Professional Documents
Culture Documents
PST 06210
Operational Research
March 2019 i
Copyright © Ministry of Health, Community Development, Gender, Elderly and Children – 2019
ii
Table of Contents
Background 4
Acknowledgment Error! Bookmark not defined.
Introduction 5
SESSION 1: Basic Statistical Concepts 10
SESSION 2: Basic Biostatistics Data 16
SESSION 3: Data Presentation 22
SESSION 4: Establishing Trends in Health Care 31
SESSION 5: Basic Concept of Research 39
SESSION 6: Types of Research 44
SESSION 7: Procedures for Conducting Operational Research 53
SESSION 8: Identification of research problem 63
SESSION 9: Analysis and statement of the problem 81
SESSION 10: Literature Review in Research 95
SESSION 11: Research Objectives and Questions 102
SESSION 12: Research methods 111
SESSION 13: Research Sampling 120
SESSION 14: Determining Sample Size 128
SESSION 15: Research ethics 136
SESSION 16: Research Budget 141
SESSION 17: Data Collection Plan 148
SESSION 18: Developing Research Tools 157
SESSION 19: Pre-Testing the Research Tools 176
SESSION 20: Data Collection 181
SESSION 21: Data Processing 189
SESSION 22: Data Analysis 196
SESSION 23: Research Report Writing 210
SESSION 24: Methods for Dissemination of Research Findings 222
iii
Background
There is currently an ever increasing demand for pharmaceutical personnel in Tanzania.
This is due to expanding investment in public and private pharmaceutical sector. Shortage of
trained pharmaceutical human resource contributes to poor quality of pharmaceutical
services and low access to medicines in the country (GIZ, 2012).
Through Public-Private-Partnership (PPP) the Pharmacy Council (PC) together with
Development Partners (DPs) in Germany and Pharmaceutical Training Institutions (PTIs)
worked together to address the shortage of human resource for pharmacy by designing a
project named “Supporting Training Institutions for Improved Pharmaceutical Services in
Tanzania” in order to improve quality and capacity of PTIs in training, particularly of lower
cadre pharmaceutical personnel.
The Pharmacy Council formed a Steering committee that conducted a stakeholder’s
workshop from18th to 22ndAugust 2014 in Morogoro to initiate the implementation of the
project.
Key activities in the implementation of this project included carrying out situational analysis,
curriculum review and harmonization, development of training manual/facilitators guide,
development of assessment plan, training of trainers and supportive supervision.
After the curricula were reviewed and harmonized, the process of developing standardized
training materials was started in August 2015 through Writer’s Workshop (WW) approach.
The approach included two workshops (of two weeks each) for developing draft documents
and a one-week workshop for reviewing, editing and formatting the sessions of the modules.
The goals of Writers Workshops were to build capacity of tutors in the development of
training materials and to develop high-quality, standardized teaching materials.
The training package for pharmacy cadres includes a Facilitator Guide, Assessment plan and
Practicum. There are 12 modules for NTA level 4 making 12 Facilitator guides and one
Practicum guide.
iv
Acknowledgment
The development of standardized training materials of a competence-based curriculum for
pharmaceutical sciences has been accomplished through involvement of different
stakeholders.
Special thanks go to the Pharmacy Council for spearheading the harmonization of training
materials in the pharmacy after noticing that training institutions in Tanzania were using
different curricula and train their students differently.
I would also like to extend my gratitude to Christian Social Service Commission (CSSC) for
their tireless efforts to mobilize funds from development partners (German Ministry of Industry
and action medeor). It is through the implementation of the Multi-Actors Partnership (MAP)
project, CSSC has been able to provide the financial and technical support needed during the
development of this training material.
Many thanks go to the Centre for Educational Development in Health Arusha (CEDHA)
experts on health material development and training who coordinated the development of
these module sessions particularly Ms. Diana H. Gamuya for her commitment in coordinating
and facilitating the planning and development to its completion.
Particular acknowledgements are sent to Mr. Dickson Mtalitinya and Members from the
secretariat of National Council for Technical Education (NACTE) for facilitating and
providing their expertise to the success of this work.
It will be unfair if I will not recognize the efforts and contributions of all CEDHA supportive
staff that made this process a success; accountant, secretary, drivers and printers
Finally, I very much appreciate the contributions of the tutors and content experts
representing PTIs, hospitals, and other health training institutions. Their participation in
meetings and workshops, and their input in the development of this training
manual/facilitators guide have been invaluable.
v
Mr. Samwel M. Zakayo Pharmacy Council
vi
Introduction
Module Overview
This module content is a guide for tutors of Pharmaceutical schools for training of students.
The session contents are based on sub-enabling outcomes and their related tasks of the
curriculum for Basic Technician Course in Pharmaceutical Sciences. The module sub-
enabling outcomes and their related tasks are as indicated in the in the Basic Technician
Certificate in Pharmaceutical Sciences (NTA Level 5) Curriculum
Target Audience
This module is intended for use primarily by tutors of pharmaceutical schools. The module’s
sessions give guidance on the time, activities and provide information on how to teach the
session. The sessions include different activities which focus on increasing students’
knowledge, skills and attitudes.
The module consists of fifteen (24) sessions; each session is divided into several parts as
indicated below:
vii
to the session topic that cannot fit into the session time. Handouts can be used by the
students to study material on their own and to refer to them after the session.
Sometimes, a handout will have questions or an exercise for the participants including the
answers to the questions.
Instructions for Use and Facilitators Preparation
Tutors are expected to use the module as a guide to train students in the classroom and
skills laboratory
The contents of the modules are the basis for teaching and learning dispensing.
Use the session contents as a guide
The tutors are therefore advised to read each session and the relevant handouts and
worksheets as preparation before facilitating the session
Tutors need to prepare all the resources, as indicated in the resource section or any other
item, for an effective teaching and learning process
Plan a schedule (timetable) of the training activities
Facilitators are expected to be innovative to make the teaching and learning process
effective
Read the sessions before facilitation; make sure you understand the contents in order to
clarify points during facilitation
Time allocated is estimated, but you are advised to follow the time as much as possible,
and adjust as needed
Use session activities and exercises suggested in the sessions as a guide
Always involve students in their own learning. When students are involved, they learn
more effectively
Facilitators are encouraged to use real life examples to make learning more realistic
Make use of appropriate reference materials and teaching resources available locally
Go through the session and identify handouts and worksheets needed for the session
Reproduce pages of these handouts and worksheets for student use while teaching the
session. This will enable students to refer to handouts and worksheets during the session
in the class. You can reproduce enough copies for students or for sharing
Give clear instructions to students on the student activity in order for the students to
follow the instructions of the activity
Refer students to the specific page in the student manual as instructed in the facilitator
guide
The student manual is a document which has the same content as the facilitator guide,
which excludes facilitator instructions and answers for exercises.
The student manual is for assisting students to learn effectively and acts as a reference
document during and after teaching the session
viii
Some of the activities included in facilitator guide are in the student manual without
facilitator instructions
Abbreviations/Acronyms
CME Continue in – service medical education
DIC Drug information center
DTC Drug therapeutic committee
EM Essential medicine
EML Essential medicines list
INN International non-proprietary name
NEMLT National essential medicine list
OTC Over the counter
RA Regulatory authority
STG’s Standard treatment guidelines
TFDA Tanzania food and drug authority
WHO World health organization
ix
Session 1: Basic Statistical Concepts
Learning Tasks
By the end of this session students are expected to be able to:
Define biostatistics
Explain the importance of different measures in statistics
Explain the application of statistics in data analysis
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
30 minutes Presentation
2 Definitions of Biostatistics
Buzzing
45 minutes Presentation
4 Application of Statistics in Data Analysis
Buzzing
1
SESSION CONTENTS
STEP1: Presentation of Session Title and Learning Tasks (5 minutes)
READ or ASK students to read the learning tasks and clarify
What is Biostatistics?
ALLOW few students to respond?
WRITE their responses on the flip chart/ board
CLARIFY and SUMMARISE by using the content below
2
Central tendency
o Measures of Central Tendency provide a summary measure that attempts to describe
data with a single value that represents the middle or centre of its distribution.
o There are three main measures of central tendency: the mean, the median and the
mode
Mean, arithmetic mean (X or M):
• The mean of a data set is also known as the average value
• The sum of the scores in a distribution divided by the number of scores in the
distribution. It is the most commonly used measure of central tendency.
• It is often reported with its companion statistic, the standard deviation, which
shows how far things vary from the average.
Median (Mdn):
• The midpoint or number in a distribution having 50% of the scores above it
and 50% of the scores below it.
• The median of a data set is the value that is at the middle of a data set arranged
from smallest to largest
• If there are an odd number of scores, the median is the middle score.
Mode (Mo):
• The number that occurs most frequently in a distribution of scores or numbers
• The mode is the most common observation of a data set, or the value in the
data set that occurs most frequently.
Quartile
• A measure of statistical dispersion being equal to the difference between the
third and first quartiles.
• The first quartile (designated Q1 ) is the lower and cuts off the lowest 25% of
data (the 25th percentile)
• The second quartile (Q2 ), or the median, cuts the data set in half (the 50th
percentile)
• The third quartile (Q3 ) cuts off highest 25% of data, or the lowest 75% (the
75th percentile)
Variations
Range (Ra): The difference between the highest and lowest scores in a distribution;
a measure of variability.
Standard deviation (SD): The most stable measure of variability, it takes into
account each and every score in a normal distribution. This descriptive statistic
assesses how far individual scores vary in standard unit lengths from its midpoint
of 0. For all normal distributions, 95% of the area is within 1.96 standard
deviations of the mean.
Variance (SD2): A measure of the dispersion of a set of data points around their
mean value. It is a mathematical expectation of the average squared deviations
from the mean.
3
STEP 3: Importance of Measures in Statistics (30 minutes)
ASK students to pair up and buzz on the following questions for 2 minutes
ALLOW few pairs to respond and let other pairs to add on points not mentioned
4
o Statistics is an important tool in pharmacological research that is used to
summarize (descriptive statistics) experimental data in terms of central tendency
(mean or median) and variance
o It enables us to conduct hypothesis testing (to determine whether the
pharmacological effect of one drug is superior to another)
o Statistics can be very helpful in formulating experimental design and drawing
appropriate inferences from the collected data
5
References
Rao, J. S., & Richard, J. (2002). An introduction to biostatistics-a manual for students in
helthsciences.third edition, New delhi, Circus: Asoke k ghosh.
Basic Statistics and epidemiology (2001). A practical guide, Radcliffe Medical Press, United
Kingdom
Beaglehole R, Bonita R and Kjellstrom (1993) Basic epidemiology, World Health
Organization, Geneva
Kazaura, M. R., Makwaya, C. K., Masanja, C. M. and Mpembeni, R.C.(1997). Lecture
notesinBiostatistics, manual of biostatistics, Muhimbili University College of Health
Sciences, Dar es Salaam
Anderson, D.R., Sweeney, D.J., Williams, T.A., Freeman, J. &Shoesmith, E. (2007).
Statistics for Business and Economics, Thomson Learning, London.
6
Session 2: Basic Biostatistics Data
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Define data
Mention characteristic of data
Explain sources of data
Describe types of data
Explain the quality of data
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
10 minutes Presentation
2 Definition of Data
Brainstorm
3 25 minutes Presentation
Characteristic of Data
4 25 minutes Presentation
Sources of Data
15 minutes Presentation
5 Types of Data
Buzzing
6 30 minutes Presentation
The Quality of Data
7 05 minutes Presentation Key Points
7
SESSION CONTENTS
8
The collected data is generally accurate and reliable.
This method of collecting primary data is feasible only in case of small scale
laboratory, field experiments or pilot surveys and is not practicable for large scale
experiments and surveys because it take too much time.
o Through investigators
The trained (experienced) investigators are employed to collect the required data
In case of surveys, they contact the individuals and fill in the questionnaires after
asking the required information, where a questionnaire is an inquiry form having a
number of questions designed to obtain information from the respondents
o Through questionnaire
The required information (data) is obtained by sending a questionnaire (printed or soft
form) to the selected individuals (respondents) (by mail) who fill in the questionnaire
and return it to the investigator
o Through local sources
The local representatives or agents are asked to send requisite information who
provide the information based upon their own experience.
This method is quick but it gives rough estimates only.
o Through Telephone
The information may be obtained by contacting the individuals on telephone.
It’s a Quick and provide accurate required information
o Through Internet
With the introduction of information technology, the people may be contacted through
internet and the individuals may be asked to provide the pertinent information
ASK students to pair up and buzz on the following question for 2 minutes
What are the types of statistics commonly used to support decision making in
provision of pharmaceuticals?
ALLOW few pairs to respond and let other pairs to add on points not mentioned
9
Primary data is collected firsthand by a researcher (organization, person,
authority, agency or party etc.) through experiments, experiments, surveys,
questionnaires, focus groups, conducting interviews and taking (required)
measurements
o Secondary Data
Secondary data is readily available (collected by someone else) and is available
to the public through publications, journals and newspapers
An ideal data collection procedure is one that captures a construct in a way that is
relevant, credible, accurate, truthful, and sensitive.
Criteria for evaluating the quality of qualitative data obtained in a study:
o Whether the data are collected by observation, self-report, or some other method,
researchers must specify under what conditions and according to what criteria the
numeric values are to be assigned to the characteristic of interest.
o Most of the following six criteria are actually aspects of the reliability and validity
issues:
Comprehensibility. Subjects and researchers should be able to comprehend the
behaviors required to secure accurate and valid measures.
Precision. An instrument should discriminate between people with different
amounts of an attribute as precisely as possible.
Speediness. For most instruments, researchers should allow adequate time to
obtain complete measurements without rushing the measuring process.
Range. The instrument should be capable of achieving a meaningful measure from
the smallest expected value of the variable to the largest.
Linearity. A researcher normally strives to construct measures that are equally
accurate and sensitive over the entire range of values.
Reactivity. The instrument should, insofar as possible, avoid affecting the attribute
being measured.
The criteria currently thought of as the gold standard for qualitative researchers are four
criteria for establishing the trustworthiness of qualitative data:
o Credibility
Credibility refers to confidence in the truth of the data and interpretations of them.
Credibility involves two aspects: first, carrying out the study in a way that
enhances the believability of the findings, and second, taking steps to demonstrate
credibility to consumers
o Dependability
The dependability of qualitative data refers to the stability of data over time and
over conditions.
One approach to assessing the dependability of data is to undertake a procedure
referred to as stepwise replication.
10
• This approach involves having a research team that can be divided into two
groups.
• These groups deal with data sources separately and conduct, essentially,
independent inquiries through which data can be compared.
• Ongoing, regular communication between the groups is essential for the
success of this procedure.
Another technique relating to dependability is the inquiry audit.
• An inquiry audit involves a scrutiny of the data and relevant supporting
documents by an external reviewer, an approach that also has a bearing on the
confirm ability of the data
o Confirm ability
Confirm ability refers to the objectivity or neutrality of the data, that is, the
potential for congruence between two or more independent people about the
data’s accuracy, relevance, or meaning.
o Transferability.
Transferability refers essentially to the generalizability of the data, that is, the
extent to which the findings can be transferred to other settings or groups.
• This is, to some extent, a sampling and design issue rather than an issue
relating to the soundness of the data per se
• The responsibility of the investigator is to provide sufficient descriptive data
in the research report so that consumers can evaluate the applicability of the
data to other contexts
11
References
Rao, J. S., & Richard, J. (2002). An introduction to bostatistics-a manual for students in
helthsciences.third edition, New delhi, Circus: Asoke k ghosh.
Basic Statistics and epidemiology (2001). A practical guide, Radcliffe Medical Press, United
Kingdom
Kazaura, M. R., Makwaya, C. K., Masanja, C. M. and Mpembeni, R.C. (1997). Lecture notesin
Biostatistics, manual of biostatistics, Muhimbili University College of Health Sciences, Dar es
Salaam
Polit, D. F and Beck, C. T (2004) Nursing Research – Principles and Methods, 7th Edition:
Lippincott Williams & Wilkins, Philadelphia
12
Session 3: Data Presentation
Learning Tasks
By the end of this session students are expected to be able to:
Define data presentation
Describe methods of data presentation
Describe the use of data presentation methods
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
15 minutes Presentation
2 Definition of Data Presentation
Brainstorming
3 40 minutes Presentation
Methods of Data Presentation
40 minutes Presentation
4 Use of Data Presentation Methods
Buzzing
13
SESSION CONTENTS
STEP1: Presentation of Session Title and Learning Tasks (5 minutes)
READ or ASK students to read the learning tasks and clarify
14
Sex course students Number of course students
Male 34
Female 27
Total 61
Percentages
o Is number of units in the sample with a certain characteristics divided by total of units
in the sample multiplied by 100
o May also be called Relative frequencies
o Standardizes the data and make it easier to compare with similar data obtained in
another sample of different size or origin
o E.g. weight of 17 nursing students at Kibong’oto nursing school on enrolment
15
31-40 12 26.7
41-50 17 37.8
51-60 11 24.4
61-70 5 11.1
Total 45 100
16
Bar charts
o Is simplest and most effective means of illustrating qualitative data
o Bars can either be horizontal or vertical
o Eg.57 Adolescents from kaloleni streets in Arusha were asked the following question:
How often have you used cannabis for the past one year? This was closed question
with the following possible answers
o Frequently(more than 5 times),Occasionally ( 3 to 5 times), rarely (1 to 2 times)and
never
Categories Number Percentage
Frequently 7 12.2
Occasionally 9 15.8
Rarely 10 17.5
Never 31 54.4
Total 57 100
Pie charts
o Provides quick view of data presented in different form.
o Used in qualitative number with few categories to avoid congestion
17
Histograms
o Numerical data are often presented in histograms
o Which are similar to bar charts important difference is that in histogram ‘the bars’ are
connected(as long as there is no gap between the data where as in bar charts are not
connected as the different categories are distinct entitles)
Line graphs
o Particularly useful for numerical data if you want to show Trend over time
o It is easy to show two or more distribution in one graph as long as difference between
lines are easy to distinguish e.g. age distribution between males and females
18
STEP 4: Use of Data Presentation Methods (40 minutes)
ASK students to pair up and buzz on the following question for 2 minutes
ALLOW few pairs to respond and let other pairs to add on points not mentioned
19
• Line graphs can also be used to compare changes over the same period of time for
more than one group.
• Bar graphs are used to compare things between different groups or to track changes
over time
• The purpose of a graph is to present data that are too numerous or complicated to be
described adequately in the text and in less space
Tables:
• Show the number of times that data with certain characteristics occur in a data set
• Tells how many or what proportion of a group has each value or range of value out of
all possible values
Charts:
• Pie charts are best to use when you are trying to compare parts of a whole. They do
not show changes over time.
20
References
Basic Statistics and epidemiology (2001). A practical guide, Radcliffe Medical Press, United
Kingdom
Kazaura, M. R., Makwaya, C. K., Masanja, C. M. and Mpembeni, R.C. (1997). Lecture
notesinBiostatistics, manual of biostatistics, Muhimbili University College of Health Sciences,
Dar es Salaam. (2000) Designing and Conducting Health Systems Research Projects
21
Session 4: Establishing Trends in Health Care
Total Session Time: 120 minutes+ 120 minutes assignment
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
List tables and graph used to determine trend
Generate tables and graphs
Interpret tables and graphs
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
22
SESSION CONTENTS
STEP1: Presentation of Session Title and Learning Tasks (5 minutes)
READ or ASK students to read the learning tasks and clarify
ASK students to pair up and buzz on the following question for 2 minutes
ALLOW few pairs to respond and let other pairs to add on points not mentioned
ASK students to form groups and discuss the following question for 10 minutes
23
Line graph
o A line graph is a diagram that shows a line joining several points, or a line that shows
the relationship between the points.
o A line graph can be taken as x y plane, where there will be an independent variable
and a dependent variable
o It specifies how the two variables are related to each other and vary with respect to
one another.
o Mostly, the independent variable is taken on the x-axis while the dependent variable
on the y-axis.
Steps to Make a Line Graph:
Step 1: Use the data from the table to choose an appropriate scale
Step 2: Draw and label the scale on the vertical and horizontal axis
Step 3: List the each item and locate the points on the graph
Step 4: Connect the points with line segments
You can see a line plotted through two points say A and B on the graph below
Click and drag the points to change the line graph
o Line graph
The data as per given in the table above has been summarized in the form of a line
graph below
24
Line graph have one or more lines plotted on the graph. They are very useful for
showing change over time
o Bar Graph
Bar graph is drawn on an x-y graph and it has labeled horizontal or vertical bars
that show different values.
• The size, length and color of the bars represent different values.
• Bar graph is very useful for non-continuous data and it helps in comparing or
contrasting the size of the different categories of the data provided
• Let’s take an example of the bar diagram and compare the percentage of a
school 90%, 100% and 60% during the year 2000, 2001 and 2002 respectively
o Frequency Polygon
The frequency polygon has most of the properties of a histogram, with an extra
feature
Here the mid-point of each class of the x-axis is marked
Then the midpoints and the frequencies are taken as the plotting point
These points are connected using line segments
We also complete the graph, that is, it's closed by joining to the x-axis.
