Effective Proposal Writing for Health Research

 
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Research and Research proposal
 
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At the end of the session, participants
should be able to
Define the term research and describe the
difference between basic and applied
researches
Describe the major characteristic of research
Describe the two major purposes of health
research
Describe what a research proposal is
 
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Search for knowledge
 
An art of scientific investigation
 
Dictionary meaning
Careful investigation or inquiry specially through
search for a new facts in any branch of knowledge
 
“Movement” from known to the unknown. It
is a voyage of discovery.
 
 
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Research
 is the 
systematic collection
,
analysis
 and 
interpretation
 of data to
answer a certain question or solve a
problem.
 
Health research
 is a research effort to
address 
health related problems
 and come
up with better solutions to mitigate the
prevailing problem
 
 
 
What makes people to undertake
research?
 
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Desire to get a research degree along with its
consequential benefits
Desire to face the challenge in solving the
unsolved problems, i.e. concern over practical
problems initiates research
Desire to get intellectual joy of doing some
creative work
Desire to be of service to society
Desire to get respectability
 
Directives of government
Employment condition
Curiosity about new things
Desire to understand causal relationship
Social thinking and awakening
 
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Basic
 versus 
applied
 research
 
Basic research- fundamental, pure
 
Is designed to extend the bases of knowledge in a
discipline, for the sake of understanding itself
Gathering knowledge for knowledge’s sake
 
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Concerned with formulation of theory
Ultimately some of this knowledge may be applied
 
Applied research – action research
 
is 
problem oriented 
& directed towards the solution of
an existing problem
 
concentrates on finding 
solutions
 to immediate
problems
 of practical nature
 
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Basic
 versus 
applied
 research
 
Empirical research
 
The philosophical approach to research is basically of two
types:
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Health research mainly follows the empirical approach, i.e.
it is based upon observation & experience
 more than upon
theory & abstraction.
 
Empirical research in the health sciences can be
qualitative
 or 
quantitative
 in nature.
 
In most cases, health science research deals with
information of a 
quantitative
 nature – i.e. measurement of
quantity or amount.
 
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is a type of formative research that offers specialized
techniques for obtaining in-depth responses about
what people 
think
 and how they 
feel
.
 
It enables program management to gain insight
into 
attitudes
, 
beliefs
, 
motives
 and 
behaviors
 of
the target population.
 
It deals with the 
emotional
 and 
contextual
aspects of human response rather than with
objective measurable behaviors and attitudes.
 
Empirical research
 
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It demands a clear 
statement of the problem
 
It requires a clear 
objective
 and a 
plan
 (it is not aimlessly
looking for something in the hope that you will come
across a solution).
 
It builds on existing data, using both positive and negative
findings
 
New data are 
systematically collected
 and 
analyzed
 to
answer the original research objectives.
 
 
 
What is research proposal?
 
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What is a research proposal?
Is a document that presents a 
plan for a project
 to reviewers for
evaluation.
It can be a supervised project submitted to instructors as part of
educational degrees (masters thesis, PhD dissertation)
Can be a project proposed to funding agency
 
Purpose of a research proposal
Convince
 reviewers that the researcher is capable of
successfully conducting the proposed research project.
 
Provide clear indication of the 
topic
 in which the researcher is
interested
 
Give indication of researcher's ability to develop an interesting
research question
 
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Reviewers have more confidence that planned projects
will be successfully completed , if proposal is well written,
organized and demonstrate careful planning
 
Is considered as preliminary indicators of the
researcher’s area of interest and potentials to undertake
the research work without problem.
 
