By: Jebesa D.
(MScBY:in clinical pharmacy
Jebesa D (MSc, Pharmacy)
Learning Outcome Two:
Undertaking Data Collection
At the end of this lecture, the students will be able to:
❖ Data collection techniques
❖ Questionnaires and its preparation
❖ Data quality control techniques
BY: Jebesa D (MSc, Pharmacy)
Introduction
❖ Data collection is systematic collection of information
about our objects of study (people, objects, phenomena)
and about settings in which they occur
❖ Research data collection begins after research problem
has been defined & research design or plan cheeked out
BY: Jebesa D (MSc, Pharmacy) 3
Introduction …
❖ Data collection is the process of gathering and measuring
information on variables to answer research questions
and evaluate outcome
❖ If data are collected haphazardly (arbitrarily), it will be
difficult to answer research questions in conclusive way
❖ Accurate and systematic data collection is critical to
conducting scientific research
BY: Jebesa D (MSc, Pharmacy) 4
Methods of data collection
❖ The choice of data collection methods is based on:
✓ The accuracy of information they will yield
✓ Practical considerations like need for personnel,
time, equipment, and other facilities
✓ What is available for data collection
BY: Jebesa D (MSc, Pharmacy) 5
Data Collection Techniques
[Link] sources
❖ It is a data that has already been collected by others
❖ It can be clinical records and other personal records,
death certificates, published mortality statistics, and
census publications, etc.
BY: Jebesa D (MSc, Pharmacy) 6
Advantage and Disadvantage of Documentary
Advantages:
❑ Can provide ready made information
❑ The best means for studying past events
Disadvantages:
➢ Problems of reliability and validity
➢ Errors may occur when information is extracted from
record
➢ The information required may not be recorded at all or
only partly recorded
BY: Jebesa D (MSc, Pharmacy) 7
2. Observation
❖ Is technique that involves systematically selecting, watching
and recording behavior and characteristics of living beings,
objects or phenomena
❖ It can be:
a. Participant observation: observer takes part in the
situation he or she observe
b. Non-participant observation: observer watches the
situation, openly or concealed, but does not participate
BY: Jebesa D (MSc, Pharmacy) 8
Advantage and Disadvantage of Observation
Advantages:
❖ Gives relatively more accurate data on behavior and
activities
Disadvantages:
❖ Observers’ own biases, prejudice, desires
❖ Needs more resources and skilled human power
during use of high level machine
BY: Jebesa D (MSc, Pharmacy) 9
3. Interview
❖ Presentation of oral-verbal stimuli and reply in
terms of oral-verbal responses
❖ This method can be used through:
✓ Personal interview and
✓ Telephone interview
BY: Jebesa D (MSc, Pharmacy) 10
Advantage and Disadvantage of Interview
Advantage
❖ Illiterate people can answer the question
❖ The interviewer can judge the non verbal behavior of
the respondent
❖ An interviewer can repeat unclear questions
Disadvantage
➢ Time consuming
➢ Lack of accessibility to respondents
BY: Jebesa D (MSc, Pharmacy) 11
4. Focus Group Discussion (FGD)
❑ FGD is group discussion of 6-12 persons guided by
facilitator which group members talk freely and
spontaneously about certain topic
❑ Functions of facilitator:
✓ Introduce the session
✓ Encourage discussion
✓ Encourage involvement
✓ Listen carefully and move discussion from topic to topic
BY: Jebesa D (MSc, Pharmacy) 31
Conducting Focus Group Discussion
❑ Recruitment of participants: who have similar
background in relation to the issue under
consideration
❑ Physical arrangements: arrange the chairs in circle
❑ Preparation of discussion guide: there should be
written list of topics to be covered
BY: Jebesa D (MSc, Pharmacy)
Advantage and Disadvantage of FGD
Advantage
❖ Obtain in-depth information on concepts, perceptions,
and ideas of group
❖ Helps to develop research hypotheses by exploring
depth
Disadvantage
❑ More expensive,participants may require payment
❑ Moderator bias could impact focus group discussion
BY: Jebesa D (MSc, Pharmacy)
5. Self-administered Questionnaire
