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1. Study Session 10
General Principles of
Health Research and Introduction to
Community Surveys
By:Alemayehu E(BSC,MPH)
@Nekemte,Oromia,Ethiopia

2. General Principles of Health Research and Introduction to
Community Surveys
When you have studied this session, you should be able to:
 Define and use correctly all of the key words printed in bold
 Describe the general principles and purposes of health research,
distinguishing between basic and applied, quantitative and
qualitative, and cross-sectional and longitudinal health research.
 Describe the types of data collected in national censuses, large-
scale surveys and local community surveys and the common
methods and questions used to collect survey data.

3. What is health research?
• Research is the collection, analysis and interpretation of data with the aim
of answering certain questions or solving certain problems.
• Health research is aimed at investigating health-related problems
systematically and using this knowledge to design better solutions for these
problems.
• It is concerned with improving the health of people and communities by
improving the efficiency and effectiveness of the health system, and
supporting the community’s own ability to take actions that preserve and
protect the health of community members

4. Cont
 The focus of health research includes:
 The health needs in your community, including for health promoting
services such as family planning and antenatal care
 Resources necessary to provide the essential health services that your
community needs.
 The effective organisation and management of the health services you
provide.
 The monitoring and evaluation of your health education initiatives and
health service provision in terms of their outcomes and impact on
community health.

5. Guidelines for health research
 The essential guidelines for every health research study:
 Research should focus on priority health problems in the
community, and there should be a clear statement of the problems.
 A research study needs clear objectives and a plan; it should not be
aimlessly looking for something in the hope that you will come
across a solution.
 The research plan should be action-oriented, i.e. aimed at
discovering solutions for a priority health problem

6. Cont
 It should be participatory in nature, involving all stakeholders
 Simple, short-term research designs, which are likely to yield
practical results quickly should be used wherever possible.
 The planned research should be cost-effective, i.e. affordable within
available budgets and offering good ‘value for money’ in terms of its
likely outcomes.
 The researcher(s) should have appropriate expertise in the data
collection methods and study design; the work should be carried out
systematically, with patience and should not be hurried.

7. Cont
 The results should be based on observable evidence; observations,
descriptions and results should be carefully recorded and accurately
reported without any bias.
 The research should be scheduled in such a way that results will be
available in time to take the necessary actions recommended by the
research findings.
 Results should be presented in formats that are most useful for
administrators, decision-makers and community members to understand
 The research should be reproducible, so that the same result could be
obtained by different investigators if they used the same methods.

8. Stakeholder participation in health research
 Many health-related problems and concerns are interrelated
and are influenced by factors in other areas beyond those
directly connected to health.
 For example, health may be affected by problems concerning
agriculture, water, roads, environmental factors, poverty, etc.
 It is better if everyone directly or indirectly concerned with a
particular health or healthcare problem is involved in
designing and implementing a health research project

9. Cont
 The stakeholders may include policymakers, managers from
the health and other public services, healthcare providers,
and community leaders and members.
 Their close involvement helps the research findings to be
relevant and accepted by all stakeholders, and the resulting
solutions are more likely to make a difference to the health
problems identified by the research.

10. Cont
 Here are some examples of what can go wrong without full
stakeholder participation in health research in a community:
 If decision-makers are only involved after a study is
completed, the report may just be shelved and the results
ignored.

11. Cont
 If the staff of health and other public services are only involved in data collection,
but not in the development of the survey or research proposal, or in the analysis and
interpretation of the results, they will have less interest in the research and may not
be motivated to collect accurate data or carry out the recommendations.
 If community members are only asked to respond to questions determined by the
researchers, the recommendations from the study may not be acceptable because
the local cultural context, beliefs and wishes have not been taken into account.
 If community members are not involved in the implementation of
recommendations, they may have little concern for whether the actions are
feasible, affordable or cost-effective.

12. Types of health research
• There are different ways of classifying health research.
 Basic and applied research
 Research can be basic or applied depending on its objectives.
 Basic (or pure) research is designed to extend knowledge for the sake of
understanding itself; the results may not have any applications –
discovering new knowledge and understanding its objective.
 Applied research is carried out in order to solve specific and practical
problems.
 Applied research is sometimes called action research.

13. Cont
• Applied health research is mainly intended to improve community health
and health services and add to greater professional effectiveness in a
practical manner.
• Most of the problems faced by healthcare providers, policymakers
and administrators are investigated through applied health research.
• Applied health research emphasises the identification of priority health
problems, evaluation of the effectiveness of health programmes and
policies, and managing the optimal use of available resources.
• As you will see later, a community survey is a type of applied health
research.

