? What is research.

1
1.1 Literally :
 Investigation undertaken in order to
discover new facts or get additional
information.
 To search again.

1.2 Scientifically :
 The systematic collection, analysis and
interpretation of data to answer certain
question or to solve a problem.
1.3 Characteristics of research :

 It demands a clear statement of the

problem.
 It requires a plan.
 It builds on existing data.
 It collects new data.
1.4 Research purposes :

Research serves two major purposes:

1- Generates new knowledge and
technologies to deal with major
unresolved health problems (basic
research) .

2. Identifies priority problems and designs

and evaluates policies and programs
(applied research) .
 1.5 Steps in development of research proposal

Questions to ask Steps Elements of steps

1. What is the problem and - Problem identification.
why should it be studied? Selection, analysis and - Problem priorization.
statement of the
research problem - Problem analysis.

- Problem definition.

Literature review
2. What is information is - Look for possible sources of
already available information.
- Review available
information.
- Present information needed.

- Avoid bias.

- Refer to author.

3. What do we want to carry - General objectives.

out the research? Formation of objective - Specific objectives.
What do we hope to - Hypothesis.
achieve?
 Cont.

Questions to ask Steps Elements of steps

4. What data needed?  Variables.
 How much is needed?  Type of the study.

 How to collected?  Data collection techniques.

 How to process and Research methodology  Sampling.

analyze?  Plan for data collection.

 Plan for data processing and

analysis.
 Ethical consideration.

 Pre-test or pilot study.

5. Who will do what and when Work-plan  Personnel.

and where?  Time table.

6. How to manage the  Administration.

project? Plan for project
administration
 Monitoring.

7. What resources are  Material support and

needed for carrying out the Budget equipment.
study?  logistics.

 Money.
 2. Statement of the research problem
2.1 Problem identification :
“ Problem is a discrepancy between what should be and what is existing”
. A well defined problem leads to good statement of research problem,
. Finding a problem is not hard but identifying one for research is not always
easy.
hypothesis, definition of key variables and selection of appropriate
methodology.

2.1.1. Criteria
Research problem has three criteria:

1. Perceived discrepancy between what is and what should be.

2. A question about why the discrepancy exists.
3. More than one possible and plausible answers to the question.
2.1.2. Example of non research problem

Problem situation:
In village x 1000 children should be immunized but not a
single is immunized.

Discrepancy:
1000 children should be immunized but no child is
immunized.

Problem question:
what factors are responsible for failure of immunizing the
children.

Answer:
No vaccines are available.
2.1.3. Example of research problem

Problem situation:
In village Z 60% of the children who are candidates for immunization are
not immunized.
Discrepancy:
100% of candidates for immunization should be immunized but only
40% are immunized.

Problem question:
What factors are responsible for failure of immunizing 60% of candidates
for immunization?

Possible answers:
1- The health worker is not exerting necessary efforts to cover the children
with immunization.
2- There is shortage of supplies.
3- The mothers are not willing to immunize their children.
Prioritizing problems for research:
Seven criteria are used for selecting a research topic. Final score for each
topic can be calculated by multiplication of the scores for all criteria:

1. Relevance :
- Not relevant = 0
- Relevant = 1
- Very relevant = 2

2. Avoidance of duplication :
- Sufficient information already available = 1
- Some information available = 2
- No information available = 3
3. Feasibility :
- Study not feasible considering available resources = 1
- Study feasible considering available resources = 2
- Study very feasible considering available resources = 3
4. Political acceptability :
- Topic not accepted to policy makers = 0
- Topic more or less accepted = 1
- Topic fully accepted = 2
 Cont.

5. Applicability :
- No chance of recommendations being implemented = 1
- Some chance of recommendations being implemented = 2
- good chance of recommendations being implemented = 3

6. Urgency :
- Information not urgently needed = 1
- Information is needed but delay is acceptable = 2
- Information very urgently needed for decision making = 3

7. Ethical acceptability :

- Not ethically accepted = 0

- Minor ethical problem = 1
- No ethical problem = 2
 2.3. Problem analysis
Once the problem has been identified and justified in depth analysis
of the problem needed.
Problem analysis focus on two issues :
1. Identify factors that may have contributed to the problem.
2. Clarify the relationship between the problem and contributing
factors.

