MMP610-HEALTH

SYSTEMS
MANAGEMENT AND
PUBLIC HEALTH
OBJECTIVES

 Define a hypothesis.
 State types of hypotheses.
 Explain characteristics of hypotheses.
HYPOTHESIS

 A supposition or explanation that is provisionally accepted in order to interpret

certain events or phenomena, and to provide guidance for further investigation.

 A hypothesis may be proven correct or wrong, and must be capable of refutation.

 It is an assumption about certain characteristics of a population.

HYPOTHESIS IN RESEARCH

1. Null hypothesis

 A null hypothesis proposes no relationship between two variables.

 Denoted by H0, it is a negative statement like “Attending physiotherapy sessions

does not affect athletes' on-field performance.”
2. Alternative hypothesis

 The opposite of a null hypothesis, an alternative hypothesis is donated as H1 or

Ha.

 It explicitly states that the dependent variable affects the independent variable. E.g
“Attending physiotherapy sessions improves athletes' on-field performance.”
CHARACTERISTICS OF A GOOD
HYPOTHESIS
 Simple yet clear to look justifiable enough.
 It has to be testable
 It has to be precise about the results
 It should be self-explanatory
 It should include the variables and establish an appropriate relationship among
them.
 A hypothesis must keep and reflect the scope for further investigations and
experiments.
LITERATURE REVIEW,CONCEPTUAL
AND THEORETICAL FRAMEWORKS
OBJECTIVES

 Identify purposes, different forms and sources of literature review.

 Understand theoretical and conceptual frameworks.

 Identify common conceptual frameworks used in health research.

 The literature review gives an account of what other researchers have contributed
to understanding your topic and the extent to which they have addressed your
research questions.

 Empirical sources are used.

 An empirical literature review is simply a scrutiny of what is coming out from the
works of other researchers who have conducted similar research work.
 These research works must have been conducted in similar environments.

• Literature review is an important part of research proposal or a plan to determine

what information is already available as basis for justification and avoid
duplication.

• It helps the researcher to find out what others have learnt and reported on the
problem to be investigated.

• it assists in refining statement of the problem.

• It helps to be familiar with the various types of methodology that may be adapted
in the study.

• It provides a convincing argument why a particular research project is needed.

Research Concepts and Applications:
Literature Review
 A research is required to:
- Avoid duplication
- If resources are available
- As a matter of urgency
- Acceptability
- Ethical consideration
 Four Distinct Reasons are proposed:

1. It prevents the researcher from duplicating work that has been done before.

2. It helps to find out what others have learnt and reported on the problem under
study.

3. It helps to become more familiar with the various types of methodologies that
might be used in a study.

4. It provides a convincing arguments for why a particular research project is needed.

 What are sources of information?

• Individuals (research experts, relevant programme managers etc);

• Organizations or Institutions

• Published information(books, articles, indexes, and abstract journals

• unpublished information(other research proposals in related fields, reports,

records and computer data bases
 Sources of Supply of Information:

• Communities, districts, provincial and national level (e.g. interviews, clinical

observations, hospital/clinic based data from routine statistics and registers; CSO,
annual reports and newspapers, ministries, NGOS, Training institutions

• International agencies, such as Bilateral and multilateral organisations (e.g.

USAID, UNFPA,WHO,IDRC,UNICEF)

• Computerized searches for international literature

 Strategies for Gaining Access to Each Source:

• Identify a key person ( researcher or decision maker) who is knowledgeable on

the topic and asking if he/she can give you a few good references or the names of
other people whom you could contact for further information.

• Looking up for names of speakers on your topic at conferences/seminars who

may be useful to contact.

• Contacting Librarians in universities or research institutions

• Examining bibliographies and reference list in key papers and books to identify
relevant references

• Looking for references in indexes (e.g index Medicus and abstract journals)

• Requesting a computerized literature search (e.g Medline, website- internet

search).
PROCESS OF LITERATURE
REVIEW
 It involves extensive search for sources of information (individuals,groups,
organization, published and unpublished information).

• Examining the bibliographies and reference lists in key papers, journals and
books to identify relevant references

• Requesting a computerized literature search

• References that are identified should be first be skimmed or read, summarizing

important information, recorded on an index card and finally writing a literature
review.
 What to Do with References that are Identified?

• Should first be skimmed or read

• Then summaries of the important information in each of the references should be

recorded on separate index or as computer entries- These should be classified so
that the information can be easily be reviewed.

• Finally, a literature review should be written.

• Information on an index card should be organized in such a way that you can
easily find all data you will need for your report (e.g by factors or variables or
objectives, methodology, major findings and so on or use key letters).

For articles, note:

 “Author(s) (surname followed by initials. Year. Title of Article. Name of journal,

volume number: page numbers of article”. For example:

 Gwebu E.T, Banda S.1985. Assessment of Nutritional Status in Pregnancy.

Central African Journal of Medicine,31(3):193-196
CITATION AND QUOTATION IN
LITERATURE REVIEW
• Citation -refers to reference of other theories/ scholars to support the argument
under investigation.

• For example: citation of author(s) in the text include:

 Chansa (2003) shows differentiated cultural practices of reproductive behaviour

and their effects on child survival between groups of rural ethnic groups.
Group of authors in the text can be:

 There are differential cultural practices of reproductive behavior and their effects
on child survival between ethnic groups of rural Zambia (Richards et al., 1999;
Luke, 2001; Chansa, 2003).
• Citation should flow with the arguments of your thoughts about your proposed
research topic.

