2. Overall objectives
Developing research proposal
Critical review of the literature in specific area
Data collection and data analysis
Managing research projects
Handling ethical issues
2
3. What is research?
• Research is systematic collection, analysis and
interpretation of data to generate new knowledge
and answer a certain question or solve a problem.
• It is a scientific inquiry aimed at learning new
facts, testing ideas, etc
• Health research is the application of principles of
research on health
3
4. purpose of health research
To provide all aspects of information necessary for
planning and effective implementation of health system
Without this knowledge, effective action is impossible
because it has no logical or empirical basis
Progress in health can only be achieved if good quality
information are generated through research
To guide interventions
Develop tools to prevent and cure illness
Devise better approaches to health care
4
5. Based on purpose
1. Basic research (also called fundamental or pure research)
• Its primary objective is the advancement of knowledge and the
theoretical understanding
• Basic research provides the foundation for further research.
• It is necessary to generate new knowledge and technologies to deal
with major unresolved health problems
2. Applied Research:
Is a research that seeks to solve practical problems
Applied research is necessary:
To identify priority problems
To design and evaluate policies and programs
Making optimal use of available resources
5
6. Types of research based on nature of research
A. Quantitative
Quantitative research is based on the measurement of
quantity or amount and compares it with past records
and tries to project for future period
It is applicable to phenomena that can be expressed in
terms of quantity.
how much? How many? How often? To what
extent? etc.
6
7. Quantitative …..
• It is a more logical and data-led approach which provides a
measure of what people think from a statistical and
numerical point of view.
• It largely uses methods such as questionnaires and surveys
with set of questions and answers that respondents tick
from a predefined selection.
• Answers can be measured in strengths of feeling such as
‘strongly agree’ ‘disagree’ or numbers such as scales out of
10.
7
8. 2. Qualitative
→Qualitative research, is concerned with qualitative phenomenon,
i.e., phenomena relating to or involving quality or kind, experience,
ideas.
Qualitative research is concerned with finding the answers to
questions which begin with:
→ why? How? In what way?
• Unlike quantitative research which relies on numbers and data, qualitative
research is more focused on how people feel, what they think and why they
make certain choices.
• Qualitative research can be valuable when you are developing new products
and you want to test reactions and refine your approach.
8
9. Characteristics of research
It demands a clear statement of the problem
It requires a plan (it is not aimless, it is “looking”
for something in the hope that you will come
across a solution)
It builds on existing data, using both positive and
negative findings
New data should be collected as required and be
organized in such a way that they answer the
research question(s)
9
10. Good Research
• Is simple
• Has good rationale
• Has clear objectives
• Uses appropriate methodology
10
12. Main components of any research work
I. Preparing a research proposal
II. Fieldwork (i.e., data collection)
III. Analyzing data and preparing a research report
12
13. Research proposal
It is a document that presents a plan for a project to
reviewers for evaluation.
Its purpose is to convince reviewers that you are capable of
successfully conducting the proposed research project.
Reviewers have more confidence that planned project will
be successfully completed if the proposal is well written
and organized, and if you demonstrate careful planning.
Proposal is similar to a research report but written before the
research project begins
It lacks result, discussion and conclusion and
recomendation sections.
13
14. Written proposal is important
• To clearly define the problem under study
• To avoid re inventing the wheel
• To clearly depict the methodology to be
used
• To be cost and time conscious
• To be clear about what to expect in the end
14
15. Components of Research Proposal
Title pages
Title page 1
Title page 2
Acknowledgements: 100 words
Proposal summary
Table of contents
List of tables
List of figures
Acronyms/Abbreviation
15
16. Cont’d
1) Statement of the Problem/Introduction,
Significance of the study
2) Literature review
3) Objectives
4) Methods
5) Work plan
6) Cost of the Project/Budget
References
Annexe 16
17. Research proposal submission form…
SUMMARY
(ONLY ONE PAGE)
(Summary must be structured under the following heading: Introduction, objectives, methods,
work plan and budget. Do not exceed 350 words).
INTROCUCTION
This section can be divided in to 3 subsections: Background: Statement of the problem; and
justification of the proposed study.
