Operational Research

UNITED REPUBLIC OF TANZANIA
Ministry of Health, Community Development, Gender, Elderly and Children
PST 06210 Operational

Research
NTA Level 6 Semester 2
Facilitator Guide
March 2019
Copyright © Ministry of Health, Community Development, Gender, Elderly and Children

2019
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Table of Contents
Table of Contents..................................................................................................2
Background.........................................................................................................11
Acknowledgment................................................................................................12
Introduction.........................................................................................................14
Module Overview...............................................................................................14
Target Audience..................................................................................................14
Organization of the Module................................................................................14
Instructions for Use.............................................................................................16
Preparation with Handouts and Worksheets.......................................................16
Using Students Manual When Teaching.............................................................16
Abbreviations......................................................................................................18
Session 1: Basic Statistical Concepts..................................................................20
Session 2: Basic Biostatistics Data.....................................................................27
Session 3: Data Presentation...............................................................................34
Session 4: Establishing Trends in Health Care...................................................45
Session 5: Basic Concept of Research................................................................55
Session 6:Classification of Research..................................................................61
Session 7: Procedures for Conducting Operational Research............................72
Session 8: Identification of Research Problem..................................................79
Session 9: Analysis and Statement of the Problem.............................................96
Session 10: Literature Review in Research......................................................106
Session 11: Research Objectives and Questions...............................................114
Session 12: Review of Study Types/Designs....................................................125
Session 13: Research Sampling........................................................................129
Session 14: Determining Sample Size..............................................................141
Session 15: Research Ethics.............................................................................147
Session 16: Developing Research Tools...........................................................153
Session 17: Pre-Testing the Research Tools.....................................................194
Session 18: Data Collection Plan......................................................................203
Session 19: Research Budget............................................................................215
Session 20: Data Collection..............................................................................224
Session 21: Data Collection - Field Work Activities........................................233
Session 22: Data Processing.............................................................................236
Session 23: Data Analysis.................................................................................244
Session 24: Research Report Writing...............................................................259
Session 25: Methods for Dissemination of Research Findings........................273
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Background
There is currently an ever increasing demand for pharmaceutical personnel in Tanzania.
This is due to expanding investment in public and private pharmaceutical sector. Shortage of
trained pharmaceutical human resource contributes to poor quality of pharmaceutical
services and low access to medicines in the country (GIZ, 2012).
Through Public-Private-Partnership (PPP) the Pharmacy Council (PC) together with

Development Partners (DPs) in Germany and Pharmaceutical Training Institutions
(PTIs)worked together to address the shortage of human resource for pharmacy by designing
a project named “Supporting Training Institutions for Improved Pharmaceutical Services in
Tanzania in order to improve quality and capacity of PTIs in training, particularly of lower
cadre pharmaceutical personnel.
The Pharmacy Council formed a Steering committee that conducted a stakeholders workshop
from18th to 22ndAugust 2014 in Morogoro to initiate the implementation of the project.
Key activities in the implementation of this project included carrying out situational analysis,
curriculum review and harmonization, development of training manual/facilitators guide,
development of assessment plan, training of trainers and supportive supervision.
After the curricula were reviewed and harmonized, the process of developing standardized
training materials was started in August 2015 through Writers Workshop (WW) approach.
The approach included two workshops (of two weeks each) for developing draft documents
and a one-week workshop for reviewing, editing and formatting the sessions of the modules.
The goals of Writers Workshops were to build capacity of tutors in the development of
training materials and to develop high-quality, standardized teaching materials.
The training package for pharmacy cadres includes a Facilitator Guide, Assessment plan and
Practicum. There are 12 modules for NTA level 6 making 12 Facilitator guides and one
Practicum guide.
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Acknowledgment
The development of standardized training materials of a competence-based curriculum for
pharmaceutical sciences has been accomplished through involvement of different
stakeholders.
Special thanks go to the Pharmacy Council for spearheading the harmonization of training
materials in the pharmacy after noticing that training institutions in Tanzania were using
different curricula and train their students differently.
I would also like to extend my gratitude to Christian Social Service Commission (CSSC) for
their tireless efforts to mobilize funds from development partners (German Ministry of Industry
and action medeor). It is through the implementation of the Multi-Actors Partnership (MAP)
project, CSSC has been able to provide the financial and technical support needed during the
development of this training material.
Many thanks go to the Centre for Educational Development in Health Arusha (CEDHA)
experts on health material development and training who coordinated the development of
these module sessions particularly Ms. Diana H. Gamuya for her commitment in coordinating
and facilitating the planning and development to its completion.
Particular acknowledgements are sent to Mr. Dickson Mtalitinya and Members from the
secretariat of National Council for Technical Education (NACTE) for facilitating and
providing their expertise to the success of this work.
It will be unfair if I will not recognize the efforts and contributions of all CEDHA supportive
staff that made this process a success; accountant, secretary, drivers and printers
Finally, I very much appreciate the contributions of the tutors and content experts
representing PTIs, hospitals, and other health training institutions. Their participation in
meetings and workshops, and their input in the development of this training
manual/facilitators guide have been invaluable.
These participants are listed with our gratitude below:
Ms. Elizabeth Shekalaghe Registrar, Pharmacy Council of Tanzania

Dr. Fadhili Lyimo Assistant Director Allied Health, MoHCDGEC
Mr. Dennis Busuguli MoHCDGEC
Dr. Jacqueline Uriyo Acting Principal, CEDHA
Dr. Sungwa N. Kabissi Project Manager - MAP, CSSC
Dr. Loishooki S. Laizer CEDHA
Ms. Diana H. Gamuya CEDHA
Mr. Dickson Mtalitinya SIBS
Ms. Grace Mallange PC
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Mr. Wensaa Muro KSP
Mr. John Mmassy CSSC
Ms. Emily Mwakibolwa Pharmacy Council
Mr. Samwel M. Zakayo Pharmacy Council
Mr. Godfrey Komba NACTE
Mr. Samweli Mdallingwa NACTE
Mr. Daniel Muhochi CEDHA
Dr. Byera Shwekerela CEDHA
Dr. Johannes Lukumay CEDHA
Dr. Mwandu Jiyenze CEDHA
Dr. Peter Sala CEDHA
Mr. Stephano Kiberiti CEDHA
Mr. Amani Phillip HKMU
Mr. John M. Bitoro CUHAS
Mr. Omary Mejjah CUHAS
Mr. Karol Marwa CUHAS
Mr. Raphael Matinde CUHAS
Mr. Rajabu I. Amiri MUHAS
Mr. Peter Njalale MUHAS
Ms. Tumaini H. Lyombe MUHAS
Ms. Dilisi J. Makawia KSP
Mr. Richard P. Mmassy KSP
Mr. Nemes Uisso RAS-KLM
Mr. Gaspar Baltazary RuCU
Mr. Goodluck Mdugi RuCU
Mr. Godfrey A. Pharaoh SIBS
Mr. Joel M.Selestine SIBS
Mr. Jimmy M. Mulee SIBS
Mr. Evalist Shileki DECOHAS
Mr. Eliabu Mshashi KIUT
Dr. Loishooki S. Laizer

Director of Human Resources Development
Ministry of Health, Community Development, Gender, Elderly and Children
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Introduction
Module Overview
This module content is a guide for tutors of Pharmaceutical schools for training of students.
The session contents are based on sub-enabling outcomes and their related tasks of the
curriculum for Basic Technician Course in Pharmaceutical Sciences. The module sub-
enabling outcomes and their related tasks are as indicated in the in the Basic Technician
Certificate in Pharmaceutical Sciences (NTA Level 6) Curriculum
Target Audience
This module is intended for use primarily by tutors of pharmaceutical schools. The module s
sessions give guidance on the time, activities and provide information on how to teach the
session. The sessions include different activities which focus on increasing students
knowledge, skills and attitudes.
Organization of the Module
The module consists of twenty five (25) sessions; each session is divided into several parts as
indicated below:
 Session Title: The name of the session

 Total Session Time: The estimated time for teaching the session, indicated in minutes
 Pre-requisites: A module or session which needs to be covered before teaching the
session.
 Learning Tasks: Statements which indicate what the student is expected to learn by the
end of the session
 Resources Needed: All resources needed for the session are listed including handouts
and worksheets
 Session Overview: The session overview box lists the steps, time for each step, the
activity or method used in each step and the step title
 Session Content: All the session contents are divided into steps. Each step has a heading
and an estimated time to teach that step as shown in the overview box. Also, this section
includes instructions for the tutor and activities with their instructions to be done during
teaching of the contents
 Key Points: Key messages for concluding the session contents at the end of a session
This step summarizes the main points and ideas from the session, based on the learning
tasks of the session
 Evaluation: The last section of the session consists of short questions based on the
learning tasks to check the understanding of students.
 Handouts: Additional information which can be used in the classroom while teaching or
later for students further learning. Handouts are used to provide extra information related
to the session topic that cannot fit into the session time. Handouts can be used by the
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students to study material on their own and to refer to them after the session. Sometimes,
a handout will have questions or an exercise for the participants including the answers to
the questions.
Instructions for Use and Facilitators Preparation
 Tutors are expected to use the module as a guide to train students in the classroom and
skills laboratory
 The contents of the modules are the basis for teaching and learning dispensing.
 Use the session contents as a guide
 The tutors are therefore advised to read each session and the relevant handouts and
worksheets as preparation before facilitating the session
 Tutors need to prepare all the resources, as indicated in the resource section or any other
item, for an effective teaching and learning process
 Plan a schedule (timetable) of the training activities
 Facilitators are expected to be innovative to make the teaching and learning process
effective
 Read the sessions before facilitation; make sure you understand the contents in order to
clarify points during facilitation
 Time allocated is estimated, but you are advised to follow the time as much as possible,
and adjust as needed
 Use session activities and exercises suggested in the sessions as a guide
 Always involve students in their own learning. When students are involved, they learn
more effectively
 Facilitators are encouraged to use real life examples to make learning more realistic
 Make use of appropriate reference materials and teaching resources available locally
Preparation with Handouts and Worksheets
 Go through the session and identify handouts and worksheets needed for the session
 Reproduce pages of these handouts and worksheets for student use while teaching the
session. This will enable students to refer to handouts and worksheets during the session
in the class. You can reproduce enough copies for students or for sharing
 Give clear instructions to students on the student activity in order for the students to
follow the instructions of the activity
 Refer students to the specific page in the student manual as instructed in the facilitator
guide
Using Students Manual When Teaching
 The student manual is a document which has the same content as the facilitator guide,
which excludes facilitator instructions and answers for exercises.
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 The student manual is for assisting students to learn effectively and acts as a reference
document during and after teaching the session
 Some of the activities included in facilitator guide are in the student manual without
facilitator instructions
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Abbreviations
AIDS Acquired Immune Deficiency Syndrome
CA Continuous Assessment
CBHC Community Based Health Care
CEDHA Centre for Educational Development in Health Arusha
CME Continue in service medical education
COSTECH Commission Science and Technology
CSSC Christian Social Service Commission
CUHAS Catholic University of Health and Allied Science
DIC Drug information center
DIC Drug information center
DMO District Medical Officer
DTC Drug therapeutic committee
EM Essential medicine
EML Essential medicines list
HIV Human Immunodeficiency Virus
INN International non-proprietary name
LCD Liquid Crystal Device
MAP Multi actor partnership
MRCC Medical Research Coordinating
MUHAS Muhimbili University of Health and Allied Science
NACTE National Council for Technical Education
Nat HREC National Health Research Ethics Committee
NEMLT National essential medicine list
NID National Immunization Day
NTA National Technical Award
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OTC Over the counter
PTIs Pharmaceutical Training Institutions
RA Regulatory authority
RuCU Ruaha Catholic University
SIBS Spring Institute for Business and Science
STGs Standard treatment guidelines
TFDA Tanzania food and drug authority
UNICEF United Nations International Childrens Emergency Fund
USAID United States Agency for International Development
WHO World Health Organization
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Session 1: Basic Statistical Concepts
Total Session Time: 120 minutes + 120 minutes assignment
Prerequisites
 None
Learning Tasks
By the end of this session students are expected to be able to:
 Define common terms used in biostatistics
 Explain the importance of different measures in statistics
 Explain the application of statistics in data analysis
Resources Needed
 Flip charts, marker pens, and masking tape
 Black/white board and chalk/whiteboard markers
 Computer and LCD computer
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 5 minutes Presentation Introduction, Learning Tasks
2 30 minutes Presentation Definitions of common terms in Biostatistics

Brainstorm
45minutes Presentation Importance of Different Measures in
3
Buzzing Statistics
30minutes Presentation
4 Application of Statistics in Data Analysis
Brainstorming
5 05minutes Presentation Key Points
6 05 minutes Presentation Evaluation
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SESSION CONTENTS
STEP1: Presentation of Session Title and Learning Tasks (5 minutes)
READ or ASK students to read the learning tasks and clarify
ASK students if they have any questions before continuing
STEP 2: Definition of common terms in Biostatistics (30 minutes)

 Biostatistics can be defined as the application of statistics to biological problems.
 Many biomedical scientists consider it to mean the application of statistics specifically to
medical problems.
 For this group of people, therefore, biostatistics and medical statistics are synonymous
Other terms:
 Statistics can be defined in two forms:
o First statistics as a noun means a descriptive measure computed from data of a
sample i.e. numerical statement - information that is available in numbers). Examples
of this include:
 Hospital data on the number of admissions for some condition in a period
 How much drug (e.g. Amoxicillin capsules) is distributed to health units -
hospitals, health centres and dispensaries
 This first part of the subject is usually referred to as descriptive statistics
o Secondly statistics as a discipline is a field of study concerned with:
 Collecting, organizing and summarizing and analysis of data in a systematic way.
 Drawing of inferences about a population on the basis of only a part of the
population targeted.
 This second part, which, provides objective means of drawing conclusions,
constitutes inferential statistics
 Population
o A collection of entities.
o A statistical population means the largest collection of entities in which we have an
interest.
o Example we may be interested in looking at how may health facilities are given
Amoxil in district X?
 Sample
o Part of a population.
o Example number of health centres given Amoxil capsules.
 Central tendency
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o Measures of central tendency provide a summary measure that attempts to describe
data with a single value that represents the middle or centre of its distribution.
o There are three main measures of central tendency:
 the mean,
 median and
 mode
Mean, arithmetic mean (X or M):

 The mean of a data set is also known as the average value
 The sum of the scores in a distribution divided by the number of scores in the distribution.
It is the most commonly used measure of central tendency.
 It is often reported with its companion statistic, the standard deviation, which shows how
far things vary from the average.
Median (Mdn):
 The midpoint or number in a distribution having 50% of the scores above it and 50% of
the scores below it.
 The median of a data set is the value that is at the middle of a data set arranged from
smallest to largest
 If there are an odd number of scores, the median is the middle score.
Mode (Mo):
 The number that occurs most frequently in a distribution of scores or numbers
 The mode is the most common observation of a data set, or the value in the data set that
occurs most frequently.
Quartile
 A measure of statistical dispersion which divides a frequency distribution into equal
groups each containing the same fraction of the total population
 The first quartile (designated Q1 ) is the lower and cuts off the lowest 25% of data (the
25th percentile)
 The second quartile (Q2 ), or the median, cuts the data set in half (the 50th percentile)
 The third quartile (Q3 ) cuts off highest 25% of data, or the lowest 75% (the 75th
percentile)
Variations
 Range (Ra): The difference between the highest and lowest scores in a distribution; a
measure of variability.
 Standard deviation (SD): The most stable measure of variability, it takes into account
each and every score in a normal distribution. This descriptive statistic assesses how far
individual scores vary in standard unit lengths from its midpoint of 0. For all normal
distributions, 95% of the area is within 1.96 standard deviations of the mean.
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 Variance (SD2): A measure of the dispersion of a set of data points around their mean
value. It is a mathematical expectation of the average squared deviations from the mean.
STEP 3:Importance of Measures in Statistics (45 minutes)

 Importance of different measures in statistics
o Measures of central tendency (Mean, Median, and Mode) in statistics
are important because of the following reasons:
 To find representative value: Measures of central tendency or averages; give us
one value for the distribution and this value represents the entire distribution
 Central tendency is very useful in psychology. It helps to know what is normal or
'average' for a set of data. It also condenses the data set down to one representative
value, which is useful when working with large amounts of data
 The mean is an important measure because it incorporates the score from every
subject in the research study
o Measures of dispersion (Range of the Data, Variance, Standard Deviation and
Quartiles) in statistics are important because of the following reasons:
 Variation is a measure of statistical dispersion
 Quartile divides a range of data or population into four equal parts
STEP 4: Application of Statistics in Data Analysis (30Minutes)

 Statistics is the mathematical science involving the collection, analysis and interpretation
of data.
 The following are application of statistics:
o To assess risk in the pharmaceutical industries.
o To study biological phenomena and observations by means of statistical analysis
o To develop new insights and understanding of performance
o Serves as the foundation and logic of interventions made in the interest of public
health and preventive medicine.
o In clinical trials to arrive at optimal or near optimal solutions to complex problems
 To quantify drug use
 Statistics is an important tool in pharmacological research that is used to
summarize (descriptive statistics) experimental data in terms of central tendency
(mean or median) and variance
o It enables us to conduct hypothesis testing (to determine whether the pharmacological
effect of one drug is superior to another)
o Very helpful in formulating experimental design and drawing appropriate inferences
from the collected data
STEP 5: Key Points (5 minutes)

 Biostatistics can be defined as the application of statistics to biological problems
 Common terms in biostatistics are biostatistics, Statistics, mean, mode, median, Quartile
and Variations
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 The importance of different measures in statistics is to give one value for the distribution
and this value represents the entire distribution, to know what is normal or 'average' for a
set of data and variations from normal.
STEP 6: Evaluation (5 minutes)

 What is the importance of different measures in statistics (central tendency, quartile and
variations)?
 What is the application of statistics in data analysis?
16
References
Anderson, D.R., Sweeney, D.J., Williams, T.A., Freeman, J. &Shoesmith, E. (2007).

Basic Statistics and Eepidemiology. A practical guide: United Kingdom: Radcliffe
Medical Press
Beaglehole R, Bonita R and Kjellstrom (1993) Basic epidemiology: Geneva, Switzerland:

World Health Organization
Kazaura, M. R., Makwaya, C. K., Masanja, C. M. and Mpembeni, R.C.(1997). Lecture notes in
Biostatistics, manual of biostatistics: Dar es Salaam, Tanzania: Muhimbili University
College of Health Sciences
Rao, J. S., & Richard, J. (2002). An introduction to bostatistics-a manual for students in
health sciences (3rd Ed); New Delhi: Circus
17
Session 2: Basic Biostatistics Data
Prerequisites
 None
Learning Tasks
 Define data
 Mention characteristics of data
 Explain sources of data
 Describe types of data
 Explain the quality of data
Resources Needed
 Computer and LCD Computer
SESSION OVERVIEW
Activity/
Step Time Content
Method
10 minutes Brainstorm
2 Definition of Data
Presentation
25 minutes
3 Presentation Characteristic of Data
25 minutes Buzzing
4 Sources of Data
Presentation
15 minutes Buzzing
5 Types of Data
Presentation
30 minutes Presentation
6 The Quality of Data
7 05 minutes Presentation Key Points
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SESSION CONTENTS
STEP 2: Definition of Data (10 minutes)

 Data is defined as the raw information from which statistics are created
o Put in the reverse, statistics provide an interpretation and summary of data.
 When it means statistical data it refers to numerical descriptions of things.
STEP 3: Characteristic of Data (25 minutes)

 The following are characteristics of statistical data:
o They must be in aggregates
o They must be affected to a marked extent by a multiplicity of
causes.
o They must be enumerated or estimated according to a reasonable standard of accuracy
o They must have been collected in a systematic manner for a predetermined purpose.
o They must be placed in relation to each other. That is, they
must be comparable
STEP 4: Sources of Data (25 minutes)

 Sources of data include:
o Vital events register
This includes data on live-births, deaths, marriages and migration. This register
should ideally provide a comprehensive coverage of the whole district/country. It is
usually used to calculate demographic indicators such as infant and under-five
mortality rate
o National Population Census

This is an important source of demographic, social and economic data. These data
form the denominator in the calculation of many quantifiable health indicators.
National population census provides total population and age structure, which is not
easy to obtain through any other method.
o Routine data collection from health facilities
Routine data collection from health facilities is a good source of information for
disease, specifically morbidity and mortality data. This is because the information is
obtained from active cases and the data are collected by a professional, qualified
person.
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o Sentinel surveillance
This is a system in which data is collected routinely from selected health facilities or
communities. It is very useful in obtaining specific morbidity data in a more detailed
form, particularly endemic diseases and those under special control programmes,
with an improved accuracy compared with routine data collection system
o Surveys
A survey is very useful for evaluation because it can be done in a shorter time and
obtains a lot of detailed representative data. Surveys have the advantage of providing
timely and relevant information. Often surveys are done in the community, and hence
become more representative of the real situation than data obtained from health
facilities e.g. Demographic and health survey
o Reports and documents

A lot of reports and documents with useful information are produced daily in the
ministries of health, in training and research institutions.
o Scientific research
Research findings are usually of very high quality and can be useful in medium and
long term planning of health services. Comparatively, researches are more focused on
the subject matter than other sources of information
o External sources
o Data are collected by individual research workers or by other organizations through
sample surveys or experiments, keeping in view the objectives of the study in your
environment
STEP 5: Types of Data (15 minutes)

 They are two types of statistical data:
o Primary Data
 Primary data means the raw data (data without fabrication or not tailored data)
which has just been collected from the source and has not gone any kind of
statistical treatment like sorting and tabulation
 Primary data is collected first hand by a researcher (organization, person,
authority, agency or party etc.) through experiments, surveys, questionnaires,
focus groups, conducting interviews and taking (required) measurements
o Secondary Data
o Secondary data is readily available (collected by someone else) and is
available to the public through publications, journals and newspapers
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STEP 6: The Quality of Data (30 minutes)
Data quality refers to the condition of a set of values of qualitative or quantitative variables.
 Data is considered of high quality if it is fit for intended uses in operations, decision
making and planning.
 Seven characteristics of quality data
o Timeliness: For data to become useful for decision-making it must reach the
manager at the appropriate time. Data on drug stock-outs and overstock should
reach the management before the meeting to make decisions on the type and
amount of drugs to procure for the next month.
o Accuracy: Data collected should be accurate enough for the manager to have
confidence in using it. However, despite the need for a high level of accuracy, it
should be borne in mind that any effort to increase the level of accuracy will be
met with an increase in the cost of collecting and processing that data. However,
the level of accuracy required in the day-to-day decision-making and planning is
not as stringent as may be required in scientific research.
o Appropriateness: Data collected should be appropriate for the intended objectives.

Inappropriate data will not be used and may become an unnecessary extra burden
for health workers. Whereas the higher level requires strategic information to
make policy decisions, the lower level requires technical information to make
management decisions.
o User-friendliness: Data should therefore be presented in a user-friendly format to

enable decision makers to interpret and use it for decision-making. Charts, maps
and graphs convey the message better than complex tables and narratives.
o Comprehensiveness: Data should be comprehensive with enough details to allow

for decision making. A pharmacist would need to be informed on not only the
type of drug that went out of stock but also the form of drug, e.g. syrup, tablets or
injectables.
o Simplicity: The process of data collection and analyses should therefore be fairly
simplified and only the necessary data should be collected on a daily 3basis.
It4667uj4y8i4nvshould always be borne in mind that the majority of lower level
health wordker have had no training in statistics.
D
o Accessibility: Information emanating from the data should be accessible to
managers at all levels to facilitate decision making, and stored properly for easy
retrieval. It should reach the manager in a timely manner, depending on the type
of decisions made.
21
 Data is defined as the raw information from which statistics are created
 They are two types of statistical data: Primary Data and Secondary Data
 Quality data is considered to be timely available, accurate, complete, appropriate,
comprehensive, simple, accessible and userfriendly
 What is data?
 What are characteristics of data?
 What are the sources of data?
What are the qualities of good data?
22
References
Anderson, D.R., Sweeney, D.J., Williams, T.A., Freeman, J. &Shoesmith, E. (2007).
Basic Statistics and epidemiology (2001). A practical guide, Radcliffe Medical Press, United
Kingdom
Beaglehole R, Bonita R and Kjellstrom (1993) Basic epidemiology, World Health

Organization, Geneva
John Wiley and Sons (2003) Introductory Biostatistics.

Kazaura, M. R., Makwaya, C. K., Masanja, C. M. and Mpembeni, R.C. (1997). Lecture notesin
Biostatistics, manual of biostatistics, Muhimbili University College of Health Sciences, Dar es
Salaam
Polit, D. F and Beck, C. T (2004) Nursing Research Principles and Methods, 7th Edition:
Lippincott Williams & Wilkins, Philadelphia
Rao, J. S., & Richard, J. (2002). An introduction to biostatistics-a manual for students in
helthsciences.third edition, New delhi, Circus: Asoke k ghosh.
Rosner B: Fundamental of Biostatistics, 4th edition, Duxbury Press, 1995.
23
Session 3: Data Presentation
Total Session Time: 120 minutes+ 120 minutes Assignment
Prerequisites
 None
Learning Tasks
 Define data presentation
 Describe methods of data presentation
 Explain the use of data presentation methods
Resources Needed
 Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
15 minutes Brainstorming
2 Definition of Data Presentation
Presentation
40 minutes
3 Presentation Methods of Data Presentation
4 Use of Data Presentation Methods
Buzzing
7 05 minutes Presentation Assignment
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SESSION CONTENTS
STEP 2: Definition of Data Presentation (15 minutes)

 Data presentation refers to the organization of data into tables, graphs or charts, so that
the logical and statistical conclusions can be derived from the collected measurements
STEP 3: Methods of Data Presentation (40 minutes)
 Data may be presented in three methods, i.e. textual, tabular or graphical
o Textual presentation of data in words (text)
o Tabular a systematic organization of data into columns and rows (a table)
o Graphical presentation of data using graphs
 Data can be presented as:
o frequency distributions
o percentages
o proportions
o ratios and rates
o figures (graph, tables, charts
o measures of central tendency (mean, mode and median)
 Frequency distribution
o Frequency distribution is description of data presented in tabular form so that data
will be more manageable.
o It gives frequency in each value that appears in data
o counts number of response in category
e.g. Frequency of categorical data
Frequency distribution of course students according to sex
Sex of course Number of course students
25
students
Male 34
Female 27
Total 61
Frequency distribution of numerical data

o Frequency distribution of numerical data is similar to that of categorical data
except here data have to be grouped in categories
o Example Weights (in kg) of 17 pharmaceutical students on enrolment at KCMC
School of Pharmacy (KSP) (45,43,45,47,54,53,62,38,54,34,45,53,56,42,51, 62,61)
o Procedures
 Select group for grouping these data (selected Groups (31-40; 41-50; 51-60;
61-70)
 Count number of measurement(wt. of pharmaceutical students) in each group:
31-40 II (34, 38)
41-50 IIIIII (42, 43, 45, 45, 45, 47)
51-60 IIIIII (51, 53, 53, 54, 54, 56)
61-70 III (61, 62, 62)
 Add up and check the total
 Rules for grouping data

o Groups must not overlap, to avoid confusion
o There must be continuity from one group to the other(no gaps)
o Groups must range from the lowest to the highest measurements
o Groups should normally be of equal width
 Percentages
o Is number of units in the sample with a certain characteristics divided by total of
units in the sample multiplied by 100
o May also be called Relative frequencies
26
o Standardizes the data and make it easier to compare with similar data obtained in
another sample of different size or origin
o E.g. weight of 17 pharmaceutical students at KCMC school of Pharmacy on
enrolment
Weight(Kg) Number of Relative frequency(percent)

pharmaceutical
students
31-40 12 26.7
41-50 17 37.8
51-60 11 24.4
61-70 5 11.1
Total 45 100
 For calculating percentage Remember:

o Dont include missing numbers and not applicable in calculation.
o Dont know' is special category that should not counted as missing data.
o Should not be used if total is less than 30, as one unit makes a big difference in
terms of percentage
 Proportions
o Sometimes relative frequency are expressed in proportion instead of percentages
o Definition: proportion is numerical expression that compares one party of study
units to the whole.
o Can be expressed in fraction or decimal
Numerator is part of denominator
e.g. Calculate proportion of modules studied in first semester
 Ratio
o Is numerical expression that indicates relationship in quantity or amount or
size between two or more parts. Numerator is not part of denominator
e.g. Ratio of module studied in first semester to module to be studied in
second semester
 Rates
27
o Is quantity or amount or degree of event or disease measured over specified
period of time.
e.g. Birth rate = number of live birth per 1000 population over period of one
year
 Figures
o Figures make the descriptive data more readable when you have many tables
For categorical data use
o Bar charts
o Pie charts
For numerical data use
o Histograms
o Line graphs
o Scatter diagrams
o Maps
 Bar charts
o Is simplest and most effective means of illustrating qualitative data
o Bars can either be horizontal or vertical
o The bars are not connected
e.g.57 Adolescents from Kaloleni streets in Arusha were asked the following
question: How often have you used cannabis for the past one year? This was
closed question with the following possible answers
28
o Frequently (more than 5 times),Occasionally ( 3 to 5 times), rarely (1 to 2 times)
and never
Categories Number Percentage
Frequently 7 12.2
Occasionally 9 15.8
Rarely 10 17.5
Never 31 54.4
Total 57 100
 Pie charts
o Provides quick view of data presented in different form.
o Used in qualitative number with few categories to avoid congestion
29
 Histograms
o Numerical data are often presented in histograms
o Are similar to bar charts however the difference is that in histogram the bars are
connected(as long as there is no gap between the data where as in bar charts the
bars are not connected as the different categories are distinct entitles)
 Line graphs
o Useful for numerical data if you want to show Trend over time
o It is easy to show two or more distribution in one graph as long as difference
between lines are easy to distinguish e.g. age distribution between males and
females
STEP 4: Use of Data Presentation Methods (35 minutes)
Conditions in which the following methods of data presentation are used
 Frequency distributions
o Frequency distributions are used for both qualitative and quantitative data.
o A frequency distribution of data can be shown in a table or graph.
o Some common methods of showing frequency
distributions include frequency tables, histograms or bar charts.
o A frequency table is a simple way to display the number of occurrences of a
particular value or characteristic.
o Statistical hypothesis testing is founded on the assessment of differences and
similarities between frequency distributions
30
o In Cross tabulation
o In Cumulative frequency
 Percentages
o Useful in expressing the relative frequency of survey responses
o In Comparison of groups
o As a fraction
o In advertisement, e.g. shops advertise discounts on products. These discounts are
percentages
 Proportions
o A proportion is simply a statement that two ratios are equal.
o Uses cross products to find a missing term in a proportion
o Used when administering medication
 Ratios and rates

o A ratio is a numerical expression which indicates the relationship in quantity, amount
or size between two or more parts.
Example the ratio of males to females is 22:33, or 2:3.
o A rate is the quantity, amount or degree of a disease or event measured over a

specified period of time
o Commonly used rates in the health sector are:
 Birth Rate - The number of live births per 1000 population over a period of one
year
 Death Rate - The number of deaths per 1000 population over a period of one
year
 Infant Mortality Rate (IMR) - The number of deaths of infants under one year
deaths of age per 1000 live births over a period of one year
 Maternal Mortality Rate (MMR) - The number of maternal pregnancy-related in

one year per 100,000 total births in the same year
31
 Incidence Rate - The number of new cases per population over a specific
period of time (usually a year)
 Prevalence Rate - The number of existing cases per population over a specific
period of time (usually a year)
 Figures (graph, tables, charts)

o Graph:
 Line graphs can also be used to compare changes over the same period of time for
more than one group.
 Bar graphs are used to compare things between different groups or to track
changes over time (trends)
 The purpose of a graph is to present data that are too numerous or complicated to
be described adequately in the text and in less space
o Tables:
 Show the number of times that data with certain characteristics occur in a data set
 Tells how many or what proportion of a group has each value or range of value
out of all possible values
o Pie charts:
 Pie charts are best to use when you are trying to compare parts of a whole. They
do not show changes over time.