Will be considered in conjunction with 
researcher’s
academic qualifications
 and previous 
exposures
 in
undertaking similar research work
 
Researcher’s qualification provide evidence about his/her
academic ability to undertake proposed research work
 
The proposal is similar to a research report, but
written before the research project begins
Research proposal
Describes 
research problems 
and its importance
 
Gives details of the 
methods
 that will be used and why
they are appropriate
 
Has 
plan
 for data collection and analysis
 
Includes 
schedules
 of the steps to be undertaken and
estimates of the 
time
 and 
budget
 required to carry out
each step of the research
 
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The proposal for quantitative research has
most important parts of the research report:
A title
An abstract
Introduction: problem statement, rationale
A literature review
Research objective
A method or design section
A bibliography
It lacks 
result
, 
discussion
, and 
conclusion
 
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Research proposal is not only judged by
its content, but also by its form
 
Must look professional
Must be typed and written in good English
Should be well structured with section
headings clearly indicated
If photocopy, it has to be of high quality
Always include bibliography/references
 
Changes to research proposal
 
It is natural for ideas to evolve and change
You will not forced to adhere to specifics of your
proposal
 
Avoid making any substantial changes to the 
broad
direction of your proposal 
after acceptance by your
donor, supervisors or organizations
 
Proposal is the basis of your working relationship with
your supervisors and potential donors and thus it cannot
be radically altered 
without discussion and consultation
with your supervisors or donors
.
Research Problem
 
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Describe the reasons for including a statement
of the problem in a research proposal
 
Describe what a research problem is
 
Outline information that should be included in
the statement of the problem
 
Prepare the statement of the problem for the
research proposal being developed during the
course.
 
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The first major section in a research proposal is
the “
statement of the problem
 
It should describe 
the problem that is to be
investigated
 and 
the question that will guide the
research process
 
All research is set in motion by the existence of
a problem
 
 
What is a research problem?
 
A problem is a perceived 
discrepancy
between what some one believes should
the situation be and what the situation is in
reality
 
While problems are initiating force behind
research, not all problems require research
 
 
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What is a research problem?
 
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Because a clear statement of the problem :
 
Is the foundation for further development of the
research proposal (
objectives, methodology, work
plan, budget,
 etc)
 
Makes it easier to find 
information & reports of similar
studies
 from which your own study design can benefit.
 
Enables you to systematically point out why the
proposed research on the problem should be
undertaken & what you hope to achieve with the study
results.
 
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Tips on how to write a problem
statement?
 
It should be 
precise & concise
, while not
forgetting to mention essential points.
 
Information concerning the problem should be
summarized
, & brief so the reader is not
“drowned” in detail.
 
An outline listing the major points to be covered
could be prepared before any writing is done, so
the section will be logical and well organized.
 
Factors Contributing to Unattended Delivery among ANC Attendants at
Government-owned Health Centers in Addis Ababa.
 
Addis Ababa is the capital city of Ethiopia with an area of 530 km2 and a total population of 3
Million. It has 10 sub-cities.  The health service coverage of Addis Ababa is 71%. There are 5
hospital, 24 health centers, 32 health posts & more than 500 private health institutions providing
health services including ANC and Delivery.
 
ANC coverage of the city is estimated at 86%.  Despite this high coverage of ANC only 56% of
pregnant women give birth in health institutions, while the remaining 44% deliver elsewhere,
including unattended home deliveries.  Unattended deliveries are known to be associated with
maternal and perinatal morbidity and mortality, such as antepartum hemorrhage (APH),
postpartum hemorrhage (PPH), birth trauma, infection, and fistula.
 
There are no studies that have examined the factors contributing to unattended delivery despite
high overall service coverage and antenatal care coverage in Addis Ababa.  Many health
institutions attempt to improve the situation through the training of traditional birth attendants,
expanding health education and community mobilization activities.  However, these efforts are
not based on systematic evidence into possible determinants of the prevailing practice.  The
present study is intended to contribute to bridging the information gap, and subsequently the
coverage of institutional deliveries in the city.
 
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Literature Review
 
Why literature review?
 
Comprehensive and focused literature review on
your particular topic is needed
To define the set (or sub-set) of knowledge to which
your research relates to most directly
 
To learn the major 'trends' or issues in that body of
knowledge that have been most significant in shaping
your study
 
To learn the theoretical agenda of that body of
knowledge to which your project relate to most directly
To identify the major controversies that are important
for your project
 
Why literature review?
 
Helps further  understanding of the problem you plan to
research, & may lead to refining of the “
Statement of the
problem
”.
 