Problem analysis diagram helps to visualize the interrelationship

between the problem and the contributing factors.
Contributing factors in general, could be grouped into three main
categories :
Service- related factors.
Disease related factors.
Socio- cultural factors.
 Elements of the problem analysis diagram :

Factor Proble
m

Factor

Problem analysis diagram (PAD) is composed of a central cell

( the problem) surrounded by peripheral cells (factor) and
arrows denoting the relation between the factors and problem
and the factors among themselves. PAD is very important for
selection and designing of data collection tools. All factors
that appear in PAD should be addressed in the questionnaire
e.g. age, occupation or in the observation checklist e.g. weight,
height. If weight is a factor there is a need for weighing scale,
if height is a factor there is a need for measuring tape and if
presence of a parasite in blood is a factor there is a need for a
microscope and special stain.
 Problem analysis diagram

Factor
Factor
Facto
r

Proble
m

Facto
r

Factor
 3. Literature Review

3.1 Why we review literature?

1. To prevent duplication.
2. To refine statement of the problem.
3. To formulate the suitable type of methodology.
4. To support the argument for need of the research.

3.2. Possible sources of the information

1. Individuals, groups and organizations.
2. Published information ( books, articles, indexes and abstracts journals ) .
3. Unpublished information (reports, records and computer data bases).
3.3. How to refer to source :

3.3.1. For an article :

Author (s) (Surname followed by initials), title of article, name of journal,
year, volume number : page numbers
e.g. Gwebu ET , Metero S, Dube N, Tagwirey J T, Mugwagwa N, Assessment
of nutritional status in pregnancy : Use of reference table of weight for
height, Central Africa Journal of Medicine, 1985, 31: 193- 196.

3.3.2 For a book :

Author (s) (surname followed by initials) title of book, edition, place:
publisher, year: number of pages in the book.
e.g. Abramson JH, Survey method in community medicine, 2nd edition
Edinburgh: Churchill Livingstone, 1979: 229.
3.5. Sources of information at different administrative level

Administrative level

Clinic and hospital based data from routine -

.statistics registers
Opinions; beliefs of key figures (through --
.(interview
Community and
District or Clinical observations, reports of clinical -
provincial level ;incidents ect
.Local surveys -
,Annual reports -
Statistics issued at provincial and district -
.level
Cont.

Articles from national journals --

National level
books identified during
literature searches at university
.and other national libraries
Documentation reports and raw -
data from ministry of health,
.central statistical offices NGOs
Cont.

: Information form
Bilateral and multilateral --
International
levels
Organizations e.g. (USAIL -
.(UNICEF ,WHO, UNFPA
Computerized searches for -
.international literature
 4. Research objectives
4.1. What is objective?
The objectives of a research project summarize what is to be
achieved by the study . The objective answers three main
questions “what, where, why”

4.2. Criteria of research objective :

. A well prepared objective satisfy the following criteria :

S Specific
M Measurable
A Achievable
R Realistic
T Timely
4.3. Role of research objective :

It helps to :
1- Focus the study
2- Avoid collection of unnecessary data
3- Organize the study in defined parts or phases.
4.4. How to state objectives:

An objectives should :
1- Cover the problem and contributing factor in coherent way
and logical sequence .
2- Be clearly phrased in operational terms.
3- Be realistic considering local condition.
4- Use action verb which are specific enough to be evaluated.
e.g. to compare , to calculate, to describe . Avoid to
understand to study, to appreciate
4.5 Categories of research objectives:

. Objectives of research are of two categories

4.5.1. General objective:

State what is expected to be achieved by the study in
general terms.

4.5.2. Specific objective:

Is the breakdown of the general objectives into
smaller, logically connected parts.
Examples :

General Objective :

“To test the validity of the syndromic approach as

diagnostic procedure for sexually transmitted diseases
and to assess its applicability by the medical
assistants at the primary care level in order to help
policy makers take decisions to adopt it as measure
for control of STDs”
Specific Objectives:

1.” To compare the sensitivity, specificity and predictive value of

the syndromic approach in diagnosis of gonococcal urethritis
in cases of urethral discharge encountered during the study
period in Mayo with that of the a etiological approach “

2.” To assess the antibiotic sensitivity of the gonococcus

gonorrhea organism or other organisms isolated from urethral
swabs of the cases of urethral discharge studies to the
antibiotics recommended by the syndromic approach for
treatment of urethral discharge”
Cont.

3. To compare the cost per patient of gonococcal urethritis

treated by syndromic approach during the study period with
the cost per patient if treated with a etiological approach.

4. “ To assess the capability of the medical assistants trained in

this study of correctly applying the syndromic approach for
management of STDs”.
 4.6 . Hypothesis

“Hypothesis is a prediction of a relationship between one or

more factors and the problem under study which can be
tested”.