 Data can be presented as: Frequency distributions, percentage, proportions, ratios and
rates, Figures (graph, tables, charts, and Measures of central tendency (mean ,mode and
median)
 Bar charts are simplest and most effective means of illustrating qualitative data
 Frequency distributions are used for both qualitative and quantitative data

 What are the methods of data presentation?
 What information should be presented in figures?
32
References
Kingdom

Hardon A, Boonmongkon P, and Streefland P. et al (editors) (2001). Applied Health research,

Anthropology of health and health care, third revised edition,, Het Spinhuis Publishers, The
Netherlands
Kazaura, M. R., Makwaya, C. K., Masanja, C. M. and Mpembeni, R.C. (1997). Lecture notes in
Salaam. (2000) Designing and Conducting Health Systems Research Projects
33
Session 4: Establishing Trends in Health Care
Total Session Time: 120 minutes+ 120 minutes assignment
Prerequisites
 None
Learning Tasks
 List tables and graphs used to determine trend
 Generate tables and graphs
 Interpret tables and graphs
Resources Needed
SESSION OVERVIEW
Activity/
Step Time Content
Method
Presentation Tables and Graph used to Determine Trend

2 15 minutes
Buzzing
60 minutes Presentation Generation of Tables and Graphs
3 Small group
discussion
4 30 minutes Presentation Interpretation of Tables and Graphs
34
SESSION CONTENTS
STEP 2: Tables and Graph Used to Determine Trend (15 minutes)

 Tables and Graphs used to determine trend are:
o Line graphs
o Bar graph
o Histogram
o Frequency polygon
o Frequency curve
o Cumulative frequency
STEP 3: Generation of Tables and Graphs (55 minutes)
 Table
A table is a drawing having columns and rows that facilitate representation of large amount
of data in an attractive easy to read and organized manner.
Steps to make a table
o Name your table write a title of the table at the top of the paper
o Decide how many rows and columns you need
o Insert/draw a table using the computer
o Label your columns and rows
o Record the data you have in the columns and rows
35
o When making cross-tabulations, check that the column and row counts correspond
to the frequency counts for each variable.
o Also check that the grand total in the table corresponds to the number of subjects in
the sample.
Example of a table
Table 1.: Type of health worker by residence
Residence Type of Health Worker Total
Doctors Pharmacists
Rural 10 (16%) 69 (38%) 79 (33%)
Urban 51 (84%) 113 (62%) 164 (67%)
Total 61 (100%) 182 (100%) 243 (100%)
 Line graph
o A line graph is a diagram that shows a line joining several points, or a line that shows
the relationship between the points.
o A line graph can be taken as xy plane, where there will be an independent variable
and a dependent variable
o It specifies how the two variables are related to each other and vary with respect to
one another.
o Mostly, the independent variable is taken on the x-axis while the dependent variable
on the y-axis.
 Steps to Make a Line Graph:

Step 1: Use the data from the table to choose an appropriate scale
The table given below shows the weights of a child in months
SNo. Age in Months Weight (Kg)
A. 1 38
B. 3 41
C. 5 43
D. 7 49
E. 9 51
36
F. 11 54
Step 2: Draw and label the scale on the vertical and horizontal axis
Step 3: List the each item and locate the points on the graph
Step 4: Connect the points with line segments
You can see a line plotted through two points say A and B on the following
graph
The data given on table above has been summarized in the form of a line graph as
follows:
Line graph have one or more lines plotted on the graph. They are very useful for showing
change over time
 Bar Graph
o Bar graph is drawn on an x-y graph and it has labeled horizontal or vertical bars that
show different values.
• The size, length and color of the bars represent different values.
• Bar graph is very useful for non-continuous data and it helps in comparing or
contrasting the size of the different categories of the data provided
• Lets take an example of the bar diagram and compare the pass percentage of a
school 90%, 100% and 60% during the year 2000, 2001 and 2002 respectively
37
 Frequency Polygon
o The frequency polygon has most of the properties of a histogram, with an
extra feature
o Here the mid-point of each class of the x-axis is marked
o Then the midpoints and the frequencies are taken as the plotting point
o These points are connected using line segments
o We also complete the graph, that is, it's closed by joining to the x-axis.
o Frequency polygon gives a less accurate representation of the distribution,
than a histogram, as it represents the frequency of each class by a single point
not by the whole class interval
o Lets consider a data table and lets try to draw frequency polygon of it
Draw a graph by using data given below:
Class interval Frequency

0-10 1
10-20 3
20-30 6
30-40 4
40-50 2
Step 1: First we need the mid-point of the class interval
Class interval Mid-point Frequency

0-10 5 1
38
10-20 15 3
20-30 25 6
30-40 35 4
40-50 45 2
Step 2: Then draw frequency polygon
 Histogram
o Histogram is the most accurate graph that represents a frequency distribution
o In the histogram the scores are spread uniformly over the entire class interval
o The class intervals are plotted on the x-axis and the frequencies on the y-axis
o Each interval is represented by a separate rectangle
39
o To plot this take the class limits on the x-axis and the frequency on the y-axis.
o On the x-axis, the scale can be 10 units whereas on the y-axis the scale can be 1
unit.
STEP 4: Interpretation of Tables and Graphs (30 minutes)
 Frequency distribution
o A frequency shows the number of times that data with particular characteristics
occur in a data set.
o The distribution tells how many or what proportion of the group has each value or
a range of values out of all possible values
 Bar chart
o the frequency of each group is represented by the length of the corresponding bar
o the height of the bar over a period represents the figure for the corresponding
period
 Histogram
o read erected rectangles over class interval representing the frequencies of the class
interval
o the frequency distributions of each grouped data by areas (height and width), e.g.
the frequency distribution of patients presenting with a certain condition in a given
period, with the patient grouped into 5-years block
 Pie chart
o compare individual category with the total
40
o depicts each category as a slice of pie with the size of each slice varying according
to its proportion of the whole pie
 Frequency polygon
o see variations in increase and decrease over time or seasons

 Tables and graph used to determine trend include line graphs, bar graph and histogram
 A line graph is a diagram that shows a line joining several points, or a line that shows
the relationship between the points
 Histogram is the most accurate graph that represents a frequency distribution

 What tables and Graph are used to determine Trend
 What is a bar graph?
 What is a line graph?
41
References
Kingdom


Netherlands
Kazaura, M. R., Makwaya, C. K., Masanja, C. M. and Mpembeni, R.C.(1997). Lecture notesin
Salaam
Sundars, M., Lewis, P and Thornhill, A (2007). Research Methods for Business Students,
Harlow, Prentice Hall.
42
Session 5: Basic Concept of Research
Prerequisites
 None
Learning Tasks
 Define research
 Outline the importance of research in pharmaceutical services
 Explain the application of research concepts in pharmaceutical services
Resources Needed
 Flip charts, marker pens, and masking tape
 Black/white board and chalk/whiteboard markers
 Computer and LCD
SESSION OVERVIEW
Activity/
Step Time Content
Method
1. 05 minutes Presentation Introduction, Learning Tasks
2. 20 minutes Presentation Brainstorming Definition of Research

Presentation
Importance of Research in Pharmaceutical
3. 35 minutes Buzzing Services
Presentation
Application of Research Concepts in
4. 50 minutes Small group discussion Pharmaceutical Services
5. 05 minutes Presentation Key Points

6. 05 minutes Presentation Evaluation
43
SESSION CONTENTS
STEP 2: Definitions of Research (20 minutes)

 Research:
o A careful and systematic process of inquiry to find answers to problem of interest.
o It is a systematic process of collection, analysis and interpretation of data
to answer a research question or solve a problem
o Includes use of facts, use of theories, data analysis, sampling, doing an experiment
o To do research is to investigate the problem systematically and thoroughly so as to
Solve problem of interest.
o Human instinct to inquiry, to know, to know more, to explore, to find out, to
explain, to overcome a problem
o An on-going process
o How we live today is partly due to research
STEP 3: Importance of research in Pharmaceutical Services (35 minutes)

 Pharmaceutical personnel in all settings can engage more fully in research in order
to :
o Improve patient outcomes and further develop the profession.
o Inform workforce development, education, practice and commissioning
decisions.
o Clinical advances resulting from research help improve the care of patients
o Research findings assist in developing new roles and practice models for
clinical pharmacists.
o Its aim is to support evidence-based policy and practice decisions
where pharmacists are employed or medicines are prescribed or used
44
STEP 4: Application of Research Concepts in Pharmaceutical Services (50
minutes)
 Application of Research Concepts in Pharmaceutical services
o Focuses on examining how and why people access pharmacy services, how
much care costs, and what happens to patients as a result of this care.
o Health policy and governance
o Quality assurance and safety
o Medicine access and rational use
o Quality, safety & standards (e.g. vaccines and biological)
o Strengthening the services they provide through:
- Building the evidence base for developing and commissioning new
services
- Improving patient care
- Contributing to the knowledge base within health service research more
widely
- Gaining both professionally and personally in the process

 Research is the systematic collection, analysis, and interpretation of data in order to
answer a certain question or solve a problem
45
 Areas in pharmaceutical services that need research: may include health policy and
governance, quality assurance and safety, rational use of drugs

 What is research?
 What is the application of research in pharmaceutical services?
46
References
Abramson JH (1990, 4 th ed.) Survey Methods in Community Medicine. London: Churchill-

Livingstone. (In particular Chapter 6)


Anthropology of health and health care, third revised edition,, Het Spinhuis Publishers,
Kazaura, M. R., Makwaya, C. K., Masanja, C. M. and Mpembeni, R.C.(1997). Lecture

notesinBiostatistics, manual of biostatistics, Muhimbili University College of Health Sciences,
Dar es Salaam
Moser CA, Kalton G (1989, 2nd ed.) Survey Methods in Social Investigation. Hants, UK:
Gower Publishing Company. (In particular Chapters 10-13)
Patton MQ (1990, 2nd ed.) Qualitative Evaluation and Research Methods. Newbury Park,
USA: Sage Publications. (In particular Chapters 17-29)
Stewart A (2001). Basic Statistics and epidemiology, A practical guide, Radcliffe Medical
Press, United Kingdom
The Netherlands Health Systems Research Projects, Vol. 2 Part I. IDRC, Ottawa
Varkevisser, C. M, Pathmanathan, I and Brownlee, A (1991). Designing and Conducting
47
Session 6: Classification of Research
Prerequisites
 None
Learning Tasks
 Identify classes of research
 Describe study designs for classes of research identified
 Explain the uses and limitations of each study design
 Identify the most appropriate study design for the research proposal you are
developing
Resources Needed
SESSION OVERVIEW
Activity/
Step Time Content
Method
Presentation Classes of research

2 15 minutes
Brainstorming
Presentation Study designs
3 40 minutes
Buzzing
Uses and Limitations of each Study design

3 30 minutes Presentation
Buzzing
4 20 minutes Presentation Appropriate Study design for the Research Proposal
48
SESSION CONTENTS
STEP1 Presentation of Session Title and Learning Tasks (5 minutes):
STEP 2: Study Types Most Used in Research (35 minutes)

Research can be classified into several categories according to the nature and purpose of
the study and other attributes.
 Types of Research Methods According to the Purpose of the Study
o Applied research which is also referred to as an action research,
o Basic research also called fundamental or pure research.
 Types of Research Methods According to Nature of the Study

Descriptive, analytical and Experimental studies or interventional studies
o Descriptive research usually involves surveys and studies that aim to identify
the facts.
o In other words it deals with the description of the state of affairs as it is at
present, and there is no control over variables in descriptive research.
o Observational or Analytical research uses facts or information already

available and analyze these in order to make a critical evaluation of the
material.
o Experimental or interventional studies are ones where researchers introduce

an intervention and study the effects. Experimental studies are usually
randomized, meaning the subjects are grouped by chance. Randomized controlled
trial (RCT): Eligible people are randomly assigned to one of two or more groups.
 Types of Research according to Research Design
Two groups; Exploratory and Conclusive.
49
o Exploratory studies only aim to explore the research area and they do not
attempt to offer final and conclusive answers to research questions.
o Conclusive studies, on the contrary, aim to provide final and conclusive
answers to research questions.
o Quantitative or qualitative
STEP 3: Uses and Limitations of Each Study Type (40 minutes)

 Basic (fundamental/pure) research
Uses
o Basic research, aim to improve scientific theories for improved understanding or
prediction of natural or other phenomena.
o Applied research, in turn, uses scientific theories to develop technology or
techniques to intervene and alter natural or other phenomena.
o Though often driven by curiosity, basic research fuels applied science's
innovations.
Limitations
o Does not usually generate findings that have immediate applications in a
practical level.
o Fundamental research is driven by curiosity and the desire to expand
knowledge in specific research area
 Applied (operational) research

Uses
o Operations research is a discipline that deals with the application of advanced
analytical methods to help make better decisions.
o It uses scientific processes and knowledge as the means to achieve a particular
practical or useful result
o Uses knowledge and skills in creative ways to solve complex problems and have
an impact on critical decisions
Limitations
o Costly: Operation Research (OR) is very costly.
o Not realistic: Operation Research experts make very complex models for solving
problems. These models may not be realistic
o Complex: Operation Research is a complex concept
50
 Quantitative research
Uses
o . Provides statistical, mathematical, or numerical results
o Tends to analyze phenomena in terms of trends and frequencies
o Quantitative research is based on the measurement of quantity or amount.
o It is applicable to phenomena that can be expressed in terms of quantity.
o Quantitative research is inquiry into an identified problem, based on testing a
theory, measured with numbers, and analyzed using statistical techniques.
o The goal of quantitative methods is to determine whether the predictive
generalizations of a theory hold true.
Limitations
o Research quality is heavily dependent on the individual skills of the researcher
o More easily influenced by the researcher's personal biases and idiosyncrasies.
o Rigor is more difficult to maintain, assess, and demonstrate
 Qualitative research
Uses
o Can provide full picture of answers and reasons behind them(ethnographic)

o Can be used to inform answers to social issues
o Find ways to improve qualitative things like customers satisfaction, health
professional's opinions
o It aims to develop concepts that aid in the understanding of natural phenomena
with emphasis on the meaning, experiences and views of the students
Limitations
o Time consuming process
o Labour intensive approach in sorting, coding data etc
o Observer may be biased when interpreting
o Not easy to make comparison
51
o No result verification in qualitative research
 Exploratory studies
Uses
o It is a small-scale study of relatively short duration, which is carried out when
little is known about a situation or a problem.
o It may include description as well as comparison.
o Used for Small scale studies
o Gathers information about unfamiliar phenomenon
o Results give insight to a problem before a large scale study is designed
Limitations
o Interpretation of findings is judgemental
o Uses small samples which may not be representative
 Descriptive studies
Uses
o involves describing the characteristics of a particular situation, event or case
o Can be carried out on a small or large scale
o Small scale, descriptive case studies
o provide quite useful insight into a problem
o Less expensive
o describe in-depth the characteristics of one or a limited number of cases e.g.
patient; village
 Analytical
Uses
o An analytical study attempts to establish causes or risk factors for certain
problems.
o Is done by comparing two or more groups some of which have or develop the
problem and some of which have not
o Describe phenomena, and
o Analyze relationship between phenomena and other variables
(determinants/association
Limitations
o Only describe phenomena: e.g. Person, Place, Time
o No analysis of determinants/association e.g. Cross-sectional descriptive
52
o Low response rate
 Comparative or analytical studies

An analytical study attempts to establish causes or risk factors for certain
problems. It compares two or more groups, some of which have or develop the
problem and some of which have not It uses Cross-sectional comparative studies,
Case-control studies and Cohort studies
 Analytical studies
Cross-sectional studies
Uses
o Quick and cheap
o Can reveal various exposures, as first step in investigating the cause
o Repeated measures can depict( represent) trend
o Data useful in assessing health care needs
Limitation
o Not possible to determine if the exposure preceded the outcome
 Cross-sectional comparative studies
Uses
o Aim at describing phenomenon and compare groups or determine factors

influencing the phenomenon
o Done at one point in time
o Measurement of exposure and effect are done at the same time
o Quick and cheap,
o Can elucidate various exposures, as first step in investigating cause,
o Repeated measures can depict trend,
o Produce data useful in assessing health care needs
Limitations
o Not possible to determine if the exposure preceded the outcome (temporal
relationship)
53
 Case-control studies
In a case-control study the investigator compares one group among whom the
problem that he wishes to investigate is present (e.g. adverse drug reactions) and
another group called a control or comparison group, where the problem is absent,
in order to find out what factors have contributed to the problem
Uses
o Useful for generating/ test hypothesis
o Cheap and quick
o Makes use of comparison (control group)
o Can study more than one risk factor
o Useful for rare disease or long latent period
Limitations
o Data on exposure might be inaccurate and biased
o Difficult to make precise selection of control group
o Retrospective cannot separate cause and effect
o Cannot be used for rare exposure
o You cannot calculate incidence (you do not know when disease occurred
 Cohort studies
• In a cohort study, a group of individuals that is exposed to a risk factor
(study group) is compared to a group of individuals not exposed to the risk
factor (control group)
• Aim at determining risk factors for diseases/outcome
• At the start identify two groups
o With exposure to a risk factor (exposed)
o Without exposure (no-n exposed)
o Both groups have not developed the disease/outcome at the start
o Follow over time
o At the end, analyses disease/outcome occurrence in both groups
and compare
Limitations
54
o Needs to get complete and accurate information about exposure
and outcome for all individuals
o Time consuming, expensive
o Inefficient in evaluating rare diseases
o Loss of follow up affect validity of results
STEP 4: Appropriate Study Type for the Research Proposal (20 minutes)
Depending on the existing state of knowledge about a problem that is being studied, different
types of questions may be asked which require different study designs. Some examples are
given in the following matrix.
State of knowledge Type of research Type of study
of the problem Questions

 Knowing that a problem  What is the nature/  Exploratory studies, or
exists but knowing little magnitude of the Descriptive studies:
about its characteristics problem?
or possible causes  Who is affected?  Descriptive case studies
How do the affected  Cross-sectional surveys
people behave?
What do they know,
believe, and think about
the problem and its
causes?
 Suspecting that certain  Are certain factors  Analytical (comparative)
factors contribute to the indeed studies
problem associated with the  Cross-sectional
problem? comparative studies
(e.g., is lack of pre-
school education related  Case-control studies
to low school  Cohort studies
performance? Is low
fibre diet related to
carcinoma of the large
intestine?)
 Having established that  What is the cause of the  Cohort studies
certain factors are problem?  Experimental or quasi-
associated with the experimental studies
problem: desiring to  Will the removal of a
establish the extent to particular factor prevent
which a particular factor or reduce the problem
causes or contributes to (e.g., stopping smoking,
the problem. providing safe water)
 Having sufficient  What is the effect of a  Experimental or quasi-
55
knowledge about cause(s) particular experimental studies
to develop and assess an intervention/strategy
intervention which would (e.g., treating with a
prevent, control or solve particular drug; being
the problem. exposed to a certain type
of health education)
 Which of two alternate
strategies gives better
results? Which strategy
is most cost-effective?
Source: Varkevisser et al: Designing and Conducting Health Systems Research Projects, Vol. 2 Part I.
 The type of study chosen depends on:

o The type of problem,
o The knowledge already available about the problem
o Resources available for the study

 Study types most used in research include basic (fundamental) research, applied
(operational) research, quantitative research, and Qualitative research
 Depending on the existing state of knowledge about a problem that is being studied,
different types of questions may be asked which require different study designs

 What are the study types used in Research?
 What are the uses and limitations of cohort study?
56
References

Netherlands

Kothari C.R (1985). Research Methodology Methods and techniques, 2nd edition, Wiley
Eastern Limited New Delhi
Ranjit K (205). Research methodology step by step guide for beginners, 2nd edition,
Singapore, pearson education

Health Systems Research Projects, Vol. 2 Part I. IDRC, Ottawa
57
Session 7: Procedures for Conducting Operational
Research
Total Session Time: 120 minutes+240 minutes assignment
Prerequisites
 None
Learning Tasks
 Outline the major characteristics of research
 Identify essential guidelines in conducting operational reseach
 Describe procedural steps for conducting operational research
Resources Needed
SESSION OVERVIEW
Activity/
Step Time Content
Method
Presentation Major characteristics of research
2. 15 minutes
Brain storming
Presentation Essential guidelines for conducting operational
3.
30 minutes Buzzing research
60 minutes Presentation Procedural steps for conducting operational
4. Group research
discussion
58
SESSION CONTENTS
STEP 2: Major Characteristics of Research (15 minutes)

Operational research encompasses a wide range of problem-solving
techniques and methods applied in the pursuit of improved decision-making and
efficiency. Therefore it has to have certain characteristics as follows:
 It demands a clear statement of the problem.
 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.
 New data should be systematically collected and analyzed to answer the original
research objectives.
STEP 3: Essential Guidelines for Conducting Operational Research (30

minutes)
Operational research is undertaken primarily to provide information to support decision-
making that can improve the functioning of the health system. Some essential guidelines for
success include:
 It should focus on priority problems in health care.
 It should be action-oriented, i.e., aimed at developing solutions.
 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.
 The research should be participatory in nature, involving all parties concerned
(from policymakers to community members) in all stages of the proposal.
 Research must be timely. Otherwise, it loses its purpose.
 Emphasis should be placed on comparatively simple, short-term research designs
which are likely to yield practical results relatively quickly.
59
 It should be cost-effective operational research should focus, to a large extent, on
low-cost studies that can be undertaken by management and service personnel in the
course of daily activities.
 Results should be presented in formats most useful for administrators, decision-
makers and the community.
 Evaluation of the research undertaken should concentrate on its ability to influence
policy, improve services and ultimately lead to better health
STEP 4: Procedural Steps for Conducting Operational Research (60 minutes)
 Research Proposal: A document written by a scientist that describes in details the

program for a proposed scientific investigation.
 It can be envisaged as the process (step by step guidelines) of planning and giving
structure to the prospective research, with the fina1 aim of increasing the validity of the
research.
 It is a written submission to spell out the nature of the design and the means and strategies
that are going to be used in a logic format.
 Purpose of Research Proposal
o Provides a defined topic scope for researching.
o Helps you to understand further how to address the technical problems of writing
research.
There are several steps to follow in chronological order in writing a research proposal:
Step 1; Select, analyze and state the research problem
This step involves
o identification of the problem
o Problem prioritization
o Problem analysis
o Stating the problem
 Step 2: Review literature and other available information
-
 Step 3; Formulate Objectives
 Step 4; Develop research methodology
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o variables
o types of study
o data collection techniques
o sampling
o plan for data collection
o plan for data processing and analysis
o ethical consideration
o pretest/pilot study
 Step 5: Prepare the work plan
 Step 6: Identification of resources required and preparation of a budget
 Step 7: Plan for project administration and utilization of results
 Step 8 Collect data in the field (implement the proposal)
 Step 9: Analyze collected data and interpret results
 Step 10: Prepare and present a final report of the research findings, including
recommendations
 Step 11: Prepare plan of action for implementation of recommendations
Writing Introduction to Research Proposal
This is written when all sections of the proposal have been completed. The introduction leads
the reader from a general subject area to a particular topic of inquiry.
 It establishes the scope, context, and significance of the research being conducted by
summarizing current understanding and background information about the topic, stating
the purpose of the work in the form of the research problem supported by:
o a hypothesis or a set of questions,
o explaining briefly the methodological approach used to examine the research
problem,
o highlighting the potential outcomes your study can reveal, and
o outlining the remaining structure and organization of the paper
 Think of the introduction as a mental road map that must answer for the reader these four
questions:
o What was I studying?
o Why was this topic important to investigate?
61
o What did we know about this topic before I did this study?
o How will this study advance new knowledge or new ways of understanding?
 According to Reyes, there are three overarching goals of a good introduction:
o First, ensure that you summarize prior studies about the topic in a manner that lays a
foundation for understanding the research problem
o Second, explain how your study specifically addresses gaps in the literature,
insufficient consideration of the topic, or other deficiency in the literature
o third, note the broader theoretical, empirical, and/or policy contributions and
implications of your research
STEP 5: Key Points

 Operational research focuses on priority problems, it is action-oriented, uses multi-
disciplinary approach, is participatory, should be timely and cost effective,
 Operational research is done systematically step by step and there are several steps
to be followed when implementing it.
STEP 6: Evaluation
 What are the characteristics of an operational plan?
 What are the steps to be followed in implementing operational research?
62
References
Netherlands
Kingdom


63
Session 8: Identification of Research Problem
Prerequisites
 None
Learning Tasks
 Define research problem
 Identify research problems
 Outline conditions for a problem to be researchable
 Explain criteria for selecting a research topic
 Explain how to prioritize topic for research
Resources Needed
 Handout 8.1: Research Problem Identification
 Handout 8.2: Examples of Research and Non-Research Problems
 Handout 8.3: Prioritizing Health Problems for Operational Research
SESSION OVERVIEW
Activity/
Step Time Content
Method
Presentation Definition of reseach problem
2 05 minutes
Brainstorming
Presentation Identification of research problem
3 30 minutes
Buzzing
Presentation Conditions for a problem to be researchable
4 10 minutes
Presentation Criteria for selecting a research problem
5 55 minutes
Small group discussion
05 minutes Assignment: Identification and selection of
8 Presentation
problem for research proposal
64
SESSION CONTENTS
STEP 2: Definition of Research Problem (5 minutes)

 Identification and formulation of research problem is the first step of research
process
 A research problem is:
o a definite or clear expression [statement] about an area of concern,
o a condition to be improved upon,
o a difficulty to be eliminated, or a troubling question that exists in scholarly
literature, in theory, or within existing practice that points to a need for
meaningful understanding and deliberate investigation.
o A question that a researcher wants to answer or a problem to be solved
STEP 3: Identification of Problems for Research (30 minutes)

Research problems can be identified through:
 Personal experiences
 Practical experiences
 Review of records/reports
 Critical appraisal of literature
 Previous research
 Existing theories
 Consumer/user feedback
 Performance improvement
 Social issues
 Mangement meetings
 Brainstorming
65
STEP 4: Conditions for a problem to be researchable (10 minutes)
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)
 There should be more than one possible answer to a question or more than one
solution to the problem.
STEP 5: Criteria for Selecting Health-Related Problems to be Given

Priority in Research (55 minutes)
 When there are many potential topics for research, a decision should be made to select
one, which is of high priority
 To do so, we need to compare the topics using some criteria.
The following are useful criteria:
o Relevance
o Avoidance of duplication
o Urgency of data (timeliness)
o Political acceptability of study
o Feasibility of study
o Applicability of results
o Ethical acceptability
Each criterion has the rating scale to enable one to decide which problem to select. The
following are the criteria and their rating scales
 Relevance
the topic should be relevant
o How large or widespread is the problem?
o Who is affected?
o How severe is the problem?
Rating scale (scores)

1 = Not relevant
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2 = Relevant
3 = Very relevant
 Avoidance of duplication
We should avoid duplicating what is already well established

o Check literature to see if the topic has been researched in the same area or
elsewhere.
o If so, ask whether or not there are issues that remain to be investigated

1= Sufficient information available
2 = Some information available but major issues not covered
3 = No sound information available
 Urgency of data (timeliness)
o How urgently are the results needed?
o Consider which research should be done first and which can be done later

1= Information not urgently needed
2 = Information could be used right away but a delay of some months would be
acceptable
3 = Information very urgently needed for use
 Political acceptability of study

Is the topic supported by the local/national authorities?

1=Topic not acceptable
2=Topic slightly acceptable
3=Topic fully acceptable
 Feasibility of study
o Can the study be done with the available resources?
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o Consider human, material, financial, time

1= Study not feasible
2= Study feasible
3= Study very feasible
 Applicability of results
Is it likely that the recommendations from the study will be implemented?