Helps you find out what others have 
learned & reported
 on
your topic, & take account of this in the design of your
study.
 
It gives you a familiarity with the various types of
methodologies
 that might be used in your study.
 
It prevents you from 
“reinventing the wheel”.
 
Properly reviewed literature lay foundation for the study
from which the 
rationale
 for the study, the statement of the
problem
, 
hypotheses
 or research 
questions
, & the 
design
 of
the research emerge or concretize
 
Why literature review?
 
A 
“long”
 but complete and thoughtful review will
help you convey the message, while skimpy review
may depict you as 
unprepared
 for, and/or 
not
seriously committed
 to the research process
 
However, the mere length of  a review without
relevance
 can bury the essence of the research
proposal itself.
 
Hence, the literature review is the 
intellectual
ancestor’ 
of the research project.
 
Literature review
 
The result of LR should be
A reaffirmation of the importance of the
theoretical rationale of the project in the light
of the work of others in the same area,
 
An emphasis on the contribution which the
project is likely to make to the ongoing task
of building & improving theory in a given
area of knowledge. 
The latter should be your
target!
 
Sources for Literature review
 
Sources for LR include
Card catalogues of books in libraries
Indexes such as INDEX MEDICUS, INTERNATIONAL NURSING
INDEX etc. that identify journal
Summaries of abstracts of books and articles
Computer-based literature searches such as MEDLINE, PUBMED.
Bibliographies such as those found at the end of the books, articles.
Books, articles, newspapers, reports, etc.
Statistics collected at the national, provincial, departmental levels.
Studies conducted in the country or region.
Responses to enquiries on ongoing research.
Theoretical works related to the topic.
Works on methodology & descriptions of methodologies of studies
Opinions, beliefs, points-of-view.
Anecdote, clinical observations, reports of incidents, etc.
 
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 Year, Volume, (number): page numbers of article.
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chapter.
 
Formulation of a
Research Objective
 
R
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What is a research objective?
 
It is a statement that clearly depicts the 
goal
to be achieved by a research project.
or
 
In other words, the objectives of a research
project 
summarize
 what is to be achieved by
the study
 
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When should the research
objectives be prepared?
 
After the statement of the problem &
before the methodology
 
R
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What are the characteristics of good
objectives?
Logical & coherent
Feasible
Considering local conditions
Defined in operational terms that can be
measured
Phrased to clearly meet the purpose of
the study
 
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Increase contraceptive prevalence by 15% in
Increase contraceptive prevalence by 15% in
women 30-49 years of age
women 30-49 years of age
Specific
Specific
:
:
 Yes, the intended outcome of the program is
 Yes, the intended outcome of the program is
specified.
specified.
Measurable
Measurable
: Yes, contraceptive prevalence is measurable.
: Yes, contraceptive prevalence is measurable.
Appropriate
Appropriate
: Unknown, because the program’s goal would need
: Unknown, because the program’s goal would need
to be provided in order to know whether the objective relates
to be provided in order to know whether the objective relates
logically to it.
logically to it.
Realistic
Realistic
: Unknown, because the resources available to the
: Unknown, because the resources available to the
program would need to be known.
program would need to be known.
Time bound
Time bound
: No, the time within which the objective is to be
: No, the time within which the objective is to be
achieved is not specified.
achieved is not specified.
So this objective is not known to be “SMART” because,
So this objective is not known to be “SMART” because,
although it meets some of the criteria, it does not meet
although it meets some of the criteria, it does not meet
them all.
them all.
 
How should objectives be stated?
 
Objectives should be stated using  
“action
verbs”
 that are specific enough to be
measured
Example:
To determine……., To compare……..
To verify….., To calculate……
To describe….., to assess………etc
Do not use vague non-action verbs
To appreciate……
To understand……, to believe…….
 
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Depends on the type of study that will be
undertaken.
If the study is 
descriptive
 or 
exploratory
 in nature,
objectives are stated in the form of questions or
positive sentences.
Questions: 
“The objectives of this study are to answer
the following questions …”
Positive sentence:  
“The objectives of this study are to
determine …”
If the researcher knows enough to make
predictions concerning what s/he is studying, then
hypotheses
 may be proposed:-
“The objective of this study is to verify the following
hypothesis...”.
 