4.7. Title of the study

* When objectives are well defined and a hypothesis is
formulated the title for the study can easy be generated.
Cont.
* Criteria for the title:
1. Aim specific: “telling exactly what your study aim at.”
2. Place specific: “telling where you undergo the study.”
3. Time specific: “telling when you undergo the study.”

Example
Wrong : “a study of utilization of child welfare clinics”
Correct : “a study of the reasons for low utilization of child
welfare clinics in Khartoum state during the
year 1999”
5. Research
Methodology
5.1. Diagram of Components

Questions asked Component of research design

3. What new information do we need? Selection of variables

8. How will we collect this Selection of type

information? study
Cont.

3. What tool do we need to collect it? Selection of data collection

Techniques and tools

4. Where should we collect it?

How many subjects do we include in the Sampling
study?
How do we select them?

5. How do we collect the data? Plan for data collection

Cont.

6. What will we do with collected data? Plan for data processing and
analysis

7. Are we going to cause harm as a result Ethical consideration

of the study?

8. Are the methods for data collection

correct? Do they need adjustment?
Pre-testing methodology
5.2. Selection of variables

5.2.1. What is a variable?

“A variable is a characteristic of person, object or phenomenon that can take on
different values .”
A variable could be expressed in number ( numerical variable) or in categories
(categorical variables.)

5.2.2. Examples of variables:

Numerical (Quantitative) :
age, weight, monthly income, distance between home and clinic, waiting time in
clinic…etc.
Categorical ( Qualitative ) :
color, outcome of disease, level of knowledge…etc.
5.2.3. Factors and variables :

Factors contributing to the problem in the problem analysis diagram are actually
variables having negative or positive values factors can be transformed into
variables as follows :

Factor Variable

- long waiting time - waiting time.

- Absence of drugs - availability of drugs.
- Lack of supervision - frequency of supervisory
visits.
 5.2.4. Types of variables

1. Dependent variables: the variable used to describe or measure the problem

under study it is affected by change in the independent variable e.g. serum level
of iodine in simple goiter.

3. Independent variable: the variable used to describe or measure the factors that
are assumed to cause or influence the problem e.g. iodine intake in case of
simple goiter.

5. Confounding variable: a variable that is associated with the problem and with a
possible cause of the problem e.g. living at high altitude for cases of simple
goiter. A confounding variable may either strengthen or weaken the apparent
relationship between the problem and a possible cause.

7. Background variable: such as age, sex, level of education, socioeconomic status

and religion if they are not dependent, independent or confounding variables in
the study.
5.2.5. Operationalization of variables:
Some variables are directly measurable e.g. (age) “level of knowledge” these need to
be operationalized.

*Operationalizing a variable means making it measurable. That us possible by using

certain indicators e.g.:
The variable “level of knowledge: is not measurable . It needs
Operationalization . A series of 15 questions can be designed to assess the level
of knowledge . Answering correctly 0 – 5 question is poor knowledge, 6 – 10
questions is reasonable knowledge, 11 – 15 questions is good knowledge. The
number of questions answered is the indicator for Operationalizing the variable.

5.2.6. Scales for measurement of variables:

1. Nominal scale.
2. Ordinal scale.
3. Ratio scale.
4. Interval scale.
5.2.7. Diagram for classification of variables

Binary (sex)
Qualitative Nomina
l
(categorical)
Ordinal Non-numerical
Variables (colour)

Discrete

Quantitativ
e Continuou
(numerical) s
5.3. Selection of type of study
5.3.1. How to select study design?
The type of study design selected depends on :
4. The type of the problem.
5. The knowledge already available about the problem.
6. The resources available for the study.

5.3.2. Classification of study types

depends on research strategy. Two major types exist :
 Observational studies (non-intervention studies).
 Experimental studies (intervention studies).

5.3.3. Non intervention studies:

Non-intervention studies include :
- Exploratory studies.
- Descriptive studies.
- Comparative (analytical).
5.3.3.1.Exploratory studies :

An exploratory study is a small-scale study of relatively short duration, which

is carried out when little is known about a situation or a problem.
Small-scale studies that compare extreme groups are very useful for detecting
management problems. Comparison is a fundamental research strategy to
identify variables that help explain why one group of persons or objects differ from
another. Small scale studies may be called exploratory case studies if they lead to
plausible assumption about the causes of the problem and explanatory case studies
if they provide sufficient explanations.
If the problem and its contributing factors are not well-defined it is always
advisable to do an exploratory study before doing a large scale descriptive or
comparative study.
 5.3.3.2. Descriptive studies :

- A descriptive study involves the systematic collection and presentation of data to

give a clear picture of particular situation.
- Descriptive study is concerned with observing and describing the distribution of disease
or health related characteristics by time , place, and person.
- Procedures involved in descriptive studies include:
1. Defining the population under study.

