Addis Ababa Medical and Business College

Master of General Public Health

Research Methods
Asamenew E. (Assit. Prof.)
 Addis Ababa Medical and Business College
Master of General Public Health

Introduction to Health Research

and Research Proposal
Learning Objectives
After completing this lesson, students will be able to:
Define research in general and health systems research in particular

Enumerate the characteristics of research

Identify the different types of research

List important features of health systems research

Enumerate criteria for research topic selection

Define research proposal

Enumerate components of research proposal

 Definition of Research
Research is the systematic collection, analysis and
interpretation of data to answer a certain question or solve a
problem.
 Undertaking a research, implies that the process:

i. Is being undertaken within a framework of a set of

philosophies ( approaches);
ii. uses procedures, methods and techniques that have been
tested for their validity and reliability;
iii. is designed to be unbiased and had objective
Research must be:
Purposeful: what do you want to contribute?
Targeted: Who are the audiences?
Credible: consider data source, method of data
collection, personnel involved…
Timely: Is the information needed?
 Types of Research
Research can be classified from three perspectives:

1. Application of research study

2. Objectives in undertaking the research

3. Inquiry mode employed

 • Based on the intended application

a) Pure (Basic) research: for developing theories and

hypotheses that may or may not have practical application at
present time.
 The findings add to the existing body of knowledge.
“Gathering knowledge for knowledge’s sake”

b) Applied research: aims at finding a solution for an

immediate problem facing a society.
For policy formulation, interventions, evaluation, etc.
 It is almost always done on the basis of basic research
 • Based on Objectives in undertaking

a) Descriptive research – to describe a situation, problem or

phenomenon, and provides information about their
currently existing conditions.

b) Correlational research – to discover or establish the

existence of a relationship between two or more aspects of
a situation.

c) Explanatory research – to clarify why and how there is a

relationship between aspects of a situation.
 3. Based on the inquiry mode adopted

a) Quantitative research – structured approach

Everything in the research process is predetermined.
To determine the extent of a problem and its variation.

b) Qualitative research – Unstructured approach

Allows flexibility in all aspects of the research process.
 To explore nature of a problem without quantifying it.
 Health Research
It is the generation of new knowledge using
scientific method to identify and deal with health
problems

It is divided into three overlapping types:

1. Essential health research
2. Clinical research
3. Biomedical research

Research is done to find solutions to health problems.

 Types of Health research

1. Essential health research:

 Consists of activities to define the health problems of a given
country or community, to measure their importance and to
assure the quality of activities to deal with them.
 The information is essential for planning and monitoring health services.

 Applicability is specific to each country with some generalized

conclusions applicable to other areas.
 Health research…

2. Clinical research:
 Studies the prevention and diagnosis of diseases through new
methods of treatment to problems of care and rehabilitation.

 Some of the findings will be of local importance; much will be

useful for other individuals in other countries.
Examples include clinical trials of disease prevention and the
design of new chemotherapeutic agents.
 Health research…

3. Biomedical research:

 Biomedical research is the broad area of science that looks for

ways to prevent and treat disease that cause illness and death in
people and animals.

 It is the most basic part of health research which demands more

resources, facilities and skilled investigators.

More often, the results of biomedical research have

universal importance and general significance.
 Health research…

 Most biomedical research involves clinical trials, which are

phased studies using human volunteers, designed to answer
safety and efficacy questions about biologics, devices,
pharmaceuticals, new therapies or new ways of using known
treatments.