1=No chance of being implemented
2=Some chance of being implemented
3=Good chance of being implemented
 Ethical acceptability
o Is the study going to cause ethical concerns?
o Acceptability by research students;
o Can consent to participate be easily obtained?
o Will the students be injured in any way?

1=Major ethical problems
2=Minor ethical problems
3=No ethical problems
After carefully assessing and scoring the topics based on the criteria, select one with
the highest score.

 When there are many potential topics for research, a decision should be made to select
one, which is of high priority
 After carefully assessing and scoring your topics and problem based on the criteria, select
the one with the highest score
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 What are criteria for selecting health-related problems?
 What is a group consensus technique used to set priorities for research?
STEP 6: Assignment (10 minutes)
Activity: Take Home Individual Assignment (10 minutes)
ASKeach student to work on the following Assignment
 Select an appropriate problem for a your research proposal
ALLOCATE time for students to do the assignments and submit
REFER students to recommended reference
69
Handout 8.1: Research Problem Identification
 Problem Identification
o Finding a problem is not difficult, but identifying one for the purpose of research is
not always easy.
o Identifying a problem situation is the first essential step in designing a research
proposal, but it must then be followed by a process of problem definition.
o The research problem identified must be defined in terms of its occurrence, intensity,
distribution, and other measures for which data are already available.
o The aim is to determine all that is currently known about the problem and the reason
it exists.
o All research is set in motion by the existence of a problem.
o A problem is a perceived difficulty, a feeling of discomfort about the way things are,
or a discrepancy between what someone believes should be the situation and what the
situation is in reality.
o While problems are the initiating force behind research, not all problems require
research.
o A potential research situation arises when three conditions exist:
 A perceived discrepancy exists between what is and what should be.
 A question exists about why there is a discrepancy.
 At least two possible and plausible answers exist to the question.
• If there is only one possible and plausible answer to the question about the
discrepancy, then a research situation does not exist.
 Problem Justification
o After the problem is identified, it is necessary next to justify the importance of the
problem. Research often is expensive and time consuming.
o Find out why the problem you wish to study is important.
Ask yourself the following questions: Can you justify your selection of the research
problem? Can you convince others that the problem is important?
70
 What to Do: Justifying the Selection of a Research Problem
o In justifying the importance of a research problem, it is helpful to ask yourself a series
of questions and then try to answer each of them.
 Is the problem you wish to study a current and timely one?
 Does the problem exist now? How widespread is the problem? Are many areas
and many people affected by the problem?
 Does the problem affect key populations, such as youth, people living with
HIV/AIDS (PLHA), mothers, or children?
 Does the problem relate to ongoing program activities?
 Does the problem relate to broad social, economic, and health issues, such as
unemployment, income distribution, poverty, the status of women, or education?
 Who else is concerned about the problem? Are top government officials
concerned? Are medical doctors or other professionals concerned?
o Review your answers to these questions, and arrange them into one or two paragraphs
that justify the importance of the research problem.
o Start by discussing the broad issues that justify the problem and then begin to focus
on the more specific issues related to a particular population group or geographical
setting.
 Sample Research Problem Justification
o Over time, millions of HIV-infected people in Africa and elsewhere in the world are
developing HIV-related illnesses. In most African countries, hospitals, clinics, and
other formal health care institutions simply cannot cope with the large numbers of
people in need of physical care and social and psychological support.
o In some hospitals, well over half of the beds are already occupied by AIDS patients.
In some countries the figure is as high as 70 percent of all hospital beds. This is a
problem of great concern to health care planners, as well as to the Ministry of
Finance, which simply does not have the resources to build new facilities or train
large numbers of new providers.
o The problem of providing care and support for PLHA is particularly challenging in
rural areas because there are relatively few health facilities or adequately trained
providers available. In this situation, an alternative is to provide care, support, and
treatment in the homes of those with AIDS. How to do this in a cost-effective manner
while simultaneously providing high-quality services is a challenge.
71
o New models of delivering care and support services in rural areas need to be
developed and tested to improve the quality of life for PLHA.
o Without effective new approaches, large numbers of people with AIDS will suffer
physical and psychological pain that might otherwise be avoided or at least lessened.
 Comments on the Sample Justification:
o The first paragraph establishes the dimensions of the problem. The large number of
people with AIDS cannot be adequately treated or supported by the formal health care
system, which is already overwhelmed in many countries.
o The second paragraph notes that the problem is particularly acute in rural areas, where
health facilities and providers are relatively few in number. An alternative is to
provide services to PLHA in their homes. The important question is how to do this.
o The paragraph ends by saying that without the development of new approaches to
care and support, large numbers of PLHA will needlessly suffer.
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Handout 8.2: Examples of Research and Non-Research Problems
Example of a Non-Research Problem

 Problem Situation
o A recent situation analysis assessment of a hospital in District A found that 125 HIV
positive adults were coming to the hospital every day as part of a DOTS program to
take medication for tuberculosis (TB). But last months service statistics from the
hospitals DOTS program revealed that for one entire week, none of the 125 patients
received any medication.
o Discrepancy
All 125 patients should be receiving a daily treatment for TB, but all 125 did not
receive a single treatment for an entire week last month.
o Problem Question
What factor or factors are responsible for 125 patients failing to receive any
treatment for their TB for an entire week?
o Answer
- During the week when the patients did not receive daily TB treatments, a very
heavy rainstorm caused flooding that washed out several roads and destroyed a
major bridge that is used to bring supplies to the district hospital. Because of the
flooding and the destroyed bridge, the hospital ran out of TB medication, and a
resupply truck could not reach the hospital for one week while the bridge was
being repaired.
- In this example, a problem situation exists, but the reason for the problem is
already known. Therefore, assuming that all the facts are correct, there is no
reason to conduct research on the factors associated with the break in the supply
of daily TB medication for 125 patients.
73
- Nonetheless, there may very well be a need to conduct research on the question of
why the supply logistics system is incapable of providing medication during the
rainy season, when it is known that roads and bridges are frequently damaged.
 Problem Situation
o A recent provincial study revealed great differences among villages in the
prevalence of HIV-positive persons. Despite the fact that all villages receive the
same level of health education and services from the Ministry of Health, some
villages have an HIV prevalence rate as high as 32 percent among adults from 15
to 49 years old, while other villages have a rate as low as 6 percent.
o Discrepancy
In a relatively small geographic area, you would expect that all villages should
have approximately the same sero-prevalence rate but, in fact, there is great
variation among villages.
o Problem Question
Which factors are responsible for the geographic variation in HIV prevalence
among villages?
o Possible Answers
- Villages differ in their socioeconomic environments, and these differences influence
the context within which HIV is transmitted.
- Some are stable agricultural villages, while some are mobile fishing communities.
- Some villages are located on major roads and have easy access to market towns;
others are more remote with very difficult access to market centers. Some villages
- have schools, health clinics, electricity, and a good water supply, while others do not
74
have these advantages.
- These and many other social, economic, and cultural differences affect the context
within which sexual relations take place and HIV is transmitted.
- Villages differ in individual and institutional support for HIV/AIDS prevention, care,
and support programs.
- In some villages, influential local leaders strongly support sexual behavior change and
condom distribution programs.
- In other villages, people are resistant to these programs, and there is substantial
stigma and discrimination associated with HIV/AIDS.
- In some villages, there are very active anti-AIDS clubs for youth, strong PLHA
organizations, and effective orphan care NGOs.
- In other villages these institutions are absent. These differences in individual
commitment to and institutional support for HIV/AIDS programs affect the sexual
behavior of individuals, the use of condoms, the level of stigma and discrimination,
and the transmission of HIV.
o While the problem situation presented above is fairly clear, the possible and plausible
reasons for the problem are complex. Several of these reasons have been described, but it
is very likely there are many more.
o In situations such as this one, the researcher must devote considerable time and attention
to identifying and clearly defining the problem situation before any potential solutions to
the problem can be tested experimentally through a longitudinal operations research
study.
o The aim of clearly identifying and defining a problem situation is to focus the research on
the most important aspects of a problem that can be changed through a program
intervention.
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Handout 8.3: Prioritizing Health Problems for Operational Research
 Relevance
o The topic you choose should be a priority problem.
o Questions to be asked include:
- How large or widespread is the problem?
- Who is affected?
- How severe is the problem?
o If you do not consider a topic relevant, it is not worthwhile to continue rating it. In
that case you should drop it from your list.
o Try to think of serious health problems that affect a great number of people or of the
most serious problems that are faced by clinicians in the area of your work.
o Also, consider the question of who perceives the problem as important. Health
managers, health staff and community members may each look at the same problem
from different perspectives.
o Community members, for example, may give a higher priority to economic concerns
than to certain public health problems.
o To ensure full participation of all parties concerned, it is advisable to define the
problem in such a way that all have an interest in solving it. Even within villages,
opinions may differ on how important a problem is.
o It is therefore obligatory to discuss the problem with community leaders, as well as
peripheral villagers, males as well as females, rich and poor, exploring their
perceptions of the problem.
 Avoidance of Duplication
o Before you decide to carry out a study, it is important that you find out whether the
suggested topic has been investigated before, either within the proposed study area or
in another area with similar conditions.
76
o If the topic has been researched, the results should be reviewed to explore whether
major questions that deserve further investigation remain unanswered. If not, another
topic should be chosen.
o Also, consider carefully whether you can find answers to the problem in already
available, unpublished information or just by using your common sense. If so, you
should drop the topic from your list.
 Urgency of Required Solution (Timeliness)

o How urgently are the results needed for making a decision or developing interventions
at various levels (from community to policy)? Consider which research should be
done first and which can be done later.
 Political Acceptability
o In general it is advisable to research a topic which has the interest and support of the
Local/national authorities. This will increase the chance that the results of the study
will be implemented.
o Under certain circumstances, however, you may feel that a study is required to show
that the government's policy needs adjustment. If so, you should make an extra effort
to involve the policy-makers concerned at an early stage, in order to limit the chances
for confrontation later.
 Feasibility
o Look at the complexity of the problem and the resources you will require to carry out
your study and time required for intervention. Thought should be given first to
manpower, time, equipment and money that are locally available.
o In situations where the local resources necessary to carry out the processes are not
sufficient, you might consider resources available at the national level. Finally,
explore the possibility of obtaining technical and financial assistance from external
sources.
 Applicability of Possible Results/Recommendations
o Is it likely that the recommendations from the study will be applied? This will depend
not only on the management capability within the team and the blessing of the
77
authorities but also on the availability of resources for implementing the
recommendations.
o Likewise, the opinion of the potential clients and of responsible staff will influence
the implementation of recommendations.
 Ethical Acceptability
o We should always consider the possibility that we may inflict harm on others while
carrying out research or any intervention.
o Therefore, consider important ethical issues such as:
- How Cultural sensitivity must be given careful consideration.
- Informed consent be obtained from the research subjects.
- Will the condition of the subjects be taken into account? For example, if
individuals are identified during the study who require treatment, will this
treatment be given?
- What if such treatment interferes with your study results?
• Will the results be shared with those who are being studied?
• Will the results be helpful in improving the lives or health of those studied?
 Scales for rating research topics
These criteria can be measured by the following rating scales:
o Relevance
1. = Not relevant
2. = Relevant
3. = Very relevant
o 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

o Urgency
1. = Information not urgently needed
2. = Information could be used right away but delay of some months would be
acceptable
3. = Data very urgently needed for decision-making
78
o Political Acceptability
1. = Topic not acceptable to high level policymakers
2. = Topic more or less acceptable
3. = Topic fully acceptable
o Feasibility
1. = Study not feasible, considering available resources
2. = Study feasible, considering available resources
3. = Study very feasible, considering available resources
o Applicability
1. = No chance of recommendations being implemented
2. = Some chance of recommendations being implemented
3. = Good chance of recommendations being implemented
o Ethical acceptability
1. = Major ethical problems
2. = Minor ethical problems
3. = No ethical problems
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Session 9: Analysis and Statement of the Problem
Total Session Time: 120 minutes
Prerequisites
 None
Learning Tasks
 Identify factors contributed to the problem.
 Clarify the relationship between the problem and contributing factors.
 Decide on the scope and focus of the research
 Formulate the problem statement
Resources Needed
 Handout 9.1: Formulating the Problem Statement
 Handout 9.2: Sample Problem Analysis Diagram
SESSION OVERVIEW
Activity/
Step Time Content
Method
Presentation Factors Contributed to the Problem.
2 30 minutes
Group discussion
Presentation Relationship Between the Problem and
3 15 minutes Contributing Factors.
Brainstorming
4 10 minutes Presentation The Scope and Focus of the Research
45minutes Presentation Formulation of the Problem Statement

5
Group discussion
80
SESSION CONTENTS
STEP 2: Factors Contributed to the Problem (30 minutes)

Analyzing the problem is a very crucial step in designing the research because it:
 Enables those concerned to pool their knowledge of the problem
 Clarifies the problem and the possible factors that may be contributing to it
 Facilitates decisions concerning the focus and scope of the research
 The factors contributed to the problem
o You have to specify and describe the core problem you selected after prioritization
 Quantify the selected problem. After identifying the core problem you should:
o Identify factors that may have contributed to the problem.
o Clarify the relationship between the problem and contributing factors
o It is helpful to visualize these inter relationships in the form of a diagram.
The basic principles of constructing such a diagram are illustrated below
 Identify further contributing factors.
81
o Extend the problem analysis diagram further by identifying additional factors that
could have contributed to or aggravated the problem.
o It may be possible to identify several generations of predisposing factors, by
asking but why
 Organise related factors together into larger categories and develop final draft
diagram. For example
o Many researchers group contributing factors into four main categories:
 Socio-cultural factors
 Economic factors
 Service-related factors
 Disease-related factors
STEP 3: Relationship Between the Problem and Contributing Factors (15

minutes)
 The relationships between contributing factors and the problem can be indicated by
arrows
o One-way arrow (for cause-effect relationships) or
o Two-way arrows (for mutual relationships)
 The core problem can be identified by drawing a double line around it
STEP 4: The Scope and Focus of the Research (10 minutes)

 Scoping is figuring out what, exactly, to explore for a study
 Decide on the focus and scope of the research
 Not necessary to research on all factors if too many
STEP 5: Formulation of the Problem Statement (45 minutes)
What information should be included in the statement of the problem?

 A brief description of socio-economic and cultural characteristics and an overview of
health status and the health-care system in the country/district in as far as these are
relevant to the problem. Include a few illustrative statistics, if available, to help describe
the context in which the problem occurs.
 A concise description of the nature of the problem (the discrepancy between what is and
what should be) and of the size, distribution and severity of the problem (who is affected,
where, since when, and what are the consequences for those affected and for the services).
For a descriptive study you will elaborate the different components of the problem.
82
 An analysis of the major factors that may influence the problem and a discussion of
why certain factors need more investigation if the problem is to be fully understood.
 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 (justification for your study).
 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.
 If necessary, a short list of definitions of crucial concepts used in the statement of the
problem.
Writing the statement of the problem
 List the major points plan to include in the problem statement and rearrange them, if
necessary, before preparing the written text for the problem statement.
 Use available reports to help specify their problem, and to search for information they do
not have. Part of the literature review, if not all, may be included in the statement of the
problem.
 Preparation of the written problem statement can be done in small groups or individually,
 The description of relevant socio-economic, cultural and health characteristics of the
country and/or district in which the study takes place can be best done at the end, after a
thorough description of the problem, to avoid irrelevant background data. It will be placed
at the beginning of the problem statement.

 Many researchers group contributing factors into four main categories: socio-cultural,
economic factors, service-related factors and disease-related factors
 The core problem can be identified by drawing a double line around it
 Formulation of the problem statement is derived from analysis of the problem, reviewing
report, literature and other relevant information available.

 What is the relationship between the problem and contributing factors?
 What information do you need to include in the statement of problem?
83
ASK each student to work on the following Assignment
 Write the statement of the problem you have identified for a research proposal
84
References
Hardon A, Boonmongkon P, and Streefland P. et al (editors)(2001). Applied Health research,
Netherlands

85
Handout 9.1: Formulating the Problem Statement
 Importance of a Well-Defined Problem
o A poorly defined research problem leads to confusion.
o A well-defined research problem statement leads to:
 Statement of research objectives
 Hypotheses
 Definition of key variables
 Selection of a methodology for measuring the variables
 Foundation for the further development of the research proposal
 Ease in finding find information and reports of similar studies from which your
own study design can benefit
 Systematic justification for undertaking the proposed research, and what the
 researcher he/she hope to achieve with the study results
 This is important to highlight when you present your project to community
members, health staff, relevant ministries and donor agencies who need to support
your study or give their consent.
 Statement of the Problem Includes:
o Identification, definition, and justification of the research problem
o One of the most important first tasks of research is to identify and clearly define the
problem you wish to study.
o If you are uncertain about the research problem or if you are not clear in your own
mind about what you want to study, others who read your proposal will also be
uncertain.
o Problem Identification and definition
o While it is always possible to guess why a problem exists, guesses are often wrong
and usually do not provide a firm basis for designing a research study.
o A far better way to define a problem situation is to review relevant literature, examine
current service statistics, seek educated opinions from persons concerned about the
problem, and obtain probable reasons for the problem from social, economic, or
health theory.
86
o Follow this general procedure when identifying and defining a problem situation:
 Start with a simple statement of the problem situation.
 Add details as you review the literature, review theoretical concepts, and
investigate the problem in greater depth.
 Simplify the focus by identifying the most important aspects of the problem that
are researchable.
 Make a first attempt at identifying the problem situation by using the following format:
o Problem Situation: Write a small, simple paragraph that identifies the problem.
o Discrepancy: State the discrepancy between what is and what should be.
o Problem Question: Write down the central problem question.
o Possible Answers: Write two or more plausible answers to the problem question.
 From the available research literature, health and behavioral theory, current service
statistics, educated opinions and other sources of information, try to add details to the
problem situation you have just identified.
 Look for theoretical concepts and operational variables that you may have missed. List
these concepts and variables on a piece of paper as you come across them. Try to answer
 the following questions:
o What are the incidence and prevalence of the problem?
o Which geographic areas are affected by the problem? Which population groups are
affected by the problem?
o What are the findings of other research studies?
o What has been done to overcome the problem in the past?
o How successful were past efforts to overcome the problem?
o What seem to be major unanswered questions about the problem?
 With the information you have collected from a literature review and other sources,
rewrite your statement identifying and defining the problem. Use the format described
above:
o Problem Situation, Discrepancy, Problem Question, and Possible Answers
o Add details that help to define the problem, but organize the information. Try to
establish the boundaries of the problem.
o Focus your attention on the most important, researchable aspects of the problem.
 Have one or more colleagues read your final statement identifying and defining the
problem situation. If they are unclear about the problem situation or cannot describe the
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discrepancy between what is and what should be, then go back to the beginning and start
all over again.
Handout 9.2: Sample Problem Diagram
Figure below shows the initial problem diagram on Irrational drug use
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Session 10: Literature Review in Research
Total Session Time: 120 minutes + 240 minutes Assignment
Prerequisites
 None
Learning Tasks
 Describe the reasons for reviewing available literature
 Identify the resources that are available for carrying out such a review
 Prepare index cards for summarization of important information obtained from literature
 Prepare a review of literature pertaining to research topic
Resources Needed
SESSION OVERVIEW
Activity/
Step Time Content
Method
Presentation
2 15 minutes Reasons for Reviewing Available Literature
Buzzing
Presentation Identification of Resources that are Available
3 10 minutes
Brainstorming for Carrying out Literature Review.
Presentation Summarizing Important Information Obtained

4 55 minutes
Lecture discusion From Index Cards
5 20 minutes Presentation Review of Literature Pertaining to Research

Topic
8 05 minutes Presentation Individual Assignment
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SESSION CONTENTS

STEP 2: Reasons for Reviewing Available Literature (15 minutes)

 A literature review is the reading of the work of others before starting your research and
doing a summary about previous studies on the topic.
 A literature review provides a helpful guide to a particular topic.
 The focus of a literature review is to summarize and synthesize the arguments and ideas
of others without adding new contributions.
 A researcher needs to find out what has been done already, and build on that foundation,
because scientific research is cumulative.
o This involves determining what has been done and what still needs to be done, and
examining what books and professional journals have already revealed in your area
or country, or in other areas/countries with similar problems/context.
 It prevents you from duplicating work that has been done before.
 It helps you to find out what others have learned and reported on the problem you want to
study. This may assist you in refining your statement of the problem.
 It helps you to become more familiar with the various research approaches that might be
used in your study.
 It should provide you with convincing arguments for why your particular research project is
needed.
STEP 3: Identification of Resources that are Available for Carrying Out
Literature Review (10 minutes)
 Resources that are available for carrying out literature review include:
o People (individuals or groups, organizations)
o Publications (books which compile research information, journals (hard or electronic
copies)
o Unpublished information [grey literature) e.g. Dissertation, research reports not in
journals, computer data base
o Supervisors and fellow students
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 Sources could be at different levels of administrative system
o Community level, district and regional levels and provincial level
o National levels e.g. national libraries, Ministries of Health, central statistics, etc.
o International levels UNICEF, WHO, USAID, etc.; including computerized search
for international literature
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Sources of Information at Various Levels of Administrative System
SN Adminisstrative level Example of resource

1  Opinions, beliefs of key informants (through
Community and district
interviews), in addition to written sources
or provincial levels  Clinic- and hospital- based data from routine
statistics, registers
 Clinical observations, reports of critical incidents
 Local surveys, annual service reports
 Statistics issued at provincial and district levels
 Newspapers, books, articles, mimeographed
reports, etc.
2. National Level  Articles from national journals, books identified

during literature searches at university and other
national libraries, WHO, UNICEF libraries, etc.
 Special collections, e.g., newspaper clippings,
archival records, library or congress collections
 Documentation, reports and raw data from:
- The Ministry of Health (e.g., 5-year plans)
- central statistical offices
- Non-governmental organizations
3. International level  Information from:

 Bilateral and multilateral organisations (e.g.,
IDRC, USAID, UNICEF, WHO);
 Computerised searches for international literature
(from national library or international
institutions).
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STEP 4: Summarizing Important Information Obtained from Index Cards
(55 minutes)
 Strategy 1: What to do with identified information

o Read through
o Summarize the content relevant to your study (use index card)
Note pertinent information
• Title of article
• Author
• Title of Journal/Book, Page, Year, etc (see later)
• Aim of study
• Methodology
• Major findings
• Utility of information
 Write the literature review section
 Prepare list of references
 Strategy 2: What to do with identified information

o Organize in groups of related information/themes
o Sequence the information from far to near (for each theme) e.g. India-Africa-East
Africa-Tanzania
o Write coherently using your own words (be writing not citing); use past tense
o Cite sources properly using recommended style
 Writing a Literature Review
o Organize your notes in groups of related statements according to which aspect of the
problem they touch upon (e.g., community factors, service factors, etc.).
o Use your problem analysis diagram as a framework (and adapt the diagram in turn as
you find more literature).
o Decide in which order you want to discuss the various issues.
 Where Do You Put Which Information?
o Some literature can be used to describe the local context (district, region, country) or
problem.
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o All facts mentioned need a source, except some general and well known statements.
o For the description of the selected problem, use all available raw or published
literature.
o Literature from other countries or regions may be used to illustrate your point.
 If these sources are many, you may have a separate section on international
literature.
o More complex studies using theoretical models should have a separate section
discussing these models, which could come after the section of statement of the
problem.
o When drafting the background section or the statement of the problem, usually do not
describe sources one by one. Instead, write a coherent discussion in your own words,
using all relevant literature linked to each other.
o It is possible to cite several sources for one statement. Reference all the literature
referred to in your review.
o At the end of your paper, list your references in order, using the format described
above.
o In research proposals, the references come before the annexes.
o Select one style of references (such as Vancouver, Harvard, etc.) and use it
consistently for citations and reference lists in your proposal.
 Bias in Literature
o Bias: A distortion of the available information in such a way that it reflects opinions
or conclusions which do not represent the real situation.
o Understanding the various types of bias helps to be critical of the existing literature.
o If you have reservations about certain references or if you find conflicting opinions in
the literature, then discuss these openly and critically. Such a critical attitude may
help you to avoid biases in your study.
o Common types of bias in literature include:
 Playing down controversies and differences in one's own study results.
 Restricting references to those that support the point of view of the author.
 Drawing far reaching conclusions from preliminary or shaky research results or
making sweeping generalizations from just one case or small study.
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STEP 5: Review of Literature Pertaining to Research Topic (20 minutes)
Review of literature pertaining to research topic avoiding the following:
 Plagiarism (pretending information is yours) is defined as:
o An object (language, words, text, diagram, graphs, ideas)
o which has been taken from a source (books, journals, internet, not just text)
o by an agent (person, student, academician)
o without adequate acknowledgement of sources
o with or without intention to deceive
 Bias in literature review
o Suppressing/omitting controversies/ conflicting opinion or differences
o Using author supportive references only
o Over concluding/ generalisation from inadequate data - one case or small study or
poor design
 Such types of bias may have serious ethical implication (may affect peoples health; take
researcher to court)
 Literature review or search is a systematic and thorough search of all types of published
literature in order to identify as many items as possible that are relevant to a particular
topic
 Resources that are available for carrying out such a review are people, publications,
unpublished information, supervisors and fellow students

 What are the reasons for reviewing available literature?
 What are the resources that are available for carrying out literature review?
STEP 8: Individual assignment (05 minutes)
Activity: Take Home Individual Assignment (05minutes)
ASK individual students to work on the following Assignment
 Review and write literature for the problem of your research proposal
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References
Netherlands

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Session 11: Research Objectives and Questions
Prerequisites
 None
Learning Tasks
 Define general and specific objectives
 Outline the characteristics of research objectives
 State the difference between general and specific objectives
 Prepare research objectives in an appropriate format for the project you are developing
 Develop research questions appropriate for the study
Resources Needed
 Handout 11.1: Broad and Specific Objectives
SESSION OVERVIEW
Activity/
Step Time Content
Method
2 Definition of General and Specific Objectives
Brainstorming
3 Characteristics of Research Objectives
Brainstorming
Presentation
4 20 minutes The Difference Between General and Specific
Buzzing Objectives
5 Preparation of Research Objectives
Lecture discussion
6 25 minutes Development of Research Questions

Presentation
05 minutes
7 Presentation Key Points
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SESSION CONTENTS

STEP 2: Definition of General and Specific Objectives (10 minutes)

 Research studies should include a statement of
o Broad objective
o Specific objectives
o Hypotheses (except in the case of purely exploratory or descriptive studies)
 Objectives: Summary of what is intended to be achieved by the study.
 General objective also known as Broad objective
o The objective of a research project summarizes what is to be achieved by the study.
o The general objective of a study states what is expected to be achieved by the study in
general terms.
o It is possible (and advisable) to break down a general objective into smaller, logically
connected parts. These are normally referred to as specific objectives.
o Related to core problem
o Shows target population and place
o Use action verb
o Normally only one per study
 Specific objectives
o Explain the broad objective in specific
o Should systematically address:
 The various aspects of the problem
 Key factors that are assumed to influence or cause the problem.
 They should specify what you will do in your study, where and for what purpose.
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 Usually focuses on quantifying or specifying the problem
 Hypothesis
o Statement/a specific prediction about the nature and expected direction of
the relationship between two or more variables that permit empirical testing.
 Why should research objectives be developed?
o To clarify and focus your intentions /focus the study (narrowing it down to
essentials).
o To have a basis for measuring your achievements at the end of the study.
o To avoid the collection of data which are not strictly necessary for understanding
and solving the problem you have identified.
o To organize the study in clearly defined parts or phases.
o To facilitate the development of your research methodology and orient the
collection, analysis, interpretation and utilization of data.
STEP 3: Characteristics of Research Objectives (10 minutes)

