Each FGD and IDI session was facilitated by two members of the research team experienced and trained in qualitative data collection and fluent in both English and local languages (Afrikaans and isiXhosa). The sessions were conducted using a semi-structured interview guide for the IDI and discussion guide for the FGD, both of which were adapted from the WHO’s MOV assessment guides for caregiver FGD and health worker IDI (attached as supplementary files).10 The guides explored participants’ experiences, and perception in relation to immunization, MOV and ways to reduce MOV. Discussions were flexible to allow participants emphasize what they considered as important and to allow further probes into unanticipated topics emerging from participants’ responses. All sessions were recorded using an audio recorder and transcribed verbatim. Local language texts in the transcripts were translated to English by a professional translator. Back-translation from English to the original language was done to ensure accuracy of translation and that meanings are not lost in translation.
To supplement the audio recordings, one of the two facilitators jotted notes, reflections and captured non-verbal gestures such as facial expressions and nods. Each focus group lasted between 45 minutes and an hour, while each IDI session lasted 30–45 minutes. Attempts were made to ensure every participant was given the opportunity to contribute during discussions. All FGD and IDI sessions were held in private rooms at a mutually convenient time for the participants. Consent to participate was re-confirmed at the start of the IDIs. Upon initial coding and thematic analysis of audio recordings to keep track of emergent themes, it was decided that saturation had been reached at the third session of FGD and fourth session of the IDI.