 Trials are often conducted in small group initially but

expanding in later stages once safety and efficacy are
demonstrated.
 Types and Methods of Medical researches

1. Studies designed to evaluate the safety, effectiveness, or

usefulness of an intervention:

 research on therapies (e.g., drugs, exercise, surgical interventions,

or medical devices)

 diagnostic procedures (e.g., CAT scans, prenatal

diagnosis through amniocentesis)

 preventive measures (e.g., vaccines, diet, or fluoridated

toothpaste)

 Research on normal human functioning and development:

 Types and Methods of Medical researches

2. Research on normal human functioning and

development:

 studies of the human body while exercising, fasting,

feeding, sleeping, or learning

 responding to such things as stress or sensory stimulation

3. Studies comparing the functioning of a particular

physiological system at different stages of development
(e.g., infancy, childhood, adolescence, adulthood, or old age)
 Types and Methods of Medical researches

4. Studies defining normal childhood development so that

deviations from normal can be identified

5. Records research – often used to develop and refine

hypotheses

6. Research on specific disease processes is often needed before

improved methods of prevention, diagnoses, and treatment
can be developed, for example:

 research on the biochemical changes associated with AIDS

 research on the neurological changes associated with senile

dementia
 Purpose of Health Research
To generate knowledge essential to
effectively promote the health of
the population.

Without that knowledge, effective action is impossible

because it has no logical or empirical basis.
Progress in health (medicine) can only be
achieved if
good quality information are generated through research

to guide interventions and to inform the general public.

 Importance of Health Research
 Guiding action

 Developing new tools

 Saving resources

 Multiplying benefits

 Enhancing capacity development process

 Features of HR

 It should focus on priority problems in health care

 It should be action-oriented.

 An integrated multi-disciplinary approach is required.

 The research should be participatory in nature.
 It must be timely.
 Features …

 Emphasis on simple, short-term research designs

 The principle of cost-effectiveness is important

 Results be presented in formats most useful for

administrators, decision-makers and the community.
Research = Identifying problems &
designing appropriate action

Established methods must be used in both!!

 Research Cycle
Problem
Identification

Application-
turning into Planning
action Research
(PROPOSAL)

Disseminating
Findings Implementing
(PAPER) research
 Key Steps in Research Process
Step-1: Define the research population or target population

Step- 2. Defining the research goal and specifying the exact

research questions
Narrow and precisely defined goals and questions far more
amenable to rigorous research designs than broadly defined
goals and objectives
Key steps in research process

Search recent and relevant literatures

After literature review is completed a research goal can
be set,
it is a general statement that convey the purpose of the
planned study
The goals provide an overview of purpose and scope,
but it lacks precision and specificity
It is the research questions that provide the precision
and specificity
Thus research questions are based on the research goal
Key steps in research process

Step 3. Determining whether the research should be

observational or experimental

Step 4. Selecting a research design that provides a rigorous

test of the research questions
Key steps in research process

Step 5. Determining the variables that must be measured

Identify the required variables
 The research question and literature review are important for variable
selections
Selection of valid and reliable measurement instruments
 Identifying appropriate measures or adapting exiting measures
Key steps in research process

Step 6. Selecting the sampling procedure

The sampling procedure is one of the most determinants of
the external validity of the study

Step 7. Implementing the research plan

A basic requirement of internal validity is consistency in
the implementation of all study protocol
Not confounded by design, measurement or poor
implementation of the study procedures
Key steps in research process

Step 8. Analysis the data

Univariate, bivariate and multivariate analysis

Step 9. Disseminating the findings

Application: from knowledge to practice
 Research Topics
It provides a brief, informative summary that will attract

your target audience

Specific and complete (at least answer, what, whom and

where questions)
 Identifying Topics For Research
A number of research questions may be posed at the
various levels of the health system.

Do you have one??

These questions can be placed in three broad
categories, depending on the type of information
sought:
 Identification….

1. Description of health situation: to plan interventions

Magnitude by person, time and place

2. Information required for M&E of ongoing

interventions
Coverage, acceptability and quality, cost-effectiveness,
impact on health, etc.