25
Frequency polygon gives a less accurate representation of the distribution, than a
histogram, as it represents the frequency of each class by a single point not by the
whole class interval
Let’s consider a data table and let’s try to draw frequency polygon of it
• Draw an graph by using data given below:
Step 1:
• First we need the mid-point of the class interval
Class interval Mid-point Frequency
0-10 5 1
10-20 14 3
20-30 25 6
30-40 35 4
40-50 45 2
26
• Histogram
o Histogram is the most accurate graph that represents a frequency distribution
o In the histogram the scores are spread uniformly over the entire class interval
o The class intervals are plotted on the x-axis and the frequencies on the y-axis
o Each interval is represented by a separate rectangle
To plot this take the class limits on the x-axis and the frequency on the y-axis.
On the x-axis, the scale can be 10 units whereas on the y-axis the scale can be
1 unit. Hence, we get
27
WRITE their responses on the flip chart/ board
28
What is a line graph?
29
References
Rao, J. S., & Richard, J. (2002). An introduction to bostatistics-a manual for students in
helthsciences.third edition, New delhi, Circus: Asoke k ghosh.
Basic Statistics and epidemiology (2001). A practical guide, Radcliffe Medical Press, United
Kingdom
Kazaura, M. R., Makwaya, C. K., Masanja, C. M. and Mpembeni, R.C.(1997). Lecture notesin
Biostatistics, manual of biostatistics, Muhimbili University College of Health Sciences, Dar es
Salaam
Sundars, M., Lewis, P and Thornhill, A (2007). Research Methods for Business Students,
Harlow, Prentice Hall.
30
Session 5: Basic Concept of Research
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Define research
Describe research data presentation
Explain the importance of research in pharmaceutical services
Explain the application of research concepts in pharmaceutical services
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
31
SESSION CONTENTS
STEP1: Presentation of Session Title and Learning Tasks (5 minutes)
READ or ASK students to read the learning tasks and clarify
What is research?
32
• A systematic organization of data in columns and rows.
ASK students to pair up and buzz on the following question for 2 minutes
ALLOW few pairs to respond and let other pairs to add on points not mentioned
33
STEP 6: Key Points (5 minutes)
Research is the systematic collection, analysis, and interpretation of data in order to
answer a certain question or solve a problem
Areas of pharmacy research may include medicines policy and governance and quality
assurance and safety
34
References
Stewart A (2001). Basic Statistics and epidemiology, A practical guide, Radcliffe Medical
Press, United Kingdom
Moser CA, Kalton G (1989, 2nd ed.) Survey Methods in Social Investigation. Hants, UK:
Gower Publishing Company. (In particular Chapters 10-13)
Patton MQ (1990, 2nd ed.) Qualitative Evaluation and Research Methods. Newbury Park,
USA: Sage Publications. (In particular Chapters 17-29)
35
Session 6: Types of Research
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Describe types Research
Define the uses and limitations of each type of research
Identify the most appropriate research type for a research proposal
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
36
SESSION CONTENTS
STEP1 Presentation of Session Title and Learning Tasks (5 minutes):
READ or ASK students to read the learning tasks and clarify
Types of research can be classified into several categories according to the nature and
purpose of the study and other attributes.
General Classification of Types of Research Methods
o Types of research methods can be broadly divided into two Quantitative and
Qualitative categories.
Quantitative research “describes, infers, and resolves problems using numbers.
Emphasis is placed on the collection of numerical data, the summary of those data
and the drawing of inferences from the data”
Qualitative research, on the other hand, is based on words, feelings, emotions,
sounds and other non-numerical and unquantifiable elements. It has been noted
that “information is considered qualitative in nature if it cannot be analyzed by
means of mathematical techniques. This characteristic may also mean that an
incident does not take place often enough to allow reliable data to be collected”
37
o Experimental or interventional studies are ones where researchers introduce an
intervention and study the effects. Experimental studies are usually randomized,
meaning the subjects are grouped by chance. Randomized controlled trial (RCT):
Eligible people are randomly assigned to one of two or more groups.
ASK students to pair up and buzz on the following question for 2 minutes
What are the uses and limitation of each study type and design?
ALLOW few pairs to respond and let other pairs to add on points not mentioned
38
o Operations research or operational research is a discipline that deals with the
application of advanced analytical methods to help make better decisions.
o Applied science is the use of scientific processes and knowledge as the means to
achieve a particular practical or useful result
o use their knowledge and skills in creative ways to solve complex problems and
have an impact on critical decisions
o Limitation
Costly: Operation Research (OR) is very costly. This is because Operation
Research makes mathematical models for taking decisions and solving
problems.
Not realistic: Operation Research experts make very complex models for
solving problems. These models may not be realistic.
Complex: Operation Research is very complex concept.
Quantitative research
o Quantitative research provides statistical, mathematical, or numerical results
o tends to analyze phenomena in terms of trends and frequencies
o Limitation
Research quality is heavily dependent on the individual skills of the researcher
and more easily influenced by the researcher's personal biases and
idiosyncrasies.
Rigor is more difficult to maintain, assess, and demonstrate.
Qualitative research
o to find ways to improve such things as customers satisfaction, health
professional's
o It aims to develop concepts that aid in the understanding of natural phenomena
with emphasis on the meaning, experiences and views of the students
o Limitation
Because quantitative research focuses on quantifying a given phenomenon, not
“why” or “how” it has occurred, it doesn’t really shed light on the human
experience attached to that phenomenon
Exploratory studies
An exploratory study is a small-scale study of relatively short duration, which is
carried out when little is known about a situation or a problem. It may include
description as well as comparison.
Used for Small scale studies
Gathers information about unfamiliar phenomenon
Results gives insight to a problem before a large scale study is designed
Descriptive studies
o A descriptive study involves describing the characteristics of a particular situation,
event or case
39
o Can be carried out on a small or large scale
o Limitation
Only describe phenomena: e.g. Person, Place, Time
No analysis of determinants/association e.g. Cross-sectional descriptive
Comparative or analytical studies
o An analytical study attempts to establish causes or risk factors for certain
problems. This is done by comparing two or more groups, some of which have or
develop the problem and some of which have not
o It uses Cross-sectional comparative studies, Case-control studies and Cohort
studies
Cross-sectional comparative studies
• Aim at describing phenomenon and compare groups or determine factors
influencing the phenomenon
• Done at one point in time
• Measurement of exposure and effect are done at the same time
• Quick and cheap, Can elucidate various exposures, as first step in
investigating cause, repeated measures can depict trend, produce data
useful in assessing health care needs
• Limitation
o Not possible to determine if the exposure preceded the outcome
(temporal relationship)
Case-control studies
• In a case-control study the investigator compares one group among
whom the problem that he wishes to investigate is present (e.g.
malnutrition) and another group called a control or comparison group,
where the problem is absent, in order to find out what factors have
contributed to the problem
• Useful for generating/ test hypothesis
• Cheap and quick
• Makes use of comparison (control group)
• Can study more than one risk factor
• Useful for rare disease or long latent period
• limitations
o Data on exposure might be inaccurate and biased
o Difficult to make precise selection of control group
o Retrospective – cannot separate cause and effect
o Cannot be used for rare exposure
o You cannot calculate incidence (you do not know when disease
occurred
Cohort studies
40
• In a cohort study, a group of individuals that is exposed to a risk
factor (study group) is compared to a group of individuals not
exposed to the risk factor (control group)
• Aim at determining risk factors for diseases/outcome
• At the start identify two groups
o With exposure to a risk factor (exposed)
o Without exposure (no-n exposed)
o Both groups have not developed the disease/outcome at the
start
o Follow over time
o At the end, analyses disease/outcome occurrence in both groups
and compare
o Limitations
Needs to get complete and accurate information about
exposure and outcome for all individuals
Time consuming, expensive
Inefficient in evaluating rare diseases
Loss of follow up affect validity of results
STEP 4: Appropriate Study Type for the Research Proposal (30 minutes)
Depending on the existing state of knowledge about a problem that is being studied,
different types of questions may be asked which require different study designs. Some
examples are given in the following
State of knowledge Type of research Type of study
41
school education related Case-control studies
to low school Cohort studies
performance? Is low
fibre diet related to
carcinoma of the large
intestine?)
42
o For these types of problems more rigorous analytical or experimental
studies will have to be conducted before we decide on appropriate
interventions.
43
References
Patton MQ (1990, 2nd ed.) Qualitative Evaluation and Research Methods. Newbury Park,
USA: Sage Publications. (In particular Chapters 17-29)
Kothari C.R (1985). Research Methodology – Methods and techniques, 2nd edition, Wiley
Eastern Limited New Delhi
Ranjit K (205). Research methodology – step by step guide for beginners, 2nd edition,
Singapore, pearson education
44
Session 7: Procedures for Conducting Operational
Research
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Define operational research
Collect relevant data for operational research
Analyze relevant data using operational research techniques
Conclude and recommend for operational research
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
Handout 7.1: Overview of Data Collection Technique
Handout 7.2: Advantages and Disadvantages of using Various Data Collection Tools
Handout 7.3: Focus Group Discussions
Handout 7.4: Function of Focus Group Facilitator
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 05 minutes Presentation Introduction, Learning Tasks
Presentation Definition of Operational Research
2 10 minutes
Buzzing
Presentation Collection of relevant data for Operational research
3 30 minutes Group
discussion
40 minutes Analysis of Data Using Operational Research
4 Presentation
Techniques
20 minutes Conclusion and Recommendation for Operational
5 Presentation
Research
6 05 minutes Presentation Key Points
7 05 minutes Presentation Evaluation
45
SESSION CONTENTS
STEP1: Presentation of Session Title and Learning Tasks (5 minutes)
READ or ASK students to read the learning tasks and clarify
ASK students if they have any questions before continuing
ASK students to pair up and buzz on the following question for 2 minutes
ALLOW few pairs to respond and let other pairs to add on points not mentioned
46
ALLOW few groups to present and the rest to add points not mentioned
Data collection techniques refer to a variety of methods which are used to gather
information for the study.
Data collection techniques allow to systematically collect information about the objects of
study (people, objects, phenomena) and about the settings in which they occur.
In the collection of data we have to be systematic.
If data are collected haphazardly then it will be difficult to answer research questions
in a conclusive way.
o Example of haphazard data collection: During a nutrition survey three different
weighing scales were used in three villages.
The researchers did not record which scales were used in which village.
After completion of the survey it was discovered that the scales were not
standardized
and indicated different weights when weighing the same child.
It was therefore impossible to conclude in which village malnutrition was most
prevalent.
Common Data Collection Techniques in Use
o Reviewing documents
o Observing/observation
o Interviewing (face-to-face)
o Administering written questionnaires
o Focus group discussions
Reviewing Documents
o Documents to be reviewed can be obtained from dispensary, health center, and
hospital records.
For example, analysis of the information routinely collected by health facilities
can be very useful for identifying problems such as flows of drug supply or
increases in the incidence of certain diseases.
o Other sources of data may be Health Information Management System, census,
unpublished reports and publications in archives and libraries or in offices,newspapers
and published case histories
Limitations of Reviewing Documents
o Data are not always easily accessible.
o Ethical issues concerning confidentiality may arise.
o Information may be inaccurate or incomplete.
Observation Technique
o Observation is a technique that involves systematically selecting, watching and
recording behavior and characteristics of living beings, objects or phenomena.
o Observation of human behavior is a much-used data collection technique.
It can be undertaken in different ways:
Participant observation: The observer takes part in the situation he or she
observes.
• For example, a doctor hospitalized with a broken hip, who now observes
hospital procedures from within.
47
o Non-participant observation: The observer watches the situation, openly or concealed,
but does not participate.
Observation becomes a scientific tool and method of data collection for the researcher,
when:
o It serves a formulated research purpose.
o Is systematically planned and recorded.
o Is subjected to checks and controls on validity and reliability.
Advantages of Observation Method
o Subjective bias is eliminated, if observation is accurately done.
o The information relates to what is currently happening.
o Not complicated by either past behavior or future intentions or attitudes.
o Independent of respondent’s willingness to respond and hence less demanding on
active cooperation on the part of the respondents.
o Suitable in studies which deal with subjects who are not capable of giving verbal
reports of their feelings for one reason or the other.
Limitations of Observation Method
o It is an expensive method
o Information provided by this method is very limited
o Sometimes unforeseen events may interfere with the observational task
o Some subjects are rarely accessible to direct observation
o If subjects know that they are being observed, they may change their behaviour
Interviewing Technique
o An interview is a data-collection technique that involves oral questioning of
respondents, either individually or as a group.
o Requires a person known as the interviewer asking questions in a face-to-face contact
to the interviewee or through other means of communication like telephone.
Limitations of Reviewing Documents
o Data are not always easily accessible.
o Ethical issues concerning confidentiality may arise.
o Information may be inaccurate or incomplete.
Observation Technique
o Observation is a technique that involves systematically selecting, watching and
recording behavior and characteristics of living beings, objects or phenomena.
o Observation of human behavior is a much-used data collection technique.
o It can be undertaken in different ways:
Participant observation: The observer takes part in the situation he or she
observes.
• For example, a doctor hospitalized with a broken hip, who now observes
hospital procedures from within.
o Non-participant observation: The observer watches the situation, openly or
concealed, but does not participate.
Observation becomes a scientific tool and method of data collection for the researcher,
when:
o It serves a formulated research purpose.
o Is systematically planned and recorded.
o Is subjected to checks and controls on validity and reliability.
Advantages of Observation Method
48
o Subjective bias is eliminated, if observation is accurately done.
o The information relates to what is currently happening.
o Not complicated by either past behavior or future intentions or attitudes.
o Independent of respondent’s willingness to respond and hence less demanding on
active cooperation on the part of the respondents.
o Suitable in studies which deal with subjects who are not capable of giving verbal
reports of their feelings for one reason or the other.
Limitations of Observation Method
o It is an expensive method
o Information provided by this method is very limited
o Sometimes unforeseen events may interfere with the observational task
o Some subjects are rarely accessible to direct observation
o If subjects know that they are being observed, they may change their behavior
Interviewing Technique
o An interview is a data-collection technique that involves oral questioning of
respondents, either individually or as a group.
o Requires a person known as the interviewer asking questions in a face-to-face contact
to the interviewee or through other means of communication like telephone.
o Answers to the questions posed during an interview can be recorded by writing them
down (either during the interview itself or immediately after the interview) or by tape-
recording the responses, or by a combination of both.
Advantages of the Interview Method
o Detailed information can be obtained.
o Interviewer could overcome resistance of the respondent, if any.
o Provides flexibility to the interviewer to restructure, clarify, or add probe questions.
o Observation can also be applied during interview.
o Is suitable for use with both literates and illiterates.
o Has higher response rate than written questionnaires.
o The interviewer can collect supplementary information about the respondent’s
personal characteristics and environment.
Limitations of Interview
o It is very expensive and time consuming especially when the sample is large.
o Chances of Interviewer as well as interviewee’s bias are high.
o People with certain high level positions like officials or executives may not be easily.
approachable under this method and to that extent the data may prove inadequate.
o Creating effective rapport with the interviewee may be a difficult.
o Some subjects may demand incentives during data collection process.
o There may be a language barrier between an interviewer and interviewee.
Pre-Requisites and Basic Tenets of Interviewing
o Interviewers should be carefully selected and trained
o They must possess technical competence (interviewing and interpersonal skills)
o They should be able to create an atmosphere of trust and confidence
Written Questionnaires
o A written questionnaire (also referred to as self-administered questionnaire) is a data
o collection method in which written questions are presented that are to be answered by
the respondents in written form. The questions can be either open-ended or closed
(with pre categorized answers).
49
o A written questionnaire can be administered in different ways, such as by:
Sending questionnaires by mail with clear instructions on how to answer the
questions and asking for mailed responses;
Gathering all or part of the respondents in one place at one time, giving oral or
written instructions, and letting the respondents fill out the questionnaires; or
Hand-delivering questionnaires to respondents and collecting them later.
Advantages of Questionnaires
o Low cost when study is large
o Free from interviewer bias
o Respondents have adequate time to give out their answers
o Respondents, who are not easily approachable, can be reached
o Used in large studies
o Permits anonymity and may result in more honest responses.
Limitations of Questionnaires
o Low rate of return of the duly filled in questionnaires
o Bias due to non-response is undetermined
o Used only when respondents are educated and cooperating
o Control over questionnaire may be lost
o Not flexible once the questionnaire has been dispatched out
o Ambiguous replies or omissions creating difficult in interpretation
o Slowest method of all when mailing is used
Focus Group Discussions (FGD)
o FGD allows a group of 6 - 12 informants to freely discuss a certain subject with the
guidance of a facilitator or reporter during which group members talk freely and
spontaneously about a certain topic.
Characteristics and Uses of Focus Group Discussions
o A FGD is a qualitative method.
o A FGD aims to be more than a question-answer interaction.
o The idea is that group members discuss the topic among themselves, with guidance
from the facilitator.
o FGD techniques can be used to:
Focus research and develop relevant research hypotheses by exploring in greater
depth the problem to be investigated and its possible causes.
Formulate appropriate questions for more structured, larger scale surveys.
Help understand and solve unexpected problems in interventions.
Develop appropriate messages for health education programmes and later evaluate
the messages for clarity.
Explore controversial topics. For example: Sexual behavior is a controversial
topic in the sense that males and females judge sexual relations and sexuality
often from very different perspectives.
Advantages of FGD
o The researcher can interact with the participants, pose, follow up questions or ask
questions that probe more deeply.
o Results can be easier to understand than complicated statistical data.
o The researcher can get information from non-verbal responses such as facial
expressions or body language.
o Information is provided more quickly than if people were interviewed separately.
Limitations of FGD
50
o The small sample size means the groups might not be a good representation of the
larger population
o Group discussions can be difficult to steer and control, so time can be lost to
irrelevant topics
o Respondents can feel peer pressure to give similar answers to the moderators’
questions
o The moderators skills in phrasing questions along with setting can affect responses
and skew results
Refer students to
Handout 7.1: Overview of Data Collection Technique
Handout 7.2: Advantages and Disadvantages of using Various Data Collection Tools
Handout 7.3: Focus Group Discussions
Handout 7.4: Function of Focus Group Facilitator
51
o Analysis is feasible
o All the information she/he needs has indeed been collected, and in a standardized way
o She/he has not collected unnecessary data which will never be analyzed
o Handling of information becomes systematic and easy
o Tools for analysis and interpreting results are arranged before hand
The plan must be made after careful consideration of the objectives of the study as well as
of the tools developed to meet the objectives.
Note: The procedures for the analysis of data collected through qualitative and
quantitative techniques are quite different.
For quantitative data the starting point in analysis is usually a description of the data for
each variable for all the study units included in the sample.
o Processing of data may take place during data collection or when all data has been
collected, description and analysis are carried out after the fieldwork has been
completed.
For qualitative data it is more a matter of describing, summarizing and interpreting the
data obtained for each study unit (or for each group of study units).
o Researcher starts analyzing while collecting the data so that questions that remains
unanswered (or new questions which come up) can be addressed before data
collection is over.
53
References
Basic Statistics and epidemiology (2001). A practical guide, Radcliffe Medical Press, United
Kingdom
Patton MQ (1990, 2nd ed.) Qualitative Evaluation and Research Methods. Newbury Park,
USA: Sage Publications. (In particular Chapters 17-29)
Kothari C.R (1985). Research Methodology – Methods and techniques, 2nd edition, Wiley
Eastern Limited New Delhi
54
Handout 7.1: Overview of Data Collection Techniques
55
diseases (leprosy, TB, AIDS) are essential observations in a study on stigma.
o Observations of human behavior can form part of any type of study, but as they are
56
o Less flexible methods of interviewing are useful when the researcher is
relatively knowledgeable about expected answers or when the number of
respondents being interviewed is relatively large.
o Then questionnaires may be used with a fixed list of questions in a
standard sequence, which have mainly fixed or pre-categorized answers.
o For example: After a number of observations on the (hygienic) behavior of
women drawing water at a well and some key informant interviews on the
use and maintenance of the wells, one may conduct a larger survey on
water use and satisfaction with the quantity and quality of the water.
Administering Written Questionnaires
o A written questionnaire (also referred to as self-administered questionnaire) is a data
collection tool in which written questions are presented that are to be answered by the
respondents in written form. A written questionnaire can be administered in different
ways, such as by:
Sending questionnaires by mail with clear instructions on how to answer the
questions and asking for mailed responses;
Gathering all or part of the respondents in one place at one time, giving oral or
written instructions, and letting the respondents fill out the questionnaires; or
hand-delivering questionnaires to respondents and collecting them later.
The questions can be either open-ended or closed (with pre-categorized answers).
Projective Techniques
o When a researcher uses projective techniques, she/he asks an informant to react to
some kind of visual or verbal stimulus. For example:
An informant may be provided with a rough outline of the body and be
asked to draw her or his perception of the conception or onset of an illness.
Another example of a projective technique is the presentation of a hypothetical
question or an incomplete sentence or case/study to an informant (‘story with a
gap’).
o A researcher may ask the informant to complete in writing sentences such as:
If I were to discover that my neighbor had TB, I would ...;
If my wife were to propose that I use condoms, I would...
Or (s) he may ask the informant: Suppose your child suffered from diarrhea, what
would you do?
o Such techniques can easily be combined with semi-structured interviews or written
questionnaires. They are also very useful in FGDs to get people’s opinion on sensitive
issues.
o Mapping and Scaling
Mapping is a valuable technique for visually displaying relationships and
resources.
