Intrduction O Research And Health Systems Research Flashcards
Questions to answer
What is research
Scientific methods consist of what three things?
Describe the major characteristics of research in HSR and research in general research
(Describe various components of the health system as a basis for understanding Health System Research (HSR).
3.Describe types of information for decision-making in the health system and the contribution various disciplines can make in providing such information.
4.Describe the purpose, scope and characteristics of HSR.) the questions in brackets should be answered at the end of everything
What is research?
•It is the systematic collection, analysis and interpretation of data to answer a certain question or solve a problem
•It is a structured enquiry that utilizes acceptable scientific methodology
•It solves problems and create new knowledge that is generally applicable.
•Scientific methods consist of systematic observation, classification and interpretation of data.
Characteristics of research in HSR
• It demands a clear statement of the problem or problem statement
• It requires clear objectives and a plan (it is not aimlessly looking for something in the hopes that you will come across a solution).
•It builds on existing data, using both positive and negative findings and this is why literature review is very important
•New data should be systematically collected and analysed to answer the original research objectives.
Characteristics of research generally
It must be systematic-meaning it should be interrelated not disjointed
Empirical-Should originate from evidence or observation
Lab work should be reproducible
It should have the potential for application- findings should be able to be used for something or applicable
➢Systematic- All steps must be interrelated- one to another
➢Logical- Agreeing with the principles of logic
➢Empirical-Conclusions should be based on evidences/observations
➢Objectivity- It must answer the research questions
➢Replicable- reproducible
➢Transmittable
➢Quality control- Accurate measurements
➢All well designed and conducted research has potential application
What is unit of analysis
Explain the two main purposes of health research
Explain health systems research
Health systems research is ultimately concerned with what?
HSR is data driven,multi sectoral or multi disciplinary. It is more or implementational research
Objectives for research guide the researcher on what to do. Objectives should be SMART(Specific,Measurable(dependent and independent variables),Achievable,Realistic,Time bound)
True or false
The target population or the right people to ask concerning your research
Two major purposes of Health research
•First, basic research is necessary to generate new knowledge and technologies to deal with major unresolved health problems.
•Second, applied research is necessary to identify priority problems and to design and evaluate policies and programmes that will deliver the greatest health benefits making optimal use of available resources.
What is Health Systems research?
•There are different interpretations of what a health system is.
•Some give a narrow definition and only consider the different levels of the public health care services as a health system
•Refer to figure 2.2, 2.3 and 2.4 in manual
Health Systems Research
•It 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
What May health policy makers want to know using HSR
Explain integrated multidisciplinary approach
Specific questions for specific levels of service
•Health Systems Research (HSR) is not only of use to policy makers; at each level managers may have questions that require further research.
•Health policy makers may want to know:
1.What are the prospects for voluntary community-based insurance?
2.What would acceptable contributions for different income groups?
3.Should the pooling of resources take place on a community or national basis?
4.How can user-fees be used as an instrument to direct demands for care to the appropriate level?
For example health policy makers would ask questions concerning health insurance(community and national health insurance) these question asked concerning health insurance have been answered in Ghana though cuz we have national health insurance and not insurance for specific needy community)
This means your HSR SHOULD have elements of public health,medical sociology,etc so that they can each work on it to come out with many solutions
Example if there’s an outbreak of cholera in a particular community and do your research and you realize it’s because if the water source,apart from involving public health specialists to educate the people,if it’s a behavioural problem you ask sociologist to find out why they pollute the water source if it’s because of them and other people you can also bring in Ghana water company to come and check out the water source if it is because of faulty connections,etc
This is a multidisciplinary approach
What May Managers at municipal/district level and managers at community level want to know using HSR
Specific questions for specific levels of service (cont’d)
•Managers at municipal/district level may raise questions such as:
1.Why is neonatal mortality in certain districts much higher than in other districts?
2.Hospital directors may ask:
3.Why do we have such a high rate of complications during child birth?
4.Are the first-line services available and adequate?
5.Are our own services adequate?
6.Are mothers coming late for delivery and, if so, why?
Specific questions for specific levels of service (cont’d)
•Managers at community level (community health committees) may want to know:
1.How can we assist women with little or no education so that they can effectively recognise the symptoms of pneumonia and go in time to the health centre with their children?