3. To find solutions for problems in interventions

Inequitable distribution of resources, vague policies, and any
environmental factors
 Sources of Research Topics (Problems)
1. People
Patients, health providers, marginalized groups

2. Problems
Diseases, mortalities, disabilities, etc.

3. Programs/services
Accessibility, quality, equity, effectiveness, impact, etc.

4. Phenomena
Changes in morbidity, policy, regulation, technology, etc.
 Research Topic Selection

 Research Topic should be narrow and specific

 For example “ HIV/AIDS” is a general one.

 it should be narrowed further like,

i. Knowledge about HIV/AIDS transmission and prevention

among pastoralist community
ii. ART adherence among ART attendant
iii. Consistent condom use for prevention of HIV/AIDS among
commercial sex workers
 Criteria for Selecting a Research Topic

Relevance
How large or widespread is the problem?
Who is affected?
How severe is the problem?

Avoidance of duplication
 Suggested topic has been investigated before?
 Criteria…

Urgency of data needed (timeliness)

How urgently are the results needed at various levels (from
community to policy)?
for making a decision or developing interventions

Political acceptability of study

 Topic that has the interest and support of the local/ national authorities.
 Increases chance of study results being implemented
 Criteria…

Feasibility
Complexity of the problem and resources needed.
 Manpower, time, equipment, money, etc.

Applicability of possible results or recommendations

 How likely the recommendations from the study will be applied?
 commitment of authorities and available resources
 Criteria…

Ethical acceptability
 How acceptable is the topic to the study participants?
- Culture? Religion? (minimizes Non-response rate)

 Can informed consent obtained from participants?

- Required/not? - Verbal/written?

 Will condition of participants be taken into account?

- Intervention given/not? - Effect on results???

 Will the participants benefit from the study results?

- Individual/social? - Directly/via policy?
 Prioritizing Topics for Research
Whether a problem situation requires research
depends on three conditions:

1. There should be a perceived difference/ discrepancy b/n what

exists and what it should be;

2. The reason(s) for the difference should be unclear;

3. There should be more than one possible answer to a question (or

solution to the problem).
 Scenario -1: Low EPI coverage in District Y

Problem situation:
In district Y, where there are 1 hosp., 2 HCs and 10 HPs, a report
showed that out of 500 <1yr children who started immunization
in the 1st month, only 25 completed by the end of the fiscal
year.

Discrepancy:
 All the 500 children at district “Y” should have completed their
vaccination but only 5% did.

Problem (research) question:

 Why only 5% of the children completed their vaccination?

Definite answer:
 Out of the found in district “Y” only 2 health stations were
functioning, the rest were closed due to insecurity in the area.

Question: Does the problem demand a research?

 Scenario - 2: Low EPI coverage in District Z

Problem situation:
In district Z (pop. 150,000) where there are 2 HCs, 1 hosp., & 15
HPs all functioning smoothly. The district’s annual report showed
an immunization coverage of only 25%.
Discrepancy:
 With 100% availability of health services, at least 80% of children
should have been fully vaccinated; however, only 25% did.
Problem question:
 What factors contributed to the low EPI coverage in district “Z”?

Possible answers:
 Mothers might have problems for not attending in the EPI
sessions.
 MCH, EPI, OPD, etc. not integrated and children missed the
opportunities
 The follow up of defaulting children might not be effective, etc.

Question: Does the problem demand a research?

 Class activities
(10 minutes)

1. Select your research focus area

2. Then write your research topic and discuss with your

colleague
The topic will serve to develop your research proposal

for the course

 Research
Proposal Writing
 Research Proposal

- Although the beginning investigator might have a

plan of what he/she wants to do in mind, it is

important to set it in writing
- Systematically presented scheme- Protocol/ Proposal

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 Planning Research
(Developing Proposal)

A written proposal is important:

 To clearly define the problem under study

 To avoid reinventing 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

 Gaps and errors are easier to recognize and correct when the
plan is seen on paper than the plan is in one’s mind
 Characteristics of a Good Research
Proposal

 Have a clear statement of the problem.