In a water supply project for example:
• mapping is invaluable. It can be used to present the placement of wells,
distance of the homes from the wells, other water systems, etc. It gives
researchers a good overview of the physical situation and may help to
highlight relationships hitherto unrecognized.
• Mapping a community is also very useful and often indispensable as a pre-
stage to sampling.
• Scaling is a technique that allows researchers through their respondents to
categorize certain variables that they would not be able to rank themselves.
57
• For example, they may ask their informant(s) to bring certain types of herbal
medicine and ask them to arrange these into piles according to their
usefulness. The informants would then be asked to explain the logic of their
ranking.
Mapping and scaling may be used as participatory techniques in rapid appraisals
or situation analyses. Rapid appraisal techniques and participatory research are
approaches often used in health systems research.
58
Handout 7.3: Focus group discussions
Uses of Focus Group Discussions
o Help understand and solve unexpected problems in interventions.
For example: In District X, the recent national (polio) immunization days (NID)
showed widely different coverage’s per village (50-90%) and in a number of villages
a marked decrease in coverage was observed compared to last year.
Eight FGD decrease were held with villages mothers, two in town, three in rural with
a marked in NID coverage and three in villages with a high coverage throughout.
59
It appeared that overall, the concept NID had raised confusion.
Most people believed that this mass campaign strengthened the children’s immunity
against any (childhood) disease, including malaria and Respiratory Tract Infections.
In the villages with a low NID coverage there had been a high incidence of malaria in
children immediately after the previous NID campaign and several children died.
Mothers therefore believed that the NID campaign was useless.
• Develop appropriate messages for health education programmes and later evaluate
the messages for clarity.
• For example: A rural health clinic wanted to develop a health education
programme focused on weaning problems most often encountered by mothers in
the surrounding villages and what to do about them.
• The focus group discussion could be used for exploring relevant local concepts as
well as for testing drafts when developing the messages.
• The messages should be developed and tested in different socio-economic groups
of mothers, as weaning practices may differ with income, means of subsistence
and education of the mothers. Also ethnic differences may have to be taken into
account.
o Explore controversial topics.
For example: Sexual behavior is a controversial topic in the sense that males and
females judge sexual relations and sexuality often from very different perspectives.
Sexual education has to take this difference into account.
Through FGDs, first with females, then with males, and then with a mixed group to
confront both sexes with the different outcomes of the separate discussions (listed on
flip charts) it becomes easier to bring these differences in the open. Especially for
teenagers, who may have many stereotypes about the other sex or be reluctant to
discuss the topic openly (particularly girls), such a ‘multi-stage’ approach is useful.
Strengths and Limitations of FDG
o Implementation of FGDs is an iterative process; each focus group discussion builds
on the previous one, with a slightly elaborated or better-focused set of themes for
discussion.
o Provided the groups have been well chosen, in terms of composition and number (see
o below), FGDs can be a powerful research tool which provides valuable spontaneous
information in a short period of time and at relatively low cost.
o FGD should not be used for quantitative purposes, such as the testing of hypotheses or
the generalization of findings for larger areas, which would require more elaborate
surveys.
o However, FGDs can profitably complement such surveys or other, qualitative
techniques.
o Depending on the topic, it may be risky to use FGDs as a single tool.
o In group discussions, people tend to centre their opinions on the most common ones,
on ‘social norms’. In reality, opinions and behavior may be more diverse. Therefore it
is advisable to combine FGDs with at least some key informant and in-depth
interviews.
o Explicitly soliciting other views during FGDs should be routine as well.
o In case of very sensitive topics, such as sexual behavior or coping with HIV/AIDS,
FGDs may also have their limitations, as group members may hesitate to air their
feelings and experiences freely.
o One possible remedy is the selection of students who do not know each other (e.g.,
60
selection of children from different schools in FGDs about adolescent sexual
behavior), while assuring absolute confidentiality.
o It may also help to alternate the FGD with other methods, for example, to precede it
by a self developed role play on sexual behavior, or to administer a written
questionnaire immediately after the FGD with open questions on sexual behavior in
which the students can anonymously state all their questions and problems. This
worked in Tanzania and Nepal.
How to Conduct a Focus Group Discussion
o Determine the purpose
A FGD can be regarded as a mini-study. It therefore requires one or two clear
objectives.
These objectives will guide the research team in the formulation of discussion
questions.
o Situation analysis
Any FGD requires good knowledge of local conditions. Communities are seldom
or never homogeneous. There are always differences between community
members, for example in education, political power, gender, economic status and
ethnic group.
These differences will be reflected in their perceptions of the problems they suffer
from and possible solutions.
A researcher must be aware of these differences, otherwise (s)he may miss
important groups of students or obtain a hotchpotch of information.
Similarly, she/she must know which key persons or organizations could be good
entry points for the selection of students in the FGDs (e.g.: women’s groups,
parent associations, youth clubs, etc.).
For example: In an intervention study on sexual health among out-of-school youth
in an urban area, the researcher first planned some interviews with key informants.
He selected the leaders of a political youth club and of a Christian youth club and
some teachers, with whom he thoroughly discussed his research topic.
• Through them he came in contact with youth of different backgrounds. He let
each of the three groups, separated into boys and girls, draw maps of the town
and asked them to mark places which they thought riskful in terms of sexual
behavior (easy contacts, unprotected sex).
• The drawings formed a good basis for further FGDs but also helped him to
identify wider networks of adolescents at risk who had to be included in the
study.
61
o You might, for example, ask every third or fourth person you find. This method might
be more suitable in urban areas.
o Physical arrangements:
Communication and interaction during the FGD should be encouraged in every
way possible. Arrange the chairs in a circle. Make sure that there will be no
disturbances, sufficient quietness, adequate lighting, etc.
Try to hold the FGD in a neutral setting which encourages students to freely
express their views. A health centre, for example, is not a good place to discuss
traditional medical beliefs or preferences for other types of treatment.
Preparation of a discussion guide:
o There should be a written list of topics to be covered, formulated as a series of open-
ended questions.
o Guides for different groups gathered to discuss the same subject may vary slightly,
depending on their knowledge or attitudes and how the subject should first be
explored with them.
Conducting the session
o One of the members of the research team should act as ‘facilitator’ or ‘moderator’ for
the focus group discussion.
o One should serve as ‘recorder’.
o The facilitator should preferably be as close as possible to the students in their
characteristics (same sex, roughly same age).
62
o Encourage involvement
o Avoid a question-and-answer session. Some useful techniques include:
Asking for clarification: ‘Can you tell me more about...?’
Reorienting the discussion when it goes ‘off the track’: Saying: ‘Wait, how does
this relate to...?’
Saying: ‘Interesting point, but how about...?’
Using one student’s remark to direct a question to another, for example, ‘Mrs. X
said ..., but how about you, Mrs. Y?’
When dealing with a dominant participant, avoiding eye contact or turning
slightly away to discourage the person from speaking, or thanking the person and
changing the subject.
When dealing with a reluctant participant, using the person’s name, requesting
his/her opinion, making more frequent eye contact to encourage his/her
participation.
o Deal correctly with sensitive issues.
o If you notice that the discussion stops when dealing with a sensitive topic, you could
o ask students (if literate) to anonymously write down their responses or opinions on the
topic.
o Alternatively, you could summarize for the group some of the opinions from previous
focus group discussions, focusing on one or two major contrasting opinions.
o Still another strategy is to form sub-groups, and to get a member of the sub-group to
summarize and present the opinions of their sub-group members after which the
whole group can still discuss these opinions.
o Build rapport, empathize
o Observe non-verbal communication.
o Ask yourself, ‘What are they saying? What does it mean to them?’
o Be aware of your own tone of voice, facial expressions, body language, and those of the
students.
o Avoid being placed in the role of expert
o When asked for your ideas or views by a respondent, remember that you are not there
o to educate or inform.
o Direct the questions back to the group by saying: ‘What do you think’, ‘What would
you do?’
o Set aside time, if necessary, after the session to give students the information they
have asked for.
o Do not try to comment on everything that is being said.
o Don’t feel you have to say something during every pause in the discussion.
o Wait a little and see what happens.
o Control the rhythm of the meeting, but in an unobtrusive way
o Listen carefully, and move the discussion from topic to topic. Subtly control the time
allocated to various topics so as to maintain interest.
o If students spontaneously jump from one topic to another, let the discussion continue
for a while since useful additional information may surface; then summarize the
points brought up and reorient the discussion.
o Take time at the end of the meeting to summarize, check for agreement and thank the
Students
o Summarize the main issues brought up, check whether all agree and ask for additional
comments.
63
o Thank the students and let them know that their ideas have been a valuable
contribution and will be used for planning the proposed research, intervention, or
health education materials.
o Listen for additional comments and spontaneous discussions which occur after the
meeting has been closed.
Functions of the Recorder
o The recorder should keep a record of the content of the discussion as well as
emotional reactions and important aspects of group interaction.
o Assessment of the emotional tone of the meeting and the group process will enable
you to judge the validity of the information collected during the FGD.
o Items to be recorded include:
Date, time, place
Names and characteristics of students
General description of the group dynamics (level of participation, presence of a
dominant participant, level of interest)
Opinions of students, recorded as much as possible in their own words, especially
for key statements
Emotional aspects (e.g., reluctance, strong feelings attached to certain opinions)
Vocabulary used - particularly in FGDs that are intended to assist in developing
questionnaires or health education materials
Spontaneous relevant discussions during breaks or after the meeting has been
closed
o It is highly recommended that a tape-recorder be used to assist in capturing
information. Even if a tape-recorder is used, notes should be taken as well, in case the
machine malfunctions and so that information will be available immediately after the
session for discussion.
o If there is no reliable tape-recorder available, it is advisable to have two recorders.
o A supplementary role for the recorder could be to assist the facilitator (if necessary)
by drawing his or her attention to: missed comments from students missed topics (the
recorder should have a copy of the discussion guide during the FGD)
Number and Duration of Sessions
o Number of sessions. The number of focus group sessions to be conducted depends
upon project needs, resources, and whether new information is still coming from the
sessions, (that is, whether contrasting views within and between various groups in the
community are still emerging). If not, you may stop.
o One should plan to conduct at least two FGDs for each sub-group (for example, two
for males and two for females). Otherwise you have no way of assessing whether the
information you get from the first FGD is representative for that group.
Duration
o A focus group session typically lasts up to an hour and a half.
o Generally the first session with a particular type of group is longer than the following
o ones because all of the information is new.
o Thereafter, if it becomes clear that all the groups have a similar opinion on particular
o topics, the facilitator may be able to move the discussion along more quickly to other
o topics which still elicit new points of view.
64
Session 8: Identification of Research Problem
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Identify criteria for selecting health-related problems to be given priority in research
Use a group consensus technique to set priorities for research
Select an appropriate problem for a research proposal
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
Handout 8.1: Formulating the Problem Statement
Handout 8.2: Examples of Research and Non-Research Problems
Handout 8.3: Prioritizing Health Problems for Operational Research
Handout 8.4: Sample Problem Analysis Diagram
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 05 minutes Presentation Introduction, Learning Tasks
Presentation Criteria for Selecting Health-Related Problems to
2 45 minutes Group be Given Priority in Research
discussion
50 minutes Presentation Group Consensus Technique used to Set Priorities
3
Buzzing for Research
4 05 minutes Presentation Key Points
5 05 minutes Presentation Evaluation
6 10 minutes Presentation Assignment: Statement of Problem
65
SESSION CONTENTS
STEP1: Presentation of Session Title and Learning Tasks (5 minutes)
READ or ASK students to read the learning tasks and clarify
ALLOW few groups to present and the rest to add points not mentioned
66
Proposal: A well written report that describes your current thinking about your research
interest.
o All research starts from an interest and a genuine curiosity about something in the
o world around you.
o A proposal is not the same as finished research.
o Proposals are flexible and not ‘written in stone’.
Purpose of Proposal
•Persuade the readers to do something, or to persuade your employer to fund a project or
to implement a program that you would like to launch.
A proposal functions as a guide.
Proposals help to map out your question(s), explain why the question is important to you,
and to identify the steps you will take to try to answer the question(s).
Help to communicate to others, while reminding yourself what you are doing, why you
are doing it, and how and when you plan to do it,.
The most basic composition of a proposal, as with any other written document, is it needs
a beginning (the introduction), a middle (the body of material to be presented) and an end
(the conclusion/recommendation).
Research Proposal: A document written by a scientist that describes in details the
program for a proposed scientific investigation.
It can be envisaged as the process (step by step guidelines) of planning and giving
structure to the prospective research, with the fina1 aim of increasing the validity of the
research.
It is a written submission to spell out the nature of the design and the means and strategies
that are going to be used in a logic format.
Purpose of Research Proposal
o Provides a defined topic scope for researching.
o Helps you to understand further how to address the technical problems of writing
research.
Components of Research Proposals
o Title
o Rationale of the Research study
o Problem statement/question
o Hypotheses statement/Goals and Objectives
o Study limitations
o Definition of terms
o Importance/Significance of the study
o Literature Review
o Methodology
o Time schedule
o Budget (where applicable)
o Researcher's qualifications
o References
67
Rationale and Statement of the Problem
The Rationale specifies the reasons for conducting the research in light of current
knowledge.
It should include a well-documented statement of the need/problem that is the basis of the
study, the cause of this problem and its possible solutions.
It should answer the question of why and what: why the research needs to be done and
what will be its relevance.
The magnitude, frequency, affected geographical areas, ethnic and gender considerations;
of the problem scientific evidence in literature.
Statement of the Problem
The first step in the development of research proposal is to state the research problem
o A focal point of your research in precise and clear statement.
o Definition of the problem is essential in order to give clarity and focus of the research
o The statement of the problem:
Is essential in the planning of the research (e.g. research objectives, hypothesis,
methodology, work plan and budget)
Is an integral part in selecting a research topic
Helps in selection of the design and method to answer the question
It gives focus and importance of the problem and need for research
How to Formulate Statement of the Problem
o Importance of stating and defining the problem
A clear statement of the problem is the foundation for the further development of
the findings. Therefore, it is critical to thoroughly analyze and state your problem
clearly. (Research objectives, hypotheses, key variables and methodology for
measuring the variables, work plan, budget).
This is very important for your research proposal. A poor problem statement will
dilute or mislead your whole study
A clear problem statement makes it easier to find information and reports of
similar studies from which your own study design can benefit.
It also enables you to systematically point out the justification for undertaking the
proposed research, and what you hope to achieve with the study results.
o This is important to highlight when you present your project to community
members, other health staff, relevant ministries and donor agencies who need
to support your study or give their consent for participation.
Characteristics of a good question
o A question which:
can be answered by a research study
get adequate cases/subjects to answer the question
is affordable in time and money
is practical and feasible
is interesting to the researcher
can provide new answers or refute previous answers or extends previous studies
68
o Identify possible contributing factors, use problem analysis diagram
o
Inaccessible Unaware of
facilities symptoms/
signs
Delay in
leprosy
diagnosis
Negative
Unskilled
attitude to
health
modern
worker
health care Lack of
diagnostic
facilities
Determine relationship between the problem and the possible contributing factors
o How do possible contributing factors lead to the problem?
o Direct relationship (proximal/primary factors)
Too many possible factors?
o Regroup the contributing factors into broad categories where appropriate
o Example:
Health service factors
Patient factors
Community factors
o Decide on the focus and scope of the research
Not necessary to research on all factors if too many
ASK students to pair up and buzz on the following question for 2 minutes
‘What are group consensus technique used to set priorities for research?
ALLOW few pairs to respond and let other pairs to add on points not mentioned
69
CLARIFY and SUMMARIZE by using the content below
When there are many potential topics for research, a decision should be made to
select one, which is of high priority
To do so, we need to compare the topics using some criteria.
o Example of useful criteria
Relevance
Avoidance of duplication
Urgency of data (timeliness)
Political acceptability of study
Feasibility of study
Applicability of results
Ethical acceptability
Relevance: the topic should be relevant
o Questions to ask:
How large or widespread is the problem?
Who is affected?
How severe is the problem?
70
o Rating scale (scores)
1=Topic not acceptable
2=Topic slightly acceptable
3=Topic fully acceptable
Feasibility of study: Can the study be done with the available resources?
o Consider human, material, financial, time
Rating scale (scores)
• 1=Study not feasible
• 2=Study feasible
• 3=Study very feasible
Applicability of results: Is it likely that the recommendations from the study will
be implemented?
Rating scale (scores)
• 1=No chance of being implemented
• 2=Some chance of being implemented
• 3=Good chance of being implemented
Ethical acceptability: Is the study going to cause ethical concerns?
o Questions to ask: Acceptability by research students; Can consent
to participate be easily obtained? Will the students be injured in
any way?
Rating scale (scores)
• 1=Major ethical problems
• 2=Minor ethical problems
• 3=No ethical problems
Present to a group for further input and consensus using a scoring table
After carefully assessing and scoring your topics based on the criteria, select the
one with the highest score.
71
STEP 6: Assignment (10 minutes)
72
References
Hardon A, Boonmongkon P, and Streefland P. et al (editors) (2001). Applied Health research,
Anthropology of health and health care, third revised edition,, Het Spinhuis Publishers, The
Netherlands
Patton MQ (1990, 2nd ed.). Qualitative Evaluation and Research Methods, Newbury Park,
USA: Sage Publications. (In particular Chapters 17-29)
Kothari C.R (1985). Research Methodology – Methods and techniques, 2nd edition, Wiley
Eastern Limited New Delhi
73
Handout 8.1: Formulating the Problem Statement
Importance of a Well-Defined Problem
o A poorly defined research problem leads to confusion.
o A well-defined research problem statement leads to:
Statement of research objectives
Hypotheses
Definition of key variables
Selection of a methodology for measuring the variables
Foundation for the further development of the research proposal
Ease in finding find information and reports of similar studies from which your
own study design can benefit
Systematic justification for undertaking the proposed research, and what the
researcher he/she hope to achieve with the study results
This is important to highlight when you present your project to community
members, health staff, relevant ministries and donor agencies who need to support
your study or give their consent.
Statement of the Problem Includes:
o Identification, definition, and justification of the research problem
o One of the most important first tasks of research is to identify and clearly define the
problem you wish to study.
o If you are uncertain about the research problem or if you are not clear in your own
mind about what you want to study, others who read your proposal will also be
uncertain.
o Problem Identification and definition
o While it is always possible to guess why a problem exists, guesses are often wrong
and usually do not provide a firm basis for designing a research study.
o A far better way to define a problem situation is to review relevant literature, examine
current service statistics, seek educated opinions from persons concerned about the
problem, and obtain probable reasons for the problem from social, economic, or
health theory.
o Follow this general procedure when identifying and defining a problem situation:
Start with a simple statement of the problem situation.
Add details as you review the literature, review theoretical concepts, and
investigate the problem in greater depth.
Simplify the focus by identifying the most important aspects of the problem that
are researchable.
Make a first attempt at identifying the problem situation by using the following format:
o Problem Situation: Write a small, simple paragraph that identifies the problem.
o Discrepancy: State the discrepancy between what is and what should be.
o Problem Question: Write down the central problem question.
o Possible Answers: Write two or more plausible answers to the problem question.
From the available research literature, health and behavioral theory, current service
74
statistics, educated opinions and other sources of information, try to add details to the
problem situation you have just identified.
Look for theoretical concepts and operational variables that you may have missed. List
these concepts and variables on a piece of paper as you come across them. Try to answer
the following questions:
o What are the incidence and prevalence of the problem?
o Which geographic areas are affected by the problem? Which population groups are
affected by the problem?
o What are the findings of other research studies?
o What has been done to overcome the problem in the past?
o How successful were past efforts to overcome the problem?
o What seem to be major unanswered questions about the problem?
With the information you have collected from a literature review and other sources,
rewrite your statement identifying and defining the problem. Use the format described
above:
o Problem Situation, Discrepancy, Problem Question, and Possible Answers
o Add details that help to define the problem, but organize the information. Try to
establish the boundaries of the problem.
o Focus your attention on the most important, researchable aspects of the problem.
Have one or more colleagues read your final statement identifying and defining the
problem situation. If they are unclear about the problem situation or cannot describe the
discrepancy between what is and what should be, then go back to the beginning and start
all over again.
Problem Identification
o Finding a problem is not difficult, but identifying one for the purpose of research is
not always easy.
o Identifying a problem situation is the first essential step in designing a research
proposal, but it must then be followed by a process of problem definition.
o The research problem identified must be defined in terms of its occurrence, intensity,
distribution, and other measures for which data are already available.
o The aim is to determine all that is currently known about the problem and the reason
it exists.
o All research is set in motion by the existence of a problem.
o 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.
o While problems are the initiating force behind research, not all problems require
research.
o A potential research situation arises when three conditions exist:
A perceived discrepancy exists between what is and what should be.
A question exists about why there is a discrepancy.
At least two possible and plausible answers exist to the question.
• If there is only one possible and plausible answer to the question about the
discrepancy, then a research situation does not exist.
Problem Justification
o After the problem is identified, it is necessary next to justify the importance of the
problem. Research often is expensive and time consuming.
o Find out why the problem you wish to study is important.
75
Ask yourself the following questions: Can you justify your selection of the research
problem? Can you convince others that the problem is important?
What to Do: Justifying the Selection of a Research Problem
o In justifying the importance of a research problem, it is helpful to ask yourself a series
of questions and then try to answer each of them.