❖ It is data collection tool in which written questions are
presented that are to be answered by the respondents in
written form
❖ The questions can be either
✓ open-ended (which subject answers in his own words)
or
✓ closed (which are answered by choosing from number of
fixed alternative responses)
BY: Jebesa D (MSc, Pharmacy)
5. Self-administered Questionnaire …
❖ Can be administered in different ways, such as or by:
✓ Sending questionnaires by mail with clear instructions
✓ Gathering respondents in one place at one time, giving
oral or written instructions, & letting the respondents
fill out questionnaire
✓ Hand-delivering questionnaires
BY: Jebesa D (MSc, Pharmacy)
Tips to prepare questionnaire
❑ Know your question type
❑ Keep it brief
❑ Use unbiased language
❑ Ensure every question is important
❑ Ask one question at time
❑ Order your questions logically
BY: Jebesa D (MSc, Pharmacy)
Advantage And Disadvantage of
Self-administered Questionnaire
Advantage
✓ Is less expensive
✓ May result honest response
✓ Eliminate bias due to biasing
Disadvantage
❑ Can not be used with illiterate respondents
❑ Questions may be misunderstood
BY: Jebesa D (MSc, Pharmacy)
Stages of Data Collection Process
Stage 1: Permission to proceed:
❖ Consent must be obtained from relevant authorities, individuals,
and community
Stage 2: Data collection:
❖ When collecting our data, we have to consider:
✓ Logistics: who will collect what, when and with what resources
✓ Quality control: keeping validity & reliability of data
Stage 3: Data handling:
❖ Ensure who will store data and how they are going to be stored
BY: Jebesa D (MSc, Pharmacy)
Data Quality Control Techniques
❖ Data quality is the measure of how data are well suited to
serve its specific purpose
❖ Data quality issues includes duplicated data, incomplete
data, inconsistent data, incorrect data, poorly defined data,
poorly organized data, and poor data security
❖ Measuring of data quality are based on data quality
characteristics like accuracy, completeness, consistency,
validity, uniqueness, and timeliness
BY: Jebesa D (MSc, Pharmacy)
Data Quality Dimensions
❖ There are six main dimensions of data quality:
➢ Accuracy: the data should reflect actual, real-world
scenario which can be confirmed with verifiable source
➢ Completeness: is measure of the data’s ability to
effectively deliver all the required values that are
available
➢ Consistency: refers to uniformity of data as it moves
across networks and applications
BY: Jebesa D (MSc, Pharmacy)
Data Quality Dimensions …
➢ Validity: Data should be collected according to defined
rules, parameters, and by right format
➢ Uniqueness: ensures there are no duplications or
overlapping of values across all data sets
➢ Timeliness: data that is available when it is required
❖ Data may be updated in real time and availableand
accessible at time
BY: Jebesa D (MSc, Pharmacy)
Data Quality Control
❖ Detecting missing mandatory information
❖ Detecting errors made during transfer or reformatting.
❖ Detecting duplicates
❖ Detecting outliers
❖ Attaching quality flag or code to each case in order to
modify observed data point
BY: Jebesa D (MSc, Pharmacy)
Epidemiological Surveillance
❖ Surveillance is continuous & systematic process of
collection, analysis, interpretation,& dissemination of
descriptive information for monitoring health problems
❖ Public health surveillance is ongoing systematic collection,
analysis, interpretation, & dissemination of health data
❖ Public health agencies use surveillance data
➢ To describe & monitor health events,
➢ To set priorities in health problems, and
➢ To assist in planning, implementation, & evaluation of public
health intervention & program
BY: Jebesa D (MSc, Pharmacy)
Cycle of Surveillance
❖ Surveillance system is network of people and activities that
maintain this process & may function at range of levels from
local to international
❖ Cycle begins when cases of disease occur & reported by
health care providers to public health agencies
BY: Jebesa D (MSc, Pharmacy)
Components of Surveillance
BY: Jebesa D (MSc, Pharmacy)
Purposes & Uses of Surveillance