Types of research objectives
 
Commonly, research objectives are classified into
general objectives
 and 
specific objectives
.
They are logically connected to each other
 
General objectives
closely related to the statement of the problem
 
Some times called 
purpose
 of the research
 
Identifies in general terms what is to be accomplished
by the research and why
 
Types of research objectives
 
Specific objectives
considered as smaller portions of the general
objectives.
identify in greater detail the specific aims of the
research project,
identify the questions that the researcher wants to
answer
Systematically address the various aspects of the
problem as defined under ‘
Statement of the Problem
’ &
the key factors that are assumed to influence or cause
the problem.
They specify 
what
 to do in a study, 
where
 & for 
what
purpose
.
 
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p
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b
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s
:
To assess the KAP of the community towards HIV/AIDS & the VCT
service
To identify barriers & concerns related to VCT & its use
To assess awareness & perception of the study community
regarding comprehensive care & support activities to PLWHA
Based on the study findings to forward practicable
recommendations for policy makers and service providers.
 
Example 2
: A study looking into factors influencing
utilization of maternal health care services in X District
 
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,
To identify factors that influence women’s attendance
at antenatal care (ANC) & institutional delivery care
services,
To identify the sources of delivery service & mothers’
preference of place of delivery,
To determine coverage with ANC & TT vaccination
among mothers
Research hypothesis
 
What is a Research Hypothesis?
 
A hypothesis is a guess (or conjecture) about the nature
of some process or interaction which is tested by
collecting facts which leads to its acceptance or rejection.
 
Instead of collecting data with the aim of ‘let’s see what
we get’ it is to collect data to prove or disprove guesses
 
A research hypothesis can be a ‘positive declaration (
the
infant mortality rates in A & B regions are different
), (
the
rate is higher in A than in B
) OR negative or null (there is
no difference between the two regions).
 
A hypothesis can be defined as “a tentative prediction or
explanation of the relationship between two or more
variables.
 
A hypothesis translates the problem statement
into a precise, unambiguous predication of
expected outcomes.”
 
Hypothesis statements are most applicable for
field intervention or evaluative studies.
 
Diagnostic or exploratory studies do not normally
require hypothesis statements because they
generally do not test relationships between
variables.
 
What is a Research Hypothesis?
 
Research Hypothesis
 
A single hypothesis might state that variable A is
associated with variable B, or that variable A causes
variable B.
 
Sometimes a hypothesis will specify that, under condition
X, Y and Z, variable A is associated with variable B.
 
When writing hypothesis statements, it is important to keep
in mind the distinction between dependent and independent
variables
 
An independent variable causes, determine or influence the
dependant variables
 
Whenever the independent variable changes, the
dependant variable changes
 
Research hypothesis
 
Example:
Independent
variables
Cause, determine
or influence
Dependant
Variable
 
Types of Research Hypotheses
 
Simple
Simple
 hypothesis predicate the relationship
between one 
independent
 & one 
dependant
variable
Example:
Health education involving active participation of
mothers will produce more positive changes in
child feeding than health education based on
lectures.”
Independent variable
: Type of health education
Dependant variable
: Changes in child feeding
 
C
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.
Independent variable
: Physicians action vs those of
nurses
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g
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n
 
Types of Research Hypotheses
 
Format of research hypothesis
 
A hypothesis can be stated in the “
null
” format,
which simply states, for example as
t
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t
 
A hypothesis can be stated in a “
directional
” or
alternative
” format, where the ‘direction’ of the
relationship is clearly indicated.
E
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.
Research Methods
 
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The methodology of the research project is the
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Taking into consideration the work already done,
i.e.
Selection of research problem
Review of the literature
Identification of research objectives or
Formulation of research hypothesis, the following
questions need to be answered when beginning to
prepare a research design for research proposal
 
Questions to be asked to prepare a research
design
 
What
 do I want to measure?
How
 can I measure it?
Where
 should I measure it?
What
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answers
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How
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What
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staff
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carry out this study?
What types of 
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Are there any 
ethical
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How can I avoid introducing 
biases
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What 
constraints
 may affect this study?
 
