Introduction to research methods

YOHANNES Y. (MPHE

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 Session objectives
At the end of the session the trainee will be able
to:
•Define research and research method
•Describe categories of research
•Describe the purposes of research
•Describe criteria for prioretizing problems for
research

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 Definitions
• Research technique: a specific approach or
tool-and –its use whereby data are gathered
and analyzed and inferences are drawn
• Research method: the manner in which a
particular project is undertaken.
 comprises one or more research techniques
 Research methodology: the study of research
methods

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What is research ?
•Research is the systematic process of
collecting and analyzing information (data) in
order to increase our understanding of the
phenomenon about which we are concerned or
interested.

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• Research is the systematic collection, analysis
and interpretation of data to answer a certain
question or solve a problem.
• Its efforts to address health and health related
problems and come up with better solutions to
mitigate the prevailing problem.

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 Types of research
Philosophical approach:

1.Empirical:
 Based upon observation and experience
 HSR mainly follows empirical approach

2. Theoretical:
 Based on theory and abstraction
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Functionally:
1. Basic research –to generate new knowledge and
technologies to deal with unresolved health
problems.
2. Applied research -to identify priority problems and
to design and evaluate policies and programs that
will deliver the greatest health benefits ,making
optimal use of available resources

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Based on approach

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• Three operation interlinked categories
1. Biomedical research deals primarily with basic research
involving processes at the cellular level
2. Clinical research deals with issues of patient(s), and
3. Behavioural research deals with the interaction of man
and the environment in a manner reflecting the beliefs
attitudes & practices of the individual in society

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 Research purpose
The three general purposes are:

 Exploration
 What?
 (when little is known about the phenomena
 Description
 summarize the characteristics
 Seeks to accurately describe current or past phenomena
 Explanation
 Why? And what will be ?
 Answers cause-effect questions

A given study can have more than one of these purposes

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 Health system Research

• Health System Research is ultimately concerned

with improving the health of people and
communities, by enhancing the efficiency and
effectiveness of the health system as an integral part
of the overall process of socio-economic
development, with full involvement of all partners.

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 Health system Research cont…

• Health System- all public and private

sectors/institutions which directly influence and
support the health of people, embedded in the wider
environmental context(geographical, socio-
economic, cultural, political, demographic,
epidemiological factors)

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 Health system Research cont…

• The major objective of HSR is to provide health

managers at all levels, as well as community
members, with the relevant information they need
to make decisions on health-related problems they
are facing.

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 Health system Research cont…
• Guidelines for HSR
• Priority problems
• Be action-oriented
• Multi-disciplinary
• Participatory/policy maker-community member/
• Be timely
• Emphasis simple and short-term research
• Cost-effectiveness
• Report formats most useful for administrators,
decision-makers and the community.
• Evaluation/ability to influence policy & improve
services/

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Characteristics of research:
• It demands/stress/ a clear statement of the
problem
• It requires clear objectives and plan
• It builds on existing data, using both positive and
negative findings.
• New data should be systematically collected and
analyzed to answer the original research
objectives
• is characterized by patient and unhurried activity
• is carefully recorded and reported
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 Research must be:
Purposeful: what do you want to be able to contribute?
Targeted: Who are the audiences?
Credible: consider sources of information, method of
data collection, personnel involved…
Timely: Is the information needed?

Research is done to find solutions to health problems.

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 Research Process
• Research process consists of series of actions or steps
necessary to effectively carry out research and the desired
sequencing of these steps.

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 Problem identification and
conceptualization
Problem?
•Discrepancy (gap) between ‘what is’ and ‘what should
be’.

•How could we identify a problem?

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Problem?...

Whether a problem requires research depends on three

conditions:

I) There should be a perceived difference or discrepancy

between what it is and what it should be;

II)The reason(s) for this difference should be unclear (so

that it makes sense to develop a research question); and

III) There should be more than one possible and plausible

answer to the question (or solution to the problem).
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 Sources of Research Problem

• The sources of a research problem could be

– Observations

– Experts

– Literature reviews

– Professional conferences

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Criteria to prioritize a problem
1.Relevance

2.Political acceptability

3.Ethical acceptability

4.Avoidance of duplication

5.Urgency of data needed

6.Feasibility

7.Applicability

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Analyzing the ‘core’ problem
• Identify factors that may have contributed to the ‘core’
problem

• Clarify the relationship between the ‘core’ problem and

the contributing factors:- best if visualized in the form of
diagram

• Diagram: core problem-box with double line, relationship

indicated using arrows: one-way (‘cause-effect’) and two-
way (mutual)