2. Defining the disease under study (operational definition rather than clinical definition)

3. Describing the diseases by: time, place, and person.

4. Measurement of disease.

5. Comparing with known indices.

6. Formulation of an aetiological hypothesis.

 Cont.

Cross-sectional surveys are example of descriptive studies that aim at quantifying the
distribution of certain variables in the study population at one point of time e.g.

Prevalence surveys

* Physical characteristics as

Evaluation of coverage

* Socio-economic characteristics : behavior, knowledge, attitudes, beliefs,

opinions etc.

Cross-sectional surveys cover a sample of the population.

If the total population it is called a census.
5.3.3.3. Analytical studies:

Descriptive Analytical
- Look at entire population - individual within the
- Formulate hypothesis - test hypothesis.

An analytical study attempts to establish causes or risk factors for certain

problems.
This is done by comparing two or more groups some of which have or develop the
problem and some of which have not.
Analytical studies comprise two types of observational studies:
- Case control study.
- Cohort study.
5.3.3.1. Case control study. “ retrospective studies ”:

The case control study is the first approach to test hypothesis.

5.3.3.3.1.(a). Criteria :
Case control study has three important criteria:
a- Both exposure and outcome occurred before the start of the study.
b- The study proceeds backwards from effect to cause.
c- It uses a control or comparison group to support or to refute an inference.

5.3.3.3.1(b). Steps :
There are four basic steps in conducting a case control study:
1. Selection of cases and controls.
2. Matching.
3. Measurement of exposure.
4. Analysis and interpretation.
 1. Selection of cases and control

* Selection of cases :
(a) Definition of a case:
- Diagnostic criteria e.g. ( for malaria are signs and symptoms enough or is
blood film is mandatory ).
- Eligibility criteria e.g. are all cases could be included or only new cases.
(b) Sources of cases:
- hospital.
- general population.
 Cont

* Selection of controls
Controls must be:
- free from the disease under the study.
- as similar as possible to cases.

Sources of control:
- Hospitals “ source of selection bias”
- Relatives “ spouses and siblings ”siblings are not suitable when
studying genetic conditions.
- Neighbors.
- general population.
How many controls are needed?
- If cases are many, one control for each case.
- If cases are less than 50, take 2,3or 4 controls for a cases.
2. Matching:
- “ Is defined as the process by which we select controls similar to cases in certain
confounding variables ( e.g. age ) which are known to influence the outcome of the
disease .”
- Is used to ensure comparability between cases and controls.
- A confounding variable is a variable associated with the exposure and the
outcome.
- Matching procedures include:
- Stratification of cases based on
e.g. age, occupation, social class.

- Group matching - Establish appropriate controls.

- Keep the frequency distribution of the
matched variables similar in
study and control groups.

- Matching by pairs : for each case a control is chosen.

3. Measurement of exposure:
By interview, questionnaire, study past records.

4. Analysis:
(1) find out exposure rates among cases and controls.
(2) Estimate disease risk associated with exposure (odds ratio)

- Relative risk = incidence among exposed

incidence among non exposed

- Odds ratio (cross product ratio)

5.3.3.1.(c) Advantages and Disadvantages of case control study:

(a) Advantages:
1. Relatively easy to carry out.
2. Rapid and inexpensive (compared with cohort study).
3. Require comparatively few subjects.
4. Particularly suitable to investigate rare diseases or diseases
about which little is known.
5. No risk to subjects.
6. Allows the study of several different aetiological factors (e.g.
sinking , physical activity and personality characteristics in
myocardial infarction).
7. Risk factors can be identified. Rational prevention and control
programmes can be established.
8. No attrition problems, because case control studies do not
require follow-up of individuals into the future.
9. Ethical problems.
Cont

(b) Disadvantages :

1. Problems of bias, e.g. relies on memory or past records, the accuracy of which
may be uncertain, validation of information obtained is difficult or sometimes
impossible.
2. Selection of an appropriate control group may be difficult.
3. We can not measure incidence, and can only estimate the relative risk.
4. Do not distinguish between causes and associated factors.
5. Not suited to the evaluation of therapy or prophylaxis of disease.
6. Another major concern is the representative ness of cases and controls.
 Diagram of case control study
Past
Present Risk factor present

Cases
Risk factor not
present

Compare

Risk factor present

Control
Risk factor not
present
 Frame-work of case control study
(The 2X2 contingency table)
Control (disease not
Risk factor Cases (disease present)
present
a b
Present
c d
Absent
a+c b+d
Total

d rates :
es =a for control = b
a+b b+d

e risk =a / c
a+b c+d

atio =axd
bxc
5.3.3.3.2. Cohort study (prospective study –
longitudinal study):

(a) Definition :
- Cohort is defined as a group of people who share a common
characteristic or experience within a defined period of time .