Components of research design
 
Components of a research design that should
be addressed in the methodology section of a
research proposal include
1.
Variables
2.
Study population
3.
Sampling method
4.
Plan for data collection
5.
Plan for data analysis
6.
Plan for interpretation of the results
7.
Staffing, supplies & equipment
8.
Ethical considerations
 
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The type of study design chosen
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The type of problem
The objectives of the study
The hypothesis formulated
The knowledge already available about the
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Resources (person, time, money, logistic &
admin support) available for the study
Descriptive
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Monthly income (expressed in Birr, or Dollars);
Number of children (1, 2, etc.).
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Variables
 
How should variables for a particular study be
selected?
 
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research may become difficult.
 
Dependent and independent variables
 
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Dependent and independent variables
 
Whether a variable is dependent or independent
is determined by the 
statement of the problem
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objectives
 of the study.
 
Example: Relationship between use of
prophylactic Ionized (INH)  and TB:
 
“Development of clinical TB” (with the values yes/no)
would be the dependent variable and  “prophylactic
INH” is the independent variable.
 
Standardization of variables
 
Each variables measured in a study
should be clearly & explicitly defined so
that
Every body understood the meaning of the
result exactly the same way
 
Similar findings would be obtained if the
study were repeated by the same or
different investigator.
 
Definition of variables and measurement
 
Definition is to ensure that observations are replicable.
 
The same term may have more than one meaning or may
mean different thing to different people.
Example
: What one person might call ‘common cold’ another
should not say ‘influenza’
 
Such difference in perception can lead to situations where
measurement of variables by different people will produce
different results, i.e. the findings are not reproducible.
 
Two kinds of definition:
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Learn about the fundamentals of research proposals for health-related studies, including defining research, understanding the purposes of health research, and exploring motivation for undertaking research. Discover the difference between basic and applied research, examine types of research, and delve into the significance of research in contributing innovative solutions to health challenges.


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  1. PROPOSAL WRITING FOR HEALTH AND HEALTH- RELATED RESEARCH Assefa Seme

  2. Research and Research proposal

  3. Learning Objectives At the end of the session, participants should be able to Define the term research and describe the difference between basic and applied researches Describe the major characteristic of research Describe the two major purposes of health research Describe what a research proposal is

  4. What is research? Search for knowledge An art of scientific investigation Dictionary meaning Careful investigation or inquiry specially through search for a new facts in any branch of knowledge Movement from known to the unknown. It is a voyage of discovery.

  5. What is research? Research is the systematic collection, analysis and interpretation of data to answer a certain question or solve a problem. Health research is a research effort to address health related problems and come up with better solutions to mitigate the prevailing problem

  6. What makes people to undertake research?

  7. Motivation in Research Desire to get a research degree along with its consequential benefits Desire to face the challenge in solving the unsolved problems, i.e. concern over practical problems initiates research Desire to get intellectual joy of doing some creative work Desire to be of service to society Desire to get respectability

  8. Motivation in Research Directives of government Employment condition Curiosity about new things Desire to understand causal relationship Social thinking and awakening

  9. Types of research

  10. Basic versus applied research Basic research- fundamental, pure Is designed to extend the bases of knowledge in a discipline, for the sake of understanding itself Gathering knowledge for knowledge s sake Purpose: is necessary to generate new knowledge and technologies to deal with major unresolved health problems Concerned with formulation of theory Ultimately some of this knowledge may be applied

  11. Basic versus applied research Applied research action research is problem oriented & directed towards the solution of an existing problem concentrates on finding solutions to immediate problems of practical nature Purpose: is necessary to identify priority problems and to design & evaluate policies and programs that will deliver the greatest health benefits, making optimal use of available resources.

  12. Empirical research The philosophical approach to research is basically of two types: Empirical and theoretical. Health research mainly follows the empirical approach, i.e. it is based upon observation & experience more than upon theory & abstraction. Empirical research in the health sciences can be qualitative or quantitative in nature. In most cases, health science research deals with information of a quantitative nature i.e. measurement of quantity or amount.