Statement of the problem
(one page or 1 and 1/2)
Literature Review
(Maximum four pages)
Justification of the proposed study
(Maximum half page)
17
18. Research proposal submission form…
OBJECTOVES (only one page, Maximum)
General objective:
Specific objectives:
METHODS
(Maximum four pages)
• Study design and period
• Study area
• Study population
• Sample size & sampling procedures
• Variables of the study
• Operational definitions
• Data collection procedures (instrument, personnel, data quality control)
• Data processing and analysis
18
19. Research proposal submission form…
ETHICAL CONSIDERATION
(Half-One page)
DISSEMINATION OF RESULTS
(Maximum half page)
WORK PLAN
(Only one page)
(Describe briefly the expected
accomplishments of the project by phase, and
the estimated time for each). 19
20. Research proposal …
COST OF THE PROJECT
(Maximum one-two pages)
Give an itemized list of the direct costs of the project.
References
(Use Vancouver Style)
Annexes
Dummy tables
Questionnaire
(Others as necessary)
20
21. Topic selection
Health research topics
• Description of health problems
• Evaluation of interventions
• Analysis of possible causes and solutions
21
22. 1. Selection of Research Topic
Objective criteria
1. Relevance: priority, magnitude of problem
2. Avoidance of duplication
3. Feasibility: complexity, manpower, time, equipment, money…
4. Political commitment: interest and support to utilize results
5. Applicability (cost-effectiveness): availability of resources
6. Timeliness: urgency of data needed for making decision
7. Ethical acceptability
subjective criteria
• Personal interest(first which guide you)
22
23. Objective Criteria
1. Relevance
Questions to be asked include:
– How large or widespread is the problem?
– Who is affected?
– How severe is the problem?
2. Avoidance of duplication
• It is whether the suggested topic has been
investigated before, either within the proposed
study area or in another area with similar conditions
3. Urgency of data needed (timeliness)
• How urgently are the results needed for
making a decision or developing interventions
at various levels (from community to policy)?
23
24. 4. Political Commitment (Local authorities acceptability)
• It needs to has the interest and support of local/ national
authorities.
• This will increase the chance that the results of t he study will be
implemented.
5. Feasibility
•Consider the complexity of the problem and the
resources you will require for carrying out
• Thought should be given first to manpower, time, equipment and
money that are locally available
• Explore the possibility of obtaining technical and financial
assistance
24
25. 6. Applicability of possible results/recommendations
• Is it likely that the recommendations from the study will be
applied?
• This will also the availability of resources for implementing
the recommendations.
• Likewise, the potential clients and of responsible staff will
influence the implementation of recommendations
7. Ethical acceptability
• We should always consider the possibility that we may
inflict harm on others while carrying out research.
25
26. Steps to be Followed to Select Research Topic
• Decide on a general area of interest – Initially the problem may be
stated in a broad way
• Discuss your ideas with others/supervisors, colleagues or with
those having some information the matter
• Examine all available literature to get acquainted with the selected
problem
In summary-for a topic to be researchable
i. There should be a perceived difference/ discrepancy b/n what it
is and what it should be
ii. The reason for the difference should be unclear (it makes sense to
develop a research question)
iii. There should be more than one possible and plausible answer to
the question(solution to the problem)
26
27. Why is it important to state and
define the problem well?
A clear statement of the problem:
• is the foundation for further development of the
research proposal
• Makes it easier to find information and reports of
similar studies.
• Enables to systematically point out why the
proposed research on the problem should be
undertaken and what you hope to achieve with the
study results.
28. Developing statement of the
problem
• Many problems may be too wide to
address.
• In such circumstances, the researcher
shall decide what aspect of the problem
he/she shall investigate
29. Developing statement of the
problem cont..
Steps in formulation of a research problem
Step 1: Identify a broad field or subject area of interest
to you
Step 2: Dissect the broad area into sub areas.
Step 3: Select what is of most interest to you.
Step 4: Raise research questions.
30. Characteristics of a good problem
statement
1. The problem reflects felt needs
2. The problem is non-hypothetical, i.e. it must
be based on factual evidence
3. It should suggest meaningful and testable
hypotheses
4. The problems should be relevant and
manageable
31. What information should be included
in the problem statement?
1. A brief description of socio-economic and
cultural characteristics and an overview of
health status and the health-care system in
the country/district in as far as these are
relevant to the problem.
2. A concise description of the nature of the
problem and of the size, distribution and
severity of the problem.
32. What information should be
included cont..
3. analysis of the major factors that may
influence the problem and a discussion of
why certain factors need more
investigation.
