RESEARCH METHODS

FOR MPH-N STUDENTS

DESSALEGN A.(MPH-E,ASSIST. PROF.)
 Course Description
 Course Title: Health Research
Methods
 Credit hours: 7ECTS
 Course Duration: 4 weeks
 Course Policies:
 Student should do all the assignments
 Cheating and plagiarism is not allowed

Research Methods
 Course contents
 Introduction to Research & Health Research methods
 Topic selection, Formulation of research question, SP
 Literature review
 Objective and hypothesis
 Choosing study design
 Sampling methods
 Data collection methods
 Questionnaire design
 Sampling and sample size
 Planning for data management and analysis
 Qualitative study
 Research ethics
 Citation of references
 Proposal/Research protocols
 Statistical software and application(SPSS/STATA, ATLAS)
….optional

Research Methods
Methods of Instruction
 Lectures
 Case studies
 Group discussions
 Online resources and Tools
 Peer review and Feed back

Research Methods
Course Instructor
 Dessalegn A(MPH In Epi, Asst Prof)
 Phone: +251 913403282
 Email: [email protected]

Research Methods
Evaluation
 Proposal development……….40%
 Presentation ……………20%
 Examination ……………….40%

Research Methods
INTRODUCTION TO
RESEARCH
Learning Objectives
After completing this session, you will be
able to:
1. Define research and health systems
research
2. Identify the different types of research
3. List the criteria for selecting a research
topic.
4. Analyze statement of the problem

Research Methods
Definition and
characteristics of research
 HOW DID YOU DEFINE RESEARCH?

Research Methods
 Definition and
characteristics of research
Definition:
Research is a scientific inquiry aimed at
learning new facts, testing ideas, etc.
It is the systematic collection, analysis
and interpretation of data to generate
new knowledge and answer a certain
question or solve a problem.

Research Methods
 Characteristics of research
 It demands a clear statement of the problem
 It requires a plan (it is not aimlessly “ looking” for
something hoping that a solution will come across )
 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)
 Aimed at solving problems and/or generating new
knowledge.

Research Methods
 Types of research
 Research covers topics in every field of science and
perceptions of its scope and activities are unlimited.
 The classical broad divisions of research are:
a) Basic research; is necessary to generate new
knowledge and technologies to deal with major
unresolved health problems.
b) Applied research; is necessary to identify
priority problems and to design and evaluate policies
and programs that will deliver the greatest health
benefit, making optimal use of available resources.

Research Methods
Quantitative and Qualitative
Research
Quantitative research Qualitative research
 concerned with  is a type of formative
investigating things which research that offers
we could observe and specialized techniques for
measure in some way. obtaining in depth responses
 Such observations and about what people think and
measurements can be how they feel.
made objectively and  It enables to gain insight
repeated by other into attitudes, beliefs,
researchers motives and behaviors of
the target population.
 In most cases, health
science research deals with
 deals with the emotional and
information of a contextual aspects of human
quantitative nature. response
 Explanatory purpose
 Exploratory Purpose

Research Methods
Qualitative and Quantitative
Approaches…
Qualitative Quantitative

Usually Non-probability based sample Typically a probability-based sample

Non- generalizable (transferability) Generalizable

Exploratory Explanatory

Answers Why? How? Answers How many? When? Where?--

In addition to why & how
Generate hypothesis Tests hypotheses
Process is inductive Process is deductive
Data are “rich” and time-consuming to Data are more efficient, but may miss
analyze contextual detail
Design may emerge as study unfolds Design decided in advance
(grounded theory)
Researcher is the instrument Various tools, instruments employed
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 Mixed method
 It uses both qualitative and quantitative
methods in the design, data collection,
and analysis.
 Triangulation (Multi-method designs)

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 Health research
 Health research is the application of
principles of research on health.
 It is the generation of new knowledge
using scientific method to identify and
deal with health problems.