  13. Empirical research Qualitative research is a type of formative research that offers specialized techniques for obtaining in-depth responses about what people think and how they feel. It enables program management to gain insight into attitudes, beliefs, motives and behaviors of the target population. It deals with the emotional and contextual aspects of human response rather than with objective measurable behaviors and attitudes.

  14. Characteristics of research It demands a clear statement of the problem It requires a clear objective and a plan (it is not aimlessly looking for something in the hope that you will come across a solution). It builds on existing data, using both positive and negative findings New data are systematically collected and analyzed to answer the original research objectives.

  15. What is research proposal?

  16. Research proposal What is a research proposal? Is a document that presents a plan for a project to reviewers for evaluation. It can be a supervised project submitted to instructors as part of educational degrees (masters thesis, PhD dissertation) Can be a project proposed to funding agency Purpose of a research proposal Convince reviewers that the researcher is capable of successfully conducting the proposed research project. Provide clear indication of the topic in which the researcher is interested Give indication of researcher's ability to develop an interesting research question

  17. Research proposal Reviewers have more confidence that planned projects will be successfully completed , if proposal is well written, organized and demonstrate careful planning Is considered as preliminary indicators of the researcher s area of interest and potentials to undertake the research work without problem. Will be considered in conjunction with researcher s academic qualifications and previous exposures in undertaking similar research work Researcher s qualification provide evidence about his/her academic ability to undertake proposed research work

  18. Research proposal The proposal is similar to a research report, but written before the research project begins Research proposal Describes research problems and its importance Gives details of the methods that will be used and why they are appropriate Has plan for data collection and analysis Includes schedules of the steps to be undertaken and estimates of the time and budget required to carry out each step of the research

  19. Content of research proposal The proposal for quantitative research has most important parts of the research report: A title An abstract Introduction: problem statement, rationale A literature review Research objective A method or design section A bibliography It lacks result, discussion, and conclusion

  20. Research proposal Research proposal is not only judged by its content, but also by its form Must look professional Must be typed and written in good English Should be well structured with section headings clearly indicated If photocopy, it has to be of high quality Always include bibliography/references

  21. Changes to research proposal It is natural for ideas to evolve and change You will not forced to adhere to specifics of your proposal Avoid making any substantial changes to the broad direction of your proposal after acceptance by your donor, supervisors or organizations Proposal is the basis of your working relationship with your supervisors and potential donors and thus it cannot be radically altered without discussion and consultation with your supervisors or donors.

  22. Research Problem

  23. Learning Objective Describe the reasons for including a statement of the problem in a research proposal Describe what a research problem is Outline information that should be included in the statement of the problem Prepare the statement of the problem for the research proposal being developed during the course.

  24. Formulating problem statement and justification of the problems The first major section in a research proposal is the statement of the problem It should describe the problem that is to be investigated and the question that will guide the research process All research is set in motion by the existence of a problem

  25. What is a research problem? A problem is a perceived discrepancy between what some one believes should the situation be and what the situation is in reality While problems are initiating force behind research, not all problems require research

  26. What is a research problem? A potential research situation arises when three conditions exist A perceived discrepancy exists between what is & what should be. A question exists about why there is a discrepancy At least two possible & plausible answers exist to the question

  27. Why is it important to state & define the problem? Because a clear statement of the problem : Is the foundation for further development of the research proposal (objectives, methodology, work plan, budget, etc) Makes it easier to find information & reports of similar studies from which your own study design can benefit. Enables you to systematically point out why the proposed research on the problem should be undertaken & what you hope to achieve with the study results.

  28. Information to be included in problem statement? Context in which the problem occurs : A brief description of socio-economic & cultural characteristics; overview of health status & health-care system; relevant statistics. Nature of the problem (the discrepancy b/n what is & what should be) & size, distribution & severity of the problem (who is affected, where, since when, & what are the consequences for those affected & for the services). For a descriptive or evaluation study the different components of the problem should be elaborated.