❖ Main function public health surveillance is to serve as “early
warning system” in providing timely information needed
for action (rapid reporting, confirmation, decision making,
and response)
❖ Purpose of conducting public health surveillance is:
❖ To learn ongoing pattern of disease occurrence & potential
for disease in population so that we can be effective in:
➢ Investigating
➢ Controlling
➢ Preventing disease in that population
BY: Jebesa D (MSc, Pharmacy)
Purposes & Uses of Surveillance …
❖ To learn more about natural history, clinical spectrum,
and epidemiology of disease (who is at risk, when and
where it occurs, exposures or risk factor for disease)
❖ This may lead to development of prevention and
control measure
❖ To provide us baseline of data which we can used to
assess prevention & control measure when they are
developed & implemented
BY: Jebesa D (MSc, Pharmacy)
Purposes & Uses of Surveillance …
Monitoring Health Events
We monitor health events for following purposes:
➢ To detect sudden changes in disease occurrence &
distribution
➢ To follow secular (long-term) trends & patterns of
disease
➢ To identify changes in agents & host factors
➢ To detect changes in health care practices
BY: Jebesa D (MSc, Pharmacy)
Sources of Data for Surveillance
❑ Sources of information for public health surveillance
BY: Jebesa D (MSc, Pharmacy)
Sources of Data for Surveillance …
❖ Many sources of data are availablethat can be used for
public health surveillance
❖ Key sources of surveillance data are:
➢ Mortality reports
➢ Morbidity reports
➢ Epidemic reports
➢ Reports of laboratory utilization (laboratory test results)
➢ Reports of individual case investigations
➢ Reports of epidemic investigations
BY: Jebesa D (MSc, Pharmacy)
Sources of Data for Surveillance …
❖ Special surveys (e.g. hospital admissions, disease
registers, and serologic surveys)
❖ Information on animal reservoirs & vectors
❖ Demographic data
❖ Environmental data
BY: Jebesa D (MSc, Pharmacy)
Characteristics of Surveillance
❖ Dynamic or continuous
❖ Current or timely
❖ Purposeful or orientation to action
Attributes of Good Surveillance
❖ Simple and flexible
❖ Acceptable
❖ Sensitive:- able to detect problem
❖ Good predictive value positive:- yield good
❖ Representative
❖ Timely
❖ Cost effective
BY: Jebesa D (MSc, Pharmacy)
Importance of Surveillance System
❖ Estimate magnitude of problem
❖ Setting priorities
❖ Plan for intervention
❖ Mobilize and allocate resources
❖ Detect epidemics early
❖ Initiate rapid response to epidemics
❖ Evaluate / monitor health intervention
❖ Assess long term disease trend
❖ Monitor changes in infectious agents
❖ Generate hypotheses, stimulate research
BY: Jebesa D (MSc, Pharmacy)
Types of Surveillance
[Link] Surveillance
❖ Physicians, laboratories, and hospitals are given forms to
complete & submit with expectation that they will report all
of cases of reportable disease that come to their attention
Advantages: Inexpensive
Disadvantages:
❖ Data are provided by busy health professionals
❖ Data are more likely to be incomplete & underestimate
presence of disease in population
BY: Jebesa D (MSc, Pharmacy)
Types of Surveillance …
2. Active Surveillance
❖ Involves regular or periodic collection of case reports
by telephone or personal visits to reporting individuals
to obtain data
Advantages:
❖ More accuratebecause it is conducted by individual
specifically employed to carry out responsibility
❖ Disadvantages: Expensive
BY: Jebesa D (MSc, Pharmacy)
Types of Surveillance …
[Link] Surveillance
❖ Means of monitoring trends of health events in chosen
population groups & chosen sites in regular and consistent
or uniform way
❖ Need not be representative:- However it is very important
to keep sites, facilities, procedures, and populations remain
similar
❖ Selection of study population must be with minimal bias
❖ Sufficientdemographic data must be collected to detect
changes in population
BY: Jebesa D (MSc, Pharmacy)
Types of Surveillance …
Main Purposes of Sentinel Surveillance
❖ To detect changes
❖ To direct and focus control efforts
❖ To develop intervention strategies