Is the problem you wish to study a current and timely one?
Does the problem exist now? How widespread is the problem? Are many areas
and many people affected by the problem?
Does the problem affect key populations, such as youth, people living with
HIV/AIDS
(PLHA), mothers, or children?
Does the problem relate to ongoing program activities?
Does the problem relate to broad social, economic, and health issues, such as
unemployment, income distribution, poverty, the status of women, or education?
Who else is concerned about the problem? Are top government officials
concerned? Are medical doctors or other professionals concerned?
o Review your answers to these questions, and arrange them into one or two paragraphs
that justify the importance of the research problem.
o Start by discussing the broad issues that justify the problem and then begin to focus
on the more specific issues related to a particular population group or geographical
setting.
Sample Research Problem Justification
o Over time, millions of HIV-infected people in Africa and elsewhere in the world are
developing HIV-related illnesses. In most African countries, hospitals, clinics, and
other formal health care institutions simply cannot cope with the large numbers of
people in need of physical care and social and psychological support.
o In some hospitals, well over half of the beds are already occupied by AIDS patients.
In some countries the figure is as high as 70 percent of all hospital beds. This is a
problem of great concern to health care planners, as well as to the Ministry of
Finance, which simply does not have the resources to build new facilities or train
large numbers of new providers.
o The problem of providing care and support for PLHA is particularly challenging in
rural areas because there are relatively few health facilities or adequately trained
providers available. In this situation, an alternative is to provide care, support, and
treatment in the homes of those with AIDS. How to do this in a cost-effective manner
while simultaneously providing high-quality services is a challenge.
o New models of delivering care and support services in rural areas need to be
developed and tested to improve the quality of life for PLHA.
o Without effective new approaches, large numbers of people with AIDS will suffer
physical and psychological pain that might otherwise be avoided or at least lessened.
Comments on the Sample Justification:
o The first paragraph establishes the dimensions of the problem. The large number of
people with AIDS cannot be adequately treated or supported by the formal health care
system, which is already overwhelmed in many countries.
o The second paragraph notes that the problem is particularly acute in rural areas, where
health facilities and providers are relatively few in number. An alternative is to
provide services to PLHA in their homes. The important question is how to do this.
o The paragraph ends by saying that without the development of new approaches to
care and support, large numbers of PLHA will needlessly suffer.
76
Handout 8.2: Examples of Research and Non-Research Problems
77
o Possible Answers
Villages differ in their socioeconomic environments, and these differences influence
the context within which HIV is transmitted.
Some are stable agricultural villages, while some are mobile fishing communities.
Some villages are located on major roads and have easy access to market towns;
others are more remote with very difficult access to market centers. Some villages
have schools, health clinics, electricity, and a good water supply, while others do not
have these advantages.
These and many other social, economic, and cultural differences affect the context
within which sexual relations take place and HIV is transmitted.
Villages differ in individual and institutional support for HIV/AIDS prevention, care,
and support programs.
In some villages, influential local leaders strongly support sexual behavior change and
condom distribution programs.
In other villages, people are resistant to these programs, and there is substantial
stigma and discrimination associated with HIV/AIDS.
In some villages, there are very active anti-AIDS clubs for youth, strong PLHA
organizations, and effective orphan care NGOs.
In other villages these institutions are absent. These differences in individual
commitment to and institutional support for HIV/AIDS programs affect the sexual
behavior of individuals, the use of condoms, the level of stigma and discrimination,
and the transmission of HIV.
o While the problem situation presented above is fairly clear, the possible and plausible
reasons for the problem are complex. Several of these reasons have been described, but it
is very likely there are many more.
o In situations such as this one, the researcher must devote considerable time and attention
to identifying and clearly defining the problem situation before any potential solutions to
the problem can be tested experimentally through a longitudinal operations research
study.
o The aim of clearly identifying and defining a problem situation is to focus the research on
the most important aspects of a problem that can be changed through a program
intervention.
78
Handout 8.3: Prioritizing Health Problems for Operational Research
Relevance
o The topic you choose should be a priority problem.
o Questions to be asked include:
How large or widespread is the problem?
Who is affected?
How severe is the problem?
o If you do not consider a topic relevant, it is not worthwhile to continue rating it. In
that case you should drop it from your list.
o Try to think of serious health problems that affect a great number of people or of the
most serious problems that are faced by clinicians in the area of your work.
o Also, consider the question of who perceives the problem as important. Health
managers, health staff and community members may each look at the same problem
from different perspectives.
o Community members, for example, may give a higher priority to economic concerns
than to certain public health problems.
o To ensure full participation of all parties concerned, it is advisable to define the
problem in such a way that all have an interest in solving it. Even within villages,
opinions may differ on how important a problem is.
o It is therefore obligatory to discuss the problem with community leaders, as well as
peripheral villagers, males as well as females, rich and poor, exploring their
perceptions of the problem.
Avoidance of Duplication
o Before you decide to carry out a study, it is important that you find out whether the
suggested topic has been investigated before, either within the proposed study area or
in another area with similar conditions.
o 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.
o Also, consider carefully whether you can find answers to the problem in already
available, unpublished information or just by using your common sense. If so, you
should drop the topic from your list.
Urgency of Required Solution (Timeliness)
o How urgently are the results needed for making a decision or developing interventions
at various levels (from community to policy)? Consider which research should be
done first and which can be done later.
Political Acceptability
o In general it is advisable to research a topic which has the interest and support of the
local/national authorities. This will increase the chance that the results of the study
will be implemented.
o Under certain circumstances, however, you may feel that a study is required to show
that the government's policy needs adjustment. If so, you should make an extra effort
to involve the policy-makers concerned at an early stage, in order to limit the chances
for confrontation later.
79
Feasibility
o Look at the complexity of the problem and the resources you will require to carry out
your study and time required for intervention. Thought should be given first to
manpower, time, equipment and money that are locally available.
o In situations where the local resources necessary to carry out the processes are not
o sufficient, you might consider resources available at the national level. Finally,
explore the possibility of obtaining technical and financial assistance from external
sources.
Applicability of Possible Results/Recommendations
o Is it likely that the recommendations from the study will be applied? This will depend
not only on the management capability within the team and the blessing of the
authorities but also on the availability of resources for implementing the
recommendations.
o Likewise, the opinion of the potential clients and of responsible staff will influence
the implementation of recommendations.
Ethical Acceptability
o We should always consider the possibility that we may inflict harm on others while
carrying out research or any intervention.
o Therefore, consider important ethical issues such as:
How Cultural sensitivity must be given careful consideration.
Informed consent be obtained from the research subjects.
Will the condition of the subjects be taken into account? For example, if
individuals are identified during the study who require treatment, will this
treatment be given?
What if such treatment interferes with your study results?
• Will the results be shared with those who are being studied?
• Will the results be helpful in improving the lives or health of those studied?
Scales for rating research topics
o These criteria can be measured by the following rating scales:
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
80
Feasibility
1. = Study not feasible, considering available resources
2. = Study feasible, considering available resources
3. = Study very feasible, considering available resources
Applicability
1. = No chance of recommendations being implemented
2. = Some chance of recommendations being implemented
3. = Good chance of recommendations being implemented
Ethical acceptability
1. = Major ethical problems
2. = Minor ethical problems
3. = No ethical problems
81
Handout 8.4: Sample Problem Diagram
Figure below shows the initial problem diagram – complications from unsafe
82
Session 9: Analysis and Statement of the Problem
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Identify factors contributed to the problem.
Clarify the relationship between the problem and contributing factors.
Decide on the scope and focus of the research
Formulate the problem statement
Prepare the statement of the problem
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Ste Activity/
Time Content
p Method
1 05 minutes Presentation Introduction, Learning Tasks
Presentation Factors Contributed to the Problem.
2 30 minutes
Group discussion
15 minutes Presentation Relationship Between the Problem and
3 Contributing Factors.
Brainstorming
83
SESSION CONTENTS
STEP1: Presentation of Session Title and Learning Tasks (5 minutes)
READ or ASK students to read the learning tasks and clarify
ALLOW few groups to present and the rest to add points not mentioned
84
Identify further contributing factors.
o Extend the problem analysis diagram further by identifying additional factors that
could have contributed to or aggravated the problem.
o It may be possible to identify several ‘generations’ of predisposing factors, by asking
‘but why’
Organise related factors together into larger categories and develop final draft diagram.
For example
o Many researchers group contributing factors into four main categories:
Socio-cultural factors
Economic factors
Service-related factors
Disease-related factors
ASK students to pair up and buzz on the following question for 2 minutes
ALLOW few pairs to respond and let other pairs to add on points not mentioned
85
o Two-way arrows (for mutual relationships)
The core problem can be identified by drawing a double line around it
Note that many of the perceived problems mentioned in step 1 are related to each other in
a cause-effect relationship e.g.
o Poor management of complications from abortion and high complication rate from
abortions, or
o In a mutual relationship (stigma on induced abortion and secrecy surrounding induced
abortion).
86
References
Hardon A, Boonmongkon P, and Streefland P. et al (editors)(2001). Applied Health research,
Anthropology of health and health care, third revised edition,, Het Spinhuis Publishers, The
Netherlands
Kitaly F (…..). Operational Research (unpublished), Muhimbili University College of Health
Sciences, Dar es Salaam
Kothari C.R (1985). Research Methodology – Methods and techniques, 2nd edition, Wiley
Eastern Limited New Delhi
87
Session 10: Literature Review in Research
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Describe the reasons for reviewing available literature
Identify the resources that are available for carrying out such a review.
Prepare index cards for summarize important information obtained from literature
Prepare a review of literature pertaining to research topic
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
Presentation
2 30 minutes Reasons for Reviewing Available Literature
Group discussion
Presentation Identification of Resources that are Available
3 10 minutes
Brainstorming for Carrying Out Literature Review.
88
SESSION CONTENTS
ALLOW few groups to present and the rest to add points not mentioned
A literature review is the reading of the works of others before starting your research and
doing a summary about previous studies on the topic.
A literature review provides a helpful guide to a particular topic.
It can be used as a foundation and as a support for a new insight that you contribute.
The focus of a literature review is to summarize and synthesize the arguments and ideas
of others without adding new contributions.
A researcher needs to find out what has been done already, and build on that foundation,
because scientific research is cumulative.
o This involves determining what has been done and what still needs to be done, and
examining what books and professional journals have already revealed in in your area
89
Figure 10.1Sources of Information at Various Levels of Administrative System
90
o At the end of your paper, list your references in order, using the format described
above.
o In research proposals, the references come before the annexes.
o Select one style of references (such as Vancouver, Harvard, etc.) and use it
consistently for citations and reference lists in your proposal.
Bias in Literature
o Bias: A distortion of the available information in such a way that it reflects opinions
or conclusions which do not represent the real situation.
o Understanding the various types of bias helps to be critical of the existing literature.
o If you have reservations about certain references or if you find conflicting opinions in
the literature, then discuss these openly and critically. Such a critical attitude may
help you to avoid biases in your study.
o Common types of bias in literature include
Playing down controversies and differences in one's own study results.
Restricting references to those that support the point of view of the author.
Drawing far reaching conclusions from preliminary or shaky research results or
making sweeping generalizations from just one case or small study.
ASK students to pair up and buzz on the following question for 2 minutes
‘What are the resources that are available for carrying out literature review?
ALLOW few pairs to respond and let other pairs to add on points not mentioned
Resources that are available for carrying out literature review include:
o People (individuals or groups, organizations)
o Publications (books which compile research information, journals (hard or electronic
copies)
o Unpublished information [grey literature) e.g. Dissertation, research reports not in
journals
o Supervisors and fellow students
Sources could be at different levels of administrative system
o Community level, district and regional levels and provincial level
91
o National levels – e.g. national libraries, Ministries of Health, central statistics, etc.
o International levels – UNICEF, WHO, USAID, etc.; including computerized search
for international literature
o Read through
o Summarize the content relevant to your study (use index card)
Note pertinent information
• Title of article
• Author
• Title of Journal/Book, Page, Year, etc (see later)
• Aim of study
• Methodology
• Major findings
• Utility of information
Write the literature review section
Prepare list of references
92
STEP 6: Key Points (10 minutes)
Literature review or search is “a systematic and thorough search of all types of published
literature in order to identify as many items as possible that are relevant to a particular
topic”
Resources that are available for carrying out such a review are people, publications,
unpublished information, supervisors and fellow students
93
References
Hardon A, Boonmongkon P, and Streefland P. et al (editors) (2001). Applied Health research,
Anthropology of health and health care, third revised edition,, Het Spinhuis Publishers, The
Netherlands
Kothari C.R (1985). Research Methodology – Methods and techniques, 2nd edition, Wiley
Eastern Limited New Delhi
94
Session 11: Research Objectives and Questions
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Write an introduction to research proposal
Define general and specific objectives
Define the characteristics of research objectives
State the difference between general and specific objectives
Prepare research objectives in an appropriate format for the project you are developing
Develop research questions appropriate for the study
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
Handout 11.1: Broad and Specific Objectives
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 05 minutes Presentation Introduction, Learning Tasks
Presentation
2 10 minutes Introduction to Research Proposal
Brainstorming
10 minutes Presentation
3 Definition of General and Specific Objectives
Brainstorming
20 minutes
4 Presentation Characteristics of Research Objectives
Presentation
5 20 minutes The Difference Between General and Specific
Brainstorming Objectives
20 minutes Presentation
6 Preparation of Research Objectives in an Appropriate
Brainstorming
Format for the Developed Project
25 minutes Presentation
7 Development of Research Questions Appropriate for
Brainstorming
the Study
8 05 minutes Presentation Key Points
9 05 minutes Presentation Evaluation
95
SESSION CONTENTS
o What did we know about this topic before I did this study?
o How will this study advance new knowledge or new ways of understanding?
o First, ensure that you summarize prior studies about the topic in a manner that lays a
foundation for understanding the research problem
o Second, explain how your study specifically addresses gaps in the literature,
insufficient consideration of the topic, or other deficiency in the literature
o third, note the broader theoretical, empirical, and/or policy contributions and
implications of your research
96
STEP 3: Definition of General and Specific Objectives (10 minutes)
ASK students to pair up and buzz on the following questions for 2 minutes
What is objectives?
ALLOW few pairs to respond and let other pairs to add on points not mentioned
97
time-span.
Budget: Estimated cost of activities to be incurred in a research.
Research studies should include a statement of
o Broad objective
o Specific objectives
o Hypotheses (except in the case of purely exploratory or descriptive studies)
Why should research objectives be developed?
o To clarify and focus your intentions /focus the study (narrowing it down to essentials).
o To have a basis for measuring your achievements at the end of the study.
o To avoid the collection of data which are not strictly necessary for understanding and
solving the problem you have identified.
o To organize the study in clearly defined parts or phases.
o To facilitate the development of your research methodology and orient the collection,
analysis, interpretation and utilization of data.
STEP 4: Characteristics of Research Objectives (20 minutes)
Activity: Brainstorming (10 minutes)
98
An objective indicating how the results will be used should be included in every
operational study, either as part of the general objective or as a specific objective.
99
Alternation hypothesis (working hypothesis) is stated to indicate the actual
expectation.
It is donated as (Ho).
Difference between Null Hypothesis and Alternative Hypothesis
o The Null Hypothesis denies the existence of any significant differences between any
compared values and stresses that even when such differences are observed, they have
occurred by chance.
o The Alternative Hypothesis is formulated in a way as to reject the null hypothesis. It
states that there is a significant cause of the observed differences between compared
values and that the difference did not happen by chance.
100
o identity?
It's absolutely essential to develop a research questions that you're interested in or care
about in order to focus your research
o For example,
Researching a broad topic such as "business management" is difficult since there
may be hundreds of sources on all aspects of business management.
On the other hand, a focused question such as "What are the pros and cons of
Japanese management style?" is easier to research and can be covered more fully
and in more depth.
How do you develop a usable research question?
o Choose an appropriate topic or issue for your research, one that actually can be
researched
o Then list all of the questions that you'd like answered yourself.
o Choose the best question, one that is neither too broad nor too narrow.
o Sometimes the number of sources you find will help you discover whether your
research question is too broad, too narrow, or okay?
o If you know a lot about the topic, you can develop a research question based on your
own knowledge. If you feel you don't know much about the topic, think again.
o It's a good idea to evaluate your research question and to ask for feedback on your
research question.
Example: Choose a Question that is Neither Too Broad or Too Narrow
o For example, if you choose juvenile delinquency (a topic that can be researched), you
might ask the following questions:
What is the 1994 rate of juvenile delinquency in the U.S.?
What can we do to reduce juvenile delinquency in the U.S.?
Does education play a role in reducing juvenile delinquents' return to crime?
o Once you complete your list, review your questions in order to choose a usable one
that is neither too broad nor too narrow.
o In this case, the best research question is "three"
Question "one" is too narrow, since it can be answered with a simple statistic
Question "two" is too broad; it implies that the researcher will cover many tactics
for reducing juvenile delinquency that could be used throughout the country
Question "three," on the other hand, is focused enough to research in some depth
101
STEP 8: Key Points (5 minutes)
Writing introduction to research proposal leads the reader from a general subject area to a
particular topic of inquiry
The general objective of a study states what is expected to be achieved by the study in
general terms
Specific objectives explain the broad objective in specific
102
References
Hardon A, Boonmongkon P, and Streefland P. et al (editors) (2001). Applied Health research,
Anthropology of health and health care, third revised edition,, Het Spinhuis Publishers, The
Netherlands
Kothari C.R (1985). Research Methodology – Methods and techniques, 2nd edition, Wiley
Eastern Limited New Delhi
103
Handout 11.2: Examples of Broad and Specific Objectives
First Example
A study into the cost and quality of home-based care for HIV/AIDS patients and their
communities in Tanzania, developed at an HSR workshop, for example, had as its general
objective:
o To explore to what extent Community Home-Based Care (CHBC) projects in
Tanzania provide adequate, affordable and sustainable care of good quality to people
with HIV/AIDS, and to identify ways in which these services can be improved.
o It was split up in the following specific objectives:
To identify the full range of economic, psychosocial, health/nursing care and other
needs of patients and their families affected by AIDS.
To determine the extent to which formal and informal support systems address
these needs from the viewpoint of service providers as well as patients.
To determine the economic costs of CHBC to the patient and family as well as to
the formal CHBC programme.
To relate the calculated costs to the quality of care provided to the patient by the
family and to the family/patient by the CHBC programme.
To determine how improved CHBC and informal support networks can contribute
to the needs of persons with AIDS and other chronically and terminally ill
patients.
To use the findings to make recommendations on the improvement of CHBC to
home care providers, donors and other concerned organisations, including
government.
In the example given above, the needs of AIDS patients and their relatives for care and
support have been defined in the first objective. The objectives which follow concentrate
on adequacy, cost and quality of care provided whereas the last two objectives specify
possible improvements with respect to CHBC, and to whom the results and
recommendations of the study will be fed back
104
Second Example
A project to reduce infant mortality by 30%: The broad objective could be:
o To reduce infant mortality by 30 percent within a period of six years by improving access
and use of insecticide impregnated bed nets in district A.
o From the broad objective stated above, the specific objectives could be:
To increase availability of insecticide impregnated bed nets at retailer shops and
MCH clinics to 100 percent within 3 years in district A.
To increase the proportion of households with ITN by 60 percent within 3 years in
district A.
To increase utilization of insecticide impregnated bed nets at household level to
80 percent within 4 years in district A.
To ensure that 80 percent of under five children sleeping under ITN within 4 years
in district A.
To determine reduction of under-five mortality by 30 percent at the end of six
years of the intervention in district A.
105
Session 12: Research methods
106
Total Session Time: 120 minutes
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Describe the study types most used in research
Explain uses and limitation of each study type most used in research
Describe how the study design can influence the validity and reliability of the study result
Identify the most appropriate study design for research
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
SESSION CONTENTS
107
STEP1: Presentation of Session Title and Learning Tasks (5 minutes)
READ or ASK students to read the learning tasks and clarify
Descriptive
o A descriptive study involves describing the characteristics of a particular situation,
event or case
o Descriptive studies
Can be carried out on a small or large scale
Small scale, descriptive case studies
describe in-depth the characteristics of one or a limited number of ‘cases’ e.g.
patient; village
provide quite useful insight into a problem
Analytical
o An analytical study attempts to establish causes or risk factors for certain
problems.
o Is done by comparing two or more groups some of which have or develop the
problem and some of which have not
o Analytical studies
Describe phenomena, and
Analyze relationship between phenomena and other variables
(determinants/association
Applied
o Research can either be applied (or action) research or fundamental (to basic or
pure research.
108
o Applied research aims at finding a solution for an immediate problem facing a
society or an industrial/business organization
Fundamental
o Fundamental research is mainly concerned with generalizations and with the
formulation of a theory.
o “gathering knowledge for knowledge’s sake is termed ‘pure’ or ‘basic’ research.”4
research concerning some natural phenomenon or relating to pure mathematics are
examples of fundamental research.
Quantitative
o Quantitative research is based on the measurement of quantity or amount. It is
applicable to phenomena that can be expressed in terms of quantity.
o Quantitative research is inquiry into an identified problem, based on testing a
theory, measured with numbers, and analyzed using statistical techniques.
o The goal of quantitative methods is to determine whether the predictive
generalizations of a theory hold true.