4. A brief description of any solutions to the
problem that have been tried in the past &
how well they have worked
33. What information should be
included cont..
5. Why further research is needed?
5. A description of the type of information
expected to result from the project and how
this information will be used to help solve the
problem.
34. How to write a Problem
Statement
• This section should be concise while not
forgetting to mention essential points.
• An outline listing the major points to be
covered could be prepared before any
writing is done
35. Example of problem statement
Factors Contributing to Unattended Delivery among ANC Attendants at Government-owned Health
Centers in Addis Ababa.
Addis Ababa is the capital city of Ethiopia with an area of 530 km2 and a total population of 3
Million. It has 10 sub- cities. The health service coverage of Addis Ababa is 71%. There are 5
hospitals, 24 health centers, 32 health posts & more than 500 private health institutions
providing health services including ANC and Delivery.
ANC coverage of the city is estimated at 86%. Despite this high coverage of ANC only 56% of
pregnant women give birth in health institutions, while the remaining 44% deliver elsewhere,
including unattended home deliveries. Unattended deliveries are known to be associated with
maternal and perinatal morbidity and mortality, such as antepartum hemorrhage (APH),
postpartum hemorrhage (PPH), birth trauma, infection, and fistula.
There are no studies that have examined the factors contributing to unattended delivery despite
high overall service coverage and antenatal care coverage in Addis Ababa. Many health
institutions attempt to improve the situation through the training of traditional birth attendants,
expanding health education and community mobilization activities. However, these efforts are
not based on systematic evidence into possible determinants of the prevailing practice. The
present study is intended to contribute to bridging the information gap, and subsequently the
coverage of institutional deliveries in the city.
36. Literature Review
Learning objectives
At the end of this session the student will be able to:
• Understand the importance of literature review
• Describe the steps of literature searching
• Search for literature from different sources
• Write literature review
36
37. Definition :-Literature review is an account of what has
been published by scholars and researchers
Purposes of literature review
• It serves as a benchmark for comparing the results with other
findings
• It helps to understand the problem you plan to research, and
may lead to refining of the “Statement of the problem”.
It provides a framework for establishing the importance of
the study
• It gives familiarity with the various types of methodology.
• It prevents you from “reinventing the wheel”.
37
38. Steps of literature search
1) Identifying key words
2) Go to the library and begin searching the catalog (i.e. journals and
books)
• Focus initially on journals and books related to the topic
• Also search the computerized data bases such as Google
• Initially, try to locate enough reports of research articles or books
4) Skim this initial group of articles or chapters, and identify those that
are central to your topic
5) Begin designing a literature map
• Literature map is a visual picture (or figure) which is groupings of the
literatures on the topic, positioning your own study within the larger
body of researches so that illustrates how your particular study will
contribute to the literatures
38
39. 6) Begin to draft summaries of the most relevant articles
• These summaries are combined into the final literature
review that you write for your proposal
• End the literature review with a summary of the major
themes and suggest how your particular study further
adds to the literature
• Include precise references to the literature using an
appropriate style
39
40. Are all sources important?
• Determine your criteria for evaluating the relevance
of retrieved materials
– Authority of author
– Relevance of content
– Date of publication
– Intended audience
– Type of publication
– Publisher 40
41. Methods of citations/Referencing cont…
A) Vancouver system- common
For an article the following information should be noted as:
• Author(s)’ Surname followed by initials. Title of article. Name of Journal. Year,
Volume(number): page numbers of article.
• Use consecutive numbers in the text to indicate your references
• Then list your references in that order at the end of your document
• Example: Louria DB. Emerging- and re-emerging infections: The societal
variables. International Journal of Infectious Disease. 1996, 1(2):59-62.
For a book
• Author(s)’ Surname followed by initials. Title of book. Place:
Publisher, Year, Edition
• Example: Abramson JH. Survey methods in community medicine.
Edinburgh: Churchill Livingstone, 1990, 4th ed.
41
42. Methods of citations/Referencing cont…
B) Harvard System
• Name of the author(s) (year), Edition. Title. Place of Publication:
Publisher
• Put the surname of the author and year of publication between
brackets in the text to indicate your references (E.g. Shiva 1998)
• List the references in Alphabetical order, at the end of the proposal
• If more than two authors write the first authors followed by et al in
text.