❖ To promote further investigations
❖ To provide basis for evaluating preventive strategies
BY: Jebesa D (MSc, Pharmacy)
Surveillance Vs Survey
BY: Jebesa D (MSc, Pharmacy)
Conducting Surveillance
❖ Conducting surveillance require collection, analysis,
interpretation, and dissemination of health data
[Link] of Surveillance Data
❖ Diseases notifiable by law: reporting from individual
to local health department to state health department
❖ Each state has morbidity reporting system that is
based on state laws or regulation adopted by state
board or department of health
BY: Jebesa D (MSc, Pharmacy)
Conducting Surveillance …
[Link] of Surveillance Data …
Typically, regulations specify the following:
❖ Diseases & conditions that must be reported
❖ Who is responsible for reporting
❖ What information is required on each case of disease
reported
❖ How, whom, & how quickly information is to be
reported
❖ Control measures to be taken for specified diseases
BY: Jebesa D (MSc, Pharmacy)
Conducting Surveillance …
[Link] of Surveillance Data …
❖ List of notifiable diseases differs from state to state,
reflecting variations in public health priorities
❖ List of notifiable diseases considers:
➢ Causes serious morbidity or death
➢ Has potential to affect additional people beyond
reported case
➢ Can be controlled or prevented with proper
intervention
BY: Jebesa D (MSc, Pharmacy)
Conducting Surveillance …
[Link] of Surveillance Data …
❖ Reporting known or suspected cases of reportable disease
is obligation of
➢ Physicians, dentists, nurses, and other health professionals
➢ Medical examiners
➢ Administrators of hospitals, clinics, schools, & nurseries
➢ Laboratory directors
➢ Any individual who know or suspect existence of
reportable disease
BY: Jebesa D (MSc, Pharmacy)
Conducting Surveillance …
2. Analysis of Surveillance Data
❖ Descriptive analysis: distribution by time, place & person
➢ Frequency of events
➢ Calculate rate i.e. need proper denominator
❖ Observe trends: comparison current data with expected
value, identify difference, and assess relevance of difference
➢ Draw graphs to show long term trends
BY: Jebesa D (MSc, Pharmacy)
Conducting Surveillance …
[Link]
❖ When expected pattern of disease is different than what
we expect in population at particular time and place then
we may need to investigate further
❖ Local health department usually determine amount of
excess necessary for action based on:
➢ Priorities assigned to various diseases
➢ Interests, capabilities, and resources of department
❖ Public, political, or media attention and pressure can make it
necessary to investigate minor variations in disease occurrence
BY: Jebesa D (MSc, Pharmacy)
Conducting Surveillance …
[Link] of Surveillance Data
❖ Disseminate surveillance data to all stakeholders
➢ Those who provide reports (health providers)
➢ Community:- affected/potentially affected
➢ Decision makers
❖ Disseminate report locally, nationally or globally as deemed
❖ Disseminate report timely & regularly
❖ Disseminate through appropriate media: newsletter or
paper or electronic
BY: Jebesa D (MSc, Pharmacy)
Common Limitation of Surveillance Systems
❖ Under reporting
❖ Lack of representativeness of reported cases
❖ Lack of timeliness
❖ Inconsistency of case-definitions
❖ Lack and shortage of qualified staff
❖ Lack of motivation
BY: Jebesa D (MSc, Pharmacy)
Integrated Disease Surveillance and
Response (IDSR)
❖ Simplified tools for data collection and analysis
❖ Common channel for reporting &receiving feedback
❖ Strengthening capacity to detect and respond to
communicable disease including emergencies
❖ Integration to maximize effective utilization of
scarce resource
BY: Jebesa D (MSc, Pharmacy)
Goal of IDSR
❖ To improve ability of districts or health facilities
❖ To detect to disease or condition that cause high
levels of illness, disability, and death
❖ To detect response to diseases after intervention
BY: Jebesa D (MSc, Pharmacy)
IDSR in African
❖ Communicable diseases are major cause of illness,
disability & deaths in Africa
❖ Countries have multiple disease surveillancesystem