Qualitative
o Qualitative research, on the other hand, is concerned with qualitative
phenomenon, i.e., phenomena relating to or involving quality or kind.
o For instance, when we are interested in investigating the reasons for human
behavior (i.e., why people think or do certain things), we quite often talk of
‘Motivation Research’, an important type of qualitative research.
Conceptual
o Conceptual research is that related to some abstract idea(s) or theory.
o It is generally used by philosophers and thinkers to develop new concepts or to
reinterpret existing ones.
Empirical
o Empirical research relies on experience or observation alone, often without due
regard for system and theory.
o It is data-based research, coming up with conclusions which are capable of being
verified by observation or experiment.
o We can also call it as experimental type of research.
o In such a research it is necessary to get at facts firsthand, at their source, and
actively to go about doing certain things to stimulate the production of desired
information.
109
STEP 3: Uses and Limitation of Each Study Type Most Used in Research
(40 minutes)
ASK students to pair up and buzz on the following question for 2 minutes
‘What are the uses and limitation of each study type most used in research?
ALLOW few pairs to respond and let other pairs to add on points not mentioned
Analytical studies
o Cross-sectional studies
Quick and cheap
Can reveal various exposures, as first step in investigating the cause
Repeated measures can depict( represent) trend
Data useful in assessing health care needs
But, have the following disadvantages
• Not possible to determine if the exposure preceded the outcome
Cohort studies
o Allows direct measurement of incidence of disease
o Multiple effects of single exposure can be examined
o Can reveal relationship between exposure and disease
o Is of value when exposure is rare
o Minimize bias in ascertainment of exposure
o But have the following disadvantages
Time consuming, expensive
Inefficient in evaluating rare diseases
Loss of follow up affect validity of results
Case –control study
o Relatively quick and inexpensive
o Suitable for rare diseases
o Can evaluate effect of multiple exposures
o Is of value for diseases with long latent periods
o But have the following disadvantages
Inefficient in evaluating rare exposures
110
Temporal relationship between exposure and disease difficult to ascertain
Prone to recall bias
Descriptive studies
o Describe in-depth the characteristics of one
o Provide quite useful insight into a problem
o But have the following disadvantages
111
What is the most appropriate study design for research proposal?
112
References
Hardon A, Boonmongkon P, and Streefland P. et al (editors) (2001). Applied Health research,
Anthropology of health and health care, third revised edition,, Het Spinhuis Publishers, The
Netherlands
Kothari C.R (1985). Research Methodology – Methods and techniques, 2nd edition, Wiley
Eastern Limited New Delhi
Stewart A (2001). Basic Statistics and epidemiology, A practical guide, Radcliffe Medical
Press, United Kingdom
113
Session 13: Research Sampling
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Define the common terms used in sampling
Identify the population(s) to be studied
Describe common methods of sampling
Explain reasons for sampling
Describe source of bias in sampling that should be avoided
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
Handout 13.1: Types of sampling methods and when to use it
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 05 minutes Presentation Introduction, Learning Tasks
114
SESSION CONTENTS
STEP1: Presentation of Session Title and Learning Tasks (5 minutes)
READ or ASK students to read the learning tasks and clarify
ASK students to pair up and buzz on the following question for 2 minutes
ALLOW few pairs to respond and let other pairs to add on points not mentioned
115
which we want to draw a sample?
How many people do we need in our sample?
How will these people be selected?
o The study population has to be clearly defined (for example, according to age, sex, and
residence.) Otherwise we cannot do the sampling
o Each study population consists of STUDY UNITS. The way we define our study
population and our study unit depends on the problem we want to investigate and on the
objectives of the study
o Representativeness
If researchers want to draw conclusions which are valid for the whole study
population, which requires a quantitative study design, they should take care to
draw a sample in such a way that it is representative of that population.
A representative sample has all the important characteristics of the population
from which it is drawn
ALLOW few groups to present and the rest to add points not mentioned
116
CLARIFY and SUMMARIZE by using the contents below
117
Stratified Sampling
o If it is important that the sample includes representative study units of small groups
with specific characteristics, then sampling frame must be divided into groups, or
strata, according to these characteristics.
o For example, residents from urban and rural areas, or different religious or ethnic
group
o Random or systematic samples of a pre-determined size will have to be obtained from
each group (stratum).
Cluster Sampling
o The selection of groups of study units (clusters) instead of the selection of study units
individually.
o Clusters are often geographic units (e.g. districts, villages) or organizational units (e.g.
clinics, training groups).
Multi-Stage Sampling
o A multi-stage sampling procedure is carried out in phases and it usually involves
more than one sampling method.
Sampling Methods for Qualitative Data
o Purposeful sampling strategies for qualitative studies
o Extreme case sampling
o Maximum variation sampling
o Homogeneous sampling
o Critical case sampling
o Snowball or chain sampling
Sample size: Number of subjects selected to represent a given study population
o Sample Size in Qualitative Studies
There are no fixed rules for sample size in qualitative research.
The size of the sample depends on what you try to find out, and from what
different informants or perspectives
o If you want to explore how you can involve mothers in your HC catchment area
you try to find that out. For example:
effectively in early detection and treatment of pneumonia, you might decide to
conduct some FGDs to assess mothers’ knowledge, attitudes and practices with
respect to pneumonia.
You could start with two FGDs among lowly educated mothers and two among
mothers with more education (who usually are of higher socio-economic status).
o If research objective is more complex e.g., attitudes of males and females towards
family planning, and has policy implications for a larger area, your sample will be
bigger. You might start with four FGDs, two among males and two among females,
subdivided according to socio-economic status.
In exploratory studies, the sample size is therefore estimated beforehand as precisely as
possible, but not determined.
118
level of accuracy.
The desirable sample size also depends on the number of cells in the cross tabulations.
A rough guideline is to have at least 5 to 10 study units per cell. For example:
o After conducting FGDs and in-depth interviews in the study on attitudes of men and
women towards family planning you might decide to conduct a bigger survey.
o If the exploratory study revealed that age and education appear to be important factors
determining FP use, compare FP use in groups with different levels of education and
of different ages.
o If you split each of these variables up in three categories, and you select four
categories of informants (male users/ spouses of female users; female users; male
non-users, female non-users) you would have 12 cells in each table. In order to obtain
5-10 answers per cell you would require 60-120 informants in each research area.
The eventual sample size is usually a compromise between what is desirable and what is
feasible.
119
action.
o It is important in any study to mention the non-response rate and to honestly discuss
whether and how the non-response might have influenced the results.
Some Biases in Sampling
o Studying volunteers only: The fact that volunteers are motivated to participate in the
study may mean that they are also different from the study population on the factors
being studied.
o It is better to avoid using non-random selection procedures that introduce such an
element of choice.
Sampling of registered patients only: Patients reporting to a clinic are likely to differ
systematically from people seeking alternative treatments.
Missing cases of short duration: In studies of the prevalence of disease, cases of short
duration are more likely to be missed. This may mean missing fatal cases, cases with
short illness episodes and mild cases.
Seasonal bias: Problem under study, for example, malnutrition, exhibits different
characteristics in different seasons of the year. For this reason, data should be collected on
the prevalence and distribution of malnutrition in a community during all seasons rather
than just at one point in time.
Tarmac bias: Study areas are often selected because they are easily accessible by car.
These areas are likely to be systematically different from more inaccessible areas.
120
What are source of bias in sampling that should be avoided?
121
References
Rao, J. S., & Richard, J. (2002). An introduction to bostatistics-a manual for students in
helthsciences.third edition, New delhi, Circus: Asoke k ghosh.
Kazaura, M. R., Makwaya, C. K., Masanja, C. M. and Mpembeni, R.C (1997). Lecture notes in
Biostatistics, manual of biostatistics, Muhimbili University College of Health Sciences, Dar es
Salaam
Kothari C.R (1985). Research Methodology – Methods and techniques, 2nd edition, Wiley
Eastern Limited New Delhi
Stewart A (2001). Basic Statistics and epidemiology, A practical guide, Radcliffe Medical
Press, United Kingdom
122
Handout 13.1: Types of sampling and when to use it
123
Session 14: Determining Sample Size
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
List the issues to consider when deciding on sample size
Calculate the sample size (desirable)
Determine the sample size(s) most appropriate for the research design (feasible)
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 05 minutes Presentation Introduction, Learning Tasks
Presentation
2 15 minutes Issues to Consider when Deciding on Sample Size
Buzzing
50 minutes Presentation
3 Calculation of the Sample Size (Desirable)
Brainstorming
30 minutes
4 Presentation Determination of Sample Size(s) Most Appropriate
for the Research Design (Feasible)
05 minutes
5 Presentation Key Points
6 05 minutes Presentation Evaluation
7 10 minutes Presentation Assignment
124
SESSION CONTENTS
ASK students to pair up and buzz on the following question for 2 minutes:
ALLOW few pairs to respond and let other pairs to add on points not mentioned
125
There are no fixed rules for sample size in qualitative research. The size of the sample
depends on WHAT you try to find out, WHY you try to find out, and HOW you are going
to use the data
Also, the sample size depends on the type of problem investigated, required precision and
to a certain extent, the resource available
If your research objective is more complex e.g., attitudes of males and females towards
family planning, and has policy implications for a larger area, your sample will be bigger.
Very few studies use the whole population (Census)
Too large Most studies use a subset of a population (Sample)
How big should a sample be?
o or too little sample is unethical:
o Too large: waste resources
o Too little: Inconclusive results
126
o The desirable sample size depends on the expected variation in the data (of the most
important variables): the more varied the data are, the larger the sample size we would
need to attain the desired level of accuracy.
o The desirable sample size also depends on the number of cells we will have in the
cross-tabulations which we need to analyze the results.
A rough guideline is to have at least 5 to 10 study units per cell
o How big it should be can be calculated. Still, the desirable sample size cannot always be
achieved for lack of resources such as time, manpower and money.
This constraint applies to quantitative as well as qualitative studies
Therefor the eventual sample size is usually a compromise between what is
desirable and what is feasible
o Sample size calculations
In quantitative studies, researchers will perform sample size calculations before
embarking on the project to find the desirable sample size
The following steps should be taken:
Estimate how big the proportion might be (say 80%).
Choose the margin of error you will allow in the estimate of the proportion (say
+ 10%). This means that, if in the survey indeed 80% of the children are found
to be vaccinated, this proportion will probably be between 70 and 90% in the
whole study population from which the sample was drawn.
Choose the precision with which you want to be confident that the vaccination
coverage in the whole population is indeed between 70 and 90%. You can never
be 100% sure. Do you want to be 95% sure? Or 99%?
Formulae
N = z2PQ
d2
N = Minimum sample size
Z = Constant, Standard normal deviate (1.96 for 95% Confidence level)
P = Population proportion with characteristic of interest
Q=1–P
d = Acceptable Margin of error
127
STEP 4: Determination of Sample Size(s) Most Appropriate for the
Research Design (Feasible) (30 minutes)
The feasible sample size determination
o Is not calculated, depends on available resources (human, time, money, transport)
Availability of finance: in practice, size of the sample depends upon the amount of
money available for the study purposes. This factor should be kept in view while
determining the size of sample for large samples result in increasing the cost of
sampling estimates
o Depends on expected variation in the data: the more varied the data are, the larger the
sample size one would need to attain the same level of accuracy
o Depends on the number of cells one will have in the cross-tabulations required to
analyze the result
A rough guideline is to have at least 20-30 study units per cell
o Eventual sample size – is a compromise between desirable and feasible
o Nature of study: If items are to be intensively and continuously studied, the sample
should be small. For a general survey the size of the sample should be large, but a
small sample is considered appropriate in technical surveys.
o Type of sampling: Sampling technique plays an important part in determining the size
of the sample. A small random sample is appropriate to be much superior to a larger
but badly selected
.
STEP 5: Key Points (5 minutes)
There are no fixed rules for sample size in qualitative research.
Eventual sample size is a compromise between desirable and feasible
128
STEP 7: Assignment (10 minutes)
Activity: Take Home Assignment (10 minutes)
129
References
Hardon A, Boonmongkon P, and Streefland P. et al (editors) (2001). Applied Health research,
Anthropology of health and health care, third revised edition,, Het Spinhuis Publishers, The
Netherlands
Kothari C.R (1985). Research Methodology – Methods and techniques, 2nd edition, Wiley
Eastern Limited New Delhi
130
Session 15: Research Ethics
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Define research ethics
Identify ethical issues involved in the implementation of research
Describe procedure for research ethical clearance
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
131
SESSION CONTENTS
ASK students to pair up and buzz on the following question for 2 minutes
132
Several methods for dealing with these issues are recommended:
o Obtaining informed consent before the study or the interview begins.
o Do not explore sensitive issues before a good relationship has been established with
the informant.
o Ensure the confidentiality of the data obtained.
Learning enough about the culture of informants to ensure it is respected during the
o data collection process.
If sensitive questions are asked, for example, about family planning or sexual
practices, or about opinions of patients on the health services provided, it is advisable
to omit names and addresses from the questionnaires.
o Inform participants that they are free to withdraw from the study at any point
ASK students to pair up and buzz on the following question for 2 minutes
133
o In case there is no any Institutional Ethics Committee, the approval will be sought
from the NatHREC.
o For all health research involving external collaborators (non-Tanzanians), the
researchers must apply for the Institutional Ethical Clearance as well as the National
Ethics Clearance.
o Non-Tanzanian researchers are required by law to get Research Clearance and
Research Permit from the Tanzania Commission for Science and Technology
(COSTECH) (www.costech.or.tz).
o Protocols for Clinical trials to be conducted in Tanzania are reviewed by another
specialized sub-committee, Clinical Trials Sub-Committee.
This sub-committee has nine members, and meets monthly and reports to the
NatHREC.
o Clinical trials are required to also obtain a Clinical Trials Certificate from Tanzania
Food and Drug Authority (www.tfda.or.tz) before the commencement of the study.
Application procedures
o Applicants for research clearance are required to submit application form, Curriculum
vitae, Research proposal and three passport size photographs preferably two month
before commencement of research.
o Permits are given for a period of one year and can be renewed for similar period
provided satisfactory progress reports for the previous periods are received by
COSTECH.
o If and when these formalities have been satisfactorily completed (which may take
several months) applicant will receive a formal written offer of a research clearance.
o Applicant should not make any irreversible preparations to leave for Tanzania unless
and until he/she receives this offer letter.
o Soon after obtaining a research permit, the researcher will be required to proceed to
the Immigration Department and apply for class C residence permit.
134
References
National Institute of Medical Research (2014) 2ND Edition. Standard Operating Procedures
for the National Health Research Ethics Committee, Dar es Salaam, Tanzania
http://www.nimr.or.tz/wp-content/uploads/2018/11/SOPS-2014-KEY-NatHREAC-SOPs-
Final-17th-June-2014.pdf
Mashalla, Y.J.S., Shija, J.K., Kitua, A.Y., Mwaikambo, E., Kohi, Y.M., Ndossi, G.D.,
Malecela, M., Mboera, L.E.G. (2009) Second edition. Guidelines of Ethics for Health
Research in Tanzania, Tanzania National Health Research Forum, Dar es Salaam, Tanzania
135
Session 16: Research Budget
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Identify the important points to be considered when starting to plan for data collection
Determine what resources are available and needed to carry out the research
Describe the activities of the research
Cost the research activities, materials and supplies required
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
50 minutes Presentation
Costing the Research Activities, Materials
5 Group and Supplies Required
discussion
136
SESSION CONTENTS
ASK students to pair up and buzz on the following question for 2 minutes:
What are the important points to be considered when starting to plan for data
collection
ALLOW few pairs to respond and let other pairs to add on points not mentioned
The most important points to be considered when starting to plan for data collection:
o It should be simple, realistic, and easily understood by those directly involved.
o It should cover the preparatory and the implementation phases of the project, as well
as data analysis, reporting, dissemination and utilization of results.
o The activities covered should include training, technical or research tasks;
administrative, secretarial and other support tasks.
o The realities of local customs (local holidays, festivals) and working hours should be
considered, when preparing the work plan.
o Also seasonal changes and their effect on travel, work habits, and on the topic you are
studying (such as incidence of disease or nutritional status), should be kept in mind as
the schedule is planned.
137
STEP 3: Determination of Resources Available and Needed to Carry Out
the Research (10 minutes)
Base on the work plan
Specify for each activity in the work plan, what resources and inputs are required
For each resource determine unit cost and ,number of units to get the total cost
STEP 4: The Activities of the Research (30 minutes)
Research activities include:
o Finalize research proposal and submit to ethical committee for clearance
o Translate questionnaires, typing, multiplying
o Recruit research assistants
o Obtain clearance and orient of DHOs, health institutions and village health workers
o Train research assistants
o Pre-test study
o Collect data
o Process data and make preliminary interpretation
o Analyze data and write report
o Disseminate and discuss research findings and preliminary recommendations with
community members, health staff
o Disseminate and discuss of research findings and preliminary recommendations with
policymakers/managers/ others
o Draft preliminary plan of action
o Hold meetings with policy makers/managers/others to discuss plan of action for
implementing recommendations
o Follow up on implementation of plan of action
STEP 5: Costing the Research Activities, Materials and Supplies Required
(50 minutes)
Activity: Small Group Discussion (5 minutes)
What research activities, materials and supplies required in the study need to be
budgeted?
138
CLARIFY and SUMMARIZE by using the contents below
Purpose of a Budget
o A detailed budget will help to identify which resources are already locally available and
which additional resources may be required.
o The process of budget design will encourage you to consider aspects of the work plan you
have not thought about before
o Serve as a useful reminder of activities planned, as your research gets underway.
Budget Preparation
o A complete budget is not prepared until the final stage of project planning.
Cost is usually a major limiting factor and therefore must always be kept in mind
during planning so that your proposals will not have an unrealistically high budget.
o Remember that both ministries and donor agencies usually set limits for research project
o budgets.
o The use of locally available resources increases the feasibility of the project from a
financial
point of view.
Categories for a Budget
o Funds for personnel allowances for researchers, and assistants during training research
assistants, field work piloting and actual study
o Funds for secretarial services e.g. typing the proposal and questionnaires, final report and
dissemination
o Funds for transport number of visits and kilometers to be covered ,funds for supplies.
o Stationary and lunch for those attending FGD, meetings
o 5% for emergency
Making Reasonable Estimates in a Budget
o Do not underestimate the time needed to complete project tasks in ‘the real world’.
o Include a 5% emergency fund if you fear that you might have budgeted for the activities
rather conservatively.
If inclusion of a contingency fund is not allowed, an alternative is to slightly over-
budget in major categories.
Budget Justification
o It is not sufficient to present a budget without explanation.
o The budget justification follows the budget as an explanatory note justifying briefly, in
the context of the proposal, why the various items in the budget are required.
o Give clear explanations concerning why items that may seem questionable or that are
particularly costly are needed and discuss how complicated expenses have been
calculated.
If a strong budget justification has been prepared then, it is less likely that essential
items will be cut during proposal review.
How to Reduce Budgets
o Explore whether other health-related institutions are willing to temporarily assign or
second personnel to the project.
o When possible, use local rather than outside personnel. If consultants are needed at the
beginning, train local personnel as soon as possible to take over their work.
o Explore the use of students or community volunteers, where appropriate.
o Plan for strict control of project expenditures, such as those for vehicle use, supplies. The
budget justification follows the budget as an explanatory note justifying briefly, in the
context of the proposal, why the various items in the budget are required.
o Give clear explanations concerning why items that may seem questionable or that are
139
particularly costly are needed and discuss how complicated expenses have been
calculated.
If a strong budget justification has been prepared then, it is less likely that essential
items
will be cut during proposal review.
d. Drivers (2)
......................................
..................................
e. Facilitator (1)
Evaluation pilot study
SUBTOTAL (I)
TRANSPORT COSTS
a. ..............................................
b. ..............................................
c. .....................etc..........................
SUBTOTAL (II)
SUPPLIES
a. ............................................................
b. ...........................................................
SUBTOTAL (III)
TOTAL (I+II+III)
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5% CONTINGENCY
GRAND TOTAL
The type of budget format to be used may vary depending upon whether the budget will
be supported by your own organization or submitted to the Ministry of Health or a donor
organization for funding.
o Most donor organizations have their own special project forms, which include a
budget format (budget format)
o Keep in mind the tendency to underestimate the time needed to complete project tasks
in ‘the real world’
o If the budget is for a period longer than a year, build in allowances for inflation before
the project begins and in subsequent years by increasing costs by a set percentage
(budget preparation)
o It is not sufficient to present a budget without explanation (Budget justification)
o When possible, use local rather than outside personnel to reduce cost
Obtaining funding for projects
To conduct research, it is usually necessary to obtain funding for the research project. In
addition to preparing a good research proposal, the following strategies are useful for
researchers who need to obtain their own funding:
o Familiarize yourself with the policies and priorities of funding agencies. Such
policies and priorities may be:
o Identify the procedures, deadlines and formats that are relevant to each agency.
o Obtain written approval and support from relevant local and national health
authorities and submit this together with your proposal.
o If you are a beginning researcher, associate yourself with an established researcher.
Host agencies scrutinize the ‘credibility’ of the researcher to whom funds are
allocated. Such credibility is based on previous projects that have been successfully
completed.
o Build up your own list of successfully completed projects (i.e., your own reports,
publications, etc.).