  29. Information to be included in problem statement? An analysis of the major factors that may influence the problem & a discussion of why certain factors need more investigation if the problem is to be fully understood. Justification for the study: A brief description of any solutions to the problem that have been tried in the past, how well they have worked, and why further research is needed. A description of the type of information expected to result from the project and how this information will be used to help solve the problem.

  30. Tips on how to write a problem statement? It should be precise & concise, while not forgetting to mention essential points. Information concerning the problem should be summarized, & brief so the reader is not drowned in detail. An outline listing the major points to be covered could be prepared before any writing is done, so the section will be logical and well organized.

  31. Example: Statement of the problem Factors Contributing to Unattended Delivery among ANC Attendants at Government-owned Health Centers in Addis Ababa. Addis Ababa is the capital city of Ethiopia with an area of 530 km2 and a total population of 3 Million. It has 10 sub-cities. The health service coverage of Addis Ababa is 71%. There are 5 hospital, 24 health centers, 32 health posts & more than 500 private health institutions providing health services including ANC and Delivery. ANC coverage of the city is estimated at 86%. Despite this high coverage of ANC only 56% of pregnant women give birth in health institutions, while the remaining 44% deliver elsewhere, including unattended home deliveries. Unattended deliveries are known to be associated with maternal and perinatal morbidity and mortality, such as antepartum hemorrhage (APH), postpartum hemorrhage (PPH), birth trauma, infection, and fistula. There are no studies that have examined the factors contributing to unattended delivery despite high overall service coverage and antenatal care coverage in Addis Ababa. Many health institutions attempt to improve the situation through the training of traditional birth attendants, expanding health education and community mobilization activities. However, these efforts are not based on systematic evidence into possible determinants of the prevailing practice. The present study is intended to contribute to bridging the information gap, and subsequently the coverage of institutional deliveries in the city.

  32. Literature Review

  33. Why literature review? Comprehensive and focused literature review on your particular topic is needed To define the set (or sub-set) of knowledge to which your research relates to most directly To learn the major 'trends' or issues in that body of knowledge that have been most significant in shaping your study To learn the theoretical agenda of that body of knowledge to which your project relate to most directly To identify the major controversies that are important for your project

  34. Why literature review? Helps further understanding of the problem you plan to research, & may lead to refining of the Statement of the problem . Helps you find out what others have learned & reported on your topic, & take account of this in the design of your study. It gives you a familiarity with the various types of methodologies that might be used in your study. It prevents you from reinventing the wheel . Properly reviewed literature lay foundation for the study from which the rationale for the study, the statement of the problem, hypotheses or research questions, & the design of the research emerge or concretize

  35. Why literature review? A long but complete and thoughtful review will help you convey the message, while skimpy review may depict you as unprepared for, and/or not seriously committed to the research process However, the mere length of a review without relevance can bury the essence of the research proposal itself. Hence, the literature review is the intellectual ancestor of the research project.

  36. Literature review The result of LR should be A reaffirmation of the importance of the theoretical rationale of the project in the light of the work of others in the same area, An emphasis on the contribution which the project is likely to make to the ongoing task of building & improving theory in a given area of knowledge. The latter should be your target!

  37. Sources for Literature review Sources for LR include Card catalogues of books in libraries Indexes such as INDEX MEDICUS, INTERNATIONAL NURSING INDEX etc. that identify journal Summaries of abstracts of books and articles Computer-based literature searches such as MEDLINE, PUBMED. Bibliographies such as those found at the end of the books, articles. Books, articles, newspapers, reports, etc. Statistics collected at the national, provincial, departmental levels. Studies conducted in the country or region. Responses to enquiries on ongoing research. Theoretical works related to the topic. Works on methodology & descriptions of methodologies of studies Opinions, beliefs, points-of-view. Anecdote, clinical observations, reports of incidents, etc.