targeting same health workers at facility & district level
❖ Data collected is often incomplete & is not analyzed or
interpreted on time at local level
❖ Delay in responding to public health emergencies lead
to unnecessary loss of lives
BY: Jebesa D (MSc, Pharmacy)
IDSR in Ethiopia
❖ FMOH initiated Integrated Diseases Surveillance (IDS)
focusing on 17 priority diseases
❖ IDSR initiative as regional strategy recognized in September
1998 by W H O
❖ Later FMOH adopted IDSR strategy & comprehensive
assessment of existing surveillance, epidemic preparedness and
response system of country was conducted in October 1999
❖ Five year strategic plan covering 2000-2004 developed and
implemented IDSR
BY: Jebesa D (MSc, Pharmacy)
Major outputs of IDSR in Ethiopia
❖ Establish & maintain national IDSR taskforce
❖ Adopt national IDSR technical guidelines
❖ Adopt and utilize national IDSR training module for IDSR
❖ Produce standard case definition for prioritized diseases
BY: Jebesa D (MSc, Pharmacy)
IDSR …
BY: Jebesa D (MSc, Pharmacy)
Evaluation of Surveillance System
❖ Surveillance system should be evaluated periodically to
ensure public health function and to meet its objective
❖ In evaluation, following should be addressed:
➢ Public health importance of health event under surveillance
➢ Objectives & operation of system
➢ System’s usefulness
➢ Attributes or qualities of surveillance system including
simplicity, flexibility, acceptability, sensitivity, timeliness, and
representativeness
➢ Cost or resource requirements for system
BY: Jebesa D (MSc, Pharmacy)
Evaluation of Surveillance System …
Public Health Importance
❖ Importance of health event & need to have surveillance can
be assessed with measures:
➢ Current impact of health events
➢ Total number of cases: incidence and prevalence
➢ Severity of illness: case fatality rate and death to case ratio
➢ Mortality: crude death rate and age specific mortality rate
➢ Morbidity: hospitalization and disability
➢ Health care costs
❖ Its potential for spread
❖ Its preventability
BY: Jebesa D (MSc, Pharmacy)
Evaluation of Surveillance System …
Objectives & Operation of System
❑ To characterize operations of surveillancesystem, we must
answer following questions:
❖ What is case definition of health event? Is it practical in this
setting?
❖ What is population under surveillance?
❖ What is time period of data collection (weekly,monthly,
annually)?
❖ What information is collected? What program is need?
❖ What are reporting sources or data sources? Who is
supposed to report?
BY: Jebesa D (MSc, Pharmacy)
Evaluation of Surveillance System …
Objectives & Operation of System …
❖ How are data handled? How data are grouped,
transferred, stored? Are there unnecessary delays?
How is confidentiality maintained?
❖ How are data analyzed? By whom? How often?
❖ How is information disseminated? How often are
reports distributed? To whom? Does it get to all those
who need to know, including medical & public health
communities & policymakers?
BY: Jebesa D (MSc, Pharmacy)
Evaluation of Surveillance System …
Usefulness of Surveillance System
❖ Whether surveillance system makes difference or not
❖ What action have been taken as result of information from
surveillance system?
❖ Who used information to make decisions & take actions?
❖ Usefulness of system is influenced greatly by its operation
including its feedback mechanism
BY: Jebesa D (MSc, Pharmacy)
Evaluation of Surveillance System …
Attributes or Qualities of Surveillance System
❖ Several qualities or attributes affect usefulness of
surveillance system
❖ Flexibility: refers to ability of surveillance system to
accommodate changes in operating conditions with little
additional cost, time, personnel, or fund
❖ Flexibility is necessary when changes occur in case
definition, or reporting form, and procedure
❖ Flexibility includes system’s ability to add new health events
BY: Jebesa D (MSc, Pharmacy)
Evaluation of Surveillance System …
Attributes or Qualities of Surveillance System …
❖ Simplicity: refers to easy of operation of system as
whole and each of its components (case definition,
reporting procedures, etc.)
