus the idea that a research team was interested in helping elites with any aspect of health care seemed a little odd and out of the ordinary, and thus contributed to more questions and suspicion around the issue of “why me?” One solution to this would have been to address this more explicitly, as although there was generally a high level of awareness and accurate knowledge about HIV among elites we interviewed, it was also clear from their responses that they were not aware of the epidemiological data discussed above. However, we were interested in how perceptions of the epidemic that linked it to poverty influenced testing attitudes and practices, so we didn’t want to explicitly discuss the data at the recruitment stage in case this influenced the responses given in the interview. This limited the extent to which we felt we could go into detail.

A further, and related, challenge to the issue of authenticity and concern for the welfare of elites was the political subtext to the research, a common issue when conducting research with elites. As Ostrander notes, elites can raise questions about the aims and objectives of studies that focus on elites—“surely you are not in this just to be helpful?” (Ostrander, 1993, p. 7). This suggests that elites, in part as a result of their position in society, are acutely aware that there is often a politicized aspect of this type of research. Was our study on a topic that already attracts a great deal of social stigma a project that elites really believed to be on a “neutral” public health issue or an attempt to unpack the complex relationship between wealth, power, status, and HIV? As noted in previous studies, it can often be difficult to get elites to agree to participate in interviews that touch upon sensitive issues, and hence it can be necessary to try and frame the research in such a way as to draw focus away from the sensitive/politicized aspect (Jackall, 1988). In our case, as previous attempts to emphasize the business impact aspect of the project had not necessarily worked as planned, the reframing of the project as a neutral public health issue meant that the underlying subtext to the research was often not alluded to directly. To some extent, this was an attempt to call the bluff of our participants and to stick to explaining the research in public health terms (which was done with persistence). Although other authors have suggested that it is good practice to be as transparent as possible (Harvey, 2011), our experience suggests this may not always be the best strategy.

The framing and reframing of our project aims to enhance the recruitment of participants and make the process less fraught raises important ethical questions regarding the nature of informed consent and whether these practices are overly deceptive (or not). As noted above, previous studies have highlighted the need to downplay the politicized element of the research with elites (Jackall, 1988), and a more recent study of politicians suggests that a request for an interview can be “customized to align with the politician’s interests and background” (Marland & Esselment, 2018, p. 10). In some situations, then, a subtle reframing may be necessary when recruiting elite participants for studies that will often (should?) address power. In our project, the reframing of the target sample as “influential” rather than wealthy was viewed as acceptable by the research team, as the category of wealthy was a proxy for other factors such as power and influence that are intimately intertwined—we did not just want to talk to wealthy men purely because of their “wealth.” However, it is unclear where the line is between permissible reframing and unacceptable deception and the extent to which the ends justify the means, with little or no guidance for researchers with respect to this issue. This requires further research to more fully explore these ethical boundaries when informed consent is sought (as opposed to research which is explicitly covert).

Socioeconomic Context

A second unexpected issue in relation to recruiting local elites, linked to some of the concerns discussed above, was due to the current socioeconomic climate in Tanzania. Following the national election in 2015, the current administration has embarked on a crackdown on public sector corruption and private sector tax evasion (International Monetary Fund [IMF], 2017). This has resulted in a huge increase in tax revenues that have been boosted by the legal enforcement of the backlogs of tax claims from both large foreign firms and local entrepreneurs (Allison, 2015; IMF, 2017; Pilling, 2016). Further, deals with foreign firms struck under previous governments are also being questioned, such as the agreement with Barrick Gold Africa, a company that has “declared years of losses while paying dividends overseas” (Pilling, 2016, p. 1), later leading to a back claim of US$70 million (Pilling, 2016). Against this socioeconomic backdrop, some local business owners regarded us with suspicion as they thought that, as researchers from a local governmental institution, we were in some way connected to this crackdown, especially as we were interested in asking about their business. This was viewed by some potential participants as a way that the government could gain information about their business affairs in a covert way. Despite the fact that in every invitation we emphasized that we did not want to know any financial or sensitive details about their business, and our strategy of emphasizing that the interviews were more about health and attitudes toward HIV testing, this was not always accepted. Further, elite participants who were trying to put us in touch with other contacts also reported this as one of the reasons for the reluctance of their network to engage with us. The tax evasion crackdown and its potential impact on the socioeconomic climate became apparent when a few potential participants were unable to be interviewed. This emphasizes that research with elites does not take place in a political vacuum and that socioeconomic concerns among elite communities can have a strong impact on recruitment rates. Therefore, researchers must be aware of the general socioeconomic climate, as well as the potential concerns of their participants to ensure that the research is presented in a way that it does not infringe upon or add to these concerns.

What Do Bosses Do? Navigating the Issue of Availability and Time

The issue of availability of elite participants for interviews, presumably because they are very busy, is a recurring issue within the literature (Goldstein, 2002; Harvey, 2011). It is noted that it can be difficult to make appointments and for elite participants to carve out enough time for the interview to take place. This was certainly the case in this project, with a number of potential participants often away for business either in the capital, Dar es Salaam, or abroad, making it impossible to get hold of them during the fieldwork period (which was not infinite). Other participants, predominantly the regional/zonal managers of private sector businesses (but also some business owners), made time to participate either during specified lunch breaks, early in the morning/late in the evening, with some interviews arranged for the weekend, emphasizing the need to be flexible when dealing with study populations like this (Conti & O’Neil, 2007; Harvey, 2011).