14. Quantitative and qualitative research
• Quantitative research is a type of research that utilises quantitative (numerical) data
and seeks answers to questions such as ‘How many? How much? and How often?’
• It involves measurement or counting,
• Example: ‘What is the average number of people living in households in your
kebele?’ ‘How many women are there in the childbearing age groups?’ ‘What
percentage of the children have been fully immunized by the age of one year?’
Quantitative research can be used to describe current situations, to investigate
relationships and to study causes and effects.
• When you conduct your community survey, the majority of the data that you collect
will be quantitative data that you can present in tables and charts

15. Cont
• Qualitative research is a type of research that utilises
qualitative (descriptive) data and seeks answers to questions
such as ‘Why? and How?’
• It is concerned with what people think and how they feel.
• For example, you might need to know why some parents are
not bringing their children for immunizations, or why some
pregnant women are reluctant to see you for antenatal care

16. An introduction to surveys
• A survey is a method of gathering information
about a large number of individuals in a
population.
• Surveys can differ in their scale (how many
people are questioned), whether the survey occurs
once at a single point in time, or is repeated again
and again, and in the methods used to collect the
data.

17. Censuses, large-scale surveys and community surveys
• A census is a collection of information on everyone in a
population
• Census information is collected in order to gain important
data that is relevant to the population as a whole and is
ideally collected from every household, although this is not
always possible in remote rural areas, or where nomadic
people are moving from place to place.

18. Cont
• Large-scale surveys are similar to a census, but the large
numbers of people who are questioned are selected to be
representative of the population (i.e. not everyone is
questioned).
• In a community survey, the aim is to obtain information
about everyone in a local community, usually by
questioning an adult member of each household.

19. Cont
• The national census, large-scale population surveys and local
community surveys all tend to collect demographic and/or
epidemiological data.
• Demographic data are counts of certain social characteristics
of a human population: for example, the number of people in a
household, their age, gender, ethnic group, whether married,
single or divorced, when children were born, etc.

20. Cont
• Epidemiological data refers to counts of diseases, disorders
and disabilities in the population, including those leading to
deaths.
• The combination of demographic and epidemiological surveys
can shed light on factors that increase the risk of developing
particular diseases, or dying from certain causes.
• The data can be collected at the national level in a census or
large-scale survey, or at the local level in a community survey

21. Cont
• An example of a large-scale national survey is EDHS, which
is a nationally-representative household survey that collects
data on health and population characteristics every five years
• The EDHS collects data from a large number of households
spread throughout the whole of the country on a wide range of
factors, including birth rates, average family size, knowledge
of issues such as family planning, mortality (death) rates in
different age groups, and the main causes of death and illness.

22. Cross-sectional and longitudinal surveys
• Cross-sectional surveys are used to gather
information on a population at a single point in time,
for example, on a certain date, or during a particular
month.
• An example of a cross-sectional survey would be a
questionnaire that collects data in a single month on
how parents feel about adolescent reproductive health
services.

23. Cont
• Longitudinal surveys gather data over a period of time, which
may be several months or even several years.
• The researcher may then analyse changes in the population’s
demographic or epidemiological features as time passes, and
attempt to describe and/or explain these changes.
• For example, a longitudinal survey could discover that the
birth rate in a particular region was falling steadily over time,
and that this seemed to be related to a rise in the acceptance of
family planning methods in the community.

24. Cont
 A community survey may be cross-sectional (e.g. you will
conduct a community survey to collect data for your
community profile when you are first deployed to a kebele),
but if you continue to collect data on the same topics every
year for several years, your survey will become longitudinal.
it takes place at one point in time
 The common survey data-collection tools are questionnaires,
interviews and focus groups.

25. Questionnaires, interviews and focus groups
• Questionnaires are a list of questions with a space under each
one for the researcher to write the answers given by the
respondent.
• Questionnaires can have several possible answers to each
question and the respondent chooses which one best represents
their status, knowledge or opinions.
• Interviews are less formal and the interviewer has a structured
conversation with one or more respondents about topics of
interest.
• Focus groups are guided discussions in a group of people who
have agreed to ‘focus’ on a particular subject, sharing their
views and experiences.
• The group has a facilitator, who keeps the group focused on
the agreed topic and records the points made in the discussion

26. Basic questions to ask in a community survey
Questions that relate to health problems might include:
 What are the most important health needs of different groups
of people in your community?
 Does the current set of health interventions cover these needs
 Given the resources available, could your health service cover
more needs, or more people, in a more cost-effective way?
 Is it possible to better control the environmental factors that
influence health and healthcare? Can other sectors help
(education, water, agriculture, public works/roads, etc.)?

27. Cont
 After you have completed your community survey and
analyzed the results, it will probably raise questions in
your mind about the reasons for certain health problems
and what you could do about them.
 One way of finding the answers is to conduct small-
scale health research projects, to investigate health-
related problems in your community more closely, to
see whether the results help in finding better solutions.

28. Thank you!