(b) Criteria :
- It has three important criteria.
a- Cohort are identified before the appearance of the disease.
b- Study groups observed over a period of time.
c- study proceeds from cause to disease.

(c) Role :
- Obtain evidence to support or refuse an association between
suspected risk factor and disease.
- Cohort study are the only sure way to establish causal relationship.
(d) Diagram of Cohort study
Present Future

Developed disease
Exposure to
risk
No disease

Compare

Developed disease
Not exposed
risk
No disease
(e) Frame work of cohort study

Cohort Disease developed Total

No
Yes
Exposed a+b
b a

Not exposed c+d

d c
Incidence of disease in the exposed = a
a+b

Incidence of disease in the non exposed = c

c +d

Relative risk = a / c
a+b c+d

Attributable risk =
a - c
a+b c+d
a
a+b
 (f) Types of cohort study :

1 - Prospective cohort study

2 - Retrospective cohort study , historical cohort study, prospective study

in retrospective or non-concurrent prospective study

3 - Combination of retrospective and prospective cohort studies.

eps of a cohort study :

1 - Selection of study subjects.

2 - Obtaining data on exposure.

3- Selection of comparison groups.

w up.
is.
 Selection of study subjects:

a – General population ( if exposure is frequent).

b – Special groups :
- Select groups(e.g professional group, doctors etc).

- Exposure groups.

ning data on exposure from :

a – Cohort members.
b – Review records.
c – Medical examination or special tests.
d – Environmental surveys.
Information about exposure should tell about :
1 – whether exposed or not.
2 – Level or degree of exposure.
 Selection of comparison groups:

(1) Internal comparison (different levels and duration of exposure).

(2) External comparisons.
(3) Comparisons with general population rates.

ow up :

eriodic medical examination.

Reviewing physician and hospital records.
Routine surveillance of death records.
Mailed questionnaires etc.
Analysis in terms of :

1- Incidence rate of outcome among exposed and non-exposed

2- Estimation of risk :

Relative = incidence of disease among exposed

Incidence of disease among non-exposed

Attributable risk =Incidence of disease among exposed – Incidence of disease among non-exposed
Incidence rate among exposed
 Case control Cohort study
1 Proceeds from ``effect to cause`` Proceeds from ``cause to effect``

2 Starts with the disease Start with people exposed to risk

factor or suspected cause.

3 Test whether the suspected cause Tests whether the disease occurs
occurs more frequently in those more frequently in those exposed ,
with the disease than among those than in those not similarly exposed
without the disease

4 Usually the first approach to the Reserved for testing of precisely

testing of a hypothesis, but also formulated hypothesis
useful for exploratory studies
 Cont.
Case control
5 Involves fewer number of
subjects
6 Yields relatively quick results
7 Suitable for the study of rare
diseases
Generally yield only estimate
8
of RR (odds ratio)
9 Cannot yield information
about disease other than that
selected for study
Relatively inexpensive
10
Cohort study
Involves large number of
subjects
Long fellow-up period often
needed, involving delayed
results
Inappropriate when the disease
or exposure under investigation
is rare
Yields incidence rate, RR as
well as AR
Cannot yield information about
more than one disease outcome
Expensive
5.3.4. intervention studies :

“It involves manipulation of a situation and measurement of the effect of this

manipulation”
Two categories exist :
1- Experimental studies.
2- Quasi-experimental studies.

5.3.4.1. Experimental studies :

5.3.4.1.1. Role :
- An experimental design is the only type of study design that can
actually prove causation.
5.3.4.1.2. Methodology :

- in experimental study individuals are randomly allocated to two groups. One group
is subject to intervention or experiment while the other is not. The outcome of the
intervention is measured by comparing the two groups later after.