• Example
• For articles: Louria D(1996). Emerging- and re-emerging infections: The
societal variables. International Journal of Infectious Disease.1(2):59-62.
• For books: Abramson JH (1990) 4th ed. Survey methods in community
medicine. Edinburgh: Churchill Livingstone.
42
43. Do not forget to
Avoid bias-
• Distorting available information for one’s own opinion
• Restricting references to those in favor self
• Drawing far reaching conclusion from preliminary /shaky
results
• Plagiarism and lack acknowledgement
Adopting or reproducing the ideas, words, or
statements of another person without appropriate
acknowledgement.
• Take from results
• To focus on your objective
• To write in your own words
• GIGO phenomena: GARBAGE IN GARBAGE OUT
43
44. 3. Formulation of Research Objectives
Learning Objectives
• Define and describe the difference between general and
specific objectives
• Describe why and when a research objective should be
developed
• Discuss the characteristics of a good research objective
• Discuss how a research objective is developed and what
formats can be used in stating a research objective
44
45. Definition:-A research objective is a statement that clearly depicts the
goal to be achieved by a research project.
Summarize what is to be achieved by the study.
• Why research objective ?
• Focus the study (narrowing it down to essentials)
• Avoid the collection of data which are not strictly necessary for
understanding and solving the problem you have identified
• Organize the study in clearly defined parts or phases
• For evaluating the project
• Guide research methodology, and orient the collection, analysis
and interpretation of data.
When Objective Should be Written?
• The objectives should be written after statement of the problem
and before methodology 45
46. What formats can be used?
Research objectives can be stated as:
A)Questions: “The objectives of this study is to answer the
following questions …”
B) Positive sentence: “The objectives of this study is to
determine …”
C) Hypothesis: “The objective of this study is to verify the
following hypothesis...”
The format chosen depends on the type of study that will be
undertaken:
• If the study is descriptive or exploratory in nature, then
objectives are stated in the form of questions or positive
sentences.
• If the researcher knows enough to make predictions of
what you is studying, hypotheses may be proposed.
46
47. How it should be stated?
Objectives should be stated using “action verbs”
that are specific enough to be measured:
Examples: use
determine calculate assess
compare verify find out
describe establish etc.
• Do not use vague non-action verbs such as:
appreciate understand study
believe comprehend etc.
47
48. Types
General objective
Identifies in general terms what is to be accomplished
by the research project.
Specific objectives
Breaking down of what is to be accomplished into smaller logical
components
• Example
General objective: To assess factors influencing schizophrenia
treatment seeking behavior of District X community, 2012.
. Specific objective:
To assess attitudes of District x community towards patient with
schizophrenia
To determine coverage of schizophrenia care and treatment services .
48
49. In summary, specific objectives should
be
• S= SPECIFIC
• M= measurable
• A=achievable
• R=realistic/relevance
• T=time bounded
49
50. 50
RESEARCH METHODS
STUDY AREA AND PERIOD
POPULATION
STUDY DESIGN
SAMPLING TECHINIQUES AND SAMPLE SIZE
DETERMINATION
DATA COLLECTION
VARIABLES AND MEASUREMENTS
PLAN FOR DATA PROCESSING AND ANALYSIS
ETHICAL ISSUES IN RESEARCH
51. METHODS… STUDY AREA AND PERIOD
Should be specified with some background
information about the area , population size,
distance, weather conditions, health and health
related information
The time of the study should be specified (it is the
time of data collection).
51
52. 52
METHODS… POPULATION
Population is the entire group of person or objects about
whom the study is concerned
• Different terms to express populationTarget
population/Reference population- pop. About which
you wish to draw a conclusion/generalized
• Study/Sampled population- from w/c samples
drawn/taken
• study unit- unit on which the observation will be
collected
53. Methods… Study Design
• Is arrangement of the condition or procedures
according to which study subjects are
gathered or data is to be collected.
• The research designs are classified as to the
main concern of the study
• Descriptive v/s analytical
• Discussions on strength and limitations
53
54. Methods… Study Design
DESCRIPTIVE ANALYTIC
Dealing with population
• Co relational or ecological
Cross sectional survey
Observational studies
• Case-control
• Cohort
Dealing with individuals
• Case report or series
Intervention studies
54
55. Epidemiological Design
Descriptive Analytical
Co relational/ Ecological
Case report
Case series
Cross sectional/ Prevalence studies
Observational
Cohort
Case-Control
Intervention/
Experimental
Figure 1: Schematic presentation of the classification of epidemiological study
designs.