 Objectives must be SMART.
o S = Specific: Specifying exactly what you are going to do, where, and for what
purpose.
o M= Measurable: Can be evaluated.
o A = Action oriented.
o R = Realistic: Considering local conditions can be done.
o T = Time bound: When exactly will the activities be carried out?pharmaceutical
services dispensaries, then the general objective of the study could be to identify the
reasons for this low utilization pharmaceutical services dispensaries in Mongoro
disstrict,, in order to find solutions.
 Formulating Specific Objectives
o Specific objectives should systematically address the various aspects of the problem
as defined under 'Statement of the Problem and the key factors that are assumed to
influence or cause the problem.
o They should specify what you will do in your study, where and for what purpose.
 The first specific objective usually focuses on quantifying or specifying the problem.
 It may be helpful to use the diagram as a point of departure and check whether the
99
problem and all major, directly contributing factors (analytic study) or major components
(descriptive or evaluation study) have been covered by the objectives.
 An objective indicating how the results will be used should be included in every
operational study, either as part of the general objective or as a specific objective.
Refer students to Handout 11.1: Broad and Specific Objectives
 How to State Objectives

o It should cover the different aspects of the problem and its contributing factors in a
coherent way and in a logical sequence.
o Are clearly phrased in operational terms, specifying exactly what you are going to do,
where, and for what purpose.
o Are realistic considering local conditions.
o Use action verbs that are specific enough to be evaluated.
 Examples of action verbs are, to determine, to reduce, to compare, to verify, to
calculate, to describe, and to establish.
o Avoid the use of vague non-action verbs such as, to appreciate, to understand, or to
study.
o Example of a Broad Objective: To determine factors associated with irrational
prescribing habits in district A.
o Examples of Specific objectives from the above broad objectives
 To determine the magnitude of irrational prescribing habits in district A.
 To identify number of drugs prescribed per prescription
 To verify the availablility of appropriate reference materials e.g.STG at
prescribers office
 To assess availability of essential drugs in the past 3 months
 Hypothesis
o It is ideally a prediction of an expected relationship between one or more factors and
the problem under study which can be tested.
o Are appropriate for field intervention or evaluation studies.
o Exploratory studies do not normally require hypothesis because they generally do not
test relationships between variables.
o Two types of research hypothesis are Null hypothesis and Alternative hypothesis
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o A Null Hypothesis is the one that is stated in negation form. It indicates that there is no
relationship between variables. It is donated as (Ho).
Example: Improved Improved prescribing habits have no effect in rational use
of drugs
 Alternation hypothesis (working hypothesis) is stated to indicate the actual
expectation.
 It is donated as (H1).
 Improved prescribing habits improves rational use of drugs.
 Difference between Null Hypothesis and Alternative Hypothesis

o The Null Hypothesis denies the existence of any significant differences between any
compared values and stresses that even when such differences are observed, they have
occurred by chance.
o The Alternative Hypothesis is formulated in a way as to reject the null hypothesis.
o It states that there is a significant cause of the observed differences between
compared values and that the difference did not happen by chance.
STEP 4: The Difference Between General and Specific Objectives (20

minutes)
 General objectives are broad and long-term while specific objectives are short term
and narrow in focus
 The general objective is met through accomplishing each of the specific objectives.
Specific objectives is to specify what really you want to concentrate with or what you
want to do, show the main point you are focusing to
STEP 5: Preparation of Research Objectives in an Appropriate Format for

the Developed Project (35 minutes)
 Take care that the objectives of your study:
o Cover the different aspects of the problem and its contributing factors in a coherent
way and in a logical sequence
101
o Are clearly phrased in operational terms, specifying exactly what you are going to do,
where, and for what purpose;
o Are realistic considering local conditions; and
o Use action verbs that are specific enough to be evaluated
 Examples of action verbs are: to determine, to compare, to verify, to calculate, to
describe, and to establish
 Avoid the use of vague non-action verbs such as: to appreciate, to understand, or
to study
o It is not necessary to develop an objective for every single contributing factor
STEP 6: Development of Research Questions Appropriate for the Study (25

minutes)
Research question: Statement that identifies the phenomenon, situation or certain
Characteristics to be studied?
 It's absolutely essential to develop a research questions that you're interested in or care
about in order to focus your research
For example,
 Researching a broad topic such as "business management" is difficult since there
may be hundreds of sources on all aspects of business management.
 On the other hand, a focused question such as "What are the pros and cons of
Japanese management style?" is easier to research and can be covered more fully
and in more depth.
 How do you develop a usable research question?
o Choose an appropriate topic or issue for your research, one that actually can be
researched
o Then list all of the questions that you'd like answered yourself.
o Choose the best question, one that is neither too broad nor too narrow.
o Sometimes the number of sources you find will help you discover whether your
research question is too broad, too narrow, or okay?
o If you know a lot about the topic, you can develop a research question based on your
own knowledge. If you feel you don't know much about the topic, think again.
o It's a good idea to evaluate your research question and to ask for feedback on your
research question.
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o Once you complete your list, review your questions in order to choose a usable one
that is neither too broad nor too narrow.
o In this case, the best research question is "three"
 Question "one" is too narrow, since it can be answered with a simple statistic
 Question "two" is too broad; it implies that the researcher will cover many tactics
for reducing the problem of irrational drug use that could be used throughout the
country
 Question "three," on the other hand, is focused enough to research in some depth

 Writing introduction to research proposal leads the reader from a general subject area
to a particular topic of inquiry
 The general objective of a study states what is expected to be achieved by the study in
general terms
Specific objectives explain the broad objective in specific

 What is objective?
 What are general and specific objectives?
 What are the characteristics of research objectives?
DIVIDE students in groups or individuals
ASK the students to work on the following Assignment
 Formulate broad and specific research objectives, hypothesis and questions for the
your research proposal
103
104
 References
Netherlands

Handout 11.2: Examples of Broad and Specific Objectives
First Example
 A study into the cost and quality of home-based care for HIV/AIDS patients and their
communities in Tanzania, was developed. It had its general
objective:
o To explore to what extent Community Home-Based Care (CHBC) projects in
Tanzania provide adequate, affordable and sustainable care of good quality to people
with HIV/AIDS, and to identify ways in which these services can be improved.
o It was split up in the following specific objectives:

 To identify economic, psychosocial and other needs of patients and their families
affected by AIDS.
 To determine the extent to which formal and informal support systems address
these needs from the viewpoint of service providers as well as patients.
 To determine the economic costs of CHBC to the patient and family as well as to
the formal CHBC programme.
 To relate the calculated costs to the quality of care provided to the patient by the
family and to the family/patient by the CHBC programme.
105
 To determine how improved CHBC and informal support networks can contribute
to the needs of persons with AIDS and other chronically and terminally ill
patients.
 To use the findings to make recommendations on the improvement of CHBC to
home care providers, donors and other concerned organisations, including
government.
 In the example given above, the needs of AIDS patients and their relatives for care and
support have been defined in the first objective. The objectives which follow concentrate
on adequacy, cost and quality of care provided whereas the last two objectives specify
possible improvements with respect to CHBC, and to whom the results and
recommendations of the study will be fed back
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Session 12: Review of Study Types/Designs
Prerequisites
 None
Learning Tasks
 Describe the study types most used in research
 Explain uses and limitation of each study type most used in research
 Describe how the study design can influence the validity and reliability of the study result
 Identify the most appropriate study design for research proposal being developed
Resources Needed
SESSION OVERVIEW
Activity/
Step Time Content
Method

Presentation
2 40 minutes Study Types Most Used in Research
Brainstorming
Presentation Uses and Limitation of Study Types most Used in
3 35 minutes
Buzzing Research
4 15 minutes Presentation Influence of Study Design on the Validity and

Reliability of the Study Result
5 Identification of the Most Appropriate Study Design
for Research Proposal being developed
107
SESSION CONTENTS


STEP 2: Study Types Most Used in Research (10 minutes)
REFER SESSION 6
STEP 3: Uses and Limitation of Each Study Type Most Used in Research
(10 minutes)
STEP 4: Influence of Study Design on the Validity and Reliability of the

Study Result (15 minutes)
 Validity: means that your scientific observations actually measure what they intend to
measure (your conclusions are true).
o Internal validity: Difference in the dependent variable is actually a result of the
o independent variable.
o External validity: Results of the study are generalizable to other groups and
environments outside the experimental setting.
 Reliability: means that someone else using the same method in the same circumstances
should be able to obtain the same findings (your findings are repeatable).
o Reliability (repeatability) refers to the possibility to replicate (repeat) the observations
and is related to the precision of the instrument used for scientific observations.
o Validity refers to the soundness of the observations and to the accurateness of the data
collected by the research method/instrument.
STEP 5: Identification of the Most Appropriate Study Design for Research

(10 Minutes)
 Consider:
o Nature of the problem/topic
o State of knowledge about the problem/topic
o Resources available
o Skills of the researcher
108
 A descriptive study involves describing the characteristics of a particular situation, event
or case
 An analytical study attempts to establish causes or risk factors for certain problems
 Any study designs used, should give valid and reliable findings

 What study types are most used in research?
 What what will you consider when selecting study design for research proposal?
ASK each student to select an appropriate study type/design for a research proposal being
developed
ALLOCATE time for students to do the assignment and submit
109
References
Netherlands


110
Session 13: Research Sampling
Prerequisites
 None
Learning Tasks
 Define the common terms used in sampling
 Identify the population(s) to be studied
 Describe common methods of sampling
 Explain reasons for sampling
 Describe source of bias in sampling that should be avoided
Resources Needed
 Handout 13.1: Types of sampling methods and when to use it
SESSION OVERVIEW
Activity/
Step Time Content
Method
2 20 minutes Presentation Definition of the Common Terms Used in Sampling
20 minutes Presentation Identification of the Population(s) to be Studied

3
Buzzing
4 Group Common Methods of Sampling
discussion
5 10 minutes Presentation Reasons for Sampling
6 15 minutes Presentation Source of Bias in Sampling that Should be Avoided

111
SESSION CONTENTS

STEP 2: Definition of Common Terms Used in Sampling (20 minutes)

 Sampling: Process of selecting a number of study units from a defined study population.
o For studies which involve only small numbers of people all of them can be included
in the investigation.
o For research which focuses on a large population, for practical reasons, it is only
possible to include some of its members in the investigation. It is important to draw a
sample from the total population.
 Sampling unit
o A single section selected to research and gather statistics of the whole.
o For example, when studying a group of college students, a single student could be a
sampling unit.
o Unit of selection in the sampling process, e.g. Person, a school, a household, etc.
 Sampling frame
o a list of units from which a sample is to be picked
 Sampling fraction (sampling ratio)
o a proportion of sampling units to be picked from a specified sampling frame
= number units in a sample
number of units in sampling frame
 Sampling interval
o An interval at which units are picked from a sampling frame when systematic
sampling is done.
112
STEP 3: Identifying the Population (s) to be Studied (20 minutes)
 Study population
o Collective of study units for which the values of the varieties of interest could
possibly be determined.
o In identifying the population(s) to be studied we must consider the following questions:
 What is the group of people (STUDY POPULATION) we are interested in from
which we want to draw a sample?
 How many people do we need in our sample?
 How will these people be selected?
 Sample is a ubset of study population selected to participate in the research
when whole study population cannot be reached
o The study population has to be clearly defined (for example, according to age, sex, and
residence.) Otherwise we cannot do the sampling
o Each study population consists of STUDY UNITS. The way we define our study
population and our study unit depends on the problem we want to investigate and on the
objectives of the study
 Representativeness
o If researchers want to draw conclusions which are valid for the whole study
population, which requires a quantitative study design, they should take care to draw a
sample in such a way that it is representative of that population.
o A representative sample has all the important characteristics of the population from
which it is drawn
113
Figure 1: Relationhip between population and sample
STEP 4: Common Methods of Sampling (35 minutes)
 The common methods of sampling are:
 Two types of sampling probability and non probability
o Non probability
o Probability (random sampling)
 Probability Sampling ( Quantitative Data)

o Involves using random selection procedures, to ensure that each unit of the sample is
chosen on the basis of chance.
o All units of the study population should have an equal, or at least a known chance of
being included in the sample.
o Requires listing of all study units exist or can be compiled. This listing is called the
sampling frame.
 Types of random or probability sampling
o Simple random sampling
o Systematic sampling
o Stratified sampling
o Cluster sampling
o Multistage sampling
 Simple Random Sampling
To select a simple random sample you need to:
114
o Make or search for an existing numbered list of all the units in the population
from which you want to draw a sample (sampling frame).
o Decide on the size of the sample.
o Select required number of sampling units, using a lottery method.
o For example, a simple random sample of 50 students is to be selected from a

school of 250 students. Using a list of all 250 students, each student is given a
number (1 to 250), and these numbers are written on small pieces of paper. All
the 250 papers are put in a box, after which the box is shaken vigorously, to
ensure randomization. Then 50 papers are taken out of the box, and the
numbers are recorded. The students belonging to these numbers will constitute
the sample.
 Systematic Sampling
o Individuals are chosen at regular intervals (for example every fifth) from the sampling
frame.
o Ideally a number to tell where to start selecting individuals from the list is randomly
selected.
For example, a systematic sample is to be selected from 1200 students of a school. The
sample size selected is 100. The sampling fraction is:
100 (= sample size) = 1
1200 (= study population) 12
The sampling interval is therefore 12.
The number of the first student to be included in the sample is chosen randomly
 Stratified Sampling
o If it is important that the sample includes representative study units of small groups
with specific characteristics, then sampling frame must be divided into groups, or
strata, according to these characteristics.
o For example, residents from urban and rural areas, or different religious or ethnic
group
o Random or systematic samples of a pre-determined size will have to be obtained from
each group (stratum).
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 Cluster Sampling
o The selection of groups of study units (clusters) instead of the selection of study units
individually.
o Clusters are often geographic units (e.g. districts, villages) or organizational units (e.g.
clinics, training groups).
 Multi-Stage Sampling
o A multi-stage sampling procedure is carried out in phases and it usually involves
more than one sampling method. Example selecting one region out of 26 then select 4
councils out of 7 in the selected region. In the 4 selected councils, the researcher
selects 3 wards out of 8 then two villages are selected from the 3 wards. The selection
method in each stage could be random or systematic.
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 Sampling Methods for Qualitative Data (Non probability)
 Non probability sampling is:
o Unequal chance of being included in the sample (non random)
o It is asampling process in which the samples are selected for specific purpose with
a predetermined basis for of selection
o Purposeful sampling strategies for qualitative studies
o Extreme case sampling
o Maximum variation sampling
o Homogeneous sampling
o Critical case sampling
o Snowball or chain sampling
 Sample size: Number of subjects selected to represent a given study population
o Sample Size in Qualitative Studies
 There are no fixed rules for sample size in qualitative research.
 The size of the sample depends on what you try to find out, and from what
different informants or perspectives
o If you want to explore how you can involve mothers in your HC catchment area
you try to find that out. For example:
 effectively in early detection and treatment of pneumonia, you might decide to
conduct some FGDs to assess mothers knowledge, attitudes and practices with
respect to antimalarials.
 You could start with two FGDs among lowly educated mothers and two among
mothers with more education (who usually are of higher socio-economic status).
o If research objective is more complex e.g., attitudes of males and females towards
family planning, and has policy implications for a larger area, your sample will be
bigger. You might start with four FGDs, two among males and two among females,
subdivided according to socio-economic status.
 In exploratory studies, the sample size is therefore estimated beforehand as precisely as
possible, but not determined.
117
 Tips for Determining Sample Size
o The desirable sample size depends on the expected variation in the data (of the most
important variables).
o The more varied the data are the larger the sample size needed to attain the desired
level of accuracy.
 The desirable sample size also depends on the number of cells in the cross tabulations.
 A rough guideline is to have at least 5 to 10 study units per cell. For example:
o After conducting FGDs and in-depth interviews in the study on attitudes of men and
women towards family planning you might decide to conduct a bigger survey.
o If the exploratory study revealed that age and education appear to be important factors
determining FP use, compare FP use in groups with different levels of education and
of different ages.
o If you split each of these variables up in three categories, and you select four
categories of informants (male users/ spouses of female users; female users; male
non-users, female non-users) you would have 12 cells in each table. In order to obtain
5-10 answers per cell you would require 60-120 informants in each research area.
 The eventual sample size is usually a compromise between what is desirable and what is
feasible.
Refer students to Handout 13.1: Types of sampling and when to use it
STEP 5: Reasons for Sampling (15 minutes)

Reasons for sampling
o Sampling is necessary when the study population is very big and the resources are not
adequate to reach everyone in the population
o To avoid or minimize bias
o Sampling can save time and money. A sample study is usually less expensive than a
census study and produces results at a relatively faster speed.
o Sampling may enable more accurate measurements for a sample study is generally
conducted by trained and experienced investigators.
o Sampling remains the only way when population contains infinitely many members.
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o Sampling remains the only choice when a test involves the destruction of the item
under study
o Sampling usually enables to estimate the sampling errors and, thus, assists in
obtaining information concerning some characteristic of the population
STEP 6: Sources of Bias in Sampling that Should be Avoided (15 minutes)

 Bias refers to systematic error in sampling procedures, which leads to a distortion in the
results of the Study can be a consequence of improper sampling procedures, which result
in the sample not being representative of the study population.
 There are several possible sources of bias that may arise when sampling. The most well
known source is non-response.
o The bigger the non-response rate, the more necessary it becomes to take remedial
action.
o It is important in any study to mention the non-response rate and to honestly discuss
whether and how the non-response might have influenced the results.
 Some Biases in Sampling
o Studying volunteers only: The fact that volunteers are motivated to participate in the
study may mean that they are also different from the study population on the factors
being studied.
o It is better to avoid using non-random selection procedures that introduce such an
element of choice.
 Sampling of registered patients only: Patients reporting to a clinic are likely to differ
systematically from people seeking alternative treatments.
 Missing cases of short duration: In studies of the prevalence of disease, cases of short
duration are more likely to be missed. This may mean missing fatal cases, cases with
short illness episodes and mild cases.
 Seasonal bias: Problem under study, for example, malnutrition, exhibits different
characteristics in different seasons of the year. For this reason, data should be collected on
the prevalence and distribution of malnutrition in a community during all seasons rather
than just at one point in time.
 Tarmac bias: Study areas are often selected because they are easily accessible by car.
 These areas are likely to be systematically different from more inaccessible areas.
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 Ways to Reduce the Possibility of Bias
o Data collection tools (including written introductions for the interviewers to use with
potential respondents) should be pre-tested. If necessary, adjustments should be made
to ensure better co-operation.
o If non-response is due to absence of the subjects, follow-up of non-respondents may
be considered.
o If non-response is due to refusal to co-operate, an extra, separate study of non-
respondents may be considered in order to identify to what extent they differ from
respondents.
o Another strategy is to include additional people in the sample, so that non-respondents
who were absent during data collection can be replaced. This can only be justified if
their absence was very unlikely to be related to the topic being studied.
action.

 Sampling is the process of selecting a number of study units from a defined study
population
 BIAS in sampling is a systematic error in sampling procedures which leads to a distortion
in the results of the study

 What are reasons for sampling?
 What are source of bias in sampling that should be avoided?
STEP 9: Assignment (5 minutes
ASK each student to select to identify population to be studied and the sampling technique
for a research proposal being developed
ALLOCATE time for student to do the assignment and submit
120
121
References

Netherlands
Kazaura, M. R., Makwaya, C. K., Masanja, C. M. and Mpembeni, R.C (1997). Lecture notes in
Salaam

122
Handout 13.1: Types of sampling and when to use it
123
Session 14: Determining Sample Size
Prerequisites
 None
Learning Tasks
 List the issues to consider when deciding on sample size
 Calculate the sample size (desirable)
 Determine the sample size(s) most appropriate for the research design (feasible)
Resources Needed
SESSION OVERVIEW
Activity/
Step Time Content
Method
Presentation
2 15 minutes Issues to Consider when Deciding on Sample Size
Buzzing
3 Calculation of the Sample Size (Desirable)
Brainstorming
4 35 minutes Presentation Determination of Sample Size(s) Most Appropriate for

the Research Design (Feasible)
5 Key Points
124
SESSION CONTENTS

STEP 2: Issues to Consider when Deciding on Sample Size (15 minutes)

 There are no fixed rules for sample size in qualitative research. The size of the sample
depends on WHAT you try to find out, WHY you try to find out, and HOW you are going
to use the data
 the sample size depends on the type of problem investigated, required precision and to a
certain extent, the resource available
 If your research objective is more complex e.g., attitudes of males and females towards
family planning, and has policy implications for a larger area, your sample will be bigger.
 Very few studies use the whole population (Census)
 Most studies use a subset of a population (Sample)
 How big should a sample be?
 Too large or too little sample is unethical:
 Too large: waste resources
 Too little: Inconclusive results
STEP 3: Calculation of the Sample Size (Desirable) (50 minutes)

 Desirable sample size is that calculated using standard formulae
 The following general rules may help to determine the desirable sample size of any
given study:
o The desirable sample size depends on the expected variation in the data (of the
most important variables): the more varied the data are, the larger the sample size
we would need to attain the desired level of accuracy.
o The desirable sample size also depends on the number of cells we will have in the
cross-tabulations which we need to analyze the results.
 A rough guideline is to have at least 5 to 10 study units per cell
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o How big can be calculated. Still, the desirable sample size cannot always be
achieved for lack of resources such as time, manpower and money.
 This constraint applies to quantitative as well as qualitative studies
 Therefore the eventual sample size is usually a compromise between what is
desirable and what is feasible
o Sample size calculations
The following steps should be taken:
 Estimate how big the proportion might be (say 80%)
 Choose the margin of error you will allow in the estimate of the proportion (say
+ 10%). This means that, if in the survey indeed 80% of the children are found
to be vaccinated, this proportion will probably be between 70 and 90% in the
whole study population from which the sample was drawn.
 Choose the precision with which you want to be confident that the vaccination
coverage in the whole population is indeed between 70 and 90%. You can never
be 100% sure. Do you want to be 95% sure? Or 99%?
o Formulae
N = z2PQ
d2
N = Minimum sample size
Z = Constant, Standard normal deviate (1.96 for 95% Confidence level)
P = Population proportion with characteristic of interest
Q=1P
d = Acceptable Margin of error
STEP 4: Determination of Sample Size(s) Most Appropriate for the

Research Design (Feasible) (35minutes)
 The feasible sample size determination
o Is not calculated, depends on available resources (human, time, money, transport)
 Availability of finance: in practice, size of the sample depends upon the amount of
money available for the study purposes. This factor should be kept in view while
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determining the size of sample for large samples result in increasing the cost of
sampling estimates
o Depends on expected variation in the data: the more varied the data are, the larger the
sample size one would need to attain the same level of accuracy
o Depends on the number of cells one will have in the cross-tabulations required to
analyze the result
 A rough guideline is to have at least 20-30 study units per cell
o Eventual sample size is a compromise between desirable and feasible
o Nature of study: If items are to be intensively and continuously studied, the sample
should be small. For a general survey the size of the sample should be large, but a
small sample is considered appropriate in technical surveys.
o Type of sampling: Sampling technique plays an important part in determining the size
of the sample. A small random sample is appropriate to be much superior to a larger
but badly selected
.
 There are no fixed rules for sample size in qualitative research.
 Eventual sample size is a compromise between desirable and feasible

 What are issues to consider when deciding on sample size?
 What is the sample size(s) most appropriate for the research design (feasible)?
Activity: Take Home Assignment (5 minutes)

Determine the sample size of the research proposal being developed
127
References
Netherlands

128
Session 15: Research Ethics
Total Session Time: 60 minutes +240 minutes assignment
Prerequisites
 None
Learning Tasks
 Define research ethics
 Identify areas of research requiring ethical clearance
 Describe procedure for research ethical clearance
Resources Needed
SESSION OVERVIEW
Activity/
Step Time Content
Method
2 10 minutes Presentation Definition of Research Ethics

10 minutes Presentation Areas of research requiring ethical clearance
3
Buzzing
20 minutes Presentation Procedure for Research Ethical Clearance
4
Brainstorming
7 05 Presentation Assignment
129
SESSION CONTENTS

STEP 2: Definition of Research Ethics (10 Minutes)

 Research ethics
o Research Ethics is defined here to be the ethics of the planning, conducting, and
reporting of research
o It is clear that research ethics should include: Protections of human and animal
subjects.
o "ethics": is defined as norms for conduct that distinguish between acceptable and
unacceptable behavior.
 STEP 3: Identification of areas of research requiring ethical

clearance (10 minutes)
 In developing data collection techniques, it is important to consider whether the research
procedures are likely to cause any physical or emotional harm.
 Harm may be caused, by:
o Violating informants right to privacy, by posing sensitive questions or by gaining
access to records which may contain personal data.
o Observing the behavior of informants without them being aware
o Allowing personal information (which informants would want to be kept private) to
be made public.
o Failing to observe/respect certain cultural values, traditions or taboos valued by your
informants.
Using human biological tissue, using human in trial of drugs.
 Several methods for dealing with ethical issues are recommended:

o Obtaining informed consent before the study or the interview begins.
o Do not explore sensitive issues before a good relationship has been established with
the informant.
o Ensure the confidentiality of the data obtained.
Learning enough about the culture of informants to ensure it is respected during the
130
o data collection process.
If sensitive questions are asked, for example, about family planning or sexual
practices, or about opinions of patients on the health services provided, it is advisable
to omit names and addresses from the questionnaires.
o Inform participants that they are free to withdraw from the study at any point
STEP 4: Procedure for Research Ethical Clearance (20 Minutes)
 Health research coordination in Tanzania is under the Medical Research Coordinating

Committee (MRCC). MRCC is the national health research coordinating body that
ensures all health research follows the national health ethics requirements.
 Procedure for research ethical clearance

o The whole process of receiving, reviewing and approving the protocols takes a
maximum of 6 weeks
o National Health Research Ethics Committee (NatHREC) carries research monitoring
by on-site visits in collaboration with district and regional medical authorities.
In this regard, copies of certificates of cleared research proposals are sent to

respective District and Regional Medical Officers where research is to be carried out.
o Research certificate approval is renewed annually and PIs are required to submit
progress reports biannually.
o To publish the findings, the principal investigator will have to seek permission from
the National Institute for Medical Research.
o All proposed health research in Tanzania must get an Institutional Ethical approval at
the host institution where the research will be based.
o In case there is no any Institutional Ethics Committee, the approval will be sought
from the NatHREC.
o For all health research involving external collaborators (non-Tanzanians), the
researchers must apply for the Institutional Ethical Clearance as well as the National
Ethics Clearance.
o Non-Tanzanian researchers are required by law to get Research Clearance and
Research Permit from the Tanzania Commission for Science and Technology
(COSTECH) (www.costech.or.tz).
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o Protocols for Clinical trials to be conducted in Tanzania are reviewed by another
specialized sub-committee, Clinical Trials Sub-Committee.
 This sub-committee has nine members, and meets monthly and reports to the
NatHREC.
o Clinical trials are required to also obtain a Clinical Trials Certificate from Tanzania
Food and Drug Authority (www.tfda.or.tz) before the commencement of the study.
 Application procedures
o Applicants for research clearance are required to submit application form, Curriculum
vitae, Research proposal and three passport size photographs preferably two month
before commencement of research.
o Permits are given for a period of one year and can be renewed for similar period
provided satisfactory progress reports for the previous periods are received by
COSTECH.
o If and when these formalities have been satisfactorily completed (which may take
several months) applicant will receive a formal written offer of a research clearance.
o Applicant should not make any irreversible preparations to leave for Tanzania unless
and until he/she receives this offer letter.
o Soon after obtaining a research permit, the researcher will be required to proceed to
the Immigration Department and apply for class C residence permit.