5.3.4.1..3. Characteristics:
- Experimental design has three characteristics:
1- Randomization.
2- Control.
3- Manipulation.
5.3.4.1.3. Diagram of experimental study :
Study population

Sampling
Study population

Randomization

Study group Comparison group

First data collection First data collection

(before intervention) (same as in study group)

Intervention
(manipulation)
Last data collection Last data collection
(after intervention) (same time as in study
group)
Compare
Randomization eliminates the effect of confounding variables.
5.3.4.2. Quasi experimental studies:
5.3.4.2.1. characteristics:
* Inquasi experimental study there is an intervention and at least
one characteristic of a true experimental study is missing (either
randomization or control).

5.3.4.2.2. Diagram of a quasi-experimental study

Study group intervention study group
(after intervention)
compare

Control group non-intervention control group

(same time) (same time)
5.3.4.2.3. Before and after study :

* If there is neither randomization nor the use of a control group, the study
design is called pre-experimental design or (before and after study ).

Study group Intervention Study group

(after intervention )

Compare
5.3.5. Deriving Valid and reliable conclusions

“Whatever the research design selected the main concern is to reach valid and
reliable conclusion “.
“Validity means that the conclusions are true”.
“Reliability means that if someone else is using the same methods in the same
circumstances he will obtain the same results”.
Representation of validity and reliability combinations for 5 trials

...
..
......
...
..

Valid and reliable Reliable but not valid

.
.
. .
…
. .
. .
.
.

Valid but not reliable Neither valid nor reliable

5.3.6. Threats to validity

Many factors can distort the study and affect either its internal
validity or external validity. Internal validity means reaching true
conclusions for the study . External validity means that the true
conclusions of the study are fairly generalizable.
Factors affecting the external validity (selection bias):

- sampling of registered cases

- non-response
- studying volunteers
Sampling
Bias

- missing cases of short duration (fatal cases/mild cases)

- taramic bias.
- seasonal bias.
- migration bias.
- perkson ‘s bias.
Factors affecting the internal validity (instrument bias)
* Faulty instrument.
- Poorly designed questionnaire.
- Defective measurement tool ( sphygmomanometer, balance,
scale….etc)
* Faulty measurement
-Inter-observer bias. Recall bias
- Intra-observer bias.
Hidden events (sad
- Respondents bias. (events
Please
interviewer

* Faulty adjustment
- Confounding.
5.4. Selection of data collection techniques

5.4.1. What is data collection technique ?

“Data collection technique is a technique that allows researcher to
systematically collect information about the study population ( people objects,
phenomena….etc) and the setting in which they occur”
 5.4.2. Types of data collection techniques:

Many data collection techniques can be used. All of them are either
based on ASKING or OBSERVING e.g. :
1- Using available information.
2- Observing.
3- Interviewing. ( face to face ).
4- Administering written questionnaires.
5- Focus group discussions (FGD).
6- Nominal group techniques (NGT).
7- Delphi technique.
Cont.

8- Life histories taking.

9- Scales and test batteries.
10-Essay analysis.
11-Case studies.
12-Mapping.
13-Rapid appraisal techniques.
14-Participatory research.
A single study may involve more than one technique.

5.4.3. What is data collection tool ?

“ Data collection tools are the tools applied in data collection. A
particular technique can involve different tools”
5.4.4. Example of tools

- Questionnaire.
- Weighing scale.
- Measuring tabe.
- Sphygmomanometer.
- Observation checklists.
- Microscope.
Data collection techniques and data collection
tools used:
Data collection techniques Data collection tools
Using available information Checklist, data compilation forms

Observing Observation checklist, eyes and other senses, pen and paper,
watch, scales, microscope
Interviewing Interview schedule, checklist, questionnaire, tape recorder

Administering written questionnaire Open ended questionnaire, closed questionnaire

Focus group discussion Focus questions, checklist of topics

Nominal group technique NGT statement or question, paper and pens, board, listing
ideas, individual expression, discussion, voting and
ranking, discussion, 2nd vote and ranking
Delphi technique Circulating questionnaire

Life history taking Key questions

Scale and test batteries Highly structured questionnaire with highly standardized
sequence of questions
Essay analysis School children hand-writing books

Case studies Checklist

Mapping Paper and pen, measuring ruler or tabe

5.5. Sampling
5.5.1. Definition
“Sampling is the selection of a number of study units from a defined study population.”

Target Study
Population Population Ssmple Sample

“A representative sample has all the important characteristics of the population

from which it is drawn”
5.5.2. Sampling questions

For sampling we need to answer 3 questions :

1- What is the group of people from which we want to draw a sample? (study
population).
2- How many people do we need in our sample? (sample size).
3- How will these people be selected? (sampling procedures).
5.5.3. Choice of sampling method :

* Choice of sampling method depends on availability of sampling frame.