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How to do analyzing the ‘core’ problem?
Steps:
1. Literature review
2. Clarify view points of stakeholders
3. Brainstorm on possible causes or factors contributing to the
‘core’ problem
4. Identify further contributing factors, if any
5. Prepare ‘initial cards’
6. Attempt to organize related factors together into large
categories, and develop final draft of the diagram

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Organizing related factors:

Example:
• Socio-cultural: women’s status, maternal literacy,
child spacing, feeding practices…
• Disease related: recurrent, chronic infections…

• Health service related: access, quality of service

• Poverty (absolute): touches many aspects

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After analyzing the core problem:
• Reconsider the scope and focus of the research
• Consider usefulness of the information to be
obtained
• Consider feasibility
• Consider duplication
• Appreciate the gap in knowledge!
• Then start formulating statement of the
problem
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Research Question
What is a Research Question?

• A Research Question is a statement that identifies the

phenomenon to be studied.

• The first major section in research is to identify the

problem.

• Without clearly defined problem conducting research

is not meaningful

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How do you develop a research question?

To develop a strong research question, you should

ask yourself:

– Do I know the field?

– What are the important research questions in my
field?
– What does the literature say about the field?
– What areas need further exploration?
– Could my study fill a gap?
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How do you develop a research question?...
– Could my study lead to greater understanding?
– Has a great deal of research already been
conducted in this topic area?
– Has this study been done before? If so, is there
room for improvement?
– Is the timing right for this question to be
answered?
– Is it a hot topic, or is it becoming obsolete?
– Would funding sources be interested?
– If you are proposing a service program, is the
target community interested?
– Most importantly, will my study have a significant
impact on the field?
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Research Question…

Articulating your research question

• Clear, concise way to explain what scientific
enquiry you are making
• It is crucial that you get this right from the
beginning
• It is surprising how far people can get without
a clearly worded research question

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Example of Research Question

Example 1
• TB programme focal point interested in why the
treatment success rate is lower in Hamar district in
SNNPR and wonders whether the high proportion of
nomadic people is responsible for the observed
difference or other possible reasons.

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Example of Research Question…
• Why does Hamar district have a lower treatment
success rate compared to other districts and is this
due to higher nomadic population or other factors that
might affect the rate including access to health
centres and a long treatment regimen which is not
acceptable to many in the population?

• What factors are responsible for the lower observed

treatment success rate in hamar district compared to
surrounding regions?

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 Example of Research Question…

Example 2
• Laboratory focal point from RHB is interested in the high
proportion of positive 2 month sputum follow-up smears
from one district facility

Research question
• What is quality of laboratory performance in district X?
• What are the reasons for the higher than expected two-
month smear follow-up positivity rate in District X?

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 Research topic selection
Selecting a research topic – initial screen
– Personal and professional interest
– Organizational interest and values
– Consistent with regional/national programme
research priorities
Concise and descriptive, self-explanatory
Catchy but simple language
Investigators
– Principal and co-investigators
– Affiliations, roles

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 Selecting a research topic – further
refinement
Relevance
Possibility of fixing constraint identified
Avoidance of duplication
Urgency of data needed (timeliness)
Political acceptability of study
Feasibility of study
Applicability of results
Ethical acceptability
Impact of research on target population or setting

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 Research topic selection criteria
The development of a health project goes through a
number of stages.

– It should be noted that development of a research

proposal is often a cyclical process.

– If the answer to the research question is obvious,

we are dealing with a management problem that
may be solved without further research.

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 Topic selection…
Whether a problem requires research depends on
three conditions:
I) There should be a perceived difference or discrepancy
between what it is and what it should be;

II)The reason(s) for this difference should be

unclear (so that it makes sense to develop a research
question); and

III) There should be more than one possible and plausible

answer to the question (or solution to the problem).

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 Topic selection…
• Example 1
– Problem situation: In district “ Y “ a report showed that in the first month
there were 500 children under one year old who started immunization, but at the
end of the year it was found out that there were only 25 children who completed
their vaccination.
– Discrepancy: All the 500 children at district “ Y “ should have completed their
vaccination but only 5% out of those who started vaccination have completed.
– Problem (research) question: why only 5% of the children completed their
vaccination?

• Definite answer: Out of the 1 hospital, 2 health centers and 10 health

stations found in district “Y” only 2 health stations were functioning, the
rest were closed due to insecurity in the area.

• In the above example, assuming that all the given information is true,
there is no need of undertaking a research, since definite answer is
obtained to the problem situation.