 Research Ethics is defined here to be the ethics of the planning, conduct, and reporting of
research
 As we develop our data collection techniques and implement research, we need to
consider whether our research procedures are likely to cause any physical or emotional
harm
 Applicants for research clearance are required to submit application form, Curriculum
vitae, Research proposal and three passport size photographs preferably two month before
commencement of research

 What is research ethics?
 What ethical issues are involved in the implementation of research?
132
 ASK the students to work on the following Assignment

Identify ethical issues you will follow when conducting the research you are developing
133
References
National Institute of Medical Research (2014) 2ND Edition. Standard Operating Procedures
for the National Health Research Ethics Committee, Dar es Salaam, Tanzania
http://www.nimr.or.tz/wp-content/uploads/2018/11/SOPS-2014-KEY-NatHREAC-SOPs-
Final-17th-June-2014.pdf
Mashalla, Y.J.S., Shija, J.K., Kitua, A.Y., Mwaikambo, E., Kohi, Y.M., Ndossi, G.D.,
Malecela, M., Mboera, L.E.G. (2009) Second edition. Guidelines of Ethics for Health
Research in Tanzania, Tanzania National Health Research Forum, Dar es Salaam, Tanzania

Netherlands
134
Session 16: Developing Research Tools
Total Session Time: 120 minutes+240 minutes assignment
Prerequisites
 None
Learning Tasks
 List common research tools
 Identify appropriate data-collection techniques
 Prepare data-collection tools
 Conduct out an interview
Resources Needed
 Handout 16.1: Overview of data collection techniques
 Handout 16.2: Advantages and disadvantages of various data collection tools
 Handout 16.3: Focus Group Discussion (FGD)
 Handout 16.4:Functions of FGD Facilitator
SESSION OVERVIEW
Activity/
Step Time Content
Method
Presentation Common Research Tools
2 10 minutes
Buzzing
3 10 minutes Presentation Identification of Data-Collection Techniques
4 45 minutes Presentation Preparation for Data-Collection Tools
35 minutes Presentation Conducting an Interview
5
Brainstorming
6 05 minutes Presentation Key points
135
SESSION CONTENTS

STEP 2: Common Research Tools (10 minutes)

 The quality of research depends on the quality of the data collection tools. The common
tools used include: questionnaire for interview and checklist
 Interviewing and administering questionnaires are probably the most commonly used
research techniques.
 Designing good questioning and interviewing tools forms an important and time
consuming phase in the development of most research proposals.
 The following questions should be considered before designing the tools
o What exactly do we want to know, according to the objectives and variables we have?
o Is questioning the right technique to obtain all answers, or additional techniques, such
as observations or analyses of records are needed?
o Who to ask questions and what techniques will be used?
o Do you understand the topic sufficiently to design a questionnaire, or
o Do you need some loosely structured interviews with key informants or a focus group
discussion first to orientate ourselves?
o Are your informants mainly literate or illiterate?
o How large is the sample that will be interviewed?
 Before examining the steps in designing a questionnaire, review the types of questions
used in interviews.
 Depending on how questions are asked and recorded distinguish two major possibilities:
o Open-ended questions, (allowing for completely open as well as partially categorized
answers).
o Closed questions.
 Completely Open-Ended Questions
o Open-Ended Questions permit free responses which should be recorded in the
136
respondents own words.
o Open questions are useful for obtaining in-depth information on
 Facts with which the researcher is not very familiar.
 Opinions, attitudes and suggestions of informants, or Sensitive issues.
 Advantages of Completely Open-Ended Questions

o Allow you to probe more deeply into issues of interest being raised.
o Issues not previously thought of when planning the study may be explored, thus
providing valuable new insights on the problem.
o Information provided in the respondents own words might be useful as examples or
illustrations, which add interest to the final report.
 Risks of Completely Open-Ended Questions

o Skilled interviewers are needed to get the discussion started and focused on relevant
issues and to record all information collected.
o A big risk is incomplete recording of all relevant issues covered in the discussion.
o Analysis is time-consuming and requires experience; otherwise important data may be
Lost
 Suggestions to Improve Use of Completely Open-Ended Questions
o Thoroughly train and supervise the interviewers or select experienced research
assistants.
o Prepare a list of further questions to keep at hand to use to probe for answer(s) in a
systematic way.
o Pre-test open-ended questions and, if possible, pre-categorize the most common
responses
 Partially Categorized Questions

o In interviews questions are often asked as open-ended questions, but to facilitate
recording and analysis, some answers can be pre-categorized. For example: How did
you become a member of the Village Health Committee?
Details stated:
1. Volunteered......................................................................................... 􀂃
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2. Elected at a community meeting.......................................................... 􀂃
3. Nominated by community leaders.........................................................􀂃
4. Nominated by the health staff............................................................... 􀂃
5. Other (specify): ........................................................................................................􀂃
In this case the first four categories of answers are known, but there may be
other possibilities.
Therefore there is a category other where other answers can be recorded.
During the analysis, these responses can still be further categorized.
o For open-ended questions, more than one answer is usually allowed.
 Advantages of Pre-Categorized Answers

o Answers can be recorded quickly
o Analysis is easier
 Risks of Pre-Categorized Answers
o If one pre-categorizes too early, a lot of interesting and valuable information may
never be recorded, or may end up in the category other.
o Interviewers may try to force the information into the categories that are listed and, by
merely ticking, this additional valuable information will be lost.
o Interviewers may stop after receiving the first answer, whereas more than one
response could be applicable.
o Sometimes, if the respondent hesitates in answering, the interviewer may be tempted
to present some possible answers, thereby causing bias.
o Frequently, questionnaires have very little space for recording full responses under
“other”, forcing the interviewer to write down a response that summarizes the
respondents answer, thereby losing valuable information.
 Minimization of Risks Associated with Pre-Categorized Answers

 Clear guidelines have to be provided to interviewers on important issues
For example:
If a question leads to an interesting discussion, it should be completely written
down
 Interviewers should be trained to solicit discussion
 Categorize questions for which all possible categories of responses are known, e.g.,
some health practices (Antimalarial use: currently using, ever used, and never used).
138
 These questions, when used, will always be followed by other questions asking for
elaboration on reasons and conditions for use or non-use of the practice.
 Closed Questions
o Closed questions have a list of possible options or answers from which the
respondents must choose.
o Closed questions are most commonly used for background variables such as age,
marital status or education, in case of age and education take the exact values and
categorize them during data analysis.
For example:
 What is your opinion on the following statement: (Circle one response).
 Women who are pregnant do not use antimalarial
􀂃 Strongly agree
􀂃 Agree
􀂃 Not sure/no opinion
􀂃 Disagree
􀂃 Strongly disagree
 Used if one is only interested in certain aspects of an issue and does not want to waste
time obtaining more information than one needs.
For example:
 A researcher who is only interested in the sources of protein in a family diet
may ask:
 Did you eat any of the following foods yesterday? (Circle yes if at least one item in
each set of items is eaten.)
􀂃 Peas, beans, lentils Yes No

􀂃 Fish or meat Yes No
􀂃 Eggs Yes No
􀂃 Milk or cheese Yes No
􀂃 Insects Yes No
 Advantages of Closed Questions
o It saves time
139
o Comparing responses of different groups, or of the same group over time, becomes
easier
 Risks of Closed Questions
o In case of illiterate respondents, the interviewer may be tempted to read the list of
possible answers in the given sequence, thereby influencing the choice of response
and introducing bias.
o Take objectives and variables as a starting point.
o Decide what questions will be needed to measure or (in the case of qualitative studies)
to define your variables and reach your objectives.
o Formulate one or more questions that will provide the information needed for each
variable.
o Check whether each question measures one thing at a time.
o Avoid leading questions.
 A question is leading if it suggests a certain answer.
 For example: Do you think that people have to give bribes at hospital X to be seen
by a doctor? Hardly leaves room for no or for other options.
 A better question would be: Have you recently visited hospital X?
 This would be followed by a series of other probing questions such as:
• By whom were you seen?
• What were the complaints?
o Ask sensitive questions in a socially acceptable way.
 Questions relating to abortion, sexual practices of adolescents, or AIDS and
mental illness in the family are usually sensitive.
o Sequencing the questions: design your interview schedule or questionnaire to be
informant friendly.
The sequence of questions must be logical for the informant and allow, as much as
possible, for a natural conversation, even in more structured interviews.
 Formatting the questionnaire: When you finalize your questionnaire, be sure that:
o A separate, introductory page is attached to each questionnaire, explaining the
purpose of the study, requesting the informants consent to be interviewed and
assuring confidentiality of the data obtained.
o Each questionnaire has a heading and space to insert the number, date and location of
the interview, and, if required, the name of the informant.
140
o Layout is such that questions belonging together appear together visually.
o If the questionnaire is long, use subheadings for groups of questions.
o Sufficient space is provided for answers to open-ended questions, categories such as
other and for comments on pre-categorized questions.
o Boxes for pre-categorized answers are placed in a consistent manner (e.g., on the right
half of the page).
 Translation
o If interviews will be conducted in one or more local languages, the questionnaire
should be translated in order to standardize the way questions will be asked.
o After having it translated you should have it retranslated into the original language by
a different person.
o Compare the two versions for differences and make decisions concerning the final
o phrasing of difficult concepts.
 Self-Administered (Written) Questionnaires
o All steps discussed above apply to written questionnaires as well as to
guides/questionnaires used in interviews.
o Self-administered questionnaires are most commonly used in large-scale surveys
using predominantly pre-categorized answers among literate study populations.
o In exploratory studies which require intensive interaction with informants in order to
gain better insight in an issue,
o Written questionnaires may sometimes be useful in small-scale studies on sensitive
topics.
They are usually combined with other tools e.g. FGD on sensitive issues like sexual
behavior.
 Checklists
o Checklists can be used to systematically observe human behavior or the condition of
specific equipment (e.g. fridge, expiring dates of medicines, or completeness of
records).
o Observations can be relatively open or can be predetermined comparisons of reality
against fixed standards.
o The objectives of the study determine the content of a checklist.
141
o A checklist includes all the items or points that must be considered during an
observation in the field, or when extracting data from existing records.
STEP 3: Identification of Data-Collection Techniques (10 minutes)

 Data collection techniques refer to a variety of methods which are used to gather
information for the study.
 Data collection techniques allow to systematically collect information about the objects of
study (people, objects, phenomena) and about the settings in which they occur.
 In the collection of data we have to be systematic.
 If data are collected haphazardly then it will be difficult to answer our research questions
in a conclusive way.
Example of haphazard data collection: During a nutrition survey three different
weighing scales were used in three villages.
o The researchers did not record which scales were used in which village.
o After completion of the survey it was discovered that the scales were not
standardized and indicated different weights when weighing the same child.
o It was therefore impossible to conclude in which village malnutrition was most
prevalent.
 Common Data Collection Techniques in Use
o Reviewing documents
o Observing/observation
o Interviewing (face-to-face)
o Administering written questionnaires
o Focus group discussions
 Reviewing Documents
Documents to be reviewed can be obtained from dispensary, health centre, and
hospital records.
For example:
o Analysis of the information routinely collected by health facilities can be very useful
for identifying problems such as flows of drug supply or dispensing
o Other sources of data may be :
 Health Information Management System, census,
142
 Unpublished reports and publications in archives and libraries or in offices,
 Newspapers and published case histories
 Advantages of Reviewing Documents
o It is inexpensive, because data is already there
o It Permits examination of trends over the past
 Limitations of Reviewing Documents
o Data are not always easily accessible
o Ethical issues concerning confidentiality may arise
o Information may be inaccurate or incomplete
 Observation Technique
o Observation is a technique that involves systematically selecting, watching and
recording behavior and characteristics of living beings, objects or phenomena
o Observation of human behavior is a much-used data collection technique
o It can be undertaken in different ways:
 Participant observation: The observer takes part in the situation he or she
observes
 For example, a doctor hospitalized with a broken hip, who now observes
hospital procedures from within.
o Non-participant observation: The observer watches the situation, openly or concealed,
but does not participate.
o Observation becomes a scientific tool and method of data collection for the
researcher, when:
 It serves a formulated research purpose.
 Is systematically planned and recorded.
 Is subjected to checks and controls on validity and reliability
 Advantages of Observation Method
o Subjective bias is eliminated, if observation is accurately done
o The information relates to what is currently happening
o Not complicated by either past behavior or future intentions or attitudes.
o Independent of respondents willingness to respond and hence less demanding on
active cooperation on the part of the respondents
143
o Suitable in studies which deal with subjects who are not capable of giving verbal
reports of their feelings for one reason or the other
 Limitations of Observation Method

o It is an expensive method
o Information provided by this method is very limited
o Sometimes unforeseen events may interfere with the observational task
o Some subjects are rarely accessible to direct observation
o If subjects know that they are being observed, they may change their behavior
 Interviewing Technique
o An interview is a data-collection technique that involves oral questioning of
respondents, either individually or as a group
o Requires a person known as the interviewer asking questions in a face-to-face contact
to the interviewee or through other means of communication like telephone
o Answers to the questions posed during an interview can be recorded by writing them
down (either during the interview itself or immediately after the interview) or by tape-
recording the responses, or by a combination of both
Advantages of the Interview Method

o Detailed information can be obtained
o Interviewer could overcome resistance of the respondent, if any.
o Provides flexibility to the interviewer to restructure, clarify, or add probe
questions
o Observation can also be applied during interview
o Is suitable for use with both literates and illiterates
o Has higher response rate than written questionnaires
o The interviewer can collect supplementary information about the respondents
personal characteristics and environment.
 Limitations of Interview
o It is very expensive and time consuming especially when the sample is large
o Chances of Interviewer as well as interviewees bias are high
144
o People with certain high level positions like officials or executives may not be easily
approachable under this method and to that extent the data may prove inadequate
o Creating effective rapport with the interviewee may be a difficult
o Some subjects may demand incentives during data collection process
o There may be a language barrier between an interviewer and interviewee
 Pre-Requisites and Basic Tenets of Interviewing
o Interviewers should be carefully selected and trained
o They must possess technical competence (interviewing and interpersonal skills)
o They should be able to create an atmosphere of trust and confidence
 Written Questionnaires
o A written questionnaire (also referred to as self-administered questionnaire) is a data
collection method in which written questions are presented that are to be answered by
the respondents in written form. The questions can be either open-ended or closed
(with pre categorized answers).
o A written questionnaire can be administered in different ways, such as by:
 Sending questionnaires by mail with clear instructions on how to answer the
questions
 and asking for mailed responses;
 Gathering all or part of the respondents in one place at one time, giving oral or
written instructions, and letting the respondents fill out the questionnaires; or
 Hand-delivering questionnaires to respondents and collecting them later
 Advantages of Questionnaires
o Low cost when study is large
o Free from interviewer bias
o Respondents have adequate time to give out their answers
o Respondents, who are not easily approachable, can be reached
o Used in large studies
o Permits anonymity and may result in more honest responses.
 Limitations of Questionnaires
o Low rate of return of the duly filled in questionnaires
o Bias due to non-response is undetermined
o Used only when respondents are educated and cooperating
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o Control over questionnaire may be lost
o Not flexible once the questionnaire has been dispatched out
o Ambiguous replies or omissions creating difficult in interpretation
o Slowest method of all when mailing is used
 Focus Group Discussions (FGD)
o FGD allows a group of 6 - 12 informants to freely discuss a certain subject with the
guidance of a facilitator or reporter during which group members talk freely and
spontaneously about a certain topic.
o Characteristics and Uses of Focus Group Discussions
 A FGD is a qualitative method.
 A FGD aims to be more than a question-answer interaction.
 The idea is that group members discuss the topic among themselves, with
guidance from the facilitator.
o FGD techniques can be used to:
 Focus research and develop relevant research hypotheses by exploring in greater
depth the problem to be investigated and its possible causes.
 Formulate appropriate questions for more structured, larger scale surveys.
 Develop appropriate messages for health education programmes and later evaluate
the messages for clarity
 Explore controversial topics. For example: Sexual behavior is a controversial
topic in the sense that males and females judge sexual relations and sexuality
often from very different perspectives.
o Advantages of FGD
 The researcher can interact with the participants, pose, follow up questions or ask
questions that probe more deeply.
 Results can be easier to understand than complicated statistical data.
 The researcher can get information from non-verbal responses such as facial
expressions or body language.
 Information is provided more quickly than if people were interviewed separately.
 Limitations of FGD
o The small sample size means the groups might not be a good representation of the
larger population
o Group discussions can be difficult to steer and control, so time can be lost to
irrelevant topics
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o Respondents can feel peer pressure to give similar answers to the moderators
questions
o The moderators skills in phrasing questions along with setting can affect responses
and skew results
Summary of Data collection Techniques and Tools
Data Collection Techniques Tools
Using available information Checklist, data compilation forms
Observing Eyes and other senses, pen/paper, watch,
scales, microscope
Administering written question
questionnaire Questionnaire
Focus Group Discussion (FGD) FGD Guide
 Bias in data collection

Bias: Is a distortion in the collected data so that it does not represent reality
 Sources of Bias
o Defective instruments
Questionnaires
 Fixed or closed questions on topics about which little is known (often
asking the wrong things).
 Open-ended questions without guidelines on how to ask (or to answer)
them vaguely phrased questions
 Leading questions that cause the respondent to believe one answer would
be preferred over another or questions placed in an illogical order
o Weighing scales or other measuring equipment that are not standardized
o These sources of bias can be prevented by:
 Carefully planning the data collection process
 By pre-testing the data collection tools
o Observer bias
 Can easily occur when conducting observations or utilizing loosely structured
group or individual interviews.
 There is a risk that the data collector will only see or hear things in which she
or he is interested or will miss information that is critical to the research.
o Effect of the interview on the informant
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The informant may mistrust the intention of the interview and avoid certain
questions or give misleading answers.
 For example: in a survey on alcoholism you ask school children:
 Does your father sometimes get drunk? Many will probably deny that he does,
even if it is true
o Such bias can be reduced by:
 Adequately introducing the purpose of the study to informants.
 Phrasing questions on sensitive issues in a positive way.
 Taking sufficient time for the interview and by assuring informants that the data
collected will be confidential.
o Information bias
 Sometimes the information itself has weaknesses.
 Medical records may have many blanks or be unreadable. This tells something
about the quality of the data and has to be recorded.
• For example, in a compliance of TB drugs study the percentage of non compliant
patient with an incomplete or missing address should be calculated.
o Another common information bias is due to gaps in peoples memory this is called
memory or recall bias.
 For example: A mother may not remember all details of her childs last diarrhoea
episode and of the treatment she gave two or three months afterwards.
 For such common diseases it is advisable to limit the period of recall, asking, for
example, Has your child had diarrhoea over the past two weeks?
STEP 4: Preparation for Data-Collection Tools (45 minutes)
 Questionnaires and interview schedules are used to collect information for

quantitative research
 The steps of designing them are the same even though they are used for different
data collection techniques ; i.e. Self-administered questionnaire and interviewing
respectively
 Before designing questionnaires consider the following:
o Study objectives and variables
o Be clear of what you want to know or measure.
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o Ascertain whether all required information is going to be obtained by
questioning only or not
o How much is known about the problem being investigated. Familiar?
Unfamiliar?
This determines whether closed/open questions should be used.
o The number of subjects to be studied.
This determines how much of open/closed questions to be used
 Open-ended (free response) questions: respondents are not given options to
choose ; they answer in their own words
 Closed questions (fixed alternatives): respondents are given alternative answers to
choose from
 Requirements of the research questions
o Should measure the variable under study
o Should be ones to which respondents are expected to know the answers
o Should be clear and unambiguous
o phrased in simple language; avoid technical terms
o Contain one idea only
o Should not be offensive
o Should not suggest an answer (leading)
 Steps in designing tools (questionnaire):
o first step: Deciding on the content
 Refer to the study objectives and variables
 Think of the question(s) needed to measure the variable
o Second step: Formulating the questions
 Formulate one (or more) question (s) that will provide the required
information
 Make sure that the questions satisfies the requirements discussed earlier
o Third step: Sequencing the questions
 Arrange them in a logical sequence to allow a natural discussion
(consumer friendly)
 Begin with non-sensitive questions and pose the sensitive ones later
o Fourth step: Formatting the questionnaire
Questionnaires normally have two major sections
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 Introductory section. This precedes the questions and have the
following contents
• Heading
• Serial number
• Date of interview
• Place of interview
• Name of interviewer
• Name/code of respondents
o Questions section. This bears the questions and the following should
be ensured
 Related questions should appear together
 There is sufficient space for respondents to fill in their responses to
open-ended questions
 The boxes for pre-categorized responses are placed in consistent
manner
 There are reserved boxes for computer coding for computer aided data
analysis
 Formatting should ensure that the questionnaire is user friendly
o Fifth step: Translation
 Translation of the questionnaire into language familiar to all
respondents should be done if the original version is in a different
language.
o Sixth step: Pretesting
 Before embarking on actual data collection it is important to check
whether the questionnaire gathers the information expected and
whether both the interviewer and interviewee feel at ease with it.
 Data compilation forms
o Designing data collection forms involves

 Step 1: Clarifying the specific needs of your application
 Step 2: Identifying the information you want to work with
 Step 3: Then devising a design that best meets your need
 Checklist
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o A checklist is a tool for identifying the presence or absence of conceptual
knowledge, skills, or behaviors
o Developing a checklist involves the following steps
Step 1: Review the learning outcome and associated criteria for success
o State the level of success required for the checklist to be considered
completed, In most cases, all items must be checked
o Decide on the response such as Yes or No, or simply have a box to be
checked once the item has been completed
Step 2: From a procedure, process, or task description list, pick those items that
are required for a good performance or product
o Itemize task descriptions in one column and
o Provide a space beside each item in a second column to check off the
completion of the task
o Group similar items or order them sequentiallykeep as short as possible
o Highlight critical steps, checkpoints, or indicators of success
Step 4: Write clear instructions for the observer
Step 5: Review the task descriptions for details and clarity
Step 6: Format the checklist
Step 7: Ask for feedback from other instructors before using it with learners
o Checklists are used for identifying whether key tasks in a procedure, process,
or activity have been done in complete and in a systematic manner.
STEP 5: Conducting an Interview (35 minutes)

 Procedures for conducting interviews include:
o The interviewer-informant relationship and interview conditions
o An interviewer needs to have the skills of turning an informant into a partner
Partnership between interviewer and informant implies that the interviewer will
try to minimize the social distance between him/herself and the informant
o a researcher has to invest in the relationship
o First she /he has to be clear to the informant about the purpose of the
interview and the study.
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 Enough information should be given to raise the interest of informants
and to enable them to judge whether they would like to participate or
not.
 Consent has to be obtained before the interview
o Second: Interviewers should try to blend in the environment. In order to
do so:
 Clothing of interviewers should be culturally acceptable and as simple
as possible
 Sitting arrangements for interviewer(s) and informant(s) should
preferably be at the same height
 Gender relations have to be respected.
 an interviewer should show interest in what the informant says, be at
ease (never in a hurry); Make the informant feel at ease
 The environment should also be supportive of the interview situation.
 Anything which disturbs (noise, other people listening, a formal
surrounding) should if possible be avoided
 Tape recording may be an enabling or a disturbing environmental
factor in the interview
 Informants should be asked for their consent before use
o Third: The interviewers tasks
• The interviewer has a number of other tasks:
 Posing questions
 Evaluating answers and probing for elaboration or more precision in
case of a superficial or invalid answer
 Noting down answers
 Leading the discussion, but at the same time encouraging the informant
to give spontaneous information relevant to the topic by letting him/her
talk
 Keeping control over the interview
 At the end, the interviewer should summarize the interview
 after-interview' discussions and questions should always be recorded,
like all spontaneous information, because discussions can shed light on
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complicated, not yet fully clear issues from many preceding
interviews.
o Fourth: Training the research team/assistants
• Research assistants should be taught basic interview techniques, such
as:
 Asking questions in a neutral manner
 Not showing by words or expression what answers one expects
 Not showing agreement, disagreement or surprise
 Recording answers to open questions precisely as they are provided,
without sifting or interpreting them
 Common research tools are interview guides, questionnaires , collecting forms and
checklists
 Common data collection techniques include; interview, self administration of
questionnaire, FGD , review of information available and Observation
 Questionnaires and interview schedules are used to collect information for
quantitative research
 An interviewer needs to have the skills of turning an informant into a partner

 What are common research tools?
 What are data collection techniques?
 What are steps in conducting out an interview?
153
 Prepare your data-collection tools (instruments), taking care that you cover all
important variables. Refer to the matrix with data collection techniques and
responsible tools
 Take care that you have an optimal mix between open-ended and pre-categorised
questions.
 Discuss the possibilities for bias, which may occur when using the data-collection tools.
Try to avoid bias as much as possible.
154
References

Netherlands

Polit, D. F and Beck, C. T (2004). Nursing Research Principles and Methods, 7th Edition:
Empire State College (2018). Questions or feedback about ESC's Online Writing Center
https://www.esc.edu/online-writing-center/resources/research/research-paper-steps/
developing-questions/
155
Handout 16.1: Overview of Data Collection Techniques
 Data collection techniques refer to a variety of methods which are used to gather
information for the study.
 Data collection techniques allow to systematically collect information about the objects of
study (people, objects, phenomena) and about the settings in which they occur.
 In the collection of data we have to be systematic.
 If data are collected haphazardly then it will be difficult to answer research questions
in a conclusive way.
 Common Data Collection Techniques in Use
o Reviewing documents
o Observing/observation
o Interviewing (face-to-face)
o Administering written questionnaires
o Focus group discussions
 Reviewing Documents
o Documents to be reviewed can be obtained from dispensary, health center, and
hospital records.
 For example, analysis of the information routinely collected by health facilities
can be very useful for identifying problems such as flows of drug supply or
increases in the incidence of certain diseases.
o Other sources of data may be Health Information Management System, census,
unpublished reports and publications in archives and libraries or in offices,newspapers
and published case histories
 Limitations of Reviewing Documents
o Data are not always easily accessible.
o Ethical issues concerning confidentiality may arise.
o Information may be inaccurate or incomplete.
 Observation Technique
recording behavior and characteristics of living beings, objects or phenomena.
o Observation of human behavior is a much-used data collection technique.
156
It can be undertaken in different ways:
 Participant observation: The observer takes part in the situation he or she
observes.
• For example, a doctor hospitalized with a broken hip, who now observes
o Non-participant observation: The observer watches the situation, openly or concealed,
but does not participate.
 Observation becomes a scientific tool and method of data collection for the researcher,
when:
o It serves a formulated research purpose.
o Is systematically planned and recorded.
o Is subjected to checks and controls on validity and reliability.
 Advantages of Observation Method
o Subjective bias is eliminated, if observation is accurately done.
o The information relates to what is currently happening.
active cooperation on the part of the respondents.
reports of their feelings for one reason or the other.
 Limitations of Observation Method
o If subjects know that they are being observed, they may change their behaviour
 Interviewing Technique
respondents, either individually or as a group.
to the interviewee or through other means of communication like telephone.
 Limitations of Reviewing Documents
157
o Data are not always easily accessible.
o Ethical issues concerning confidentiality may arise.
o Information may be inaccurate or incomplete.
 Observation Technique
recording behavior and characteristics of living beings, objects or phenomena.
o Observation of human behavior is a much-used data collection technique.
o It can be undertaken in different ways:
 Participant observation: The observer takes part in the situation he or she
observes.
• For example, a doctor hospitalized with a broken hip, who now observes
o Non-participant observation: The observer watches the situation, openly or
concealed, but does not participate.
 Observation becomes a scientific tool and method of data collection for the researcher,
when:
o It serves a formulated research purpose.
o Is systematically planned and recorded.
o Is subjected to checks and controls on validity and reliability.
 Advantages of Observation Method
o Subjective bias is eliminated, if observation is accurately done.
o The information relates to what is currently happening.
active cooperation on the part of the respondents.
reports of their feelings for one reason or the other.
 Limitations of Observation Method
158
o If subjects know that they are being observed, they may change their behavior
 Interviewing Technique
respondents, either individually or as a group.
to the interviewee or through other means of communication like telephone.
o Answers to the questions posed during an interview can be recorded by writing them
down (either during the interview itself or immediately after the interview) or by tape-
recording the responses, or by a combination of both.
 Advantages of the Interview Method
o Detailed information can be obtained.
o Interviewer could overcome resistance of the respondent, if any.
o Provides flexibility to the interviewer to restructure, clarify, or add probe questions.
o Observation can also be applied during interview.
o Is suitable for use with both literates and illiterates.
o Has higher response rate than written questionnaires.
o The interviewer can collect supplementary information about the respondent s
personal characteristics and environment.
 Limitations of Interview
o It is very expensive and time consuming especially when the sample is large.
o Chances of Interviewer as well as interviewees bias are high.
o People with certain high level positions like officials or executives may not be easily.
approachable under this method and to that extent the data may prove inadequate.
o Creating effective rapport with the interviewee may be a difficult.
o Some subjects may demand incentives during data collection process.
o There may be a language barrier between an interviewer and interviewee.
 Pre-Requisites and Basic Tenets of Interviewing
o Interviewers should be carefully selected and trained
o They must possess technical competence (interviewing and interpersonal skills)
o They should be able to create an atmosphere of trust and confidence
 Written Questionnaires
o A written questionnaire (also referred to as self-administered questionnaire) is a data
159
o collection method in which written questions are presented that are to be answered by
the respondents in written form. The questions can be either open-ended or closed
(with pre categorized answers).
o A written questionnaire can be administered in different ways, such as by:
 Sending questionnaires by mail with clear instructions on how to answer the
questions and asking for mailed responses;
 Gathering all or part of the respondents in one place at one time, giving oral or
written instructions, and letting the respondents fill out the questionnaires; or
 Hand-delivering questionnaires to respondents and collecting them later.
 Advantages of Questionnaires
o Low cost when study is large
o Free from interviewer bias
o Respondents have adequate time to give out their answers
o Respondents, who are not easily approachable, can be reached
o Used in large studies
o Permits anonymity and may result in more honest responses.
 Limitations of Questionnaires
o Low rate of return of the duly filled in questionnaires
o Bias due to non-response is undetermined
o Used only when respondents are educated and cooperating
o Control over questionnaire may be lost
o Not flexible once the questionnaire has been dispatched out
o Ambiguous replies or omissions creating difficult in interpretation
o Slowest method of all when mailing is used
 Focus Group Discussions (FGD)
o FGD allows a group of 6 - 12 informants to freely discuss a certain subject with the
guidance of a facilitator or reporter during which group members talk freely and
spontaneously about a certain topic.
 Characteristics and Uses of Focus Group Discussions
o A FGD is a qualitative method.
o A FGD aims to be more than a question-answer interaction.
160
o The idea is that group members discuss the topic among themselves, with guidance
from the facilitator.
o FGD techniques can be used to:
 Focus research and develop relevant research hypotheses by exploring in greater
depth the problem to be investigated and its possible causes.
 Formulate appropriate questions for more structured, larger scale surveys.
 Help understand and solve unexpected problems in interventions.
 Develop appropriate messages for health education programmes and later evaluate
the messages for clarity.
 Explore controversial topics. For example: Sexual behavior is a controversial
topic in the sense that males and females judge sexual relations and sexuality
often from very different perspectives.
 Advantages of FGD
o The researcher can interact with the participants, pose, follow up questions or ask
questions that probe more deeply.
o Results can be easier to understand than complicated statistical data.
o The researcher can get information from non-verbal responses such as facial
expressions or body language.
o Information is provided more quickly than if people were interviewed separately.
 Limitations of FGD
o The small sample size means the groups might not be a good representation of the
larger population
o Group discussions can be difficult to steer and control, so time can be lost to
irrelevant topics
o Respondents can feel peer pressure to give similar answers to the moderators
questions
o The moderators skills in phrasing questions along with setting can affect responses
and skew results
 Advantage of using Available Information