Research Methods
 Essential Features of Health
Systems Research (HSR)
• HSR should focus on priority problems.
• It should be action oriented (i.e., aimed at developing
solutions)
• An integrated multidisciplinary approach is required
• The research should be participatory in nature (from
policy makers to community members)
• Research must be timely.
• It should emphasis on comparatively simple, short-
term research designs that are likely to yield practical
results
Research Methods
 Steps of conducting a health
research:
A. Prioritizing and selecting a research topic
B. Review of literature and other existing
information
C. Development of a research proposal
D. Implementation of study:
i. Data collection
ii. Data processing and analysis
iii. Interpretation of results
iv. Final report writing
v. Presenting the results
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Steps

Research Methods
Steps cont’d….

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TOPIC SELECTION
 Sources of research Topic
Co
w ns n al e
ith u so enc
l r al
ex tat Pe eri i c
pe ion x p a ct nce
E x po rt E Pr erie ical f
sure s p C ri t a l o
field to E x
r a is re
situa p u
tions Ap erat
li t
c es
our f Previous
Folklores S o arc
se Research
R e h em
obl
n Pr E x i st
iti o in
Intu theo g
ries
mi ng
st or
in So
Br a cia
l Iss
ue
s

Research Methods
 Whether a problem requires research
depends on three conditions:

I. There should be a perceived difference or

discrepancy between what it is and what it
should be;
II. The reason(s) for this difference should be
unclear (so that it makes sense to develop
a research question);
III. There should be more than one possible
and plausible answer to the question (or
solution to the problem).
Research Methods
Example 1:
 Problem situation: In district “ X “ a
report showed that in the first month there
were 500 children under one year old who
started immunization, but at the end of the
year it was found out that there were only 25
children who completed their vaccination.
 Discrepancy: All the 500 children at district
“X“ should have completed their vaccination
but only 5% out of those who started
vaccination have completed.

Research Methods
Cont`d…
 Problem (research) question: why only 5%
of the children completed their vaccination?
 Definite answer: Out of the 1 hospital, 2
health centers and 10 health stations found in
district “X” only 2 health stations were
functioning, the rest were closed due to
insecurity in the area.
Þ In the above example, assuming that all the
given facts are true, there is no need of
undertaking a research, since definite answer is
obtained to the problem situation.
Research Methods
 Example 2:
 Problem situation: In district “Z” (population
150,000) there are 2 health centers, 1 hospital
and 15 health stations and all of them function
smoothly. However, at the end of the year it
was found that the EPI coverage was only 25%.
 Discrepancy: Although district “Z” had 100%
availability of health services and at least 80%
of the children should have had full
vaccinations.
 Problem question: What factors influence the
low EPI coverage in district “Z”?
Research Methods
Cont`d…
 Possible answers:

Mothers might have problems for not attending
in the EPI sessions.

The MCH, EPI, OPD, CDD, etc… programs might
not have been integrated; hence children might
have missed opportunities in getting
immunization.

The follow up of defaulting children might not be
effective and other reasons.
Þ Thus, the above problem situation is
researchable.
Research Methods
 Exercise 1
 Assume in Arba Minch zuria Woreda,
many people who are diseased with P.f
malaria are being treated with Coartem.
However, the Woreda health office
reported that there is an increasing
number of patients with repeat case
nowadays.

Research Methods
 Criteria for prioritizing problems
for research

 Before deciding on a research topic,

each proposed topic must be compared
with all other options.
 The selection and analysis of the problem

for research should involve those who

are responsible for the health status of
the community.

Research Methods
 A. Criteria for selecting a
research topic

1. Relevance: The topic you choose should be a

priority problem:
Questions to be asked include:
 How large or widespread is the problem?

 Who is affected?

 How severe is the problem?

 Advance scientific knowledge?

 Impact health policy?

 Guide future research?