2.How much community labour will be required to manage the new water system?
State and explain nine guidelines for HSR
Guidelines for HSR
1.HSR should focus on priority problems in health care.
2.It should be action-oriented, i.e., aimed at developing solutions.
3.An integrated multi-disciplinary approach is required, i.e., research approaches from many disciplines are needed since health is affected by the broader context of socio-economic development.
4.The research should be participatory in nature, involving all parties concerned (from policymakers to community members) in all stages of the project
Studies should be scheduled in such a way that results will be available when needed for key decisions; research must be timely.
- Emphasis should be placed on comparatively simple, short-term research designs that are likely to yield practical results relatively quickly.
The principle of cost-effectiveness is important in the selection of research projects.
8. Results should be presented in formats most useful for administrators, decision-makers and the community:
–A clear presentation of results with a summary of the major findings adapted to the interests of the party being targeted by the research.
–Honest discussion of practical or methodological problems that could have affected the findings.
–Alternative courses of action that could follow from the results and the advantages and drawbacks of each, formulated with inputs from all parties concerned.
•8. Evaluation of the research undertaken should concentrate on its ability to influence policy, improve services and ultimately lead to better health.
State three ways topics for research are identified
Whether a problem situation requires research depends on three conditions. State them
Identification of topic
•Three broad categories, depending on the type of information could be sought:
1.Description of the health situation, required for planning interventions
2.Information required to evaluate ongoing interventions
3.Information required to define problem situations in interventions
Whether a problem situation requires research depends on three conditions
•There should be a perceived difference or discrepancy between what exists and the ideal or planned situation;
•The reason(s) for this difference should be unclear (so that it makes sense to develop research questions); and
•There should be more than one possible answer to a question or more than one solution to the problem.
Explain the three ways topics for research are identified(so the questions under each way must be answered and so you choosing a topic for research will depend on the type of question you want to answer or the kind of info you are looking for. For example a research topic on the awareness of fertility diseases among students of UCC falls under number one in the answer because you want information on the health duty to plan an intervention. A research topic on the impact of vaccines on reducing under five mortality falls under number two cuz you want information to evaluate the vaccination interventions and a research topic on how a particular policy may be harming interventions falls under number three cuz it’ll help you understand or define problems in interventions better )
- Description of the health situation, required for planning interventions
Planners need to know, for example,
•the magnitude and distribution of health needs in a population as well as of services;
•the risk factors for certain problems and people’s awareness;
•the utilization patterns and cost-effectiveness of available and potential interventions, in order to formulate adequate policies and adapt or plan interventions.
- Information required to evaluate ongoing interventions
•coverage of priority health needs
•coverage of target group(s)
•acceptability and quality
•cost-effectiveness
•impact on health
- Information required to define problem situations in interventions
These causes may include:
•lack of or inequitable distribution of resources
•vague policies
•and any environmental factors affecting needs, interventions and resources
Problem situation
For example:
•In District X (pop. 145,000) sanitary conditions are poor (5% of households have latrines) and diseases connected with poor sanitation, such as hepatitis, gastro-enteritis and worms, are very common. The Ministry of Health has therefore initiated a sanitation project that aims at increasing the percentage of households with latrines by 15% each year. The project provides materials, and the population should provide labour. Two years later, less than half of the target has been reached
State the discrepancy and the research topic that can be derived from this problem as well as the possible answers to the discrepancy
.
Discrepancy:
35% of the households should have latrines, but only 15% do have them.
Research question:
What factors can explain this difference?
Possible answers
1.Service-related factors, such as forgetting to adequately inform and involve the population,
2.Bottlenecks in the supply of materials, differences in training and effectiveness of sanitary staff, lack of co-operation between sectors.
3.Population-related factors, such as situations where community members lack understanding of the relationship between disease and sanitation or have other problems, for example due to poverty, which they consider more important.
4.Physical factors/ecosystems, such as hard soil, or land subjected to frequent flooding.