❖ Sensitivity: is ability of system to detect cases or
other health events in its intention to detect
❖ Sensitivity also refers to system’s ability to detect
epidemics & other changes in disease occurrence
BY: Jebesa D (MSc, Pharmacy)
Evaluation of Surveillance System …
Attributes or Qualities of Surveillance System …
❖ Acceptability: reflects willingness of individuals and
organizations to participate in surveillance system
❖ Representativeness: is extent to which surveillance
system accurately describes incidence of health event
in population by person, place, and time
❖ Timeliness: is availability of data in time for
appropriate action
BY: Jebesa D (MSc, Pharmacy)
Evaluation of Surveillance System …
Cost or Resource Requirements for System
Resource Requirement (Cost): direct cost of
surveillance system includes personnel & financial
resource expended to maintain all phase of system
including collection, analysis, and dissemination
BY: Jebesa D (MSc, Pharmacy)
Limitation of Notifiable Disease Reporting
System
a. Underreporting
❑ Lack of knowledge for reporting requirement
❖ Unaware of responsibility to report
❖ Assume that others responsibility to report (e.g. laboratory)
❖ Unaware of which diseases must be reported
❖ Unaware of how and to whom reported
BY: Jebesa D (MSc, Pharmacy)
Limitation of Notifiable Disease
Reporting System …
b. Negative Attitude toward Reporting
❖ Time consuming
❖ Too much stress (e.g. bulky report form or procedure)
❖ Lack of incentive
❖ Lack of feedback
❖ Distrust of government
BY: Jebesa D (MSc, Pharmacy)
Limitation of Notifiable Disease
Reporting System …
c. Misconception due to Lack of Knowledge /Negative Attitude
❖ Compromise patient-physician relationship
❖ Concern that report may result in breach of confidentiality
❖ Disagreement with need to report
✓ Judgment that the disease is not that serious
✓ Belief that no effective public health measures exist
✓ Perception that health department does not act on report
BY: Jebesa D (MSc, Pharmacy)
Ways to Improve Surveillance System
❖ Improve awareness of Practitioners
❖ Simplify Reporting: reporting should be simple and
painless as possible for reporter
❖ Frequent Feedback
❖ Wide network of active surveillance:- increase
number and proportion of reported cases
BY: Jebesa D (MSc, Pharmacy)
Identification of Disease Priority
❖ Use standard case definition to identify priority
of diseases or cases
❖ Use laboratory & laboratory networks to confirm
suspected outbreaks
BY: Jebesa D (MSc, Pharmacy)
Identification of Disease Priority …
Case Definition
❖ Case definition is set of criteria used to decide if person
has particular disease and if case can be considered for
reporting & investigation
❖ If use of case definition is agreed by every one in country
or across boundaries is “standard case definition”
➢ Clinical criteria
➢ Restriction by time, place , and person
❖ Case definition must be simple, understandable, and
acceptable
BY: Jebesa D (MSc, Pharmacy)
Identification of Disease Priority …
Case Definition can be
❖ Confirmed
❖ Probable
❖ Possible/ suspected
Advantage of Case Definition
❖ Facilitateearly detection and prompt management
even if diagnosis is not confirmed
❖ Lab test is expensive, difficult to obtain
❖ Comparison from one area to another
BY: Jebesa D (MSc, Pharmacy)
Identification of Disease Priority …
Diseases Targeted for Surveillance
22 diseases which are three categories
A. Epidemic Prone Diseases
[Link] Targeted for Elimination or Eradication
C. Other Diseases of Public Health
BY: Jebesa D (MSc, Pharmacy)
Identification of Disease Priority …
A. Epidemic prone diseases
1. Cholera
2. Dysentery
3. Measles
4. Meningitis
5. Plague
6. VHF (Viral hemorrhagic fever)
7. Avian flu
8. YF(yellow Fever)
9. Typhoid fever
10. RF(Relapsing fever)
11. Epidemic typhus
12. Malaria
BY: Jebesa D (MSc, Pharmacy)
Identification of Disease Priority …
B. Diseases Targeted for Eradication & Elimination
1. Polio
2. Leprosy
C. Other Diseases of Public Health
1. Pneumonia (in children <5 years of age)
2. Diarrhea (in children <5 years of age)
3. New AIDS cases
4. Oncho-cerciasis
5. STIs
6. Tuberculosis
7. Rabies
BY: Jebesa D (MSc, Pharmacy)
Identification of Disease Priority …
Reporting Frequency
❖ Immediately
❖ Weekly
❖ Monthly
❖ Quarterly
BY: Jebesa D (MSc, Pharmacy)
Reference
1. Corlien M. , Indra P. , Ann B. Designing and
Conducting Health Systems Research Projects.
Amsterdam; KIT, 2003.
2. Kothari C.R. Research Methodology. New Delhi;
New Age International (P) Ltd, 2004;second edition.
3. Getu Degu, Tegbar Yigzaw. Research Methodology.
University of Gondar, 2006
BY: Jebesa D (MSc, Pharmacy)
Thanks for your
attention!
BY: Jebesa D (MSc, Pharmacy)