 Have clear plans: objectives & methods

 Have clear vision of the outcome

 Builds on existing data

Components of Research Proposal
 Title
 Summary/Abstract
 Introduction (Statement of the Problem)
 Literature review
 Objectives (research questions & hypothesis)
 Methodology (Ethical Considerations)
 Plan of Dissemination and Utilization of Results
 Work plan
 Budget (Cost of the Project)
 References
 Annex/Appendix
 Assurance of the investigator
 Advisor (approval)
A. Title
 A good title is defined as the fewest possible words that can
adequately describe the contents of the study
 Remember that the title will be read by thousands of people
 Perhaps few people will read the entire paper

 All words in the title should be chosen with great care and
association with one another must be carefully managed

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Length of a title:
 Occasionally titles are too short
 Much more often, titles are too long
 Long titles are less meaningful than short ones
 Maximum of 15 words

Words such as “Studies on”, “Investigations on” and

“Observations on” are waste words

Titles should almost never contain abbreviations

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 3 min. Activity Evaluate the Titles

Assessment of different types of diagnostic methods

and prevalence of pulmonary TB among the general
population of Dire Dawa City Administration, Easter
Ethiopia. A quantitative study approach

Types of diagnostic methods and prevalence of

pulmonary tuberculosis among Dire Dawa
communities.

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B. Summary
 A concise summary of the material presented in the proposal,
 it is a mini version of the paper
 These materials are condensed to a page or less (less than 250
words).
 Summary should be typed as a single paragraph

 A well prepared summary enables reader to:

 Identify the basic content of a document quickly & accurately
 Determines its relevance to their interest, and
 Decide whether they need to read the document in its entirely

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 summary

It must cover the essential points of the proposal:

1. Brief description of the background (problem statement)
and the rationale of the project
2. Goals and objectives
3. Brief methods
4. Implementation plan
5. Total cost
C. Introduction
1. Background

2. Statement of the problem

3. Significance of the study

Introduction generally contains information showing:
 What has been accomplished in the field
 That the investigator is well acquainted with the past and
current work and with the literature in the field, and
 Whether the proposed project will advance or add to the
present store of knowledge in the field or be important to
the solution of the problem.

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Background

Brief description of the topic

What is the problem to be studied?

Define the problem, concepts and issues related to the topic

Statement of the problem

It describes the problem that is to be investigated and

the questions that will guide the research process
Concise description of the problem like:
the magnitude, distribution (who, where, when), severity and
consequences
It is a foundation for further development of the
research proposal
Significance of the study

Describe the significance of the proposed study what

you hope to achieve with the study results

A description of the type of information expected to

result from project and how this information will be
used to help solve the problem
 D. Review of Literature
It is both a summary and explanation of the complete
and current state of knowledge on a limited topic as
found in journal articles and academic books

It provides an excellent starting point for researchers

beginning to do research in a new area by forcing
them to summarize, evaluate, and compare original
research in that specific area
 E. Research Objective and Hypothesis

 Research objective is a statement that clearly depicts the

goal to be achieved by a research project.

 The general objective is closely related to the statement of

the problem
 The Specific Objective facilitate the development of research

methodology and help to orient the collection, analysis,

interpretation and utilization of data
F. Methods

“The worth of all scientific findings depends heavily on the

manner in which the data were collected and
analysed”
Your Proposal
Simple and clear
Good statement of the problem: why do you want
to study?
Pertinent literature review
Few objectives
Clear and detailed methodological description
Good work plan
Reasonable budget
 See to whole picture
Process
• Selection of study population
•Use of appropriate methods
•Use of appropriate tools

Outcome
•What would be the result?
Objectives •What can be concluded?

Dummy Tables, conclusions•What

and can be recommended?
recommendations

Always focus on your objectives!!!

 Managing your research project

 Keep good note

 Establish good communication with your advisor(s)
 Keep time and promises: always motivate your advisor(s)
 Keep your document to a manageable size: readability and clear
message
 Lead your research work: be ready to manage crisis
 Advisors: advisors, assessors but not dictators
Be realistic;
don’t be over ambitious!!
Any questions?