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What are the most important points to consider when starting planning for data
collection?
What resources are available and needed to carry out the study?
142
References
Hardon A, Boonmongkon P, and Streefland P. et al (editors) (2001). Applied Health research,
Anthropology of health and health care, third revised edition, Het Spinhuis Publishers, The
Netherlands
Kothari C.R (1985). Research Methodology – Methods and techniques, 2nd edition, Wiley
Eastern Limited New Delhi
143
Session 17: Data Collection Plan
Total Session Time: 120 minutes + 240 minutes assignment
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Describe typical problems that may arise during data collection and how they may be
solved.
Prepare a plan for data collection for the developed research proposal
Determine the various tasks of the staff needed for research
Prepare a work schedule (GANTT chart)
Draw a work schedule(GANTT chart)
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
Handout 17.1: Example of a GANTT
Handout 17.2: Example of a work schedule (GANTT chart)
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 05 minutes Presentation Introduction, Learning Tasks
144
SESSION CONTENTS
STEP 2: Typical Problems that May Arise During Data Collection and
Solutions (15 minutes)
Activity: Buzzing ( 5 minutes)
ASK students to pair up and buzz on the following question for 2 minutes
What are problems that may arise during data collection and solutions
Possible problems
o sources of data distortion (bias) that might include:
Deviations from the sampling procedures set out in the proposal.
Variability or bias in observations or measurements made because
• Research assistants are placed under too much stress
• Inadequate supervision of research assistants.
• Questionnaire not filled in completely
Solutions
o Training research assistant
o Pretest instrument
o Adequate supervision of data collection
o Revise method to check quality of data
o Prior anticipation of problems that might occur and prepare plan to overcome them
STEP 3: Preparation of a Plan for Data Collection for the Developed
Research Proposal (10 minutes)
A Plan for Data Collection
o Listing the tasks that have to be carried out, and who should be involved,
o Making a rough estimate of the time needed for the different parts of the study
145
o Identifying the most appropriate period in which to carry out the research.
o Scheduling the different activities that have to be carried out each week in a work
plan.
Pre-Testing
o Before the proposal development is finished, a pre-test of the data collection and data
analysis procedures should be made.
o The advantages of conducting a pre-test before the proposal is that we can draft the
work plan and budget based on more realistic estimates, as well as revise the data
collection tools before we submit the proposal for approval.
o However, further pre-testing and planning of the research have to be done in the field.
Stages in the Data Collection Process
o Stage 1: Permission to proceed
o Stage 2: Data collection
o Stage 3: Data handling
Stage 1: Permission to Proceed
o Consent must be obtained from the relevant authorities, individuals and the
community in which the project is to be carried out.
This may involve organizing meetings at national or provincial level, at district
and at village level.
o For clinical studies this may also involve obtaining written informed consent.
o The principal investigator will be responsible for obtaining permission to proceed at
the various levels.
o The Health Research Unit in the Ministry of Health or the institution organizing the
course may assist in obtaining permission from the national level.
Stage 2: Data Collection
o During data collection consider:
Logistics: who will collect what, when and with what resources
Quality control (data must be reliable and valid)
o When allocating tasks for data collection, it is recommended that first list type of data
required.
o Identify who could best implement each of the tasks.
If it is clear earlier that your research team will not be able to carry out the entire
study by itself
Plan to look for research assistants to assist in relatively simple but time-
consuming tasks.
For example, in a study into the effects of improvements in delivery care on
utilization of these services the following task division could be proposed (Figure
1)
146
Step 1: Time for Data Collection
o Think about how long will it take to collect data for each component of the Study?
The time required to reach the study area(s)
The time required locating the study units (persons, groups, records), search for
specific informants (e.g., users or defaulters of a specific service)
• It might take more time to locate informants than to interview them
o The number of visits required per study unit.
o Calculate the number of interviews that can be carried out per person per day (e.g. 4)
o Calculate the number of days needed to carry out the interviews. For example:
147
their interaction and possible stigma from different perspectives, better link the
numbers.
For example, if you have interviewed a patient, P9, his neighbor will be N9 and
his wife or son/daughter will be R9.
Identify the person responsible for storing data and the place where it will be stored.
Decide how data should be stored.
Record forms should be kept in the sequence in which they have been numbered. In what
sequence should data be collected?
o In general, it is advisable to start with analysis of data that is already available. This is
essential if the sample of respondents is to be selected from the records.
o Another rule of thumb is that qualitative research techniques (such as key informant
interviews, focus group discussions) that are devised to focus the content of
questionnaires for interviewing larger groups of informants should be carried out
before finalization of these questionnaires.
o FGDs designed to provide feedback on issues raised in larger surveys, should,
o logically, be conducted after preliminary analysis of the questionnaires.
o To use time and transport efficiently, data to be drawn from different sources but in
one locality should be collected at the same time.
For example, interviews with health staff in a Health Centre (HC), observations of
equipment available in the HC and interviews with mothers living around the HC
should be scheduled together.
Note: It is always advisable to slightly overestimate the period needed for data collection
to allow for unforeseen delays.
It is extremely important that the data collected are of good quality (reliable and valid).
o Otherwise we will come up with false or misleading conclusions.
Possible sources of data distortion (bias) that should try to prevent, include:
o Deviations from the sampling procedures set out in the proposal.
o Variability or bias in observations or measurements made because:
Subject changes his/her behavior as a consequence of the research. For
example, a subject may act more positively while being observed, blood
pressure and pulse may increase when the subject is anxious. Use of
unstandardized weighing scales or inaccurate or no guidelines for interviewing.
Variation in Researchers observations (observer variability) in what they
observe or measure. For example, researchers may be selective in their
observations (observer bias), measure, question or note down answers with
varying accuracy or follow different approaches (one being more open, friendly,
probing than the other).
Variations in criteria for measurement or for categorizing answers because we
changed them during the study.
Measures ensure good quality of data
o Prepare a field work manual for the research team as a whole, including:
Guidelines on sampling procedures and what to do if respondents are not available
or to co-operate.
A clear explanation of the purpose and procedures of the study which should be
used to introduce each interview
Instruction sheets on how to ask certain questions and how to record the
148
STEP 4: Determination of Various Tasks of the Staff Needed for Research
(30 minutes)
Activity: Small Group Discussion (5 minutes)
149
The time required to reach the study area(s);
The time required to locate the study units (persons, groups, records);
• If you have to search for specific informants (e.g., users or defaulters of a
specific service) it might take more time to locate informants than to interview
them.)
The number of visits required per study unit.
• For some studies it may be necessary to visit informants a number of times,
for example, follow-up of pregnant mothers or malnourished children
Time needed for follow-up of non-respondents should also be considered.
o Step 2:
Calculate the number of interviews that can be carried out per person per day
(e.g., 4)
o Step 3:
Calculate the number of days needed to carry out the interviews.
o For example:
you need to do 200 interviews
your research team of 5 people each can do 4 interviews per day
you will need how many days for the interviews
o Step 4:
Calculate the time needed for the other parts of the study, (for example, 10 days)
o Step 5:
Determine how much time you can devote to the study. It is unlikely that team
members can spend more than 30 working days on the entire study
5 days for preparation (including pre-testing and finalizing questionnaires)
20 days actual field work
5 days data processing and preliminary analysis
Refer students to Handout 17.1: Example of a GANTT
150
o The task to be performed
o Who is responsible for the task
o The time each task is expected to take
o The length of each task is shown by a bar that extends over the number of days, weeks
or months the task is expected to take
151
References
Hardon A, Boonmongkon P, and Streefland P. et al (editors) (2001). Applied Health research,
Anthropology of health and health care, third revised edition,, Het Spinhuis Publishers, The
Netherlands
Varkevisser, C. M, Pathmanathan, I and Brownlee, A (1991). Designing and Conducting
Health Systems Research Projects, Vol. 2 Part I. IDRC, Ottawa
Polit, D. F and Beck, C. T (2004). Nursing Research – Principles and Methods, 7th Edition:
Lippincott Williams & Wilkins, Philadelphia
152
Handout 17.1: Example of a GANTT
153
154
Corlien, Pathmanathan, & Brownlee. (2003).
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
List common research tools
Identify appropriate data-collection techniques
Prepare data-collection tools
Conduct out an interview
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 05 minutes Presentation Introduction, Learning Tasks
Presentation Common Research Tools
2 10 minutes
Buzzing
3 10 minutes Presentation Identification of Data-Collection Techniques
4 40 minutes Presentation Preparation for Data-Collection Tools
35 minutes Presentation Conducting an Interview
5
Brainstorming
6 05 minutes Presentation Key points
7 05 minutes Presentation Evaluation
8 10 minutes Presentation Assignment
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SESSION CONTENTS
ASK students to pair up and buzz on the following question for 2 minutes:
ALLOW few pairs to respond and let other pairs to add on points not mentioned
The quality of research depends on the quality of the data collection tools.
Interviewing and administering questionnaires are probably the most commonly used
research techniques.
Designing good questioning and interviewing tools forms an important and time
consuming phase in the development of most research proposals.
Once the decision has been made to use these tools, the following questions should be
considered before designing them.
o What exactly do we want to know, according to the objectives and variables we have?
o Is questioning the right technique to obtain all answers, or additional techniques, such
as observations or analyses of records are needed?
o Who to ask questions and what techniques will be used?
o Do you understand the topic sufficiently to design a questionnaire, or
o Do you need some loosely structured interviews with key informants or a focus group
discussion first to orientate ourselves?
o Are your informants mainly literate or illiterate?
o How large is the sample that will be interviewed?
Before examining the steps in designing a questionnaire, review the types of questions
used in interviews.
Depending on how questions are asked and recorded distinguish two major possibilities:
o Open-ended questions, (allowing for completely open as well as partially categorized
answers).
156
o Closed questions.
157
o Answers can be recorded quickly
o Analysis is easier
Closed Questions
o Closed questions have a list of possible options or answers from which the
respondents must choose.
o Closed questions are most commonly used for background variables such as age,
marital status or education, in case of age and education take the exact values and
categorize them during data analysis.
For example: What is your opinion on the following statement: (Circle one
response).
Women who have induced-abortion should be severely punished
strongly agree
Agree
Not sure/no opinion
Disagree
strongly disagree
Used if one is only interested in certain aspects of an issue and does not want to waste
time obtaining more information than one needs.
For example: A researcher who is only interested in the sources of protein in a family diet
may ask:
o Did you eat any of the following foods yesterday?’ (Circle yes if at least one item in
each set of items is eaten.)
Peas, beans, lentils Yes No
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Fish or meat Yes No
Eggs Yes No
Milk or cheese Yes No
Insects Yes No
Advantages of Closed Questions
o It saves time
o Comparing responses of different groups, or of the same group over time, becomes
easier
159
o After having it translated you should have it retranslated into the original language by
a different person.
o Compare the two versions for differences and make decisions concerning the final
o phrasing of difficult concepts.
Self-Administered (Written) Questionnaires
o All steps discussed above apply to written questionnaires as well as to
guides/questionnaires used in interviews.
o Self-administered questionnaires are most commonly used in large-scale surveys
using predominantly pre-categorized answers among literate study populations.
o In exploratory studies which require intensive interaction with informants in order to
gain better insight in an issue, self-administered questionnaires would, moreover, be
inadequate tools.
o Written questionnaires may sometimes be useful in small-scale studies on sensitive
topics.
They are usually combined with other tools e.g. FGD on sensitive issues like
sexual behavior.
Checklists
o Checklists can be used to systematically observe human behavior or the condition of
specific equipment (e.g. fridge, expiring dates of medicines, or completeness of
records).
o Observations can be relatively open or can be predetermined comparisons of reality
against fixed standards.
The objectives of the study determine the content of a checklist.
A checklist includes all the items or points that must be considered during an
observation in the field, or when extracting data from existing records.
ASK students to pair up and buzz on the following question for 2 minutes
160
in a conclusive way.
o Example of haphazard data collection: During a nutrition survey three different
weighing scales were used in three villages.
The researchers did not record which scales were used in which village.
After completion of the survey it was discovered that the scales were not
standardized and indicated different weights when weighing the same child.
It was therefore impossible to conclude in which village malnutrition was most
prevalent.
Common Data Collection Techniques in Use
o Reviewing documents
o Observing/observation
o Interviewing (face-to-face)
o Administering written questionnaires
o Focus group discussions
Reviewing Documents
o Documents to be reviewed can be obtained from dispensary, health center, and
hospital records.
For example, analysis of the information routinely collected by health facilities
can be very useful for identifying problems such as flows of drug supply or
increases in the incidence of certain diseases.
Other sources of data may be Health Information Management System, census,
unpublished reports and publications in archives and libraries or in offices,
newspapers and published case histories
Advantages of Reviewing Documents
o It is inexpensive, because data is already there.
o It Permits examination of trends over the past.
Limitations of Reviewing Documents
o Data are not always easily accessible.
o Ethical issues concerning confidentiality may arise.
o Information may be inaccurate or incomplete.
Observation Technique
o Observation is a technique that involves systematically selecting, watching and
recording behavior and characteristics of living beings, objects or phenomena.
o Observation of human behavior is a much-used data collection technique.
o It can be undertaken in different ways:
Participant observation: The observer takes part in the situation he or she
observes.
• For example, a doctor hospitalized with a broken hip, who now observes
hospital procedures from within.
o Non-participant observation: The observer watches the situation, openly or concealed,
but does not participate.
o Observation becomes a scientific tool and method of data collection for the
researcher, when:
It serves a formulated research purpose.
Is systematically planned and recorded.
Is subjected to checks and controls on validity and reliability.
Advantages of Observation Method
o Subjective bias is eliminated, if observation is accurately done.
o The information relates to what is currently happening.
161
o Not complicated by either past behavior or future intentions or attitudes.
o Independent of respondent’s willingness to respond and hence less demanding on
active
cooperation on the part of the respondents.
o Suitable in studies which deal with subjects who are not capable of giving verbal
reports of their feelings for one reason or the other.
Limitations of Observation Method
o It is an expensive method
o Information provided by this method is very limited
o Sometimes unforeseen events may interfere with the observational task
o Some subjects are rarely accessible to direct observation
o If subjects know that they are being observed, they may change their behavior
Interviewing Technique
o An interview is a data-collection technique that involves oral questioning of
respondents, either individually or as a group.
o Requires a person known as the interviewer asking questions in a face-to-face contact
to the interviewee or through other means of communication like telephone.
o Answers to the questions posed during an interview can be recorded by writing them
down (either during the interview itself or immediately after the interview) or by tape-
recording the responses, or by a combination of both.
Advantages of the Interview Method
o Detailed information can be obtained.
o Interviewer could overcome resistance of the respondent, if any.
o Provides flexibility to the interviewer to restructure, clarify, or add probe questions.
o Observation can also be applied during interview.
o Is suitable for use with both literates and illiterates.
o Has higher response rate than written questionnaires.
o The interviewer can collect supplementary information about the respondent’s
personal characteristics and environment.
Limitations of Interview
• It is very expensive and time consuming especially when the sample is large.
• Chances of Interviewer as well as interviewee’s bias are high.
• People with certain high level positions like officials or executives may not be easily.
approachable under this method and to that extent the data may prove inadequate
Limitations of Interview
o It is very expensive and time consuming especially when the sample is large.
o Chances of Interviewer as well as interviewee’s bias are high.
o People with certain high level positions like officials or executives may not be easily.
approachable under this method and to that extent the data may prove inadequate.
o Creating effective rapport with the interviewee may be a difficult.
o Some subjects may demand incentives during data collection process.
o There may be a language barrier between an interviewer and interviewee.
Pre-Requisites and Basic Tenets of Interviewing
o Interviewers should be carefully selected and trained
o They must possess technical competence (interviewing and interpersonal skills)
o They should be able to create an atmosphere of trust and confidence
Written Questionnaires
o A written questionnaire (also referred to as self-administered questionnaire) is a data
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collection method in which written questions are presented that are to be answered by
the respondents in written form. The questions can be either open-ended or closed
(with pre categorized answers).
o A written questionnaire can be administered in different ways, such as by:
Sending questionnaires by mail with clear instructions on how to answer the
questions
and asking for mailed responses;
Gathering all or part of the respondents in one place at one time, giving oral or
written
instructions, and letting the respondents fill out the questionnaires; or
Hand-delivering questionnaires to respondents and collecting them later.
Advantages of Questionnaires
o Low cost when study is large
o Free from interviewer bias
o Respondents have adequate time to give out their answers
o Respondents, who are not easily approachable, can be reached
o Used in large studies
o Permits anonymity and may result in more honest responses.
Limitations of Questionnaires
o Low rate of return of the duly filled in questionnaires
o Bias due to non-response is undetermined
o Used only when respondents are educated and cooperating
o Control over questionnaire may be lost
o Not flexible once the questionnaire has been dispatched out
o Ambiguous replies or omissions creating difficult in interpretation
o Slowest method of all when mailing is used
Focus Group Discussions (FGD)
o FGD allows a group of 6 - 12 informants to freely discuss a certain subject with the
guidance of a facilitator or reporter during which group members talk freely and
spontaneously about a certain topic.
o Characteristics and Uses of Focus Group Discussions
A FGD is a qualitative method.
A FGD aims to be more than a question-answer interaction.
The idea is that group members discuss the topic among themselves, with
guidance from the facilitator.
o FGD techniques can be used to:
Focus research and develop relevant research hypotheses by exploring in greater
depth the problem to be investigated and its possible causes.
Formulate appropriate questions for more structured, larger scale surveys.
Help understand and solve unexpected problems in interventions.
Develop appropriate messages for health education programmes and later evaluate
the messages for clarity.
Explore controversial topics. For example: Sexual behavior is a controversial
topic in the sense that males and females judge sexual relations and sexuality
often from very different perspectives.
o Advantages of FGD
The researcher can interact with the participants, pose, follow up questions or ask
163
questions that probe more deeply.
Results can be easier to understand than complicated statistical data.
The researcher can get information from non-verbal responses such as facial
expressions
or body language.
Information is provided more quickly than if people were interviewed separately.
Limitations of FGD
o The small sample size means the groups might not be a good representation of the
larger population
o Group discussions can be difficult to steer and control, so time can be lost to
irrelevant topics
o Respondents can feel peer pressure to give similar answers to the moderators’
questions
o The moderators skills in phrasing questions along with setting can affect responses
and skew results
164
or give misleading answers.
• For example: in a survey on alcoholism you ask school children: ‘Does your
father sometimes get drunk?’ Many will probably deny that he does, even if it is
true
• Such bias can be reduced by:
• Adequately introducing the purpose of the study to informants.
• Phrasing questions on sensitive issues in a positive way.
• Taking sufficient time for the interview and by assuring informants that the
data collected will be confidential.
o Information bias
Sometimes the information itself has weaknesses.
Medical records may have many blanks or be unreadable. This tells something about
the quality of the data and has to be recorded.
• For example, in a TB defaulter study the percentage of defaulters with an
incomplete or missing address should be calculated.
o Another common information bias is due to gaps in people’s memory this is called
memory or recall bias.
For example: A mother may not remember all details of her child’s last diarrhoea
episode and of the treatment she gave two or three months afterwards.
For such common diseases it is advisable to limit the period of recall, asking, for
example, ‘Has your child had diarrhoea over the past two weeks?’
Questionnaires and interview schedules are used to collect information for quantitative
research
The steps of designing them are the same even though they are used for different data
collection techniques ; i.e. Self-administered questionnaire and interviewing respectively
Before designing questionnaires consider the following:
o Study objectives and variables.
Be clear of what you want to know or measure.
165
o Ascertain whether all required information is going to be obtained by questioning
only or not.
o How much is known about the problem being investigated. Familiar? Unfamiliar?
This determines whether closed/open questions should be used.
o The number of subjects to be studied.
This determines how much of open/closed questions to be used
• Open-ended (free response) questions: rrespondents are not given options to
choose from; they answer in their own words.
• Closed questions (fixed alternatives): respondents are given alternative
answers to choose from
166
• Introductory section. This precedes the questions and have the following
contents
o Heading
o Serial number
o Date of interview
o Place of interview
o Name of interviewer
o Name/code of respondents
Questions section. This bears the questions and the following should be ensured
• Related questions should appear together
• There is sufficient space for respondents to fill in their responses to open-
ended questions
• The boxes for pre-categorized responses are placed in consistent manner
• There are reserved boxes for computer coding for computer aided data
analysis
• Formatting should ensure that the questionnaire is user friendly
o Fifth step: Translation
Translation of the questionnaire into language familiar to all respondents should
be done if the original version is in a different language.
o Sixth step: Pretesting
Before embarking on actual data collection it is important to check whether the
questionnaire gathers the information expected and whether both the interviewer
and interviewee feel at ease with it.
Data compilation forms
o Designing data collection forms involves
Step 1: Clarifying the specific needs of your application
Step 2: Identifying the information you want to work with
Step 3: Then devising a design that best meets your need
Checklist
o A checklist is a tool for identifying the presence or absence of conceptual knowledge,
skills, or behaviors
o Developing a checklist involves the following steps
Step 1: Review the learning outcome and associated criteria for success
• State the level of success required for the checklist to be considered
completed, In most cases, all items must be checked
• Decide on the response such as “Yes” or “No”, or simply have a box to
be checked once the item has been completed
Step 2: From a procedure, process, or task description list, pick those items that
are required for a good performance or product
• Itemize task descriptions in one column and
167
• Provide a space beside each item in a second column to check off the
completion of the task
• Group similar items or order them sequentially—keep as short as
possible
• Highlight critical steps, checkpoints, or indicators of success
Step 4: Write clear instructions for the observer
Step 5: Review the task descriptions for details and clarity
Step 6: Format the checklist
Step 7: Ask for feedback from other instructors before using it with learners
Checklists are used for identifying whether key tasks in a procedure, process,
or activity have been done in complete and in a systematic manner.