State the criteria for prioritizing topics for research
Explain three
(This criteria can be used to explain the justification part of the research proposal. So it can explain why you chose that topic or why that topic is relevant )
Criteria for prioritising topics for research
Criteria for selecting a research topic:
1. Relevance
2. Avoidance of duplication
3. Urgency of data needed (timeliness)
4. Political acceptability of study
5. Feasibility of study
6. Applicability of results
7. Ethical acceptability
Relevance
•The topic you choose should be a priority problem. Questions to be asked include:
•How large or widespread is the problem?
•Who is affected?
•How severe is the problem?
Avoidance of duplication
•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
•another area with similar conditions.
•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
Urgency of data needed (timeliness)
•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.
Explain Four criteria for prioritizing topics for research
Political acceptability of study
•In general it is advisable to research a topic that has the interest and support of the local/national authorities.
•This will increase the chance that the results of the study will be implemented. 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.
Feasibility
•Look at the project you are proposing and consider the complexity of the problem and the resources you will require carrying out your study
•Thought should be given first to manpower, 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 resources available at the national level; for example, in research units, research councils or local universities
•Finally, explore the possibility of obtaining technical and financial assistance from external sources
Applicability of possible results/recommendations
•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.
–Likewise, the opinion of the potential clients and of responsible staff will influence the implementation of recommendation
Ethical acceptability
•We should always consider the possibility that we may inflict harm on others while carrying out research.
–How acceptable is the research to those who will be studied? (Cultural sensitivity must be given careful consideration). Is the problem shared by target group and health staff/researchers?
–Can 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?
What is research?
Why do we research?(state seven)
In research you’ll get more of incidence than prevalence
(Read abo it hypothesis in biostat and the types of hypothesis null and alternate hypothesis)
➢A careful investigation for new facts in any branch of knowledge
➢Redman and Mory: Research is a systematic effort to gain new knowledge
Research finds out why a problem hasn’t been solved
Research identifies a problem and establishes causality or a relationship
defining and redefining problems, formulating hypothesis/objectives;
•collecting, organizing and evaluating data;
• making deductions and reaching conclusions;
•testing the conclusions to determine whether they fit the formulating hypothesis/objectives
Why do research?
➢Desire to get a research degree along with its consequential benefits
➢Desire to face the challenge in solving the unsolved problems
➢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 conditions etc.
To find population dynamics
To provide datta for donors
To prove data for decision making and planning
Why do research?…
•Validate intuition
•Improve methods
•Demands of the Job
•For publication/patent
How do you choose a subject for research?
Explain the important features of a research design
Based on:
•an idea or interest
•your experience
•your reading
•originality
The important features of a research design
➢A plan
Specify the sources & types of information relevant to the research problem
➢A strategy
Which approach will be used for gathering and analyzing the data
➢The time and budgets
Most studies are done under these two constraints
How do you define your objectives?
Explain literature review or search and it’s importance
For literature review take note of the methodology,study design,data collection methods ,findings, conclusion in the articles you’ll read and thesis come out for recommendations for further studies true or false
Try to keep these simple
•The more variables the more difficult
•Use the opportunity
•Get help at this stage
•Senior colleagues
•Experienced researchers
Literature search:
Literature review you read about other peoples works or published textbooks
Peer literature review is preferred
Example of places to do literature search is google scholar and journal for specific disciplines (so if you want to do research on adolescents then you’ll find different topics in the word adolescents
.Check to see if your idea is original
•Get articles
•Read articles and their references
•Most of these will be vital when writing up reports
•Find gap areas
•Find obsolete measurements and results
•Define objectives of the study
State the nine steps of the research process
State nine things a research report generally includes
Identification of general problem/question
2.Literature review
3.Specify questions/hypotheses
4.Determination of design/methodology
5.Data collection
6.Data analysis/presentation
7.Results and discussion
8.Generalization, interpretation and drawing conclusions
9.Preparation of the project report or writing thesis
A Research Report
A Research Report generally include:
•Introduction and Statement of problem
•Statement of hypothesis or research objectives
•Review of relevant literature
•Theoretical resume
•Description of research design
•Description Experimental design
•Description of measurement and data analysis
•Error compounding
•Presentation of Results
•Discussion
•Conclusion, limitations, and implications
•Suggestions for future work
•Acknowledgements
•References cited
•Appendices