Research Methods
 Criteria…
2. Avoidance of duplication:
 Investigate whether the topic has been
researched.
 If the topic has been researched, the
results should be reviewed to explore
whether major questions that deserve
further investigation remain unanswered.
 If not, another topic should be chosen.
Research Methods
 Criteria…
3. Feasibility: Consider the complexity
of the problem and the resources you
will require to carry out the study.
 Thought should be given first to

available;

Personnel

Time

Equipment

Money
Research Methods
 Criteria…
4. Political acceptability:
 It is advisable to research a topic that

has the interest and support of the

authorities.
 This will facilitate the smooth conduct of

the research and increases the chance

that the results of the study will be
implemented.
Research Methods
 Criteria…
5. Applicability of possible results
and recommendations
 Is it likely that the recommendations
from the study will be applied?
 This will depend not only on the blessing
of the authorities but also on the
availability of resources for
implementing the recommendations.
Research Methods
 Criteria…
6. Urgency of data needed:
 How urgently are the results needed for
making a decision?
 Which research should be done first and which
can be done late?
7. Ethical acceptability:
 We should always consider the possibility that
we may inflict harm on others while carrying
out research.
Research Methods
 B. Scales for rating
research topics
 Relevance
1 = Not relevant
2 = Relevant
3 = very relevant
 Avoidance of duplication
1 = Sufficient information already available
2 = Some information available but major issues not
covered
3 = No sound information available on which to base
problem-solving

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 Scales…cont`d
 Feasibility

1 = Study not feasible considering

available resources
2 = Study feasible considering available
resources
3 = Study very feasible considering
available resources

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 Scales…cont`d
 Political acceptability
1 = Topic not acceptable
2 = Topic somewhat acceptable
3 = Topic fully acceptable
 Applicability
1 = No chance of recommendations being
implemented
2 = Some chance of recommendations being
implemented
3 = Good chance of recommendations being
implemented
Research Methods
 Scales…cont`d
 Urgency
1 = Information not urgently needed
2 = Information could be used but a delay of some
months would be acceptable
3 = Data very urgently needed for decision-making
 Ethical acceptability
N.B. The above rating
1 = Major ethical problems should be based on the
existing data and not on
2 = Minor ethical problems mere assumptions
3 = No ethical problems

Research Methods
 Rating Sheet
Criteria for Proposed topic
selecting a
research topic Health Health Health
problem I problem II problem III

1. Relevance
2. Avoidance of
duplication

3. Feasibility
4. Political
acceptability

5. Applicability
6. Urgency of
data needed

7. Ethical
acceptability
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Total 20 21 11
Summary…
Title
 It should describe key words of the
objective
 It should be short and precise to
describe the objective of the paper
 It should use attractive key words for its
audience
 It should be self explanatory,
informative, adequately descriptive
(what, where, when)

Research Methods
 Introduction of Research
 Can be divided into 3 sections or the
concepts of the 3 sections can be
merged together
 Sections:
o
Background
o
Statement of the problem/
Problem statement
o
Justification of the study

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 Background
 Contains the preliminary information about
your research question, or thesis topic and
readers will be learning in your paper
 Identifies and describes the history and
nature of a well defined research problem
with reference to the existing literature
 Initial part of the introduction prepares the readers
for more detailed and specific information that is
given later 43
The Research Problem
 What is research
problem ?
 A problem is a;

perceived difficulty,

a feeling of discomfort about the way things
are, or

a discrepancy between what someone
believes should be the situation and what the
situation is in reality.
 It is a situation or circumstance that requires
a solution to be described, explained, or
predicted.
 It is an unsatisfactory situation that wants
you to confront.
Research Methods
 What is research
problem ?
 If a situation has no possible solutions
it makes no sense expending
resources researching it
 E.g. “everybody wants to go to heaven
but no body wants to die”
 Dying looks like a problem that needs a
solution

Research Methods
 What is problem
statement?
 A problem statement is the description of an
issue currently existing which needs to be
addressed
 Problem statement section tells us about:
 the actual problem itself ,
 what we know about it,
 what we don’t know,
 what researchers want us to know.
 The statement of the problem is the focal point
of any research.
Research Methods
 Analyzing the problem
 A systematic analysis of the problem,
completed jointly by the:
 Researchers
 Health workers
 Managers
 community representatives
 is a very crucial step in designing the
research
Research Methods
 Analyzing the problem...
 Enables those concerned to bring
together their knowledge of the
problem,
 Clarifies the problem and the possible
factors that may be contributing to it,
 Facilitates decisions concerning the
focus and scope of the research.