Usually there is a large amount of data that has already been collected by others, although it
may not necessarily have been analyzed or published. Locating these sources and retrieving
the information is a good starting point in any data collection effort. For example,
161
o Analysis of the information routinely collected by health facilities can be very useful
for identifying problems in certain interventions or in flows of drug supply, or for
identifying increases in the incidence of certain diseases.
o Analysis of health information system data, census data, unpublished reports and
publications in archives and libraries or in offices at the various levels of health and
health-related services, this may be a study in itself. Usually, however, it forms part of
a study in which other data collection techniques are also used.
o The use of key informants is another important technique to gain access to available
information. Key informants could be knowledgeable community leaders or health
staff at various levels and one or two informative members of the target group (e.g.,
adolescents on their sexual behavior). They can be involved in various stages of the
research, from the statement of the problem to analysis of the data and development
of recommendations.
o Other sources of available data are newspapers and published case histories, e.g.,
patients suffering from serious diseases, or their relatives, telling their experiences
and how they cope.
o The advantage of using existing data is that: Collection is inexpensive. However, it is
sometimes difficult to gain access to the records or reports required, and the data may
not always be complete and precise enough, or too disorganized.
Note:
 In order to retrieve the data from available sources, the researcher will have to design
an instrument such as a checklist or compilation sheet.
 In designing such instruments, it is important to inspect the layout of the source
documents from which the data is to be extracted.
 For health information system (HIS) data, for example, the data compilation sheet
should be designed in such a way that the items of data can be transferred in the order
in which the items appear in the source document. This will save time and reduce
error.
 Interviewing
respondents, either individually or as a group. Answers to the questions posed during
an interview can be recorded by writing them down (either during the interview itself
162
or immediately after the interview) or by tape-recording the responses, or by a
combination of both.
o Interviews can be conducted with varying degrees of flexibility. The two extremes,
high and low degree of flexibility, are described below:
 High degree of flexibility:
• For example: When studying sensitive issues such as teenage pregnancy and
abortions, the investigator may use a list of topics rather than fixed questions.
• These may, e.g., include how teenagers started sexual intercourse, the
responsibilities girls and their partners take to prevent pregnancy (if at all),
and the actions they take in the event of unwanted pregnancies.
• The investigator should have an additional list of topics ready when the
respondent falls silent, (e.g., when asked about abortion methods used, who
made the decision and who paid).
• The sequence of topics should be determined by the flow of discussion. It is
often possible to come back to a topic discussed earlier in a later stage of the
interview.
• The unstructured or loosely structured method of asking questions can be used
for interviewing individuals as well as groups of key informants.
• A flexible method of interviewing is useful if a researcher has as yet little
understanding of the problem or situation he is investigating, or if the topic is
sensitive. It is frequently applied in exploratory studies.
• The instrument used may be called an interview guide or interview schedule.*
• Low degree of flexibility:
o Less flexible methods of interviewing are useful when the researcher is
relatively knowledgeable about expected answers or when the number of
respondents being interviewed is relatively large.
o Then questionnaires may be used with a fixed list of questions in a
standard sequence, which have mainly fixed or pre-categorized answers.
o For example: After a number of observations on the (hygienic) behavior of
women drawing water at a well and some key informant interviews on the
use and maintenance of the wells, one may conduct a larger survey on
water use and satisfaction with the quantity and quality of the water.
 Administering Written Questionnaires
163
o A written questionnaire (also referred to as self-administered questionnaire) is
a data
collection tool in which written questions are presented that are to be answered by the
respondents in written form. A written questionnaire can be administered in different
ways, such as by:
o Sending questionnaires by mail with clear instructions on how to answer the questions
and asking for mailed responses;
o Gathering all or part of the respondents in one place at one time, giving oral or written
instructions, and letting the respondents fill out the questionnaires; or hand-delivering
questionnaires to respondents and collecting them later.
o The questions can be either open-ended or closed (with pre-categorized answers).
 Projective Techniques
o When a researcher uses projective techniques, she/he asks an informant to react to
some kind of visual or verbal stimulus. For example:
 An informant may be provided with a rough outline of the body and be asked to draw
her or his perception of the conception or onset of an illness.
 Another example of a projective technique is the presentation of a hypothetical
question or an incomplete sentence or case/study to an informant (story with a gap).
o A researcher may ask the informant to complete in writing sentences such as:
 If I were to discover that my neighbor had TB, I would ...;
 If my wife were to propose that I use condoms, I would...
 Or (s) he may ask the informant: Suppose your child suffered from diarrhea, what
would you do?
o Such techniques can easily be combined with semi-structured interviews or written
questionnaires. They are also very useful in FGDs to get peoples opinion on sensitive
issues.
o Mapping and Scaling
 Mapping is a valuable technique for visually displaying relationships and
resources.
 In a water supply project for example:
• Mapping is invaluable. It can be used to present the placement of wells,
164
distance of the homes from the wells, other water systems, etc. It gives
researchers a good overview of the physical situation and may help to
highlight relationships hitherto unrecognized.
• Mapping a community is also very useful and often indispensable as a pre-
stage to sampling.
• Scaling is a technique that allows researchers through their respondents to
categorize certain variables that they would not be able to rank themselves.
• For example, they may ask their informant(s) to bring certain types of herbal
medicine and ask them to arrange these into piles according to their
usefulness. The informants would then be asked to explain the logic of their
ranking.
 Mapping and scaling may be used as participatory techniques in rapid appraisals
or situation analyses. Rapid appraisal techniques and participatory research are
approaches often used in health systems research.
165
Handout 16.2: Advantages and disadvantages of using various data
collection tools
Table for advantages and disadvantages of using various data collection tools
166
Corlien, Pathmanathan, & Brownlee. (2003).
Handout 16.3: Focus group discussions

 Uses of Focus Group Discussions
o Help understand and solve unexpected problems in interventions.
For example:
 In District X, the recent national (polio) immunization days (NID) showed widely
different coverages per village (50-90%) and in a number of villages a marked
decrease in coverage was observed compared to last year.
 Eight FGD decrease were held with villages mothers, two in town, three in rural with
a marked in NID coverage and three in villages with a high coverage throughout.
 It appeared that overall; the concept NID had raised confusion.
 Most people believed that this mass campaign strengthened the childrens immunity
o Against any (childhood) disease, including Malaria and Respiratory Tract
Infections.
 In the villages with a low NID coverage there had been a high incidence of malaria in
o Children immediately after the previous NID campaign and several children
died.
 Mothers therefore believed that the NID campaign was useless.
• Develop appropriate messages for health education programmes and later evaluate
the messages for clarity.
• For example: A rural health clinic wanted to develop a health education
programme focused on weaning problems most often encountered by mothers in
the surrounding villages and what to do about them.
• The focus group discussion could be used for exploring relevant local concepts as
well as for testing drafts when developing the messages.
• The messages should be developed and tested in different socio-economic groups
of mothers, as weaning practices may differ with income, means of subsistence
and education of the mothers. Also ethnic differences may have to be taken into
account.
o Explore controversial topics.
167
 For example: Sexual behavior is a controversial topic in the sense that males and
females judge sexual relations and sexuality often from very different perspectives.
 Sexual education has to take this difference into account.
 Through FGDs, first with females, then with males, and then with a mixed group to
confront both sexes with the different outcomes of the separate discussions (listed on
flip charts) it becomes easier to bring these differences in the open. Especially for
teenagers, who may have many stereotypes about the other sex or be reluctant to
discuss the topic openly (particularly girls), such a multi-stage approach is useful.
 Strengths and Limitations of FDG
o Implementation of FGDs is an iterative process; each focus group discussion builds
on the previous one, with a slightly elaborated or better-focused set of themes for
discussion.
o Provided the groups have been well chosen, in terms of composition and number (see
o below), FGDs can be a powerful research tool which provides valuable spontaneous
information in a short period of time and at relatively low cost.
o FGD should not be used for quantitative purposes, such as the testing of hypotheses or
the generalization of findings for larger areas, which would require more elaborate
surveys.
o However, FGDs can profitably complement such surveys or other, qualitative
techniques.
o Depending on the topic, it may be risky to use FGDs as a single tool.
o In group discussions, people tend to centre their opinions on the most common ones,
on social norms. In reality, opinions and behavior may be more diverse. Therefore it
is advisable to combine FGDs with at least some key informant and in-depth
interviews.
o Explicitly soliciting other views during FGDs should be routine as well.
o In case of very sensitive topics, such as sexual behavior or coping with HIV/AIDS,
FGDs may also have their limitations, as group members may hesitate to air their
feelings and experiences freely.
o One possible remedy is the selection of students who do not know each other (e.g.,
selection of children from different schools in FGDs about adolescent sexual
behavior), while assuring absolute confidentiality.
168
o It may also help to alternate the FGD with other methods, for example, to precede it
by a self developed role play on sexual behavior, or to administer a written
questionnaire immediately after the FGD with open questions on sexual behavior in
which the students can anonymously state all their questions and problems. This
worked in Tanzania and Nepal.
 How to Conduct a Focus Group Discussion
o Determine the purpose
 A FGD can be regarded as a mini-study. It therefore requires one or two clear
objectives.
 These objectives will guide the research team in the formulation of discussion
questions.
o Situation analysis
 Any FGD requires good knowledge of local conditions. Communities are seldom
or never homogeneous. There are always differences between community
members, for example in education, political power, gender, economic status and
ethnic group.
 These differences will be reflected in their perceptions of the problems they suffer
from and possible solutions.
 A researcher must be aware of these differences, otherwise (s)he may miss
important groups of students or obtain a hotchpotch of information.
 Similarly, she/she must know which key persons or organizations could be good
entry points for the selection of students in the FGDs (e.g.: womens groups,
parent associations, youth clubs, etc.).
 For example: In an intervention study on sexual health among out-of-school youth
in an urban area, the researcher first planned some interviews with key informants.
 He selected the leaders of a political youth club and of a Christian youth club and
some teachers, with whom he thoroughly discussed his research topic.
• Through them he came in contact with youth of different backgrounds. He let
each of the three groups, separated into boys and girls, draw maps of the town
and asked them to mark places which they thought riskful in terms of sexual
behavior (easy contacts, unprotected sex).
• The drawings formed a good basis for further FGDs but also helped him to
identify wider networks of adolescents at risk who had to be included in the
169
study.
 Points to be Considered when Preparing the FGD

o Recruitment of students: Students should be roughly of the same socio-economic
group or have a similar background in relation to the issue under investigation. The
age and sexual composition of the group should facilitate free discussion.
o Selection of students: If you are an outsider in the research area, you may have to rely
on your key informants for the first selection of students in FGDs.
o Your key informants to whom you have explained thoroughly the purpose and the
process of the FGD might each suggest some individuals who could be invited to a
focus group discussion.
o Another way of getting students is to conveniently select individuals in a systematic
way, to try and ensure a range of views.
o You might, for example, ask every third or fourth person you find. This method might
be more suitable in urban areas.
o Physical arrangements:
 Communication and interaction during the FGD should be encouraged in every
way possible. Arrange the chairs in a circle. Make sure that there will be no
disturbances, sufficient quietness, adequate lighting, etc.
 Try to hold the FGD in a neutral setting which encourages students to freely
express their views. A health centre, for example, is not a good place to discuss
traditional medical beliefs or preferences for other types of treatment.
 Preparation of a discussion guide:
o There should be a written list of topics to be covered, formulated as a series of open-
ended questions.
o Guides for different groups gathered to discuss the same subject may vary slightly,
depending on their knowledge or attitudes and how the subject should first be
explored with them.
 Conducting the session
o One of the members of the research team should act as facilitator or moderator for
the focus group discussion.
170
o One should serve as recorder.
o The facilitator should preferably be as close as possible to the students in their
characteristics (same sex, roughly same age).
171
Handout 16.4: Function of Focus Group Facilitator
 Functions of the Facilitator of the FDG ( Focus Discussion group)

o The facilitator should NOT act as an expert on the topic. His or her role is to stimulate
and support discussion.
o Introduce the session
 Introduce yourself as facilitator and introduce the recorder.
 Let students introduce themselves with whatever names they wish to use.
 Put the students at ease and explain the purpose of the FGD, the kind of
information needed, and how the information will be used (for the planning of a
health programme, an education programme).
 Ask permission to use a tape-recorder, let people hear their own voices before the
session starts.
 You might offer drinks and allow some informal discussion before the actual
session starts.
o Encourage discussion
 Be enthusiastic, lively, and humorous and show your interest in the groups ideas.
 Formulate questions and encourage as many students as possible to express their
views.
 Remember there are no right or wrong answers.
 React neutrally to both verbal and non-verbal responses.
o Encourage involvement
o Avoid a question-and-answer session. Some useful techniques include:
 Asking for clarification: Can you tell me more about...?
 Reorienting the discussion when it goes off the track: Saying: Wait, how does
 this relate to...?
 Saying: Interesting point, but how about...?
 Using one students remark to direct a question to another, for example, Mrs. X
said ..., but how about you, Mrs. Y?
172
 When dealing with a dominant participant, avoiding eye contact or turning
 slightly away to discourage the person from speaking, or thanking the
person and changing the subject.
 When dealing with a reluctant participant, using the person s name,
requesting his/her opinion, making more frequent eye contact to encourage
his/her participation is important.
o Deal correctly with sensitive issues.
o If you notice that the discussion stops when dealing with a sensitive topic, you could
o ask students (if literate) to anonymously write down their responses or opinions on the
topic.
o Alternatively, you could summarize for the group some of the opinions from previous
focus group discussions, focusing on one or two major contrasting opinions.
o Still another strategy is to form sub-groups, and to get a member of the sub-group to
summarize and present the opinions of their sub-group members after which the
whole group can still discuss these opinions.
o Build rapport, empathize
o Observe non-verbal communication.
o Ask yourself, What are they saying? What does it mean to them?
o Be aware of your own tone of voice, facial expressions, body language, and those of the
students.
o Avoid being placed in the role of expert
o When asked for your ideas or views by a respondent, remember that you are not there
o to educate or inform.
o Direct the questions back to the group by saying: What do you think, What would
you do?
o Set aside time, if necessary, after the session to give students the information they
have asked for.
o Do not try to comment on everything that is being said.
o Dont feel you have to say something during every pause in the discussion.
o Wait a little and see what happens.
o Control the rhythm of the meeting, but in an unobtrusive way
o Listen carefully, and move the discussion from topic to topic. Subtly control the time
173
allocated to various topics so as to maintain interest.
o If students spontaneously jump from one topic to another, let the discussion continue
for a while since useful additional information may surface; then summarize the
points brought up and reorient the discussion.
o Take time at the end of the meeting to summarize, check for agreement and thank the
Students
o Summarize the main issues brought up, check whether all agree and ask for additional
comments.
o Thank the students and let them know that their ideas have been a valuable
contribution and will be used for planning the proposed research, intervention, or
health education materials.
o Listen for additional comments and spontaneous discussions which occur after the
meeting has been closed.
 Functions of the Recorder
o The recorder should keep a record of the content of the discussion as well as
emotional reactions and important aspects of group interaction.
o Assessment of the emotional tone of the meeting and the group process will enable
you to judge the validity of the information collected during the FGD.
o Items to be recorded include:
 Date, time, place
 Names and characteristics of students
 General description of the group dynamics (level of participation, presence of a
dominant participant, level of interest)
 Opinions of students, recorded as much as possible in their own words, especially
for key statements
 Emotional aspects (e.g., reluctance, strong feelings attached to certain opinions)
 Vocabulary used - particularly in FGDs that are intended to assist in developing
questionnaires or health education materials
 Spontaneous relevant discussions during breaks or after the meeting has been
closed
o It is highly recommended that a tape-recorder be used to assist in capturing
information. Even if a tape-recorder is used, notes should be taken as well, in case the
machine malfunctions and so that information will be available immediately after the
174
session for discussion.
o If there is no reliable tape-recorder available, it is advisable to have two recorders.

o A supplementary role for the recorder could be to assist the facilitator (if necessary)
by drawing his or her attention to: missed comments from students missed topics (the
recorder should have a copy of the discussion guide during the FGD)
 Number and Duration of Sessions
o Number of sessions. The number of focus group sessions to be conducted depends
upon project needs, resources, and whether new information is still coming from the
sessions, (that is, whether contrasting views within and between various groups in the
community are still emerging). If not, you may stop.
o One should plan to conduct at least two FGDs for each sub-group (for example, two
for males and two for females). Otherwise you have no way of assessing whether the
information you get from the first FGD is representative for that group.
 Duration
o A focus group session typically lasts up to an hour and a half.
o Generally the first session with a particular type of group is longer than the following
ones because all of the information is new.
o Thereafter, if all the groups have a similar opinion on particular
topics, the facilitator may be able to move the discussion along more quickly to other
topics which still elicit new points of view.
175
Session 17: Pre-Testing the Research Tools
Prerequisites
 None
Learning Tasks
 Define pretest and pilot study
 Outline reasons for pretest
 Describe the components of a pre-test
 Plan and carry out pre-test of research components
Resources Needed
 Handout 17.1: Summary of points to assess during a pre-test or pilot study
SESSION OVERVIEW
Activity/
Step Time Content
Method
05 Introduction, Learning Tasks
1. Presentation
minutes
05 Presentation Definition of pretest and pilot study
2.
minutes Brainstorming
Presentation Reasons for pretesting
10
3. Lecture
minutes
discussion
15 Presentation
4. Components of a Pre-Test and Pilot Study
minutes Buzzing
10 Presentation
5. Planning and Carrying out Pre-Test of
minutes Buzzing Research Components
05
6. Presentation Key Points
minutes
05
7. Presentation Evaluation
minutes
8. 05 Presentation Assignment
176
minutes
SESSION CONTENTS

STEP 2:Definition of a Pre-Test or Pilot Study (05 minutes)

 A pre-test
o Refers to a small scale trial of particular research components
 A pilot study
o is the process of carrying out a preliminary study, going through the entire
research procedure with a small sample
STEP 3: Reasons for Pre-Testing (10 minutes)
 Help to identify potential problems in the proposed study.
 Enables, if necessary, to revise the methods and logistics of data collection before
starting the actual field works.
 As a result, a good deal of time, effort and money can be saved.
 Pre-testing is simpler and less time-consuming and costly than conducting an entire
pilot study.
177
o STEP 4:Components of Pre-Testing (15 minutes)
 The components of research to be pre-test include:

o Reactions of the respondents to the research procedures
o The data-collection tools
o Sampling procedures
o Staffing and activities of the research team
o Procedures for data processing and analysis
o The proposed work plan and budget for research activities
 Reactions of the respondents to the research procedures
o Availability of the study population
o Study population daily work schedules
o Acceptability of the methods used
o Acceptability of the questions asked
o willingness of the respondents to answer the question
 The data-collection tools
o Whether the tools can collect the information you need and whether they are
reliable
o How much time is needed to collect data
o Whether there is any need to revise the format or presentation of interview
guides/questionnaires e.g.
 Sequencing
 Wording
 Translation
 Space for answers
 Sampling procedures
o Instructions followed
o Time need to locate respondents
 Staffing and activities of the research team
o training
o Logistics
178
o team work
 Procedures for data processing and analysis
 work plan and budget for research activities
STEP 4: Planning and Carrying Out Pre-Tests of Research Components

(10 minutes)
Components of research to be assessed during the pre-testing
 During training
o The reactions
o Appropriateness of study type(s) and research tools
o Format and wording of questionnaires and interview schedules
o Accuracy of the translations
o The time
o Sampling procedures
Data processing and analysis.
 Pre-test in the actual research area

o What difficulties do you expect in the implementation of your proposal?
o Inexperience with a certain data-collection technique
o Which parts of your study will be most costly and time-consuming?
 It is highly recommended that you analyse the data collected during the pre-test right
away

 A pre-test refers to a small scale trial of particular research components
 A pilot study is the process of carrying out a preliminary study, going through the entire
research procedure with a small sample
 It is highly recommended that you the pre-test some components of your study

 What is a pre-test?
179
 What is pilot study?
 What research components are to be pre-tested?
 Identify what aspects of the study you would like to pre-test in your research area and
why, with whom, when and where.
 Summarize this information in one or two paragraphs in your research proposal.
180
References
Netherlands

181
Handout 17.1: Summary of points to assess during a pre-test or pilot study
1. Reactions of respondents to your Acceptable Not Suggestions

research procedures acceptable
Availability of sample needed for full

study
Work schedules of population that may

affect their availability
Desire of population to participate
Acceptability of questions
Clarity of the language used
Acceptable
2. The data-collection tools Not Suggestions
acceptable
Whether the tools provide the

information you need and are reliable
The time needed for administering each

of the data-collection tools
Presentation of questions and format of

questionnaire
Accuracy of translation
Pre-categorising of questions
Coding system and coding guidelines

Handling and administering the tools
182
3. Sampling procedures Acceptable Not Suggestions
acceptable
Whether the instructions to obtain the

sample are used uniformly by all staff
The time needed to locate the

individuals to be included in the study
4. Preparation and effectiveness of Acceptable Not Suggestions

research team acceptable
Adequacy of staff training
Output of each team member
Team dynamics
Reliability of tools when administered

by different team members
Accuracy of interpretation
Appropriateness of plan for supervision
5. Procedures for data processing Acceptable Not Suggestions

and analysis acceptable
Use of data master sheets
Effectiveness of data quality control
Appropriateness of statistical
procedures
Ease of data interpretation
183
6. Schedule for research activities Acceptable Not Suggestions
acceptable
Amount of time allowed for:

 field trips for data collection
 supervision
 administration
 analysis of data
 Sequence of activities
Source: Corlien, Pathmanathan, & Brownlee. (2003).
184
Session 18: Data Collection Plan
Prerequisites
 None
Learning Tasks
 Describe problems that may arise during data collection and how they may be solved.
 Prepare a plan for data collection for the developed research proposal
 Determine the various tasks of the staff needed for research
 Prepare a work schedule (GANTT chart)
 Draw a work schedule(GANTT chart)
Resources Needed
 Handout 18.1: Example of a GANTT
Handout 18.2: Example of a work schedule
185
SESSION OVERVIEW
Activity/
Step Time Content
Method
Presentation
2 15 minutes Typical Problems that May Arise During Data
Buzzing Collection and Solutions.
3 10 minutes Presentation Preparation of a Plan for Data Collection for the

Developed Research Proposal
Presentation
4 25 minutes Group Determination of Various Tasks of the Staff Needed for
discussion Research
5 Presentation Preparation of a Work Schedule (GANTT Chart)
25 minutes
6 Presentation Drawing a Work Schedule (GANTT Chart)
25 minutes
8 Evaluation
SESSION CONTENTS
STEP 1: Presentation of Session Title and Learning Tasks (5 minutes)


STEP 2: Typical Problems that May Arise During Data Collection and
Solutions (15 minutes)
 Possible problems
Sources of data distortion (bias) that might include:
o Deviations from the sampling procedures set out in the proposal.
o Variability or bias in observations or measurements made because
 Research assistants are placed under too much stress
 Inadequate supervision of research assistants.
 Questionnaire not filled in completely
 Solutions
186
o Training research assistant
o Pretest instrument
o Adequate supervision of data collection
o Revise method to check quality of data
o Prior anticipation of problems that might occur and prepare plan to overcome them
STEP 3: Preparation of a Plan for Data Collection for the Developed

Research Proposal (10 minutes)
 A Plan for Data Collection
o Listing the tasks that have to be carried out, and who should be involved,
o Making a rough estimate of the time needed for the different parts of the study
o Identifying the most appropriate period in which to carry out the research.
o Scheduling the different activities that have to be carried out each week in a work
plan.
 Pre-Testing
o Before the proposal development is finished, a pre-test of the data collection and data
analysis procedures should be made.
o The advantages of conducting a pre-test before the proposal is that we can draft the
work plan and budget based on more realistic estimates, as well as revise the data
collection tools before we submit the proposal for approval.
o However, further pre-testing and planning of the research have to be done in the field.
 Stages in the Data Collection Process
o Stage 1: Permission to proceed
o Stage 2: Data collection
o Stage 3: Data handling
 Stage 1: Permission to Proceed
o Consent must be obtained from the relevant authorities, individuals and the
community in which the project is to be carried out.
 This may involve organizing meetings at national or provincial level, at district
and at village level.
o For clinical studies this may also involve obtaining written informed consent.
o The principal investigator will be responsible for obtaining permission to proceed at
the various levels.
187
o The Health Research Unit in the Ministry of Health or the institution organizing the
course may assist in obtaining permission from the national level.
 Stage 2: Data Collection
o During data collection consider:
 Logistics: who will collect what, when and with what resources
 Quality control (data must be reliable and valid)
o When allocating tasks for data collection, it is recommended that first list type of data
required.
o Identify who could best implement each of the tasks.
 If it is clear earlier that your research team will not be able to carry out the entire
study by itself
 Plan to look for research assistants to assist in relatively simple but time-
consuming tasks.
Consider the following:
 Time for Data Collection
o Think about how long will it take to collect data for each component of the Study?
 The time required to reach the study area(s)
 The time required locating the study units (persons, groups, records), search for
specific informants (e.g., users or defaulters of a specific service)
 It might take more time to locate informants than to interview them; consider the
number of visits required per study unit.
o Calculate the number of interviews that can be carried out per person per day (e.g. 4)
o Calculate the number of days needed to carry out the interviews. For example:
You need to do 200 interviews
o Your research team of 5 people can do 5 x 4 = 20 interviews per day
o You will need 200:20 = 10 days for the interviews
 Calculate the time needed for the other parts of the study, (for example, 10 days)
 Determine how much time you can devote to the study.
o Since the research team usually consists of very busy people, it is unlikely that team
members can spend more than 30 working days on the entire study:
o 5 days for preparation (including pre-testing and finalizing questionnaires)
o 20 days actual field work
o 5 days data processing + preliminary analysis
188
 Think of when should the data be collected? The type of data to be collected and the
demands of the project will determine the actual time needed for the data collection
 Consider:
o Availability of research team members and research assistants
o The appropriate season(s) to conduct the field work (if the problem is season-related
or if data collection would be difficult during certain periods)
o Accessibility and availability of the sampled population
o Public holidays and vacation periods
 Stage 3: Data Handling
o Develop a clear procedure for handling and storing data
o Number questionnaires and other research tools. Decide if this should be done at the
time of the interview or at the time the questionnaires are stored.
o Each tool used will get its own numbers starting from 1. If some data sets are linked,
e.g., you interview leprosy patients as well as their relatives and neighbors to analyze
their interaction and possible stigma from different perspectives, better link the
numbers.
o Identify the person responsible for storing data and the place where it will be stored.
o Decide how data should be stored.
o Record forms should be kept in the sequence in which they have been numbered. In
what sequence should data be collected?
o Other isues to consider during data collection
 In general, it is advisable to start with analysis of data that is already available.
 data to be drawn from different sources but in one locality should be collected at
the same time.
 It is extremely important that the data collected are of good quality (reliable and
valid)..
 Possible sources of data distortion (bias) that should try to prevent, include:
o Deviations from the sampling procedures set out in the proposal.
o Variability or bias in observations or measurements made because:
 Subject changes his/her behavior
 Use of unstandardized weighing scales or inaccurate or no guidelines for
interviewing.
189
 Variation in researchers observations (observer variability) in what they
observe or measure.
_ Variations in criteria for measurement or for categorizing answers;
changed them during the study.
 Measures to ensure good quality of data
 Prepare a field work manual for the research team as a whole, including:
 Guidelines on sampling procedures and what to do if respondents are not available
or to co-operate.
 A clear explanation of the purpose and procedures of the study which should be
used to introduce each interview
 Instruction sheets on how to ask certain questions and how to record
STEP 4: Determination of Various Tasks of the Staff Needed for Research
(25 minutes)
 When allocating tasks for data collection, it is recommended that you first list them.
 Then you may identify who could best implement each of the tasks as example given
in the following matrix.
Task To be carried out by
Reviewing record (hospital + HCs) Research team, with research assistant

Focus group discussions with health staff
Research team
before and after individual staff interviews
Individual health staff interviews Research team
Shadowing RCH nurses Principal investigator
Interviews with mothers (community-based)

Research team, with research assistants
before and after delivery
STEP 5: Preparation of a Work Schedule (Gantt chart) (25 minutes)
 How to Develop a Work Schedule
o Review and revise, if necessary, the list of tasks you prepared for your plan for data
collection.
o Add to the list other tasks you must complete not related to data collection (such as
clearance of proposal; data analysis and report writing; and feedback to authorities
and target group).
190
o Number all tasks.
o Make revisions, if required
o Preparing a work schedule (Gantt chart)
o Step 1: Consider:
 The time required to reach the study area(s);
 The time required to locate the study units (persons, groups, records);
• If you have to search for specific informants (e.g., users or defaulters of a
specific service) it might take more time to locate informants than to interview
them.)
 The number of visits required per study unit.
• For some studies it may be necessary to visit informants a number of times,
for example, follow-up of pregnant mothers or malnourished children
 Time needed for follow-up of non-respondents should also be considered.
o Step 2: Calculate the number of interviews that can be carried out per person per day
(e.g., 4)
o Step 3: Calculate the number of days needed to carry out the interviews.
For example:
 you need to do 200 interviews
 your research team of 5 people each can do 4 interviews per day
 you will need how many days for the interviews
o Step 4: Calculate the time needed for the other parts of the study, (for example, 10 days)
o Step 5: Determine how much time you can devote to the study. It is unlikely that team
members can spend more than 30 working days on the entire study
 5 days for preparation (including pre-testing and finalizing questionnaires)
 20 days actual field work
 5 days data processing and preliminary analysis
Refer students to Handout 18. 1: Example of a GANTT
STEP 6: Drawing a Work Schedule (Gantt chart) (25 minutes)

 A Gantt chart is a chart that shows all of the different sub-tasks of a project and
how they relate to each other in terms of time. It's a way of displaying project
schedule, and it helps get the work done on time.
191
 It shows all of the tasks that need to be done, the amount of time each task is
expected to take, the time frames in which individual tasks are to be completed,
and the relationship between various tasks.
 This way, everything gets done on schedule, and you never waste time waiting
for a task to be completed that should have been done already.
 The Gantt chart should indicate

o The task to be performed
o Who is responsible for the task
o The time each task is expected to take
o The length of each task is shown by a bar that extends over the number of
days, weeks or months the task is expected to take
Refer students to Handout 18.2: Example of a Work Schedule

 Problems that may arise during data collection are sources of data distortion
(bias)
 The Gantt chart is planning tool which depicts graphically the order in which
various tasks must be completed and the duration of each activity
 When allocating tasks for data collection, it is recommended that you first list
them, then you may identify who could best implement each of the tasks

 What are the tasks of research staff?
 What are typical problems that may arise during data collection?
 What steps are in preparing a work schedule (Gantt chart)?
192

 Prepare a plan of action for conducting the research you are developing.
 Summarize it in a work schedule or GANTT chart
193
 References
Netherlands

194
Handout 18.1: Example of a GANTT
195
196
Handout 18.2: Example of a Work Schedule
197
Session 19: Research Budget
Prerequisites
 None
Learning Tasks
 Identify the important points to be considered when starting to plan for data collection
 Determine what resources are available and needed to carry out the research
 Describe the activities of the research
 Cost the research activities, materials and supplies required
Resources Needed
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 05 minutes Presentation Introduction, Learning Objectives
Identification of Important Points to be
Presentation
2 15 minutes Considered when Starting to Plan for Data
Buzzing
Collection
Presentation Determination of Resources Available and
3
10 minutes Brainstorming Needed to Carry Out the Research
4 25 minutes Presentation Activities of the Research
50 minutes Presentation Costing the Research Activities, Materials and
5
Group discussion Supplies Required
198
SESSION CONTENTS