  38. Method of citation For an article the following information should be noted: Author (s) Surname followed by initials. Title of article. Name of Journal. Year, Volume, (number): page numbers of article. Example: Louria DB. Emerging- and re-emerging infections: The societal variables. International Journal of Infectious Disease. 1996, 1(2):59-62. For a book the following information should be noted: Author (s) Surname followed by initials. Title of book. Place: publisher, Year, Edition Example: Abramson JH. Survey methods in community medicine. Edinburgh: Churchill Livingstone, 1990, 4th ed For a chapter in a book, the reference can include: Author (s) of chapter (Surname (s) followed by initials). Chapter title. In: Editor (s) of book, (Surname (s) followed by initials). (eds). Title of book. Place: Publisher, Year: Page numbers of chapter.

  39. Formulation of a Research Objective

  40. Research objectives What is a research objective? It is a statement that clearly depicts the goal to be achieved by a research project. or In other words, the objectives of a research project summarize what is to be achieved by the study

  41. Why should research objectives be formulated? The formulation of the objectives will help you Focus the study (narrowing it down to essentials); Avoid the collection of data which are not necessary for understanding & solving the problem identified (to establish the limits of the study); Organize the study in clearly defined parts or phases. Facilitate the development of research methodology Orient the collection, analysis, interpretation & utilization of data.

  42. Research objectives When should the research objectives be prepared? After the statement of the problem & before the methodology

  43. Research objectives What are the characteristics of good objectives? Logical & coherent Feasible Considering local conditions Defined in operational terms that can be measured Phrased to clearly meet the purpose of the study

  44. Is this objective a SMART? Increase contraceptive prevalence by 15% in women 30-49 years of age Specific: Yes, the intended outcome of the program is specified. Measurable: Yes, contraceptive prevalence is measurable. Appropriate: Unknown, because the program s goal would need to be provided in order to know whether the objective relates logically to it. Realistic: Unknown, because the resources available to the program would need to be known. Time bound: No, the time within which the objective is to be achieved is not specified. So this objective is not known to be SMART because, although it meets some of the criteria, it does not meet them all.

  45. How should objectives be stated? Objectives should be stated using action verbs that are specific enough to be measured Example: To determine ., To compare .. To verify .., To calculate To describe .., to assess etc Do not use vague non-action verbs To appreciate To understand , to believe .

  46. What formats can be used for stating research objectives? Depends on the type of study that will be undertaken. If the study is descriptive or exploratory in nature, objectives are stated in the form of questions or positive sentences. Questions: The objectives of this study are to answer the following questions Positive sentence: The objectives of this study are to determine If the researcher knows enough to make predictions concerning what s/he is studying, then hypotheses may be proposed:- The objective of this study is to verify the following hypothesis... .

  47. Types of research objectives Commonly, research objectives are classified into general objectives and specific objectives. They are logically connected to each other General objectives closely related to the statement of the problem Some times called purpose of the research Identifies in general terms what is to be accomplished by the research and why

  48. Types of research objectives Specific objectives considered as smaller portions of the general objectives. identify in greater detail the specific aims of the research project, identify the questions that the researcher wants to answer Systematically address the various aspects of the problem as defined under Statement of the Problem & the key factors that are assumed to influence or cause the problem. They specify what to do in a study, where & for what purpose.

  49. Example 1:A study to assess the Accessibility & Acceptability of the VCT & community perception towards HIV/AIDS C&S in X Regional State General Objective: To identify factors that affect the acceptability of VCT services & to assess perception of the community towards a comprehensive care & support activity for HIV/AIDS. Specific Objectives: To assess the KAP of the community towards HIV/AIDS & the VCT service To identify barriers & concerns related to VCT & its use To assess awareness & perception of the study community regarding comprehensive care & support activities to PLWHA Based on the study findings to forward practicable recommendations for policy makers and service providers.

  50. Example 2: A study looking into factors influencing utilization of maternal health care services in X District General objective To assess factors influencing utilization of maternal healthcare services in District X. Specific Objectives To assess the KAP of pregnant women regarding antenatal care, and TT vaccination, To identify factors that influence women s attendance at antenatal care (ANC) & institutional delivery care services, To identify the sources of delivery service & mothers preference of place of delivery, To determine coverage with ANC & TT vaccination among mothers

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