Research Methods
 Formulating the problem
statement
 After identifying, selecting and
analyzing the problem, the next major
section in a research proposal is
“statement of the problem”

Research Methods
 Why is it important to state and define
the problem well?

 Because a clear statement of the

problem:
 Is the foundation for the further
development of the research proposal
(research objectives, methods, work plan,
etc);
 Makes it easier to find information and
reports of similar studies from which your
own study design can benefit;
Research Methods
 Why is it important to state and define
the problem well?...

 Enables the researcher to

systematically point out why the
proposed research on:

the problem should be undertaken

what you hope to achieve with the study
results.
Research Methods
 A health problem selected to be
studied has to be justified in terms of
its:

 Being a current and existing problem

which needs solution
 Being a widely spread problem affecting
a target population
 Effects on the health service programs
 Being a problem which concerns the
planners, policy makers and the
communities at large.
Research Methods
 Information included in the
statement of a problem
 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
 If necessary, a short list of definitions of crucial
concepts used in the statement of the problem.
 A list of abbreviations may be annexed to the
proposal, but each abbreviation also has to be
written out in full when introduced in the text the
first time

Research Methods
 What information should be included
in the problem statement?
 A brief description of socio-economic and cultural
characteristics and an overview of health status
and the health-care system in the country/district
and Include a few illustrative statistics.
 A concise description of the nature of the
problem, the size, distribution and severity of the
problem.

who is affected

Where

since when

what are the consequences for those affected and for the
services

Research Methods
 What information…
 A brief description of any solutions to the
problem that have been tried in the past,
how well they have worked, and why
further research is needed (justification
for your study).

Research Methods
 Information included in the
statement of a problem
 a convincing argument that available
knowledge is insufficient to answer a certain
question and to update the previous
knowledge.
 An analysis of the major factors that may
influence the problem and a discussion of why
certain factors need more investigation if the
problem is to be fully understood

Research Methods
 How to write a Problem Statement
 The section should be precise and concise, while
not forgetting to mention essential points.
 Information concerning the problem should be
summarized, so the reader is not “drowned” in
detail.
 An outline listing the major points to be covered

could be prepared before any writing is done, so

the section will be logical and well organized.
 Effective problem statements answer the
question “Why does this research need to be
conducted.”
Research Methods
The three main steps in writing a
statement of the problem

Research Methods
 Rationale of the study
 Describing why?
 Increased morbidity that can be prevented
 Increased mortality
 Generating knowledge for science
advancement (filling research gaps)
 Knowing factors that can be used for
intervention
 Totally unknown problem
 There is a discrepancy in data

Research Methods
 Significance of the study
 The importance of your research
 Highlight how your research will contribute to the
broader problem in your field
 The specific group that will benefit from your
research
 Highlight how your research will be beneficial to the
development of science and the society in general
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 Significance ….
 Contribution to public Health
 Program relevance: Intervention relevance
 Policy relevance
 Research relevance
 Public/ Community relevance

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 Class activities/scenarios

 Research questions??

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 Research problem formulation – definition of the
problem (Who? What? When? Where? By how much?
How? Why?)

 What causes ………….?

 What is the extent of …………….?
 What factors lead to ………………?
 What are the consequences of ………?

64
 Does the “X” factor cause the “Y” event? How and
why?

 How much will a certain amount of exposure to the

factor “X” affect the outcome “Y”?

65
General topic:

 Poor quality of lab service at a given hospital

Formal research questions:

 What factors determine the quality of laboratory

services?
 Is there a relationship between the training of laboratory

personnel and the quality of their diagnosis?

 Is the quality of laboratory diagnosis influenced by high

workload on laboratory personnel?

 what else???

66
Example: Problem Situation
 In District X (population =145,000), sanitary conditions are poor
(10% of households have latrines) and diseases such as
diarrhea, and worms are common.

 The MoH has initiated a sanitation project that aims at

increasing the number of households with latrines by 20% each
year for two years.

 The project provides materials and the population should

provide labor.

 Two years later, less than half (30%) of the target has been
achieved
67
 Discrepancy:

• 50% of the households should have latrines, but

only 30% do.

• What factors can explain this difference?

68
Thank you!

Research Methods