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•an interviewer should show interest in what the informant says, be at ease
(never in a hurry)
Make the informant feel at ease
• This implies that the interviewer should never show any disapproval of the
information received during the interview.
The environment should also be supportive of the interview situation.
• Anything which disturbs (noise, other people listening, a formal
surrounding) should if possible be avoided.
• Tape recording may be an enabling or a disturbing environmental factor in
the interview. Informants should be asked for their consent before use,
o Third: The interviewer’s tasks
Apart from the introduction to the interview, which includes building a
partnership which needs to last throughout the interview and even beyond, the
interviewer has a number of other tasks:
• Posing questions
• Evaluating answers and probing for elaboration or more precision in case
of a superficial or invalid answer
• Noting down answers
• Leading the discussion, but at the same time encouraging the informant to
give spontaneous information relevant to the topic by letting him/her talk
• Keeping control over the interview
• At the end, the interviewer should summarize the interview
• after-interview' discussions and questions should always be recorded, like
all spontaneous information, because discussions can shed light on
complicated, not yet fully clear issues from many preceding interviews.
o Fourth: Training the research team/assistants
Research assistants should be taught basic interview techniques, such as
• Asking questions in a neutral manner
• Not showing by words or expression what answers one expects
• Not showing agreement, disagreement or surprise
• Recording answers to open questions precisely as they are provided,
without sifting or interpreting them
STEP 6: Key Points (5 minutes)
Common research tools are interview guides, questionnaires , collecting forms and
checklists
Questionnaires and interview schedules are used to collect information for quantitative
research
An interviewer needs to have the skills of turning an informant into a partner
169
STEP 8: Assignment (10 minutes)
Take care that you have an optimal mix between open-ended and pre-categorized
questions.
Discuss the possibilities for bias, which may occur when using the data-collection
tools. Try to avoid bias as much as possible.
References
170
Kothari C.R (1985). Research Methodology – Methods and techniques, 2nd edition, Wiley
Eastern Limited New Delhi
Polit, D. F and Beck, C. T (2004). Nursing Research – Principles and Methods, 7th Edition:
Lippincott Williams & Wilkins, Philadelphia
Empire State College (2018). Questions or feedback about ESC's Online Writing Center
https://www.esc.edu/online-writing-center/resources/research/research-paper-steps/
developing-questions/
171
Session 19: Pre-Testing the Research Tools
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Describe the components of a pre-test or pilot study
Plan and carry out pre-tests of research components
Finalize the tools for the proposal being developed
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 05 minutes Presentation Introduction, Learning Tasks
Presentation
2 15 minutes Components of a Pre-Test or Pilot Study
Brainstorming
10 minutes Presentation
3 Planning and Carrying out Pre-Tests of Research
Buzzing Components
20 minutes
4 Presentation Finalizing the Tools for the Proposal being
Developed
5 05 minutes Presentation Key Points
6 05 minutes Presentation Evaluation
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SESSION CONTENTS
A pre-test
o Refers to a small scale trial of particular research components
A pilot study
o is the process of carrying out a preliminary study, going through the entire
research procedure with a small sample
The components of research to be pre-test tools or pilot study
o Reactions of the respondents to the research procedures
o The data-collection tools
o Sampling procedures
o Staffing and activities of the research team
o Procedures for data processing and analysis
o The proposed work plan and budget for research activities
Reactions of the respondents to the research procedures
o Availability of the study population
o Study population daily work schedules
o Acceptability of the methods used
o Acceptability of the questions asked
o willingness of the respondents to answer the question
The data-collection tools
173
o Whether the tools can collect the information you need and whether they are
reliable
o How much time is needed to collect data
o Whether there is any need to revise the format or presentation of interview
guides/questionnaires e.g.
Sequencing
Wording
Translation
Space for answers
Sampling procedures
o Instructions followed
o Time need to locate respondents
Staffing and activities of the research team
o training
o Logistics
o team work
Procedures for data processing and analysis
work plan and budget for research activities
ASK students to pair up and buzz on the following question for 2 minutes
What are the components of research should be assessed during the pre-testing?
174
Pre-test in the actual research area
o What difficulties do you expect in the implementation of your proposal?
o Inexperience with a certain data-collection technique
o Which parts of your study will be most costly and time-consuming?
STEP 4: Finalizing the Tools for the Proposal Being Developed (20
minutes)
It is highly recommended that you analyse the data collected during the pre-test right
away
Then finalise and adjust the master sheets, if necessary
Make totals for each variable included in the master sheets
Fill in some dummy tables and prepare all the dummy tables you need, considering your
research objectives
Do all this even if you plan to analyse the data by computer.
A pilot study is the process of carrying out a preliminary study, going through the entire
research procedure with a small sample
175
References
Hardon A, Boonmongkon P, and Streefland P. et al (editors) (2001). Applied Health research,
Anthropology of health and health care, third revised edition,, Het Spinhuis Publishers, The
Netherlands
Kothari C.R (1985). Research Methodology – Methods and techniques, 2nd edition, Wiley
Eastern Limited New Delhi
Polit, D. F and Beck, C. T (2004). Nursing Research – Principles and Methods, 7th Edition:
Lippincott Williams & Wilkins, Philadelphia
176
Session 20: Data Collection
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Describe various data-collection techniques
State the uses and limitations of different data collection methods
Mention issues to consider in selecting data collection methods
List advantages of using a combination of different data collection techniques
Explain difference between data collection methods and tools
Identify various sources of bias in data collection and ways of preventing
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 05 minutes Presentation Introduction, Learning Tasks
Presentation
2 10 minutes Various Data-Collection Techniques
Buzzing
Presentation
3 35 minutes Group The Uses and Limitations of Different Data
discussion Collection Methods
177
SESSION CONTENTS
ASK students to pair up and buzz on the following question for 2 minutes
Data-collection techniques
Use of available information
Observation
Interview
Administering a questionnaire
Focus group discussion
In-depth interview
What are the uses and limitations of different data collection methods?
178
ALLOW few groups to present and the rest to add points not mentioned
o Disadvantages
May be difficult to access the data
Information may be incomplete or imprecise
Ethical concerns regarding confidentiality may arise
Observation
o Means: Watching and recording, no talking with respondent
o advantages
Gives information of what is currently happening
Doesn't depend on respondent’s willingness to respond
Disadvantages
Observer may notice only what interests him/her (bias)
Presence of observer may influence behaviour of respondent
Ethical concerns regarding confidentiality may arise
Interview
o Means: Asking a respondent questions orally
o Advantages
Can be used for illiterates
Allows clarification of questions
Higher response rate
o Disadvantages
Expensive (time, human resources)
Presence of interviewer may influence response
Administering a questionnaire
o Means: giving respondents written questions (questionnaire) so that they read the
questions themselves and provide answers
o Advantages
179
Questions may be misunderstood by respondents
Some respondents may choose responses simply because they saw it there,
otherwise they wouldn't have thought of it
180
Researchers often use a combination of flexible and less flexible research techniques.
Flexible techniques include:
o Loosely structured interviews using open-ended questions.
o Focus group discussions.
o Participant observations are also called qualitative research techniques.
o They produce qualitative data that is often recorded in narrative form.
181
STEP 7: Sources of Bias in Data Collection and Ways of Preventing (15 Minutes)
Sources of bias:
o Defective instruments or tools
o Interviewers and observers – different data collectors eliciting different information
o Effect of the interview – respondents mistrust the interview intention, thus dodge the
questions
o Information bias – incomplete record, respondents being unable to recall
Ways to Reduce the Possibility of Bias:
o Data collection tools (including written introductions for the interviewers to use with
potential respondents) should be pre-tested. If necessary, adjustments should be made
to ensure better co-operation.
o If non-response is due to absence of the subjects, follow-up of non-respondents may
be considered.
o If non-response is due to refusal to co-operate, an extra, separate study of non-
respondents may be considered in order to identify to what extent they differ from
respondents.
o Another strategy is to include additional people in the sample, so that non-respondents
who were absent during data collection can be replaced. This can only be justified if
their absence was very unlikely to be related to the topic being studied.
o The bigger the non-response rate, the more necessary it becomes to take remedial
action.
o It is important in any study to mention the non-response rate and to honestly discuss
whether and how the non-response might have influenced the results.
182
References
Hardon A, Boonmongkon P, and Streefland P. et al (editors) (2001). Applied Health research,
Anthropology of health and health care, third revised edition,, Het Spinhuis Publishers, The
Netherlands
Kothari C.R (1985); Research Methodology – Methods and techniques, 2nd edition, Wiley
Eastern Limited New Delhi
Ranjit K (205); Research methodology – step by step guide for begginers, 2nd edition,
Singapore, pearson education
Polit, D. F and Beck, C. T (2004) Nursing Research – Principles and Methods, 7th Edition:
Lippincott Williams & Wilkins, Philadelphia
183
Session 21: Data Processing
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Categorize the data
Code the data
Summarize the data in data master sheets
Compile the data manually without master sheets
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 05 minutes Presentation Introduction, Learning Tasks
Presentation
2 20 minutes Group Categorizing the Data
discussion
20 minutes Presentation
3 Coding the Data
Brainstorming
30 minutes
4 Presentation Summarizing the Data in Data Master Sheets
35 minutes
5 Presentation Compiling the Data Manually without Master Sheets
6 05 minutes Presentation Key Points
7 05 minutes Presentation Evaluation
184
SESSION CONTENTS
ALLOW few groups to present and the rest to add points not mentioned
185
o If an inconsistency is clearly due to a mistake made by the researcher/research
assistant
o For example if a person in an earlier question is recorded as being a non-smoker,
whereas all other questions reveal that he is smoking, it may still be possible to check
with the person who conducted the interview and to correct the answer.
If the inconsistency is less clearly a mistake in recording, it may be possible (in a small
scale study) to return to the respondent and ask for clarification.
If it is not possible to correct information that is clearly inconsistent, consider excluding
this particular part of the data from further processing and analysis as it will affect the
validity of the study.
If a certain question produces unclear answers throughout, the whole question should be
excluded from further analysis. (Normally, however, you would discover such a problem
during the pre-test and change the wording of the question.)
The Questions to be answered before Processing
o Have the data been sorted appropriately?
o Have questionnaires been numbered?
o Major categories of informants distinguished?
o Have quality checks been performed? For completeness and consistency of
information?
o Has all qualitative data been categorized as far as possible?
Data Processing – Quantitative Data
o Decide on the method for processing and analyzing data from questionnaires
Manually, using data master sheets or manual compilation of the questionnaires
By computer, for example, using micro-computer and existing software or self-
written programmes for data analysis
Data processing in both cases involves
o Categorizing/classifying the data
o Coding
o Summarizing the data in data master sheets, manual compilation without master
o sheets, or data entry and verification by computer
Categorizing/Classifying Data
Decisions have to be made concerning how to categorize responses.
Categorical variables that are investigated through closed questions or observation,
the categories are decided earlier.
In interviews the answers to open-ended questions, the answers can be pre-
categorized to
• a certain extent, depending on the knowledge of possible answers that may be
given.
• Should always be a category called ‘Others, specify ...’, which can only be
categorized afterwards.
• Answers that are difficult or impossible to categorize may be put in a separate
residual category called ‘others’, but this category should not contain more than
5% of the answers obtained.
These responses should be listed and placed in categories that are a logical continuation
of the categories you already have.
For numerical variables, the data are often better collected without any pre-categorization.
If you do not exactly know the range and the dispersion of the different values of these
variables when you collect your sample (e.g., home-clinic distance for out-patients, or
income), decisions concerning how to categorize and code the data at the time you
186
develop your tools may be premature.
If you notice during data analysis that your categories had been wrongly chosen you
cannot reclassify the data anymore.
STEP 3: Coding the Data (20 minutes)
Activity: Brainstorming (10 minutes)
Coding
o If the data will be entered in a computer for subsequent processing and analysis, it is
essential to develop a coding system.
o For computer analysis, each category of a variable can be coded with a letter, group of
letters or word, or be given a number.
For example, the answer ‘yes’ may be coded as ‘Y’ or 1; ‘no’ as ‘N’ or 2 and ‘no
response’ or ‘unknown’ as 'Ú' or 9.
The codes should be entered on the questionnaires (or checklists) themselves.
o When finalising your questionnaire, for each question you should insert a box for the
code in the right margin of the page.
o These boxes should not be used by the interviewer. They are only filled in afterwards
during data processing.
o Take care that you have as many boxes as the number of digits in each code.
If analysis is done by hand using data master sheets, it is useful to code your data as well
Coding conventions
o Common responses should have the same code in each question, as this minimizes
mistakes by coders.
o For example
Yes (or positive response) code - Y or 1
No response/unknown code - U or 9
Codes for open-ended questions (in questionnaires) can be done only after examining a
sample of (say 20) questionnaires.
187
o You may group similar types of responses into single categories, so as to limit their
number to at most 6 or 7.
o If there are too many categories it is difficult to analyse the data.
Finally it should be borne in mind that the personnel responsible for computer analysis
should be consulted very early in the study
1 Y 4 PS N 1 3
2 Y 9 SS N 4 NA
3 N NA NA NA 5 NA
4 U PS Y 0 2
In any small scale study processed by hand in which groups will be compared, a different
master sheet should be made for each of those groups, e.g., good and poor compliers to
treatment.
As gender is an important cross-cutting theme, it is usually also advisable to subdivide
males and females within each of the groups that are being compared
STEP 5: Compiling the Data Manually without Master Sheets (35 Minutes)
When the sample is small (say less than 30) and the collected data is limited, it might be
more efficient to do the compilation manually
Certain procedures will help to ensure accuracy and speed.
o If only one person is doing the compilation use manual sorting.
o If a team of 2 persons work together use either manual sorting or tally counting.
Manual sorting can be used only if data on each subject is on a different sheet of paper/
entered in a separate questionnaire.
To do manual sorting the basic procedure is to:
o Take one question at a time, for example, ‘use of health facility’,
188
o Sort the questionnaires into different piles representing the various responses to the
question, e.g., hospital/ health centre/ traditional practitioners) and
o Count the number in each pile.
To do tally counting the basic procedure is:
o One member of the compiling team reads out the information while the other records
it in the form of a tally (e.g., III representing 3 subjects)
o Tally count for no more than two variables at one time (e.g., sex plus type of facility
used)
o After tally counting, add the tallies and record the number of subjects in each group.
After doing either manual or tally counting, check the total number of subjects/responses
in each question to make sure that there has been no omission or double count
It should be noted that hand tallying is often used in combination with master sheet
analysis when the relationship between two or three variables needs to be established, or
details analyzed
189
References
Hardon A, Boonmongkon P, and Streefland P. et al (editors) (2001). Applied Health research,
Anthropology of health and health care, third revised edition,, Het Spinhuis Publishers, The
Netherlands
Kothari C.R (1985). Research Methodology – Methods and techniques, 2nd edition, Wiley
Eastern Limited New Delhi
Polit, D. F and Beck, C. T (2004). Nursing Research – Principles and Methods, 7th Edition:
Lippincott Williams & Wilkins, Philadelphia
190
Session 22: Data Analysis
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Describe data in terms of frequency distribution, percentages and proportion
Use figures to present data.
Explain the difference between mean, mode and median
Calculate the frequencies, percentages, proportion, ratios, rates means, medians,
modes for major variables.
Identify variables that are necessary for analysis of the collected data
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 05 minutes Presentation Introduction, Learning Tasks
Presentation Description of Data in Terms of Frequency
2 15 minutes
Brainstorming Distribution, Percentages and Proportion
10 minutes
3 Presentation Using Figures to Present Data.
30 minutes Presentation
4 Group Difference Between Mean, Mode and Median
discussion
35 minutes
Calculation of the Frequencies, Percentages,
5 Presentation Proportion, Ratios, Rates Means, Medians, Modes for
Major Variables.
15 minutes
6 Presentation Identification of Variables that are Necessary for
Analysis of the Collected Data
7 05 minutes Presentation Key Points
8 05 minutes Presentation Evaluation
191
SESSION CONTENTS
Data analysis involves the production and interpretation of frequencies, tables, graphs,
etc., that describe the data.
o Frequency counts
From the data master sheets, simple tables can be made with frequency counts for
each variable.
A frequency count is an enumeration of how often a certain measurement or a
certain answer to a specific question occurs.
For example
Smokers 51
Non-smokers 93
Total 144
• If numbers are large enough it is better to calculate the frequency distribution in
percentages (relative frequencies):
o 51/144 x 100 = 35% are smokers and 93/144 x 100 = 65% non-smokers.
o This makes it easier to compare groups than when only absolute numbers are
given. In other words, percentages standardize the data.
It is usually necessary to summarize the data from numerical variables by dividing them
into categories. This process may include the following steps:
o Inspect all the figures: What is their range? (The range is the difference between the
largest and the smallest measurement.)
192
o Divide the range into three to five categories. You can either aim at having a
reasonable number in each category (e.g. 0-2 km, 3-4 km, 5-9 km, 10+ km for home-
clinic distance) or you can define the categories in such a way that they are each equal
in size (e.g., 20-29 years, 30-39 years, 40-49 years, etc.)
o Construct a table indicating how data are grouped and count the number of
observations in each group.
o Categorical data
Bar charts
Pie charts
Bar charts
o Is simplest and most effective means of illustrating qualitative data
o Bars can either be horizontal or vertical
o Eg.57 Adolescents from kaloleni streets in Arusha were asked the following question:
How often have you used cannabis for the past one year? This was closed question
with the following possible answers
Frequently 7 12.2
Occasionally 9 15.8
Rarely 10 17.5
Never 31 54.4
Total 57 100
193
Pie charts
Provides quick view of data presented in different form.
Used in qualitative number with few categories to avoid congestion
Histograms
Numerical data are often presented in histograms
Which are similar to bar charts important difference is that in histogram ‘the bars’
are connected(as long as there is no gap between the data where as in bar charts
are not connected as the different categories are distinct entitles)
Line graphs
Particularly useful for numerical data if you want to show Trend over time
It is easy to show two or more distribution in one graph as long as difference
between lines are easy to distinguish e.g. age distribution between males and
females
194
STEP 4: The Difference Between Mean, Mode and Median (30 minutes)
ALLOW few groups to present and the rest to add points not mentioned
Mean
o The mean of a data set is also known as the average value. It is calculated by dividing
the sum of all values in a data set by the number of values.
o So in a data set of 1, 2, 2, 3, 4, 5, we would calculate the mean by adding the values
(1+2+2+3+4+5) and dividing by the total number of values (6). Our mean then is
17/5, which equals 3.4
Mode
o The mode is the most common observation of a data set, or the value in the data set
that occurs most frequently.
o The example of the mode in: 1, 2, 2, 3, 4, 5, is 2
o The mode is an appropriate measure to use with categorical data
Median
o The median of a data set is the value that is at the middle of a data set arranged from
smallest to largest.
o In the data set 1, 2, 3, 4, 5, the median is 3.
o In a data set with an even number of observations, the median is calculated by
dividing the sum of the two middle values by two. So in: 1, 2, 2, 3, 4, 5, the median is
(2+3)/2, which equals 2.5.
o The median is appropriate to use with ordinal variables, and with interval variables
with a skewed distribution
195
STEP 5: Calculation of the Frequencies, Percentages, Proportion, Ratios,
Rates, Means, Medians, Modes for Major Variables (35 minutes)
Frequency distribution
o Frequency distribution is description of data presented in tabular form.
o Gives frequency in each value appears in data
o Count number of response in category
o E.g. Frequency of categorical nominal data
Distribution of course students according to sex
Male 34
Female 27
Total 61
196
o E.g. weight of 17 nursing students at Kibong’oto nursing school on enrolment
31-40 12 26.7
41-50 17 37.8
51-60 11 24.4
61-70 5 11.1
Total 45 100
197
STEP 6: Identification of Variables that are Necessary for Analysis of the
Collected Data (15 minutes)
Variables: A characteristic of a person, object or phenomenon, which can take on different
values. These may be in the form of numbers (e.g. age) or non-numerical characteristics (e.g.
sex).
o Variables are something that varies or logical groupings of attributes.
Attributes: Are characteristics or qualities that describe an object or categories that make up a
variable.
o Variables and attributes are the derived from the concepts and they are part of the
operational definition for measurement.
198
problem
o This is done by formulating variables both dependent (outcome/problem) variable and
independent variables (factors influencing the outcome or problem)
o For example, if we find that becoming a dropout of TB treatment is strongly
associated with the following factors then, we have clues which will help us to solve
the problem
Patient’s lack of knowledge concerning the actual duration of treatment and the
danger of relapse or death when the full course is not completed
Living more than 8 km away from the clinic where the drugs have to be collected
monthly
Being between 15 and 30 years of age
The example above shows that, dropout of TB is a dependent variable, it depends on
the knowledge of the patients, living more than 8 km away (distance) and (age) 15and
30 years
Knowledge, distance and age are independent variables
Types of Variables
o Numerical Variables
When the values of the variables are expressed in numbers
• Example of a variable in the form of numbers is person’s age. The variable
‘age’ can take on different values since a person can be 20 years old, 35 years
old and so on.