Hypothesis testing ?
Comparison group ?
Yes
No
55
56. Descriptive Vs Analytical
1. Descriptive epidemiology:
♣ Describe patterns of disease occurrence in relation
to person, place and time
♣ Generates idea(s)/ hypothesis for presence of
association between risk factor and illness
2. Analytical epidemiology:
♣Uses comparison groups to establish an association
between risk factors and illness in the two groups
♣Tests hypotheses
60. Person
“Who is getting the disease?” Age, race, sex
Place
“Where are the rates of disease highest/
lowest?”
Time
“When does the disease occur commonly/
rarely?”
“Is the frequency of the disease now different
from the corresponding frequency in the past?”
61. Types of Descriptive Studies
• Ecological / correlational studies
The unit of observation is the entire population to
compare disease frequency b/n different groups during
the same period of time or in the same population at
different points in time.
Advantages:
• Quick and inexpensive
• Often use already available information
Disadvantages:
• Unable to link exposure with disease at individual level
• Lack of ability to control for potential confounders
62. Types of Descriptive …Cont’d
• Case report or case series
– Detailed report of a single patient (case report) or a
group of patients (case series) with unusual and
medical occurrences
– Gives the first clues in the identification of new
disease and adverse effects of exposures
In 1980 and 1981, five cases of PCP were reported
among young homosexual men in Los Angeles.
Previously it occurred in older cancer patients with
compromised immunity
63. • Case reports / case series
Advantages
– Simple, quick, inexpensive
Disadvantages
– Based on the experience of one or few people
– Lacks comparison group
64. Types of Descriptive …Cont’d
• Cross-Sectional Studies
• Often called prevalence surveys.
Eg. KAP, DHS, etc
• Collection of data at one point in time OR
• Presence or absence of both exposure and disease
is assessed
• Used to assess the health care status and health
care needs of a population
65. Cross-Sectional Studies
Advantages Disadvantages
• Quick and inexpensive
• Used for planning
•Multiple factors/ outcomes
• Temporal r/s of exposure
& disease not
distinguishable
•No incidence or relative
risk
67. Analytical Studies
Purpose/aim
• Focus on determinants of cause
• Search for cause and effect.
• Answer questions like: Why? How?
• Test hypothesis about causal relationship/Proof
• It is the use of comparison group that allows testing of
epidemiologic hypotheses
68. Types of analytic studies-based on
role of the investigator
- Observational studies
- the investigator simply observes the natural
course of event
– Interventional studies
• the investigator assigns study subjects to
exposure and non-exposure then follows to
measure for outcome.
69. Observational Studies
• Case-control = Both the exposure and disease
have already occurred at the time of the study
• Cohort = only the exposure of interest has
occurred or disease may has already occurred
(retrospective)
71. • Case-Control Study: Compares people with
disease (case) and without disease (control) to
determine the exposure status by looking
backward in time.
• Data are analyzed whether exposure was
different for cases and for controls
• Higher proportion of risk factor among cases
than controls suggests association
• Very common type of epidemiologic studies
73. Selection of cases
• Subjects are selected on the basis of disease
• A case should be clearly defined with regard to
specific characteristic of disease
• Needs appropriate diagnostic criteria
• Can be identified from:
– hospital setting = hospital-based case-control
– defined general population = population-based
– disease registries with complete records
74. Selection of Controls
• Be comparable to the cases: as similar to a case as
possible but without the disease in question
• Must have the same opportunity for exposure as a
case
• Involves consideration of a number of issues:
Scientific, economic and practical considerations
– Cases and controls have the same characteristics
other than the disease
– Ensures comparability
75. Sources of Controls
• Community (population) controls
• Hospital controls: patients attending or
admitted to the same institution as cases
• Relatives or neighborhood
• Friends
76. Case-Control Studies
Advantages
• Rare disease
• evaluation of diseases with long latent periods
• Quick and inexpensive
• Relatively efficient, small sample size
• Little problem with attrition
• Can examine multiple etiologic exposures
• No ethical problems
77. Case-Control Studies
Disadvantages
• Inefficient for rare exposures
• No calculation of rates and risks
• Sometimes, the temporal r/s between exposure
and disease may be difficult to establish
• Prone to selection and recall bias