However, on other occasions, it was not always clear that potential participants were that busy. For example, when meeting one of our potential participants to discuss the project, we were told that he was very busy preparing for another meeting and could only see us for 5 min. However, on entering his office, there was certainly no preparation for a meeting going on, and he was watching the news on TV in the corner of the room. We ended up discussing the project for around 40 min before making our excuses and leaving. On other occasions, business owners were able to spare time to talk to us, give us tours of their premises (etc.) without much notice. This can be explained by the fact that those in elite positions have a high degree of autonomy, and thus if they agree to participate it can be easy to do the interview, especially if you are already there and prepared to do it on the spot. This calls to mind the work of Marglin (1974), who questions what bosses actually do, suggesting the daily burden of productive activities is rarely borne by business owners or management. Further, with large wealth disparities in a setting such as Tanzania in mind, elites have the power (and status) to just do the interviews if that is their inclination to do so. Further, business owners often have senior managers who in reality look after day-to-day activities or at least can do so during an interview.

A related concern is the amount of time the interview may take. The literature suggests that being upfront about how much time is needed for the interview is the best strategy, as it prevents wasting everyone’s time over unfinished interviews and minimizes the potential for interruptions (Harvey, 2011). In one instance at the beginning of the project, a potential participant asked if the interview could be done in 15 min. We said that it could not, that it would realistically take around 45 min, and so as the potential participant insisted that he only had 15 min to spare, we decided not to do the interview. The next time that this happened, the research assistant speculatively decided to agree that it could be done in 15 min, thinking that it was actually quite likely the participant had enough time for it. Consequently, the interview ended up taking over 50 min, and the participant continued to discuss the themes raised in the interview well after it had finished. Therefore, in some situations, a calculated risk may bear fruit, whereas rigidly sticking to stating the time an interview will take up front and declining if the initial response is that the potential participant does not have enough time may not always be a successful approach. While there are ethical concerns that need to be borne in mind, as well as potential damage to rapport and the quality of the interview if participants feel they have been duped, overall, despite initial concerns around the availability of elites, it often did not seem as though the potential length of the interview was an important factor that influenced participation.

Who Has the Final Say Over Participation? Autonomy and Decision-Making Power Among Elites

A final reflection on the recruitment process is related to who actually has the autonomy to make decisions over whether to participate or not, even among elite participants. For business owners, as noted above, this was not an issue as they had the ultimate say over whether they participated or not (and when). However, particularly for senior managers of private firms, this was not necessarily the case, with potential participants often stating that they would need to seek permission from a senior country manager or public relations manager, who was predominantly based in the capital city or further afield. This issue was more pronounced for subsidiaries of multinational firms, who exerted a strong control over external public relations and the flow of information about the firm to outsiders (even when anonymity and confidentiality were assured). Conversely, internal organizational power structures and hierarchies that supported the deference of decisions to participate to senior management themselves were encountered to a lesser extent in subsidiaries that were national but not multinational. With regard to public institutions, regional managers were also able to make autonomous decisions over whether to participate, and indeed there existed a tangible expectation that they would support the activities of another public institution. Therefore, the degree of autonomy to agree to participate and make time for the interview was also related to the type of firm or institution that zonal/regional managers worked for and the differential time commitments that each role required.

To address this issue, in a number of cases, the research team returned to private sector firms and public institutions with formal letters of introduction from the director of NIMR. In the case of public institutions, this was to some extent a formality, as it was expected that they would cooperate with the request to participate. For private sector firms, managers informed us that they had faxed the letter to senior managers and would let us know the response. In some cases, this approach was successful in gaining us an interview, in others not, suggesting that the outcome of this was also influenced by the views and feelings toward the project of the regional managers themselves.

Conclusion

This article has discussed a range of lessons and related to gaining access and recruiting elites in a research project on a sensitive issue in a low-income setting. We have focused on this aspect of the research process with elites to emphasize the difficulties and complexities of conducting research with this population and to add to the growing conversation concerning an important aspect of the research process that is not often unpacked in the literature. The primary challenges we faced in recruiting participants relate to how the research is initially framed in funding bids and ethical clearance and the often unintended consequences related to how this is then communicated to potential participants who do not necessarily want to be labeled as wealthy. Further, the issue of explaining to participants “why them?” was complicated not only by the framing, but also other concerns around the unacknowledged politicized nature of the research, and the ways in which the project team tried to present the research as a more neutral public health issue. We also emphasized the role of the broader socioeconomic context in influencing elite participation, which presented an unexpected and unconsidered barrier to participation, as well as debates around how to approach the issue of making time for elite participants who may (or may not) be busy, and also the degree of autonomy elites have over their time use. Our experience of attempting to improve the recruitment process through reframing our project when explaining it to elite participants raises an important ethical issue regarding whether this was acceptable reframing or unacceptable deception.

Solutions to some of these issues include careful consideration upfront of how the project should be described and labelled, a careful thinking through of how to present sensitive and politicized research in an ethical but politically neutral way, and a real focus on how to explain the benefits of participation to powerful elites. An important lesson learnt is that researchers need to be opportunistic in gaining interviews and we recommend trying to do them immediately rather than make an appointment that may never be honored, as well as a flexible and not always transparent approach to how much time interviews may take, depending on the degree of autonomy over decision-making that the potential participant may have. However, it is also acknowledged that solutions will be context specific and that what may work in some instances will not in others. Above all, our experience is in agreement with those who describe recruiting elites for qualitative research as more art than science, though this should not prevent a careful consideration and modification of approaches before and during the data collection process to help ensure that good quality data from appropriate samples are gathered.