“ Sampling frame is a list of all the units that compose the study population”

Non-probability Probability
Sampling Sampling Sampling
Not Present
Methods Frame Methods
Present
5.5.4. Sampling Methods
There are two major categories :

Non-probability sampling method :

- Convenience sampling .
- Quota sampling.

Probability sampling methods :

- Simple random sampling.
- Systematic sampling.
- Stratified sampling.
- Cluster sampling.
- Multistage sampling.
5.5.4.1. Non probability sampling method
5.5.4.1.1. Convenience sampling :
“ Is a method in which for convenience sake all the study units that
happen to be available at the time of data collection are selected in the
sample.”

Problems :
- Un-representative of the study population
- Over selection of certain study units.
- Under selection of certain study units.
- Missing of some study units.
5.5.4.1.2. Quota sampling

“ Is a method that ensures that certain number of sample units from different
categories with specific characteristic appear in the sample so that all these
characteristic are represented “.
o Useful when a convenience sample would not provide desired
balance of study units.
o Not representative of the entire population.
5.5.4.2. Probability sampling :

“Involves random selection procedures to ensure that each unit of the sample
is chosen on basis of chance. All units of the study population has an equal
or at least known chance of being included in the sample.”
5.4.2.1. Simple random sample :

All units have the same chance of being selected.

o All units listed in number.
o Sample size decided.

o Required size taken randomly from the listed numbers.

o Units having the numbers chosen are included.

o Table of random number can be used.

5.4.2.2. Systematic sampling :

“ Individuals are chosen at regular intervals (sampling intervals) from the

sampling frame. The first starting number is selected randomly .”
It is requires a sampling frame and a sampling intervals .

Sampling intervals = Size of study population

Required sample size
5.4.2.3. Stratified sampling :

Stratification can be used with simple random sampling or systematic

sampling to ensure the desired representative of specific groups.
Stratification can be made by age (age groups ) race ( ethnic groups ), or
any other basis required e.g. type of family planning method used. The
sample fraction can be decided on the size of different strata in the study
population so as to have strata representative of the total population or
equal fractions can be used.
 Cont.

Stratum

Random sampling
Study Stratification Or
Stratum Sample
population Systematic sampling

Stratum
5.5.4.2.4. Cluster sampling
 Cluster are often “geographical units” e.g. provinces, villages, localities
or organized units e.g. clinics, training groups.
 Cluster are selected using simple random, systematic random or stratified
sampling techniques.
 All elements in each selected cluster are then studied.

5.5.4.2.5. Multi Stage Sampling

Used to draw samples from very large and diverse population.

First stage : Divided the population into naturally occurring cluster and
then draw a sample of them.

Second stage : Sample individual elements from each of the sampled

clusters.
Cont.

The first stage can be of many stages e.g.

• States are selected in the first stage.
• Provinces are selected in the 2nd stage.
• Localities are selected in the 3rd stage.
• Popular committees in the 4th stage.
• Individuals in the last stage.
5.5.4.2.6. Probability proportional to size (PPS) :

This procedure is a variation on multistage sampling in which the

probability of selecting a cluster is proportional to its size and an equal
number of elements is sampled within each cluster . The PPS methods of
sampling is useful when the cluster vary greatly in size. In such situation
the PPS often reduced the sampling variance and the data collection costs.
5.6. plan of data collection
Having selected your variables to be studied and decided on the type
of study needed and the data collection techniques and sampling method a
clear plan for data collection is needed.
The plan should include :
1- Type and number of data collection tools needed. (questionnaires,
measuring tabes, weighing scales, sphygmomanometers etc)
2- Categories and number of data collecting personnel (doctors,
nurses, nutritionist, sociologist etc)
3- Duration and content of training needed.
4- Schedule for data collection (Selection of personnel, training,
preparation of tools, preparation of logistics, starting date, closing date,
time for each study phrase etc.)
5- logistical support (vehicles, fuel, lubricants, food, drinks etc.)
6- Estimated budget for data collection phrase (budget for tools,
budget for training, budget for logistics, budget for perdiems)
5.7. Plan for data processing and analysis

5.7.1. Time for plan :

The plan for processing and analysis of data must be prepared
before the data is collected in the field so that it is still possible to make
change in the list of variables or the data collection tools.

5.7.2. Why is it necessary to prepare a plan for

processing and analysis of data?