• Only cite surname of authors followed by year of publication, if it is in the text.

Quotation- is repeating or writing the words used by another author.

• Example: “malaria is a threat to human soul in Africa” (Komesha 1990:16)-indicates

author’s surname, year and page number in brackets from the book or article to
acknowledge the proof of the idea that it is not yours.

• Quoting author’s ideas should flow with the statement of your argument, and it can
include a sentence or a paragraph.

• Citation and quotation consolidate support for the justification of your research question
or statement of problem.
 Literature review should follow immediately after statement of problem.
DIFFERENT WAYS TO ORGANISE A
LITERATURE REVIEW
1. CHRONOLOGICAL (by date):

Organize it in stages of how the topic has changed: the first definitions of it, then major
time periods of change as researchers talked about it, then how it is thought about today.

2. BROAD-TO-SPECIFIC:

start with a section on the general type of issue you're reviewing, then narrow down to
increasingly specific issues in the literature until you reach the articles that are most
specifically similar to your research question, thesis statement or hypothesis.
3. MAJOR MODELS or MAJOR THEORIES:

When there are multiple models or prominent theories, it is a good idea to outline the
theories or models that are applied the most in your articles.
4. PROMINENT AUTHORS: If a certain researcher started a field, and there are
several famous people who developed it more, a good approach can be grouping the
famous author/researchers and what each is known to have said about the topic.

 With this organization it can help to look at the citations your articles list in them,
to see if there is one author that appears over and over.
5. CONTRASTING SCHOOLS OF THOUGHT: If you find a dominant argument
comes up in your research, with researchers taking two sides and talking about how
the other is wrong, you may want to group your literature review by those schools of
thought and contrast the differences in their approaches and ideas.
THEORETICAL FRAMEWORK IN
RESEARCH
 It is a foundational review of existing theories that serves as a roadmap for
developing the arguments you will use in your own work.

 A theoretical framework explains the existing theories that support your research,
showing that your topic is relevant and grounded in established ideas.

 A well-rounded theoretical framework sets you up for success later on in your

research and writing process.
 Your theoretical framework is your opportunity to present and explain what
you’ve learnt, situated within your future research topic.
 While a theoretical framework describes the theoretical underpinnings of your
work based on existing research, a conceptual framework allows you to draw your
own conclusions, mapping out the variables you may use in your study and the
interplay between them.
CONCEPTUAL FRAMEWORK

 It illustrates the expected relationship between your variables. It defines the

relevant objectives for your research process and maps out how they come
together to draw coherent conclusions.

 It is often represented in a visual format and illustrate cause-and-effect

relationships.
Step 1: Select your research objective

 Your research objective guides your work by determining exactly what you want
to find out, giving your research process a clear focus.
Developing a conceptual framework

Step 2: Select your independent and dependent variables

 In order to move forward with your research question and test a cause-and-effect
relationship, you must first identify at least two key variables: your independent
and dependent variables.

 The expected cause, “hours of study,” is the independent variable (the predictor,
or explanatory variable)

 The expected effect, “exam score,” is the dependent variable (the response, or
outcome variable).
 In other words, you suspect that “exam score” depends on “hours of study.” Thus,
your hypothesis will be that the more hours a student studies, the better they will
do on the exam.

 Note that causal relationships often involve several independent variables that
affect the dependent variable. For the purpose of this example, we’ll work with
just one independent variable (“hours of study”).
Step 3: Visualize your cause-and-effect relationship

 This can be demonstrated using basic design components of boxes and arrows.
Here, each variable appears in a box.

 To indicate a causal relationship, each arrow should start from the independent
variable (the cause) and point to the dependent variable (the effect).
Step 4: Identify other influencing variables

 It’s crucial to identify other variables that can influence the relationship between
your independent and dependent variables early in your research process.

 Some common variables to include are moderating, mediating, and control

variables.
Moderating variables (Moderators)

 These alter the effect that an independent variable has on a dependent variable.

 They change the “effect” component of the cause-and-effect relationship.

 Example: We expect that the number of hours a student studies is related to their
exam score—i.e., the more you prepare, the higher your score will be.

 Let’s add the moderator “IQ.” Here, a student’s IQ level can change the effect that
the variable “hours of study” has on the exam score. The higher the IQ, the fewer
hours of study are needed to do well on the exam.

 We expect that the “IQ” moderator moderates the effect that the number of study
hours has on the exam score.
Mediating variables

 They link the independent and dependent variables, allowing the relationship
between them to be better explained.

 Example: The mediating variable of “number of practice problems completed”

comes between the independent and dependent variables.

 Hours of study impacts the number of practice problems, which in turn impacts
the exam
 A moderating variable is not affected by the independent variable, even though it
affects the dependent variable. For example, no matter how many hours you study
(the independent variable), your IQ will not get higher.

 A mediating variable is affected by the independent variable. In turn, it also

affects the dependent variable. Therefore, it links the two variables and helps
explain the relationship between them.
Control variables

 These are variables that are held constant so that they don’t interfere with the
results. Even though you aren’t interested in measuring them for your study.
 Example: It is very possible that if a student feels ill, they will get a lower score
on the exam. However, we are not interested in measuring health outcomes a part
of our research.

 This makes “health” a good candidate for a control variable. It still impacts our
results, but we aren’t interested in studying it.

 Now, we add “health” to our conceptual framework, but decide to keep it

constant. This means we’ll only include participants who are in good health on the
day of the exam.
QUESTIONS??