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 Topic selection…
Example 2
•Problem situation: In district “Z” (population 150,000) there are 2 health
centers, 1 hospital and 15 health stations and all of them function smoothly.
However, at the end of the year it was found that the EPI coverage was only 25%
•Discrepancy: Although district “Z ” had 100% availability of health services
and at least 80% of the children should have had full vaccinations the EPI
coverage was only 25% as seen above.
•Problem question: What factors influence the low EPI coverage in district “Z”?

Possible answers:
•Mothers might have problems for not attending in the EPI sessions.
•The MCH, EPI, OPD, etc… programmes might not have been integrated; hence
children might have missed opportunities in getting immunization. The follow
up of defaulting children might not be effective and other reasons.
•Thus, the above problem situation is researchable.

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 Topic Selection….
• Each problem that is proposed for research has to be judged
according to certain guidelines or criteria.

• Before deciding on a research topic, each proposed topic

must be compared with all other options.

• The guidelines or criteria given below can help in the

process of selection of topics.

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 Exercises
1. In a certain district (population, 150,000), sanitary
conditions are very poor (only 10% of households have
latrines) and diseases connected with poor sanitation, such
as, gastroenteritis and worms are very common. The
Ministry of Health has initiated a sanitation project that
aims at increasing the number of households with latrines
by 20% each year. The project provides materials and the
population should provide labor. Two years later, less than
half of the target has been reached.
• State the discrepancy, research question and the possible
answers. Is this problem situation researchable?
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 Objective criteria
1. Relevance : The topic you choose should be a priority
problem:

Questions to be asked include:

ƒ How large or widespread is the problem?

ƒ Who is affected?
ƒ How severe is the problem?

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 Conti…
2. Avoidance of duplication:

• Investigate whether the topic has been researched.

• If the topic has been researched, the results should be

reviewed to explore whether major questions that deserve
further investigation remain unanswered.

• If not, another topic should be chosen.

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 Conti….
3. Feasibility

• Consider the complexity of the problem and the resources

you will require to carry out the study.

• Thought should be given first to personnel, time, equipment

and money that are locally available.

• In situations where the local resources necessary to carry

out the project are not sufficient, you might consider
sources available at the national level.
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 Conti…
4. Political acceptability
• It is advisable to research a topic that has the interest and
support of the authorities.

• This will facilitate the smooth conduct of the research and

increases the chance that the results of the study will be
implemented.

5. Applicability of possible results and recommendations

• Is it likely that the recommendations from the study will be
applied?
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 Conti…
• This will depend not only on the blessing of the authorities
but also on the availability of resources for implementing
the recommendations.

6. Urgency of data needed

• How urgently are the results needed for making a decision?

• Which research should be done first and which can be done

late?

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7. Ethical acceptability
• We should always consider the possibility that we may
inflict harm on others while carrying out research.

Therefore, it will be useful to review the proposed study.

• Personal interest

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 Scales for rating research topics
Relevance
1 = Not relevant
2 = Relevant
3 = very relevant
Avoidance of duplication
1 = Sufficient information already available
2=Some information available but major issues not covered
3 = No sound information available on which to base problem-
solving

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 Conti…
Feasibility
1 = Study not feasible considering available resources
2 = Study feasible considering available resources
3 = Study very feasible considering available resources

Political acceptability
1 = Topic not acceptable
2 = Topic somewhat acceptable
3 = Topic fully acceptable

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 Conti…
Applicability

1 = No chance of recommendations being implemented

2 = Some chance of recommendations being implemented
3 = Good chance of recommendations being implemented
Urgency
1 = Information not urgently needed
2 = Information could be used but a delay of some months
would be acceptable
3 = Data very urgently needed for decision-making
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 Conti…

Ethical acceptability
1 = Major ethical problems
2 = Minor ethical problems
3 = No ethical problems
N.B. The above rating should be based on the existing data
and not on mere assumptions.

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 What are the qualities of a good research topic?

• The first thing that determines the success of your research

is your research topic.
• A good research topic should have the following qualities.
 Clarity is the most important quality of any research topic.
It should have to be clear so that others can easily
understand the nature of your research.
 Well-defined and well-phrased research topic is a half
guarantee of a successful research.

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 What are the qualities of …

 The language of the research topic should have to be simple.

You should use technical terms only when it is necessary,
otherwise use simple words so that everyone can
understand it.
 The titling of the research problem should follow the rules of
titling. there are various rules of titling.
You can either use a sentence case or a title case but most
of the titles follow title case.
 Current importance :An obsolete topic will not be beneficial
for anyone.

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 Exercises
1. Go to the nearby health institution and identify
three health problems. Discuss about these health
problems and rate them based on the selection
criteria.
When rating these problems based on the criteria, use
the rating scale indicated at the bottom of the
table.You can do the exercise in small groups.
Which topic do you select for research? Defend your
first choice in a plenary session.

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