STEP 2: Identification of Important Points to be Considered when Starting

to Plan for Data Collection (15 minutes)
Activity: Buzzing ( 5 minutes)
ASK students to pair up and buzz on the following question for 2 minutes:
 What are the important points to be considered when starting to plan for data collection
ALLOW few pairs to respond and let other pairs to add on points not mentioned
WRITE their response on the flip chart/board
CLARIFY and SUMMARIZE by using the content below
 The most important points to be considered when starting to plan for data collection:
o It should be simple, realistic, and easily understood by those directly involved.
o It should cover the preparatory and the implementation phases of the project, as well
as data analysis, reporting, dissemination and utilization of results.
o The activities covered should include training, technical or research tasks;
administrative, secretarial and other support tasks.
o The realities of local customs (local holidays, festivals) and working hours should be
considered, when preparing the work plan.
o Also seasonal changes and their effect on travel, work habits, and on the topic you are
studying (such as incidence of disease or nutritional status), should be kept in mind as
the schedule is planned.
STEP 3: Determination of Resources Available and Needed to Carry Out
the Research (10 minutes)
 Base on the work plan
199
 Specify for each activity in the work plan, what resources and inputs are required
 For each resource determine unit cost and ,number of units to get the total cost
STEP 4: The Activities of the Research (30 minutes)

Research activities include:
o Finalize research proposal and submit to ethical committee for clearance
o Translate questionnaires, typing, multiplying
o Recruit research assistants
o Obtain clearance and orient of DMOs, health institutions and village health workers
o Train research assistants
o Pre-test study
o Collect data
o Process data and make preliminary interpretation
o Analyze data and write report
o Disseminate and discuss research findings and preliminary recommendations with
community members, health staff
o Disseminate and discuss of research findings and preliminary recommendations with
policymakers/managers/ others
o Draft preliminary plan of action
o Hold meetings with policy makers/managers/others to discuss plan of action for
implementing recommendations
o Follow up on implementation of plan of action
STEP 5: Costing the Research Activities, Materials and Supplies Required

(50 minutes)
Activity: Small Group Discussion (5 minutes)
DIVIDE students into small manageable groups
ASK students to discuss on the following question
 What research activities, materials and supplies required in the study need to be
budgeted?
ALLOW few students to respond
200
WRITE their responses on flipchart or board
CLARIFY and SUMMARIZE by using the contents below

 Purpose of a Budget
o A detailed budget will help to identify which resources are already locally available
and
which additional resources may be required.
o The process of budget design will encourage you to consider aspects of the work plan
you
have not thought about before
o Serve as a useful reminder of activities planned, as your research gets underway.
 Budget Preparation
o A complete budget is not prepared until the final stage of project planning.
 Cost is usually a major limiting factor and therefore must always be kept in mind
during planning so that your proposals will not have an unrealistically high
budget.
o Remember that both ministries and donor agencies usually set limits for research
project
o budgets.
o The use of locally available resources increases the feasibility of the project from a
financial
point of view.
 Categories for a Budget
o Funds for personnel allowances for researchers, and assistants during training
research
assistants, field work piloting and actual study
o Funds for secretarial services e.g. typing the proposal and questionnaires, final report
and
dissemination
o Funds for transport number of visits and kilometers to be covered, funds for supplies.
o Stationary and lunch for those attending FGD, meetings
o 5% for emergency
 Making Reasonable Estimates in a Budget
201
o Do not underestimate the time needed to complete project tasks in the real world.
o Include a 5% emergency fund if you fear that you might have budgeted for the
activities
rather conservatively.
 If inclusion of a contingency fund is not allowed, an alternative is to slightly over-
budget in major categories.
 Budget Justification
o It is not sufficient to present a budget without explanation.
o The budget justification follows the budget as an explanatory note justifying briefly,
in the context of the proposal, why the various items in the budget are required.
o Give clear explanations concerning why items that may seem questionable or that are
particularly costly are needed and discuss how complicated expenses have been
calculated.
 If a strong budget justification has been prepared then, it is less likely that
essential items will be cut during proposal review.
 How to Reduce Budgets
o Explore whether other health-related institutions are willing to temporarily assign or
second personnel to the project.
o When possible, use local rather than outside personnel. If consultants are needed at
the
beginning, train local personnel as soon as possible to take over their work.
o Explore the use of students or community volunteers, where appropriate.
o Plan for strict control of project expenditures, such as those for vehicle use, supplies.
The budget justification follows the budget as an explanatory note justifying briefly,
in the
context of the proposal, why the various items in the budget are required.
o Give clear explanations concerning why items that may seem questionable or that are
particularly costly are needed and discuss how complicated expenses have been
calculated.
 If a strong budget justification has been prepared then, it is less likely that
essential items will be cut during proposal review.
202
 Example of a field budget : Costs involved in fieldwork
Category Unit Cost Multiplying Cost
(Tsh) Factors (Tsh)
ALLOWANCES
a. Researchers (5)
b. Research assistants (5)
c. Secretary (1)
d. Drivers (2)
e. Facilitator (1)
Evaluation pilot study
Subtotal (I)
Transport Costs
Subtotal (II)
Supplies
Subtotal (III)
Total (I+II+III)
5% Contingency
Grand Total
 The type of budget format to be used may vary depending upon whether the budget will
be supported by your own organization or submitted to the Ministry of Health or a donor
organization.

o Most donor organizations have their own special project forms, which include a
budget format (budget format)
o Keep in mind the tendency to underestimate the time needed to complete project tasks
in the real world
o If the budget is for a period longer than a year, build in allowances for inflation before
the project begins and in subsequent years by increasing costs by a set percentage
(budget preparation)
o It is not sufficient to present a budget without explanation (Budget justification)
203
o When possible, use local rather than outside personnel to reduce cost
 Obtaining funding for projects
o To conduct research, it is usually necessary to obtain funding for the research
project. In addition to preparing a good research proposal, the following strategies
are useful for researchers who need to obtain their own funding:
o Familiarize yourself with the policies and priorities of funding agencies. Such
policies and priorities may be:
o Identify the procedures, deadlines and formats that are relevant to each agency.
o Obtain written approval and support from relevant local and national health
authorities and submit this together with your proposal.
o If you are a beginning researcher, associate yourself with an established researcher.
Host agencies scrutinize the credibility of the researcher to whom funds are
allocated. Such credibility is based on previous projects that have been successfully
completed.
o Build up your own list of successfully completed projects (i.e., your own reports,
publications, etc.).

 Plan for data collection should be simple, realistic, and easily understood by those
directly involved.
 To conduct research, it is usually necessary to obtain funding for the research project
 The type of budget format to be used may vary depending upon whether the budget
will be supported by your own organization or submitted to the Ministry of Health or a
donor organization

 What are the most important points to consider when starting planning for
research budget?
 What resources are available and needed for preparation of research budget?
204

Prepare the budget for conducting the research you are developing
205
References
Anthropology of health and health care, third revised edition, Het Spinhuis Publishers, The
Netherlands

206
Session 20: Data Collection
Total Session Time: 60 minutes + 360 minutes
Prerequisites
 None
Learning Tasks
 Review previous data-collection techniques
 State the uses and limitations of different data collection methods
 Mention issues to consider in selecting data collection methods
 List advantages of using a combination of different data collection techniques
 Explain difference between data collection methods and tools
 Identify various sources of bias in data collection and ways of preventing
Resources Needed
SESSION OVERVIEW
Activity/
Step Time Content
Method
Presentation
2 10 minutes Various Data-Collection Techniques
Buzzing
Presentation
3 Group The Uses and Limitations of Different Data Collection
35 minutes discussion Methods
4 Presentation Issues to Consider In Selecting Data Collection

10 minutes Methods
5 Presentation Advantages of Using a Combination of Different Data

10 minutes Collection Techniques
6 Presentation Difference between Data Collection

25 minutes Methods/techniques and Tools
207
7 Presentation Sources of Bias in Data Collection and Ways of
15 minutes Preventing
SESSION CONTENTS

STEP 2: Various data-Collection Techniques (10 minutes)

 Data-collection techniques
 Use of available information
 Observation
 Interview
 Administering a questionnaire
 Focus group discussion
 In-depth interview
STEP 3: Uses and Limitations of Different Data Collection Methods (35 minutes)
 Use of available information
o Means: Looking into records and extracting information
o Advantages
 Cheaper since information is already there
 Doesn't depend on respondents willingness to respond
 Allow observation of trend
o Disadvantages
 May be difficult to access the data
 Information may be incomplete or imprecise
 Ethical concerns regarding confidentiality may arise
 Observation
o Means: Watching and recording, no talking with respondent
o advantages
208
 Gives information of what is currently happening
 Doesn't depend on respondents willingness to respond
 Disadvantages
 Observer may notice only what interests him/her (bias)
 Presence of observer may influence behaviour of respondent
 Ethical concerns regarding confidentiality may arise
 Interview
o Means: Asking a respondent questions orally
o Advantages
 Can be used for illiterates
 Allows clarification of questions
 Higher response rate
o Disadvantages
 Expensive (time, human resources)
 Presence of interviewer may influence response
 Administering a questionnaire
o Means: giving respondents written questions (questionnaire) so that they read the
questions themselves and provide answers
o Advantages
 Quick and cheap, no many research assistants needed
 Allows anonymity, hence more honest responses
o disadvantages
 Require literate respondents
 Response rate could be low
 Questions may be misunderstood by respondents
 Some respondents may choose responses simply because they saw it there,
otherwise they wouldn't have thought of it
 Focus group discussion

o Means: A discussion of a topic by a group of selected persons guided by a
facilitator
o Advantages
 Flexibility to explore new issues that arises
209
 Findings are more believable
 Relatively cheaper
o Disadvantage
 Discussion could base on irrelevant issues
 Minority opinion may not be expressed
 Difficult to analyse the data
 Require highly trained moderator
 In-depth interview
o Means: A person to person conversation in order to gain insight into people's
thoughts, feelings, and behaviour on important issues
o Advantages
 Collects large amount of data quickly
 Allows clarification of issues
o Disadvantages
 Needs skilled interviewer
 Data difficult to analyse
 Views could be subjective
STEP 4: Issues to Consider in Selecting Data Collection Methods (10 Minutes)

 Objectives of the study
 Nature of required information (quantitative or qualitative)
 Resources available (time, money, personnel)
 Acceptability of the method by respondents
STEP 5: Advantages of Using a Combination of Different Data Collection Techniques

(10 minutes)
 Data collection techniques can complement each other.
 A skilful use of a combination of different techniques can reduce the chance of bias and
give a more comprehensive understanding of the topic under study.
 Researchers often use a combination of flexible and less flexible research techniques.
 Flexible techniques include:
o Loosely structured interviews using open-ended questions.
210
o Focus group discussions.
o Participant observations are also called qualitative research techniques.
o They produce qualitative data that is often recorded in narrative form.
 Qualitative Research Techniques

o Involve the identification and exploration of a number of often mutually related
variables that give insight in human behavior (motivations, opinions, attitudes), in the
nature and causes of certain problems and in the consequences of the problems for
those affected.
o In qualitative technique why, what and how are important questions.
 Quantitative Research Techniques
o Quantitative technique is used to quantify the size, distribution, and association of
certain variables in a study population.
o In quantitative research techniques, how many? How often? and how significant? are
important questions.
o Structured questionnaires that enable the researcher to quantify pre- or post-
categorized answers to questions are an example of quantitative research techniques.
 The answers to questions can be counted and expressed numerically.
 Both qualitative and quantitative research techniques are often used within a single study.
 In research it is common to use more than one data collection technique.
o Example: Observation and interview
 This allows better understanding of the issue being studied and avoidance of bias
STEP 6: Difference Between Data Collection Methods and Tools (25 minutes)
 Data collection instruments and tools are things that are used in collecting
information.
o Example of instrument: Data compilation form, interview guide, etc.
o Example of tool: Pen, weighing scale
 Different techniques need different instruments and tools
Technique Instrument/tool Tool

Use of available information Data compilation form Eye, pen
211
Observation Checklist Eye, pen
Interview Interview schedule, guide Ears, pen, recorder
Administering a questionnaire Questionnaire Pen

Focus Group Discussion FGD guide Recorder, notebook, pen
(FGD)
STEP 7: Sources of Bias in Data Collection and Ways of Preventing (15 Minutes)
 Sources of bias:
o Defective instruments or tools
o Interviewers and observers different data collectors eliciting different information
o Effect of the interview respondents mistrust the interview intention, thus dodge the
questions
o Information bias incomplete record, respondents being unable to recall
 Ways to Reduce the Possibility of Bias:
o Data collection tools (including written introductions for the interviewers to use with
potential respondents) should be pre-tested. If necessary, adjustments should be made
to ensure better co-operation.
o If non-response is due to absence of the subjects, follow-up of non-respondents may
be considered.
o If non-response is due to refusal to co-operate, an extra, separate study of non-
respondents may be considered in order to identify to what extent they differ from
respondents.
o Another strategy is to include additional people in the sample, so that non-respondents
who were absent during data collection can be replaced. This can only be justified if
their absence was very unlikely to be related to the topic being studied.
action.
212
 Data collection methods include; use of available information, observation, interview
administering questionnaires , focus group discussion, in-depth interview
 Sources of bias in data collection may arise from tools, interviewer and information
recorded
 Data collection instruments and tools are things that are used in collecting
information

 What data-collection methods/techniques are commonly used?
 What to consider in selecting data collection methods?
 What are sources of bias in data collection?
213
References
Netherlands
Kothari C.R (1985); Research Methodology Methods and techniques, 2nd edition, Wiley
Ranjit K (205); Research methodology step by step guide for begginers, 2nd edition,
Singapore, pearson education
Varkevisser, C. M, Pathmanathan, I and Brownlee, A (1991) Designing and Conducting

Polit, D. F and Beck, C. T (2004) Nursing Research Principles and Methods, 7th Edition:
Kazaura, M. R., Makwaya, C. K., Masanja, C. M. and Mpembeni, R.C.(1997). Lecture

notesinBiostatistics, manual of biostatistics, Muhimbili University College of Health Sciences,
Dar es Salaam
214
Session 21: Data Collection - Field Work Activities
Prerequisites
 None
Learning Tasks
 Identify activities to be done before data collection
 Collect data
 Process data while in the field
Resources Needed
 SESSION OVERVIEW
Activity/
Step Time Content
Method
Presentation
2. 15 minutes Activities to be done before data collection
Buzzing
Presentation
3. 20 minutes Lecture Data collection
discussion
Presentation
4. Data processing
10 minutes Brainstorming
7. 05 minutes Presentation Field wok data collection
SESSION CONTENTS

215
STEP 2: Activities to be Done before Data Collection
 Briefing managers, health service personnel and community members concerned
 Identifying and obtaining resources for the study
 Reviewing availability of subjects and information
 Organizing logistics for data collection
 Preparing field work manuals (if necessary)
 Training of research team members, including assistants
 Conducting the pre-test in the research location, with preliminary data analysis and
revision of data-collection tools (if was not done)
STEP 3: Data Collection

Having obtained permission for the study, and having
 obtained the necessary resources,
 trained the team members,
 organised the logistics, and
 Pre-tested and modified the data-collection tools and procedures,
the data collection can now be carried out.
STEP 4: Data Processing

After collecting and sorting the data, all data should be checked for errors. The content may
be converted into codes or keywords for processing by computer or using master sheets.
The steps during this process include:
1. Editing/cleaning,
2. Categorising and coding,
3. Summarising data on data master sheets, or
4. If a computer is used, writing instructions to the computer analyst concerning data
input and analysis.
STEP 5: Key Points

Before one collects data, preparation is very important in terms of informing relevant
authoeirties and seeking permission, preparing logistics and thing of staring data processing
while in the field.
216
STEP 6: Evaluation
 What are the important preparations one will do before embarking in data collection?
STEP 7:Field work data collection

Arrange areas for students to go and collect data using tools and techniques they have
identified.
217
Session 22: Data Processing
Prerequisites
 None
Learning Tasks
 Categorize the data
 Code the data
 Summarize the data in data master sheets
 Compile the data manually without master sheets
Resources Needed
SESSION OVERVIEW
Activity/
Step Time Content
Method
Presentation
2 20 minutes Group Categorizing the Data
discussion
3 Coding the Data
Brainstorming
30 minutes
4 Presentation Summarizing the Data in Data Master Sheets
35 minutes
5 Presentation Compiling the Data Manually without Master Sheets
218
SESSION CONTENTS


STEP 2: Categorizing the Data (20 minutes)
 In data processing following important issues should be considered:
o Sorting data
o Performing quality-control checks
o Data processing
o Data analysis
 Sorting Data
o An appropriate system for sorting the data is important for facilitating subsequent
processing and analysis.
o If you have different study populations (for example village health workers, village
health committees and the general population), number the questionnaires separately.
o In a comparative study sort the data right after collection into the two or three groups
that will be compared during data analysis.
 Performing Quality Control Checks
o Checked in the field to ensure that all the information has been properly collected and
recorded.
o Before and during data processing, the information should be checked again for
completeness and internal consistency.
o If a questionnaire has not been filled in completely you will have missing data for
some of the variables.
o If there are many missing data in a particular questionnaire, the decision may be to
exclude the whole questionnaire from further analysis.
o If an inconsistency is clearly due to a mistake made by the researcher/research
assistant
o For example if a person in an earlier question is recorded as being a non-smoker,
whereas all other questions reveal that he is smoking, it may still be possible to check
219
with the person who conducted the interview and to correct the answer.
 If the inconsistency is less clearly a mistake in recording, it may be possible (in a small
scale study) to return to the respondent and ask for clarification.
 If it is not possible to correct information that is clearly inconsistent, consider excluding
this particular part of the data from further processing and analysis as it will affect the
validity of the study.
 If a certain question produces unclear answers throughout, the whole question should be
excluded from further analysis. (Normally, however, you would discover such a problem
during the pre-test and change the wording of the question.)
 The Questions to be answered before Processing
o Have the data been sorted appropriately?
o Have questionnaires been numbered?
o Major categories of informants distinguished?
o Have quality checks been performed? For completeness and consistency of
information?
o Has all qualitative data been categorized as far as possible?
 Data Processing Quantitative Data
o Decide on the method for processing and analyzing data from questionnaires
 Manually, using data master sheets or manual compilation of the questionnaires
 By computer, for example, using micro-computer and existing software or self-
written programmes for data analysis
 Data processing in both cases involves
o Categorizing/classifying the data
o Coding
o Summarizing the data in data master sheets, manual compilation without master
o sheets, or data entry and verification by computer
 Categorizing/Classifying Data
o Decisions have to be made concerning how to categorize responses.
o Categorical variables that are investigated through closed questions or observation,
the categories are decided earlier.
220
o In interviews the answers to open-ended questions, the answers can be pre-
categorized to a certain extent, depending on the knowledge of possible answers that
may be given.
• Answers that are difficult or impossible to categorize may be put in a separate
residual category called others, but this category should not contain more than
5% of the answers obtained.
 For numerical variables, the data are often better collected without any pre-categorization.
 If you do not exactly know the range and the dispersion of the different values of these
variables when you collect your sample (e.g., home-clinic distance for out-patients, or
income), decisions concerning how to categorize and code the data at the time you
develop your tools may be premature.
 If you notice during data analysis that your categories had been wrongly chosen you
cannot reclassify the data anymore.
STEP 3: Coding the Data (20 minutes)
 Coding
o If the data will be entered in a computer for subsequent processing and analysis, it is
essential to develop a coding system.
o For computer analysis, each category of a variable can be coded with a letter, group of
letters or word, or be given a number.
For example, the answer yes may be coded as Y or 1; no as N or 2 and no
response or unknown as 'Ú' or 9.
o The codes should be entered on the questionnaires (or checklists) themselves.
o When finalising your questionnaire, for each question you should insert a box for the
code in the right margin of the page.
o These boxes should not be used by the interviewer. They are only filled in afterwards
during data processing.
o Take care that you have as many boxes as the number of digits in each code.
o If analysis is done by hand using data master sheets, it is useful to code your data as
well
o Coding conventions
o Common responses should have the same code in each question, as this minimizes
mistakes by coders.
o For example
221
Yes (or positive response) code - Y or 1
No (or negative response) code - N or 2
Don't know code - D or 8
No response/unknown code - U or 9
 Codes for open-ended questions (in questionnaires) can be done only after examining a
sample of (say 20) questionnaires.
o You may group similar types of responses into single categories, so as to limit their
number to at most 6 or 7.
o If there are too many categories it is difficult to analyse the data.
 Remember that the personnel responsible for computer analysis should be consulted very
early in the study
STEP 4: Summarizing the Data in Data Master Sheets (30 Minutes)

Data master sheets
 On a data master sheet all the answers of individual respondents are entered by hand.
You would need several sheets to include all answers.
 Enter the different codes for one question in one column instead of having different
columns of which you tick one
No Education (Q3) Occupation (Q4)
Y/N Highest level Still in Self Head HH

school
Years Type
1 Y 4 PS N 1 3
2 Y 9 SS N 4 NA
3 N NA NA NA 5 NA
4 U PS Y 0 2
 In any small scale study processed by hand in which groups will be compared, a
different master sheet should be made for each of those groups, e.g., good and poor
compliers to treatment.
 As gender is an important cross-cutting theme, it is usually also advisable to subdivide
males and females within each of the groups that are being compared
222
STEP 5: Compiling the Data Manually without Master Sheets (35 Minutes)
 When the sample is small (say less than 30) and the collected data is limited, it might be
more efficient to do the compilation manually
 Certain procedures will help to ensure accuracy and speed.
o If only one person is doing the compilation use manual sorting.
o If a team of 2 persons work together use either manual sorting or tally counting.
 Manual sorting can be used only if data on each subject is on a different sheet of paper/
entered in a separate questionnaire.
 In manual sorting the basic procedure is to:
o Take one question at a time, for example, use of health facility,
o Sort the questionnaires into different piles representing the various responses to the
question, e.g., hospital/ health centre/ traditional practitioners) and
o Count the number in each pile.
 To do tally counting the basic procedure is:
o One member of the compiling team reads out the information while the other records
it in the form of a tally (e.g., III representing 3 subjects)
o Tally count for no more than two variables at one time (e.g., sex plus type of facility
used)
o After tally counting, add the tallies and record the number of subjects in each group.
 Then doing either manual or tally counting, check the total number of subjects/responses
in each question to make sure that there has been no omission or double count
 It should be noted that hand tallying is often used in combination with master sheet
analysis when the relationship between two or three variables needs to be established, or
details analyzed

 It is often most efficient to summarise the raw research data in a so-called data master
sheet, to facilitate data analysis
 If the data will be entered in a computer for subsequent processing and analysis, it is
essential to develop a coding system
 When the sample is small (say less than 30) and the collected data is limited, do the
compilation manually
223
 How are the data categorised?
 How are the data coded?
 How are the data Summarised?
224
References
Netherlands

225
Session 23: Data Analysis

Refer to session 3 and 4
Prerequisites
 None
Learning Tasks
 Describe data in terms of frequency distribution, percentages and proportion
 Use figures to present data.
 Explain the difference between mean, mode and median
 Calculate the frequencies, percentages, proportion, ratios, rates means, medians,
modes for major variables.
 Identify variables that are necessary for analysis of the collected data
Resources Needed
226
SESSION OVERVIEW
Activity/
Step Time Content
Method
Presentation Description of Data in Terms of Frequency
2 15 minutes
Brainstorming Distribution, Percentages and Proportion
10 minutes
3 Presentation Using Figures to Present Data.
20minutes Presentation
4 Group Difference Between Mean, Mode and Median
discussion
20 minutes
Calculation of the Frequencies, Percentages,
5 Presentation Proportion, Ratios, Rates Means, Medians, Modes for
Major Variables.
40 minutes
6 Presentation Identification of Variables that are Necessary for
Analysis of the Collected Data
SESSION CONTENTS


STEP 2: Description of Data in Terms of Frequency Distribution,
Percentages and Proportion (10 minutes)
 Data analysis involves the production and interpretation of frequencies, tables, graphs,
etc., that describe the data.
o Frequency counts
 From the data master sheets, simple tables can be made with frequency
counts for each variable.
 A frequency count is an enumeration of how often a certain
measurement or a certain answer to a specific question occurs.
 For example
227
Smokers 51
Non-smokers 93
Total 144
• If numbers are large enough it is better to calculate the frequency distribution in
percentages (relative frequencies):
o 51/144 x 100 = 35% are smokers and 93/144 x 100 = 65% non-smokers.
o This makes it easier to compare groups than when only absolute numbers are
given. In other words, percentages standardize the data.
 It is usually necessary to summarize the data from numerical variables by dividing them
into categories. This process may include the following steps:
o Inspect all the figures: What is their range? (The range is the difference between the
largest and the smallest measurement.)
o Divide the range into three to five categories. You can either aim at having a
reasonable number in each category (e.g. 0-2 km, 3-4 km, 5-9 km, 10+ km for home-
clinic distance) or you can define the categories in such a way that they are each equal
in size (e.g., 20-29 years, 30-39 years, 40-49 years, etc.)
o Construct a table indicating how data are grouped and count the number of
observations in each group.
STEP 3: Using Figures to Present Data (10 minutes)

 Figures
o Figures make the descriptive data more readable when you have many tables
o Numerical data
 Histograms
 Line graphs
 Scatter diagrams
 maps
o Categorical data
 Bar charts
 Pie charts
 Bar charts
o Is simplest and most effective means of illustrating qualitative data
o Bars can either be horizontal or vertical
o Eg.57 Adolescents from Kaloleni streets in Arusha were asked the following question:
How often have you used cannabis for the past one year? This was closed question
with the following possible answers
228
o Frequently(more than 5 times),Occasionally ( 3 to 5 times), rarely (1 to 2 times)and
never
Categories Number Percentage
Frequently 7 12.2
Occasionally 9 15.8
Rarely 10 17.5
Never 31 54.4
Total 57 100
 Pie charts
o Provides quick view of data presented in different form.
o Used in qualitative number with few categories to avoid congestion
229
 Histograms
o Numerical data are often presented in histograms
o Which are similar to bar charts important difference is that in histogram the
bars are connected(as long as there is no gap between the data where as in bar
charts are not connected as the different categories are distinct entitles)
 Line graphs
o Particularly useful for numerical data if you want to show Trend over time
o It is easy to show two or more distribution in one graph as long as difference
between lines are easy to distinguish e.g. age distribution between males and
females
STEP 4: The Difference Between Mean, Mode and Median (30 minutes)
 Mean
o The mean of a data set is also known as the average value. It is calculated by dividing
the sum of all values in a data set by the number of values.
o So in a data set of 1, 2, 2, 3, 4, 5, we would calculate the mean by adding the values
(1+2+2+3+4+5) and dividing by the total number of values (6). Our mean then is
17/5, which equals 3.4
 Mode
o The mode is the most common observation of a data set, or the value in the data set
that occurs most frequently.
o The example of the mode in: 1, 2, 2, 3, 4, 5, is 2
o The mode is an appropriate measure to use with categorical data
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 Median
o The median of a data set is the value that is at the middle of a data set arranged from
smallest to largest.
o In the data set 1, 2, 3, 4, 5, the median is 3.
o In a data set with an even number of observations, the median is calculated by
dividing the sum of the two middle values by two. So in: 1, 2, 2, 3, 4, 5, the median is
(2+3)/2, which equals 2.5.
o The median is appropriate to use with ordinal variables, and with interval variables
with a skewed distribution
STEP 5: Calculation of the Frequencies, Percentages, Proportion, Ratios,

Rates, Means, Medians, Modes for Major Variables (35 minutes)
 Frequency distribution
o Frequency distribution is description of data presented in tabular form.
o Gives frequency in each value appears in data
o Count number of response in category
o E.g. Frequency of categorical nominal data
 Distribution of course students according to sex
Sex course students Number of course students
Male 34
Female 27
Total 61
 Frequency distribution of numerical data

o Frequency distribution of numerical data is similar to that of categorical data
except here data have to be grouped in categories
o E.g. Weights (in kg) of 17 nursing students on enrolment at Kibong oto Nursing
school (45,43,45,47,54,53,62,38,54,34,45,53,56,42,51, 62,61)
o Procedures
 Select group for grouping these data (selected Groups (31-40; 41-50;
51-60; 61-70)
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 Count number of measurement(wt. of nurses) in each group:
31-40 II (34, 38)
41-50 IIIIII (42, 43, 45, 45, 45, 47)
51-60 IIIIII (51, 53, 53, 54, 54, 56)
61-70 III (61, 62, 62)
 Add up and check totals.
 Rules for grouping data

o Groups must not overlap, to avoid confusion
o There must be continuity from one group to the other(no gaps)
o Groups must range from the lowest to the highest measurements
o Groups should normally be of equal width
 Percentages
o is number of units in the sample with a certain characteristics divided by total of units
in the sample multiplied by 100
o May also be called Relative frequencies
o Standardizes the data and make it easier to compare with similar data obtained in
another sample of different size or origin
o E.g. weight of 17 Pharmacy students at KSP school on enrolment
Weight(Kg) Number of Pharmacy Relative frequency

students (percent)
31-40 12 26.7
41-50 17 37.8
51-60 11 24.4
61-70 5 11.1
Total 45 100
 For calculating percentage Remember:

o Dont include missing numbers and not applicable in calculation.
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o Dont know' is special category that should not counted as missing data.
o Should not be used if total is less than 30, as one unit makes a big difference in terms
of percentage
 Proportions
o Sometimes relative frequency are expressed in proportion instead of percentages
o Definition: proportion is numerical expression that compares one party of study units
to the whole.
o Can be expressed in fraction or decimal
 Numerator is part of denominator
• E.g. Calculate proportion of modules studied in first semester
 Ratio
o It is numerical expression that indicates relationship in quantity or amount or size
between two or more parts.
 Numerator is not part of denominator
Example: Ratio of module studied in first semester to module to be studied in
second semester
 Rates
o Is quantity or amount or degree of event or disease measured over specified period of
time.
o E.g. Birth rate = number of live birth per 1000 population over period of one year
STEP 6: Identification of Variables that are Necessary for Analysis of the

Collected Data (40 minutes)
 Variables: A characteristic of a person, object or phenomenon, which can take on different
values. These may be in the form of numbers (e.g. age) or non-numerical characteristics (e.g.
sex).
o Variables are something that varies or logical groupings of attributes.
 Attributes: Are characteristics or qualities that describe an object or categories that make up a
variable.
o Variables and attributes are the derived from the concepts and they are part of the
operational definition for measurement.
Figure :Variables and Attributes
Variables Attributes
Age Young
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Gender Female
Occupation Lecturer
Race Chinese
Social Class Low
Economic class High
 Dependent variable: Used to describe or measure the problem under study.