• Other examples of variables are:
o Weigh (expressed in kilograms or in pounds)
o Homes-clinic distance (expressed in kilometers or in minutes walking
distance);
o Monthly income (expressed in dollars, Shillings)
o Number of children (e.g. 1,2)
Categorical Variables
o Some variables may be expressed in categories. For example, the variable sex has two
distinct categories, male and female.
199
• Categorical variables: Can either be Ordinal or Nominal
o Ordinal variables: These are grouped variables that are ordered or ranked in increasing or
decreasing order.
For example: High income (above $3000 per month), middle income ($1000-
$3000 per month), and low income (less than 1000 USD per months).
• The definition of high (income) or far (distance) will vary from country to
country and from region to region.
• If a researcher has little idea about the distribution of a certain variable in a
population (e.g. if you do not know whether 30%, 50%, or 95% are below the
• poverty line of $ 100 per month) then it is advisable to categorize numerical
data only after the pre-test, or even after data collection.
Other examples
• Disability: no disability, partial disability, serious or total disability.
• Seriousness of a disease: severe, moderate, mild.
• Agreement with a statement: fully agree, partially agree, and fully disagree.
Nominal variables: The groups in these variables do not have an order or ranking.
• For example
o Sex: Male, female.
o Main food crops: Maize, millet, rice.
o Religion: Christian, Muslim, Hindu, Buddhism.
Factors Rephrased as Variables
o Most of what we call factors are in fact variables which have negative values.
o Contributing factors in negative phrase are such as lack of knowledge.
Quantitative variables: Variables which have definitive quantitative values (age in years-
24 year or 4 years or weight or height) and can be manipulated according to the rules of
mathematics.
Ordinal variables: Variables which do not have numerical values but can be graded
(e.g.level of education as primary school, advanced diploma and bachelor degree or
quality of services as poor, average, good).
Nominal qualitative variables or attributes (do not belong to either of the above) examples
are marital status-married, single, divorced or gender as male or female.
For a selected research problem, you may find that you are interested on many variables,
but to make a research manageable, pick few of them and leave others.
200
Causes and Associations, and Confounding
o Because in health systems research you often look for causal explanations, it is
important to make a distinction between dependent and independent variables.
o For example, in a study of the relationship between smoking and lung cancer,
suffering from lung cancer, (with the values yes, no) would be the dependent variable
and smoking (varying from not smoking to smoking more than three packets a day)
the independent variable
Whether a variable is dependent or independent is determined by, the statement of the
problem and the objectives of the study.
It is therefore important when designing an analytical study to clearly state which
variable is the dependent and which the independent ones are.
o If a researcher investigates why people smoke, smoke is the dependent variable then,
pressure, from peers to smoke, could be an independent variable.
o In the lung cancer Study smoking is the independent variable.
Mostly people speak of possible causes of problems, in scientific language it is preferred
to speak of associations between variables, unless a causal relationship can be proven.
o If there is an association between smoking and cancer then, it can be conclude that
smoking causes cancer only if it can be demonstrated that the cancer was developed
after the patient started smoking and that there are no other factors that may have
caused both the cancer and the habit of smoking.
o For example, nervous people may both smoke more and suffer more from cancer than
persons who are not nervous.
Confounding variable: Is associated with the problem and with a possible cause of the
problem.
o A confounding variable may either strengthen or weaken the apparent relationship
between the problem and a possible cause.
201
In order to give a true picture of cause and effect, possible confounding variables must be
considered, either at planning stage or while doing data analysis. For example:
A relationship is shown between bottle-feeding and diarrhea in under-twos. However,
mother’s education may be related to bottle-feeding as well as to diarrhea.
o Mother’s education is a potential confounding variable. In order to give a true picture
of the relationship between bottle feeding and diarrhea of under-twos, the influence
of mother’s education should be controlled.
o This could either be done in the research design, e.g., by selecting only mothers with a
specific level of education, or it can be taken into account in the analysis of the
findings. Then the relation between bottle feeding and diarrhea would be analyzed
separately for mothers with different levels of education.
Background Variables
o Related to a number of independent variables, so they influence the problem
indirectly
o In almost every study, background variables appear, such as
Age, sex, educational level, socio-economic status, marital status and religion.
• Only background variables important to the study should be measured.
• Background variables are notorious ‘confounders’.
202
STEP 7: Key Points (5 minutes)
Data analysis involves the production and interpretation of frequencies, tables,
, etc., that describe the data
Figures make the descriptive data more readable when you have many tables
Frequency distribution is description of data presented in tabular form
203
References
Rao, J. S., & Richard, J. (2002). An introduction to bostatistics-a manual for students in
helthsciences.third edition, New delhi, Circus: Asoke k ghosh.
Kothari C.R (1985). Research Methodology – Methods and techniques, 2nd edition, Wiley
Eastern Limited New Delhi
Polit, D. F and Beck, C. T (2004). Nursing Research – Principles and Methods, 7th Edition:
Lippincott Williams & Wilkins, Philadelphia
204
Session 23: Research Report Writing
Total Session Time: 60 minutes + 300 minutes assignment
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
List the main components of a research report
Make an outline of research report
Write drafts of report in stages
Check the final draft of report for completeness
Draft recommendations for action based on research findings
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 05 minutes Presentation Introduction, Learning Tasks
Presentation The Main Components of a Research Report
2 15 minutes
Brainstorming
40 minutes Presentation An Outline of Research Report.
3 Group
discussion
4 30 minutes Presentation Drafts of Report in Stages.
205
SESSION CONTENTS
The research report outline should contain the following components in the following
Order:
o Title and Cover Page
o Summary of Study Design, Findings and Recommendations
o Acknowledgements
o Table of Contents
o List of tables, figures (optional)
o List of abbreviations (optional)
o Introduction (statement of the problem in its local context, including relevant
o literature)
o Objectives
o Methodology
o Research Findings
o Discussion
o Conclusions and Recommendations
o References
o Annexes (data collection tools; tables)
Note: When assigning page numbers to the report, components number 1-6 use small
Roman Numerals (For example: i, ii, iii, iv, v…).
Introduction (Component number 7), is Page 1 of the actual report.
The findings, discussion of findings, conclusions and recommendations will form the
most substantial part of the report, which has to be written from scratch.
It is strongly advised that start with the findings, discussion and conclusions.
206
Write each component in stages as follows:
o Create an outline
o Write Introduction
o Write the Objectives
o Write the Methodology
o Write your Findings
o Discuss your Findings
o Write conclusions and recommendations
o References
o Annex
o Summary
o Acknowledgement
o Table of contents
o Title and Cover page
ALLOW few groups to present and the rest to add points not mentioned
207
The summary should be written only after the first or even the second draft of the
report has been completed. It should contain:
o A very brief description of the problem (WHY this study was needed)
o The main objectives (WHAT has been studied)
o The place of study (WHERE)
o The type of study and methods used (HOW)
o Major findings and conclusions, followed by
o The major (or all) recommendations
o The summary will be the first part of the study that will be read.
o Acknowledgements
It is good practice to thank those who supported you technically or
financially in the design and implementation of your study.
Also your employer who has allowed you to invest time in the study and
the respondents may be acknowledged.
Acknowledgements are usually placed right after the title page or at the
end of the report, before the references
o Table of contents
It provides the reader a quick overview of the major sections of your report, with page
references
List of tables, figures
List of abbreviations (optional)
The table of contents and lists of tables, figures, abbreviations should be prepared last
o Chapter 1: Introduction
Contains
Background information
Statement of the problem
Literature review collected during the implementation of the study
o Chapter 2: Objectives
The general and specific objectives should be included as stated in the proposal.
You can adjust them slightly for style and sequence.
If you have not been able to meet some of the objectives state them in the
methodology section and in the discussion of the findings.
o Chapter 3: Methodology
Should be described in detail and include a description of:
• The study type
• Major study variables
• The study population(s), sampling method(s) and the size of the sample(s)
• Data-collection techniques used for the different study populations
• Should be described in detail and include a description of:
• The study type
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• Major study variables
• The study population(s), sampling method(s) and the size of the sample(s)
• Data-collection techniques used for the different study populations;
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They should contain any additional information needed to enable professionals to
follow your research procedures and data analysis.
Examples :
o Tables referred to in the text but not included in order to keep the report short;
o Lists of hospitals, districts, villages etc. That participated in the study
o Questionnaires or check lists used for data collection.
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o If there are many tables or figures, then they may be listed in a table of contents type
of format with page numbers.
List of Abbreviations (optional)
o If abbreviations or acronyms are used in the report, these should be stated in full in
the text the first time they are mentioned.
o If there are many, then they should be listed in alphabetical order as well.
o The list can be placed before the first chapter of the report.
o The table of contents and lists of tables, figures, abbreviations should be prepared last
o A t this time include the page numbers of all chapters and sub-sections in the table of
contents.
Finalize the numbering of figures and tables and include all abbreviations.
Chapter 1: Introduction
o The introduction is a relatively easy part of the report that can best be written after a
first draft of the findings has been made.
o It should contain relevant (environmental/ administrative/ economic/ social)
background data about the country, the health status of the population, and health
service data which are related to the problem that has been studied.
o The statement of the problem should follow, again revised from your research
proposal with additional comments and relevant literature collected during the
implementation of the study.
o It should contain a paragraph on what you hope to achieve with the results of the
study.
Chapter 2: Objectives
o The general and specific objectives should be included as stated in the proposal.
o If necessary, you can adjust them slightly for style and sequence. However, you
should not change their basic nature.
o If you have not been able to meet some of the objectives this should be stated in the
methodology section and in the discussion of the findings.
o The objectives form the HEART of your study. They determined the methodology
you chose and will determine how you structure the reporting of your findings.
Chapter 3: Methodology
o The methodology you followed for the collection of your data should be described in
detail. This section should include a description of:
The study type;
Major study themes or variables (a more detailed list of variables on which data
was collected may be annexed);
The study population(s), sampling method(s) and the size of the sample(s);
Data-collection techniques used for the different study populations;
how the data was collected and by whom;
Procedures used for data analysis, including statistical tests (if applicable)
Chapter 4: Research Findings
o The systematic presentation of the findings in relation to the research objectives is the
crucial part of your report.
o The description of findings should offer a good combination or triangulation of data
from qualitative and quantitative components of the study.
o Prepare an outline for the whole report, taking the main components of a research
report as a point of departure.
o An outline should contain:
The headings of the main sections of the report,
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The headings of subsections,
The points to be made in each section, and
A list of tables figures and/or quotes to illustrate each section.
o Example of the outline of the chapter 4 on Research Findings
Findings
• 4.1 Description of the sample: (e.g., location, age, marital status, education, social
economic status, of mothers; age and sex of children weight/measured by research
area).
• 4.2 Extent and seasonal variation of malnutrition in district X
• 4.3 Possible causes of malnutrition
• 4.3.1 Limited availability of food
• 4.3.2 Non-optimal utilization of available food
• 4.3.3 High prevalence of communicable diseases
• 4.3.4 Limited access to Mother to Child Health (MCH) and weaknesses in
• 4.3.4 Limited access to Mother to Child Health (MCH) and weaknesses in
MCH/nutrition services
o The system of numbering is flexible and can be extended according to need with further
headings or subheadings.
It allows to keep an overview of the process when different group members work on
different sections of the report at the same time.
o The outline for the chapter on findings will predictably be the most elaborated.
o The first section under findings is usually a description of the study population.
o If different study populations have been studied, then provide a short description of
each group before presenting the data pertaining to these informants.
o Depending on the study design, provide more information on the problem studied
(size, distribution, characteristics).
o In an analytic study, the degree to which different independent variables influence the
problem will be discussed.
o Tables and figures in the text need numbers and clear titles.
o Include only those tables and figures that present main findings and need more
elaborate discussion in the text.
o The first draft of your findings is never final.
o Therefore you might concentrate primarily on content rather than on style.
o Nevertheless, it is advisable to structure the text from the beginning in paragraph
o Note: It is unnecessary to describe in detail a table that you include in the report. Only
present the main conclusions.
Chapter 5: Discussion
o The findings can be discussed by objective or by cluster of related variables or
themes, which should lead to conclusions and possible recommendations.
o The discussion may include findings from other related studies that support or
contradict your own.
Chapter 6: Conclusions and Recommendations
o The conclusions and recommendations should follow logically from the discussion of
the findings.
o Conclusions can be short, as they have already been elaborately discussed in chapter
5.
o As the discussion will follow the sequence in which the findings have been presented
(which in turn depends on your objectives) the conclusions should logically follow the
same order.
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o Note: It makes easy reading for an outsider if the recommendations are again placed
in roughly the same sequence as the conclusions.
o The recommendations may be summarized according to the groups towards which
they are directed, for example:
Policy-makers
Health and health-related managers at district or lower level
Health and health-related staff who could implement the activities
Potential clients
The community at large
o Remember that action-oriented groups are most interested in this section.
o In making recommendations, use not only the findings of the study, but also
supportive information from other sources.
o The recommendations should take into consideration the local characteristics of the
health system, constraints, feasibility and usefulness of the proposed solutions.
o They should be discussed with all concerned before they are finalized.
o If the recommendations are short (roughly one page), include them all in the summary
and omit them as a separate section in Chapter 6 in order to avoid repetition.
References
o The references in your text can be numbered in the sequence in which they appear in
the report and then listed in this order in the list of references (Vancouver system).
o Another possibility is the Harvard system of listing in brackets the author’s name(s) in
the text followed by the date of the publication and page number, for example:
You can choose either system as long as you use it consistently throughout the
report.
Annexes or Appendices
o The annexes should contain any additional information needed to enable professionals
to follow your research procedures and data analysis.
o Information that would be useful to special categories of readers but is not of interest
to the average reader can be included in annexes as well.
o Examples of information that can be presented in annexes are:
Tables referred to in the text but not included in order to keep the report short;
lists of hospitals, districts, villages etc. that participated in the study;
Questionnaires or check lists used for data collection.
Revising and Finalizing the Text
o When a first draft of the findings, discussion and conclusions has been completed, all
working group members and facilitators should read it critically and make comments.
o The following questions should be kept in mind when reading the draft
Have all important findings been included?
Do the conclusions follow logically from the findings?
If some of the findings contradict each other, has this been discussed and
explained, if possible?
Have weaknesses in the methodology, if any, been revealed?
Are there any overlaps in the draft that have to be removed?
Is it possible to condense the content?
In general a text gains by shortening. Some parts less relevant for action may be
included in annexes. Check if descriptive paragraphs may be shortened and
introduced or finished by a concluding sentence.
Do data in the text agree with data in the tables?
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Are all tables consistent (with the same number of informants per variable), are
they numbered in sequence, and do they have clear titles and headings?
Is the sequence of paragraphs and subsections logical and coherent?
Is there a smooth connection between successive paragraphs and sections?
Is the phrasing of findings and conclusions precise and clear?
For a final check on readability you might skim through the pages and read the first
sentences of each paragraph. If this gives a clear impression of the organization and
results of the study, then one may conclude that you did the best you could.
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Checking whether the format has been followed
Revising and finalizing the text
o When a first draft of the findings, discussion and conclusions has been completed, all
working group members and facilitators should read it critically and make comments.
o The following questions should be kept in mind when reading the draft:
Have all important findings been included?
Do the conclusions follow logically from the findings? If some of the findings
contradict each other, has this been discussed and explained, if possible? Have
weaknesses in the methodology, if any, been revealed?
Are there any overlaps in the draft that have to be removed?
Is it possible to condense the content? In general a text gains by shortening. Some
parts less relevant for action may be included in annexes. Check if descriptive
paragraphs may be shortened and introduced or finished by a concluding sentence.
Do data in the text agree with data in the tables? Are all tables consistent (with the
same number of informants per variable), are they numbered in sequence, and do
they have clear titles and headings?
Is the sequence of paragraphs and subsections logical and coherent? Is there a
smooth connection between successive paragraphs and sections? Is the phrasing of
findings and conclusions precise and clear?
The original authors of each section may prepare a second draft, taking into
consideration all comments that have been made. However, you might consider
the appointment of two editors amongst yourselves, to draft the complete version.
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References
Kitaly F (…..). Operational Research (unpublished), Muhimbili University College of Health
Sciences, Dar es Salaam
Kothari C.R (1985). Research Methodology – Methods and techniques, 2nd edition, Wiley
Eastern Limited New Delhi
Polit, D. F and Beck, C. T (2004). Nursing Research – Principles and Methods, 7th Edition:
Lippincott Williams & Wilkins, Philadelphia
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Session 24: Methods for Dissemination of Research
Findings
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Define dissemination of research findings
List various dissemination channel and tools
Describe dissemination strategy of research finings
List dissemination content of research findings
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 05 minutes Presentation Introduction, Learning Tasks
Presentation
2 10 minutes Definition of Dissemination of Research Findings
Buzzing
35 minutes Presentation
3 Group Dissemination Channel and Tools
discussion
35 minutes
4 Presentation Dissemination Strategy of Research Findings
10 minutes
5 Presentation Dissemination Content of Research Findings
6 05 minutes Presentation Key Points
7 05 minutes Presentation Evaluation
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SESSION CONTENTS
ASK students to pair up and buzz on the following question for 2 minutes:
What is dissemination of research findings?
ALLOW few pairs to respond and let other pairs to add on points not mentioned
ALLOW few groups to present and the rest to add points not mentioned
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The following are dissemination channels
o Community meetings
o Interpersonal communication
o Local events
o Web sites
o Email messages
o Project team conference/meetings
o Policy briefs
o Dissemination workshops
o Technical reports
o Scientific seminars
o Mass media
o Scientific publication
o Communication of research findings
Some of the channels and their instruments are shown below
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o Mass media
When action is planned, one should also think of the mass media as information
channel:
Newspapers,
Radio,
TV,
Posters.
These are effective in disseminating information to a wide range of audiences
Mass media and interpersonal channels may fruitfully complement each other
o Identify key contact persons in each news organization, including reporters who cover the
area of your research,
Approach them through a letter to the news editor including relevant information
about your project, since he is the one who assigns reporters stories to cover.
Existing summaries of the study may be used, but it might be useful to elaborate on
the problem so that the reason for the study can be fully understood by a non-health
person.
o Articles in research journals
Other researchers may be interested as well in the research results and research
methods used, especially those in community health or social science departments.
o Presentation of research results
To interested students and staff are therefore appropriate, even if those presentations
are not directly related to action
To present results from HSR projects at ‘research days’ organised to improve
communication between a selected group of health managers and health researchers
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Identify which communication channels already exist which can be used to discuss and
disseminate results.
Channels for discussing and disseminating results may include
o Provincial or district development team meetings.
o Provincial or district health team meetings.
o Supervisory visits to health facilities involved, staff meetings.
o Mobile clinics or other health activities carried out in villages included in the study,
monthly meetings of village health workers when they collect drugs, meetings of
village health committees.
Determine what written materials should be prepared to keep relevant parties informed.
They may include:
o A one to two page summary of the project proposal that includes details on expected
results to distribute when you introduce the project to policy makers and staff
concerned.
o An introductory statement to use with interview guides and questionnaires, explaining
to informants the purpose and procedures of the study, as well as expected results.
A progress report of four to five pages, including preliminary findings and
recommendations, should be prepared for presentation of the data analysis and report
writing workshop.
o Used to inform authorities that will be crucial to utilization of project results.
To obtain feedback from decision makers and target groups in the community, you will
need a different summary, concentrating in simple words on the findings and preliminary
recommendations that directly concern them.
Make sure that summaries of your findings and preliminary recommendations are adapted
to the level of understanding and interests of different audiences
o This will increase their motivation to provide thorough feedback and to participate in
the implementation of the final recommendations collectively agreed up on.
Determine whether additional actions should be taken or mechanisms developed to
discuss the study results with all parties concerned and obtain their input, approval and
co-operation for the implementation of the recommendations
Key Steps
Develop and use a systematic dissemination and communication strategy for reaching
different audiences of potential users.
Present the research results to all stakeholders and obtain feedback on findings and
recommendations.
Develop a plan of action to promote the implementation of the recommendations that
resulted from the study.
STEP 5: Dissemination Contents of Research Findings (10 minutes)
Technical issues
Societal issues
Ethical issues
Personnel/organizational issues
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STEP 6: Key Points (5 minutes)
A strategy for dissemination and communication to promote utilization of research
findings should be developed, taking into account the major contributing factors and
proposed actions to solve it
The consideration of appropriate channels is an essential step as it helps to narrow down,
in very realistic ways, the types of communications tools that are practical, reach the right
audiences and within the available budgets
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References
World Health Organization (2014). Disseminating the Research Findings, module 5, WHO
Document Production Services, Geneva, Switzerland.
(https://www.who.int/tdr/publications/year/2014/participant-workbook5_030414.pdf
accessed 15/12/2018)
Kothari C.R (1985). Research Methodology – Methods and techniques, 2nd edition, Wiley
Eastern Limited New Delhi
Polit, D. F and Beck, C. T (2004). Nursing Research – Principles and Methods, 7th Edition:
Lippincott Williams & Wilkins, Philadelphia
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