 Independent variable: Used to describe or measure the factors that are assumed to cause
or at least to influence the problem. Refers to cause, it is what you (or nature) manipulate.
 Confounding factors: Something that provides an alternative explanation for an
exposure-condition association.
o To be a confounder
 A risk factor must be associated with the risk factor under study.
 It must also be a risk factor for the condition/problem being investigated.
 A potential confounder is any factor that is believed to have a real effect on the
risk of the problem under study e.g. smoking, age, socioeconomic status and
education level
Types of Variables and scales

 To find associations between the problem and contributing factors, it is important to
carefully define the problem and each of the factors identified when analyzing the
problem
 This is done by formulating variables both dependent (outcome /problem) variable
and independent variables(factors influencing the outcome or problem)
Numerical Variables
o When the values of the variables are expressed in numbers
Example of a variable in the form of numbers is persons age. The variable
age can take on different values since a person can be 20 years old, 35 years
old and so on.
 Weigh (expressed in kilograms or in pounds)
 Homes-clinic distance (expressed in kilometers or in minutes walking
distance);
 Monthly income (expressed in dollars, Shillings)
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 Number of children (e.g. 1,2)
 Categorical Variables
o Some variables may be expressed in categories. For example, the variable sex has two
distinct categories, male and female.
Figure: Example of categorical variable
Variable Categories
Colour Red, blue, green, yellow
Main type of staple food Maize, rice, millet, cassava
Types of drugs Antibiotics, anti inflammatory
Numerical variables can either be continuous or discrete.

o Continuous: With this type of data, one can develop more and more accurate
measurements depending on the instrument used. For example height in centimeters
(2.546 cm or 2.543216 cm) and Temperature in degrees Celsius (37.20 c or 37.190).
o Discrete: These are variables in which numbers can only take full values, e.g.
number of visits to a clinic (0, 1, 2, 3, and 4). Number of sexual partners (0, 1, 2, 3,
4,and 5).
Categorical variables: Can either be Ordinal or Nominal

o Ordinal variables: These are grouped variables that are ordered or ranked in increasing or
decreasing order.
For example:
 High income (above $3000 per month), middle income ($1000-$3000 per month),
and low income (less than 1000 USD per months).
 Disability: no disability, partial disability, serious or total disability.
 Seriousness of a disease: severe, moderate, mild.
 Agreement with a statement: fully agree, partially agree, and fully disagree.
o Nominal variables: The groups in these variables do not have an order or ranking.
For example
 Sex: Male, female.
 Main food crops: Maize, millet, rice.
 Religion: Christian, Muslim, Hindu, Buddhism.
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 Factors Rephrased as Variables
o Most of what we call factors are variables which have negative values.
o Contributing factors in negative phrase are such as lack of knowledge.
Example:
Factor Variables
 Long waiting time Waiting time
 Absence of drugs Availability of drugs
 Lack of supervision Frequency of supervision
o Quantitative variables:
 Variables which have definitive quantitative values (age in years- 24 year or 4 years
or weight or height) and can be manipulated according to the rules of mathematics.
 Ordinal variables: Variables which do not have numerical values but can be graded
(e.g. level of education as primary school, advanced diploma and bachelor degree or
quality of services as poor, average, good).
 Nominal qualitative variables or attributes (do not belong to either of the above)
examples are marital status-married, single, divorced or gender as male or female.
 For a selected research problem, you may find that you are interested on many
variables, but to make a research manageable, pick few of them and leave others.
 Causes and Associations, and Confounding

Because in health research you often look for causal explanations, it is important to
make a distinction between dependent and independent variables.
 Whether a variable is dependent or independent is determined by, the statement of the
problem and the objectives of the study.
 It is therefore important when designing an analytical study to clearly state which
variable is the dependent and which the independent ones are.
 possible causes of problems, in scientific language is same as
to speak of associations between variables, unless a causal relationship can be proven.
 Confounding variable: Is associated with the problem and with a possible cause of the
problem.
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o A confounding variable may either strengthen or weaken the apparent relationship
between the problem and a possible cause.
Figure :Cause and Effect/outcome
 In order to give a true picture of cause and effect, possible confounding variables must be
considered, either at planning stage or while doing data analysis.
For example:
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o A relationship is shown between compliance with antimalaria treatment and
severe malaria in under-five children. However,mothers education may be related
to compliance with the treament and severe malaria.
o Mothers education is a potential confounding variable. In order to give a true picture
of the relationship between compliance with the treament and severe malaria in under
five children, the influence of mothers education should be controlled.
o This could either be done in the research design, e.g., by selecting only mothers with a
specific level of education, or it can be taken into account in the analysis of the
findings. Then the relation between compilance with antimalaria and severe malaria
would be analyzed separately for mothers with different levels of education.
Figure..;Compliance with antimalaria treatment and Severe malaria
 Background Variables
o Related to a number of independent variables, so they influence the problem
indirectly
o In almost every study, background variables appear, such as
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Age, sex, educational level, socio-economic status, marital status and religion.
 Only background variables important to the study should be measured.
 Background variables are notorious confounders.

 Data analysis involves the production and interpretation of frequencies, tables,
, etc., that describe the data
 Figures make the descriptive data more readable when you have many tables
 Frequency distribution is description of data presented in tabular form

 What figures are used to present data?
 What is variable?
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References

Netherlands

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Session 24: Research Report Writing
Prerequisites
 None
Learning Tasks
 List the main components of a research report
 Make an outline of research report
 Write drafts of report in stages
 Check the final draft of report for completeness
 Draft recommendations for action based on research findings
Resources Needed
SESSION OVERVIEW
Activity/
Step Time Content
Method
Presentation The Main Components of a Research Report
2 15 minutes
Brainstorming
40 minutes Presentation An Outline of Research Report.
3 Group
discussion
4 30 minutes Presentation Drafts of Report in Stages.
5 10 minutes Presentation Checking the Final Draft for Completeness

10 minutes Recommendations for Action Based on Research
6 Presentation
Findings
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SESSION CONTENTS

STEP 2: The Main Components of a Research Report (15 minutes)

Activity: Brainstorming (10 minutes)
Ask students to brainstorm on the following question:
 What are the main components of a research report?
ALLOW few students to respond?
WRITE their responses on the flip chart/ board
CLARIFY and SUMMARISE by using the content below
 The research report outline should contain the following components in the following
order :
o Title and Cover Page
o Summary of Study Design, Findings and Recommendations
o Acknowledgements
o Table of Contents
o List of tables, figures (optional)
o List of abbreviations (optional)
o Introduction (statement of the problem in its local context, including
relevantliterature)
o Objectives
o Methodology
o Research Findings
o Discussion
o Conclusions and Recommendations
o References
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o Annexes (data collection tools; tables)
Note: When assigning page numbers to the report, components bullet number 1-6 use small
Roman Numerals (For example: i, ii, iii, iv, v ).
 Introduction (Component number 7), is Page 1 of the actual report.
 The findings, discussion of findings, conclusions and recommendations will form the
most substantial part of the report, which has to be written from scratch.
 It is strongly advised that start with the findings, discussion and conclusions.
 Write each component in stages as follows:
o Create an outline
o Write Introduction
o Write the Objectives
o Write the Methodology
o Write your Findings
o Discuss your Findings
o Write conclusions and recommendations
o References
o Annex
o Summary
o Acknowledgement
o Table of contents
o Title and Cover page
.STEP 3: An Outline of Research Report (40 minutes)

Activity: Small Group Discussion ( 20 minutes)
 What is an outline of a research report?
ALLOW students to discuss for 10 minutes
ALLOW few groups to present and the rest to add points not mentioned
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CLARIFY and SUMMARIZE by using the following contents
 An outline of a research report:
o Cover page
 The cover page should contain the
 Title
 The names of the authors with their titles and positions,
 The institution that is publishing the report, (e.g., Research Unit, Ministry of
Health) and
 The month and year of publication.
 The title in line with the broad objectives
o Abstract/Summary
 The summary should be written only after the first or even the second draft of the
report has been completed. It should contain:
 A very brief description of the problem (WHY this study was needed)
 The main objectives (WHAT has been studied)
 The place of study (WHERE)
 The type of study and methods used (HOW)
 Major findings and conclusions, followed by
 The major (or all) recommendations
 The summary will be the first part of the study that will be read.
o Acknowledgements
 It is good practice to thank those who supported you technically or financially
in the design and implementation of your study.
 Also your employer who has allowed you to invest time in the study and the
respondents may be acknowledged.
 Acknowledgements are usually placed right after the title page or at the end of
the report, before the references
o Table of contents
 It provides the reader a quick overview of the major sections of your report,
with page references
 List of tables, figures
 List of abbreviations (optional)
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 The table of contents and lists of tables, figures, abbreviations should be
prepared last
o Chapter 1: Introduction
 Contains
 Background information
 Statement of the problem
 Literature review collected during the implementation of the study
o Chapter 2: Objectives
 The general and specific objectives should be included as stated in the proposal.
 You can adjust them slightly for style and sequence.
 If you have not been able to meet some of the objectives state them in the
methodology section and in the discussion of the findings.
o Chapter 3: Methodology
Should be described in detail and include a description of:
 The study type
 The study population(s), sampling method(s) and the size of the sample(s)
 Major study variables
 Data-collection techniques and tools used for the different study populations
 Ethical consideration
o Chapter 4: Research findings
 The systematic presentation of research findings in relation to the research objectives
is the crucial part of a report.
 The description of findings should offer a good combination or triangulation of data
from qualitative and quantitative components of the study
 There are two different ways in presentation of findings:
An integrated presentation of all data by objective
• As you listed all data by objective this should be easy.
• These integrated presentations will be a compilation of tables, graphs,
narrative interpretation and illustrative quotes from in-depth interviews
or FGDs
Presentation of data by research instrument
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• Analyze the data by instrument and integrate the findings only in the
discussion.
• Separate analysis is indicated for objectives that are covered by distinct
study populations using specific instruments
• The list of data by objective will help you to decide how to organise
the presentation of data.
• When all data have been analysed, a detailed OUTLINE has to be
made for the presentation of the findings. This will help the decision-
making on how to organize the data
o Chapter 5: Discussion
The findings can now be discussed by
 Objective or by cluster of related variables or themes,
 The discussion should also include findings from other related studies that support
or contradict your own
o Chapter 6: Conclusions and Recommendations
 They should follow logically from the discussion of the findings
 Conclusions should be short
 It should follow the sequence in which the findings have been presented.
 The recommendations should be summarized according to the groups towards
which they are directed (specific), e.g. Policy-makers, managers, communities,
students etc.
o References
APA
o Annexes or Appendices
They should contain any additional information needed to enable professionals to follow
your research procedures and data analysis.
Examples :
 Tables referred to in the text but not included in order to keep the report short;
 Lists of hospitals, districts, villages etc. That participated in the study
 Questionnaires or check lists used for data collection.
STEP 4: Write Drafts of study Report in Stages (10 minutes)

 Cover page
o The cover page should contain the title, the names of the authors with their titles and
246
positions, the institution that is publishing the report, (e.g. Pharmacy Council of the
MOH Tanzania), the month and year of publication.
o The title could consist of a challenging statement or question, followed by an
informative subtitle covering the content of the study and indicating the area where
the study was implemented.
 Summary
o The summary should be written only after the first or even the second draft of the
report has been completed.
o It should contain:
 A very brief description of the problem (why this study was needed)
 The main objectives (what has been studied)
 The place of study (where)
 The type of study and methods used (how)
 Major findings and conclusions, followed by
 The major (or all) recommendations
 The summary will be the first (and for busy health decision makers most likely the only)
part of your study that will be read.
 Several drafts have to be made, each discussed by the research team as a whole.
o If you collaborated with various groups during the drafting and implementation of the
research proposal, then consider writing different summaries for each of these groups.
o For example, you may prepare different summaries
 For policy makers and health managers
 For health staff of lower levels
 For community members
 For the public at large (newspaper, TV)
o In a later stage you may write articles in scientific journals
 Acknowledgements
o Thank those who supported technically or financially in the design and
implementation of your study.
o Acknowledgements are usually placed right after the title page or at the end of the
report, before the references.
 Table of Contents
o A table of contents is essential
247
o It provides the reader a quick overview of the major sections of your report, with page
references, so that she/he can go through the report in a different order or skip certain
sections.
 List of Tables, Figures
o If there are many tables or figures, then they may be listed in a table of contents type
of format with page numbers.
 List of Abbreviations (optional)
o If abbreviations or acronyms are used in the report, these should be stated in full in
the text the first time they are mentioned
o If there are many, then they should be listed in alphabetical order as well
o The list can be placed before the first chapter of the report.
o The table of contents and lists of tables, figures, abbreviations should be prepared last
o A t this time include the page numbers of all chapters and sub-sections in the table of
contents.
 Finalize the numbering of figures and tables and include all abbreviations.
 Chapter 1: Introduction
o Should contain relevant (environmental/ administrative/ economic/ social)
background data about the country, the health status of the population, and health
service data which are related to the problem that has been studied.
o The statement of the problem should follow
o Relevant literature collected during the implementation of the study.
o It should contain a paragraph on what you hope to achieve with the results of the
study.
 Chapter 2: Objectives
o The general and specific objectives should be included as stated in the proposal.
o If you have not been able to meet some of the objectives this should be stated in the
methodology section and in the discussion of the findings.
o The objectives form the HEART of your study. They determined the methodology
you chose and will determine how you structure the reporting of your findings.
 Chapter 3: Methodology
o The methodology you followed for the collection of your data should be described in
detail. This section should include a description of:
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 The study type;
 Major study themes or variables (a more detailed list of variables on which data was
collected may be annexed);
 The study population(s), sampling method(s) and the size of the sample(s);
 Data-collection techniques used for the different study populations; how the data was
collected and by whom;
 Procedures used for data analysis, including statistical tests (if applicable)
 Chapter 4: Research Findings

o The systematic presentation of the findings in relation to the research objectives is the
crucial part of your report.
o The description of findings should offer a good combination or triangulation of data
from qualitative and quantitative components of the study.
o Prepare an outline for the whole report, taking the main components of a research
report as a point of departure.
o An outline should contain:
 The headings of the main sections of the report
 The headings of subsections,
 The points to be made in each section
 A list of tables figures and/or quotes to illustrate each section
o Example of the outline of the chapter 4 on Research Findings
 4.1 Description of the sample: (e.g., location, age, marital status, education,
social
economic status, of mothers; age and sex of children weight/measured by
research area).
 4.2 Extent and seasonal variation of malnutrition in district X
 4.3 Possible causes of malnutrition
 4.3.1 Limited availability of food
 4.3.2 Non-optimal utilization of available food
 4.3.3 High prevalence of communicable diseases
 4.3.4 Limited access to Reproductive and Child Health (RCH) and weaknesses
in RCH/nutrition services
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o The system of numbering is flexible and can be extended according to need with
further headings or subheadings.
o The outline for the chapter on findings will predictably be the most elaborated.
o The first section under findings is usually a description of the study population.
o If different study populations have been studied, then provide a short description of
each group before presenting the data pertaining to these informants.
o Depending on the study design, provide more information on the problem studied
(size, distribution, characteristics).
o In an analytic study, the degree to which different independent variables influence the
problem has be discussed.
o Tables and figures in the text need numbers and clear titles.
o Include only those tables and figures that present main findings and need more
elaborate discussion in the text.
o The first draft of your findings is never final.
o Therefore you might concentrate primarily on content rather than on style.
o Nevertheless, it is advisable to structure the text from the beginning in paragraph
.
 Chapter 5: Discussion
o The findings can be discussed by objective or by cluster of related variables or
themes, which should lead to conclusions and possible recommendations.
o The discussion may include findings from other related studies that support or
contradict your own.
 Chapter 6: Conclusions and Recommendations

o The conclusions and recommendations should follow logically from the discussion of
the findings.
o Conclusions can be short, as they have already been elaborately discussed in chapter
5.
o As the discussion will follow the sequence in which the findings have been presented
(which in turn depends on your objectives) the conclusions should logically follow the
Specific objectives
o The recommendations may be summarized according to the groups towards which
they are directed, for example:
250
 Policy-makers
 Health and health-related managers at district or lower level
 Health and health-related staff who could implement the activities
 Potential clients
 The community at large
o Remember that action-oriented groups are most interested in this section.
o In making recommendations, use not only the findings of the study, but also
supportive information from other sources.
o The recommendations should take into consideration the local characteristics of the
health system, constraints, feasibility and usefulness of the proposed solutions.
o They should be discussed with all concerned before they are finalized.
o If the recommendations are short (roughly one page), include them all in the summary
and omit them as a separate section in Chapter 6 in order to avoid repetition.
 References
o The references in your text can be numbered in the sequence in which they appear in
the report and then listed in this order in the list of references (Vancouver system).
o Another possibility is the Harvard system of listing in brackets the authors name(s) in
the text followed by the date of the publication and page number, for example:
 Annexes or Appendices
o The annexes should contain any additional information needed to enable professionals
to follow your research procedures and data analysis.
o Information that would be useful to special categories of readers but is not of interest
to the average reader can be included in annexes.
o Examples of information that can be presented in annexes are:
 Tables referred to in the text but not included in order to keep the report short;
 lists of hospitals, districts, villages etc. that participated in the study;
 Questionnaires or check lists used for data collection.
 Revising and Finalizing the Text
o When a first draft of the findings, discussion and conclusions has been completed, all
working group members should read it critically and make comments.
o The following questions should be kept in mind when reading the draft
 Have all important findings been included?
 Do the conclusions follow logically from the findings?
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 If some of the findings contradict each other, has this been discussed and explained, if
possible?
 Have weaknesses in the methodology, if any, been revealed?
 Are there any overlaps in the draft that have to be removed?
 Is it possible to condense the content?
 In general a text gains by shortening. Some parts less relevant for action may be
included in the annex
Check if descriptive paragraphs may be shortened and introduced or finished
by a concluding sentence.
 Do data in the text agree with data in the tables?
 Are all tables consistent (with the same number of informants per variable), are they
numbered in sequence, and do they have clear titles and headings?
 Is the sequence of paragraphs and subsections logical and coherent?
 Is there a smooth connection between successive paragraphs and sections?
 Is the phrasing of findings and conclusions precise and clear?
 For a final check on readability you might skim through the pages and read the first
sentences of each paragraph. If this gives a clear impression of the organization and
results of the study, then one may conclude that you did the best you could.
STEP 5: Checking the Final Draft for Completeness (10 minutes)

 At the outset, researcher must invariably satisfy himself that
o The data are appropriate, trustworthy adequate for drawing inferences;
o The data reflect good homogeneity;
o Proper analysis has been done through statistical methods
 While rewriting and polishing one should check the report for
o Weaknesses in logical development or presentation.
 See whether or not the material, as it is presented, has unity and cohesion;
 The researcher should give due attention to the fact that in his rough draft he has
been consistent or not.
 The researcher should check the mechanics of writinggrammar, spelling and
usage
 The report being written in a concise and objective style and in simple language,
 Vague expressions has been the researcher has to avoid abstract terminology and
technical jargon
252
 Checking whether the format has been followed
 Revising and finalizing the text
o When a first draft of the findings, discussion and conclusions has been completed, all
working group members and facilitators should read it critically and make comments.
o The following questions should be kept in mind when reading the draft:
 Have all important findings been included?
 Do the conclusions follow logically from the findings?
 Have weaknesses in the methodology, if any, been revealed?
 Are there any overlaps in the draft that have to be removed?
 Is it possible to condense the content?.
 Do data in the text agree with data in the tables and figures? Are all tables and
figures consistent (with the same number of informants per variable), are they
numbered in sequence, and do they have clear titles and headings?
 Is the sequence of paragraphs and subsections logical and coherent? Is there a
smooth connection between successive paragraphs and sections? Is the phrasing of
findings and conclusions precise and clear?
STEP 6: Drafting Recommendations for Operational Research Findings
(10 Minutes)
 Recommendations
o They should follow logically from the discussion of the findings
o It should follow the sequence in which the findings have been presented.
o The recommendations should be summarised according to the groups towards which
they are directed (specific), e.g.
 Policy-makers, managers, communities, students etc.

 Research report is normally written in stages starting with clarifying the nature of the
planned report, and its intended audience
 Recommendations should follow logically from the discussion of the findings

 What are the main components of a research report?
253
 What is an outline of a research report?
References
Netherlands

254
Session 25: Methods for Dissemination of Research
Findings
Total Session Time: Time: 120 minutes + 240.minutes assignment
Prerequisites
 None
Learning Tasks
 Define dissemination of research findings
 List various dissemination channel and tools
 Describe dissemination strategy of research finings
 List dissemination content of research findings
Resources Needed
SESSION OVERVIEW
Activity/
Step Time Content
Method
Presentation
2 10 minutes Definition of Dissemination of Research Findings
Buzzing
3 Group Dissemination Channel and Tools
discussion
35 minutes
4 Presentation Dissemination Strategy of Research Findings
10 minutes
5 Presentation Dissemination Content of Research Findings
255
SESSION CONTENTS

STEP 2: Definition of Dissemination of Research Findings (10 minutes)
Activity: Buzzing ( 5 minutes)
ASK students to pair up and buzz on the following question for 2 minutes:
 What is dissemination of research findings?
ALLOW few pairs to respond and let other pairs to add on points not mentioned
WRITE their response on the flip chart/board
CLARIFY and SUMMARIZE by using the content below
 Dissemination is defined as, A planned process that involves consideration of target

audiences and the settings in which research findings are to be received and, where
appropriate, communicating and interacting with wider policy and health service
audiences in ways that will facilitate research uptake in decision-making
STEP 3: Dissemination Channel and Tools (40minutes)

Activity: Small Group Discussion ( 20 minutes)
 What are dissemination channels and tools of research findings?
ALLOW students to discuss for 10 minutes
ALLOW few groups to present and the rest to add points not mentioned
CLARIFY and SUMMARIZE by using the contents below
256
 The following are dissemination channels
o Community meetings
o Interpersonal communication
o Local events
o Web sites
o Email messages
o Project team conference/meetings
o Policy briefs
o Dissemination workshops
o Technical reports
o Scientific seminars
o Mass media
o Scientific publication
o Communication of research findings
 Some of the channels and their instruments are shown as follows:
Information channels Instruments

Community/Village Report summaries
meetings Overheads
Posters
Oral explanation
Discussion
Regular meetings Discussion,reports
Personal briefings
Mass media Mass media materials for schools, newspaper articles and
radio broadcasts on planned and implemented activities
 Select appropriate information channels

o Interpersonal communication
Partners identified should normally be informed through interpersonal
communication.
o Regular meeting
The DHMT would be best approached at a regular meeting. Similarly, a meeting
of village leaders could be easily convened, together with VDC and VHC
members, VHW religions leaders and representatives of womens groups
257
o Personal briefings
Personal briefings would have to be organized between research team members
and the Ministry of Health Community Development Gender Elderly And
Children
o Mass media
When action is planned, one should also think of the mass media as information
channel:
 Newspapers,
 Radio,
 TV,
 Posters.
These are effective in disseminating information to a wide range of audiences
Mass media and interpersonal channels may fruitfully complement each other
o Identify key contact persons in each news organization, including reporters who cover the
area of your research,
 Approach them through a letter to the news editor including relevant information
about your study
o Existing summaries of the study may be used
o Articles in research journals
o Presentation of research results to interested students and staff
To present results from research at research days to a selected group of health
managers and health researchers
STEP 4: Dissemination Strategy of Research Findings (35 minutes)

 Planning for the Dissemination, Communication and Utilization of Research Results
o The beneficiaries of research are not only the health professionals.
Promote and increase the utilization of the research results among all potential
users, varying from community members to donor agencies.
 Plan on how the results of the study could be used.
 Think of who will be interested in the Results?
o Depending on the topic selected, the results may be useful to the community, staff and
managers of health and health-related services and to researchers and donor agencies
258
in your own local area, as well as others.
o Research team and program should benefit from the results, as they have developed
the proposal to help solve one of their own priority problems.
 Strategies to Ensure the Results of the Study will be Used
o Involve relevant authorities, staff and community members in the selection of the
topic and in the definition of your problem.
o List two or three major recommendations you expect to obtain from the study
o Identify who should be involved in their implementation.
o Distinguish between two categories of people who should be involved.
 Those who authorize you to implement the recommendations.
 Partners in the implementation process.
 Identify which communication channels already exist which can be used to discuss and
disseminate results.
 Channels for discussing and disseminating results may include
o Provincial or district development team meetings.
o Provincial or district health team meetings.
o Supervisory visits to health facilities involved, staff meetings.
o Mobile clinics or other health activities carried out in villages included in the study,
monthly meetings of village health workers when they collect drugs, meetings of
village health committees.
 Determine what written materials should be prepared to keep relevant parties informed.
 They may include:
o A one to two page summary of the project proposal that includes details on expected
results to distribute when you introduce the project to policy makers and staff
concerned.
o An introductory statement to use with interview guides and questionnaires, explaining
to informants the purpose and procedures of the study, as well as expected results.
 A progress report of four to five pages, including preliminary findings and
recommendations, should be prepared for presentation of the data analysis and report
writing workshop.
o Used to inform authorities that will be crucial to utilization of project results.
 To obtain feedback from decision makers and target groups in the community, you will
259
need a different summary, concentrating in simple words on the findings and preliminary
recommendations that directly concern them.
 Make sure that summaries of your findings and preliminary recommendations are adapted
to the level of understanding and interests of different audiences
o This will increase their motivation to provide thorough feedback and to participate in
the implementation of the final recommendations collectively agreed up on.
 Determine whether additional actions should be taken or mechanisms developed to
discuss the study results with all parties concerned and obtain their input, approval and
co-operation for the implementation of the recommendations
 Key Steps
 Develop and use a systematic dissemination and communication strategy for reaching
different audiences of potential users.
 Present the research results to all stakeholders and obtain feedback on findings and
recommendations.
 Develop a plan of action to promote the implementation of the recommendations that
 resulted from the study.
STEP 5: Dissemination Contents of Research Findings (10 minutes)
 Technical issues
 Societal issues
 Ethical issues
 Personnel/organizational issues

 A strategy for dissemination and communication to promote utilization of research
findings should be developed, taking into account the major contributing factors and
proposed actions to solve it
 The consideration of appropriate channels is an essential step, the types of

communications tools that are practical, reach the right audiences and within the available
budgets

 What are dissemination channels?
 What are dissemination contents?
 What are dissemination strategy?
260
261
References
World Health Organization (2014). Disseminating the Research Findings, module 5, WHO
Document Production Services, Geneva, Switzerland.
(https://www.who.int/tdr/publications/year/2014/participant-workbook5_030414.pdf
accessed 15/12/2018)

262

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UNITED REPUBLIC OF TANZANIA

Ministry of Health, Community Development, Gender, Elderly and Children

PST 06210 Operational

Copyright © Ministry of Health, Community Development, Gender, Elderly and Children 

Through Public-Private-Partnership (PPP) the Pharmacy Council (PC) together with

These participants are listed with our gratitude below:

Ms. Elizabeth Shekalaghe Registrar, Pharmacy Council of Tanzania

Dr. Loishooki S. Laizer

Organization of the Module

 Session Title: The name of the session

Instructions for Use and Facilitators Preparation

Preparation with Handouts and Worksheets

Using Students Manual When Teaching

AIDS Acquired Immune Deficiency Syndrome

CBHC Community Based Health Care

CEDHA Centre for Educational Development in Health Arusha

CME Continue in  service medical education

COSTECH Commission Science and Technology

CSSC Christian Social Service Commission

CUHAS Catholic University of Health and Allied Science

DIC Drug information center

DIC Drug information center

DMO District Medical Officer

DTC Drug therapeutic committee

EML Essential medicines list

HIV Human Immunodeficiency Virus

INN International non-proprietary name

LCD Liquid Crystal Device

MAP Multi actor partnership

MRCC Medical Research Coordinating

MUHAS Muhimbili University of Health and Allied Science

NACTE National Council for Technical Education

Nat HREC National Health Research Ethics Committee

NEMLT National essential medicine list

NID National Immunization Day

NTA National Technical Award

PTIs Pharmaceutical Training Institutions

RuCU Ruaha Catholic University

SIBS Spring Institute for Business and Science

STGs Standard treatment guidelines

TFDA Tanzania food and drug authority

UNICEF United Nations International Childrens Emergency Fund

USAID United States Agency for International Development

WHO World Health Organization

Total Session Time: 120 minutes + 120 minutes assignment

2 30 minutes Presentation Definitions of common terms in Biostatistics

6 05 minutes Presentation Evaluation

ASK students if they have any questions before continuing

STEP 2: Definition of common terms in Biostatistics (30 minutes)

Mean, arithmetic mean (X or M):

STEP 3:Importance of Measures in Statistics (45 minutes)

STEP 4: Application of Statistics in Data Analysis (30Minutes)

STEP 5: Key Points (5 minutes)

STEP 6: Evaluation (5 minutes)

Anderson, D.R., Sweeney, D.J., Williams, T.A., Freeman, J. &Shoesmith, E. (2007).

Beaglehole R, Bonita R and Kjellstrom (1993) Basic epidemiology: Geneva, Switzerland:

Total Session Time: 120 minutes + 240 minutes assignment

8 05 minutes Presentation Evaluation

ASK students if they have any questions before continuing

STEP 2: Definition of Data (10 minutes)

Copyright © Ministry of Health, Community Development, Gender, Elderly and Children

CME Continue in service medical education

STGs Standard treatment guidelines

UNICEF United Nations International Childrens Emergency Fund