1- To assure that all needed information are going to be collected in a

standardized way.
2- To avoid collecting unnecessary data.
5.7.3. Content of the plan:
The plan should include :
1- Sorting data (data collection).
2- Performing quality control checks (data cleaning).
3- Data processing.
4- data analysis.
5.7.3.1. Sorting data:
 If studying more than one study population number the
questionnaire separately.
 In comparative study sort the data right after collection into the
groups that you will compare.

5.7.3.2. Performing quality control checks :

 Checks for completeness : missing questions.
 Checks for consistency.
 Range checks.
5.7.3.3. data processing
Decide an either processing.
• Manually
• By computer
Processing involves :
• Categorizing
• Coding

1. Categorizing
- Categorizing is needed for (open- ended) questions where on the list there is
need for a category called (others).
- Closed- question has only two categories. Numerical variables can be
categorized after their collection.

2. Coding
- Coding is the translation of data into symbols appropriate for analysis e.g.
yes = 1 no = 2 no response = 9
 5.7.3.4 Summarizing the data on
master sheet
- Data master sheet is needed if data is processed manually. On the master sheet all
the answer of individual respondents are tallied by hand.

Respondent Age Sex Schooling Smoking Number

(Number – of
name) M F <4 4-12 Yes No No cigarette
>12 Response
 Master sheet
Category Level No. of care providers Availability of lab Availability of drugs

Govern Non govern Hosp HC Dis Dr. MA G.S DFM Cul K P Cot Tet Met Nyst
5.7.3.5. Data Analysis:

 Prepare dummy tables.

 Frequency counts (numbers).
 Relative frequency.
 Cross tabulation.
5.7.4. Plan for the processing and analysis of data:

A plan for the processing and analysis of data includes:

1- Decision on means of processing : hand or computer.
2- preparation of dummy tables.
3- Decision on the sequence in which tables should be analyzed .
4- Decision on how qualitative data should be analyzed.
5- Estimate of total time for analysis.
6- Decision on staff needed for analysis.
7- Estimate of total cost for analysis.
5.8 Pre-test or pilot study
Definition :
 Pretest means small-scale trail of a particular research component .
 Pilot study is the process of carrying out a preliminary
study going through the entire research procedure with a small sample.

Role of Pre-test :
 Identify potential problems in the proposed study.
 Enable to revise the methods and logistics of data collection before starting
the actual field work.
Aspects evaluated during pre-test :
1- Reaction of the respondents to the research procedures to determine :
- Availability of study population.
- Acceptability of methods used.
- Acceptability of questions asked.
- Willingness of respondents to answer the questions.

2- Data collection tools to determine :

- If they allow to collect information needed.
- If they are reliable.
- If collected data relevant information.
- How much time needed to administer the questionnaire.
- If there is need to revise the format in sequence, wording or space for
answers.
Cont.

3- Sampling procedures to determine:

- If instructions are easily followed by all staff.
- the time needed to complete the sample size

4- Staffing and activities of the research team to determine:

- Work output of each member.
- Benefits gained from training.
- Adequacy of logistical support.
- Adequacy of staff supervision.

5- Procedures of data processing and analysis to determine:

- Appropriateness of data master sheets and dummy tables.
Effectiveness of the system for quality control.
Cont.

6- The proposed work-plan and budget for research activities to determine:

- Appropriateness of time for different phases.
- Accuracy of scheduling of various activities.
- Appropriateness of budget allocated for different aspects.

Staff and time for pre-test:

- All the research team should be involved in the pre-test.
- Time and duration for pretest is determined by:
1- Size and duration of the research.
2- Complexity of the methodology used.
 6. Work-Plan

6.1. What is work-plan ?

A work plan is regarded as:

1- tool for planning the details of the project activities and budgeting
funds.
2- An outline of the sequence of project operations.
3- A management tool for the researcher and his team showing required
tasks and activities, their timing and who will do what.
4- A tool for monitoring and evaluation.
6.2. When to prepare the work- plan?

Work-plan should be prepared when the project proposal is developed.

A more detailed work-plan should be prepared after the pretest of the
methodology.

6.3. How could a work-plan be presented?

 Gantt chart is the best tool for presentation of a work-plan.
 Gantt chart indicates:
1- The task to be performed.
2- Who is responsible for each task.
 Here is an example of Gantt chart of the work- plan for the
research on assessment of validity and applicability of
syndromic approach for management of STDs at primary level
in Mayo Hay El Nasr health area 1998-1999
 7. Plan for project administration

Based on the activities and tasks in the work-plan a clear project

administration should be prepared.
This plan should focus on :
1- Selection of participants in the study and clarification of the role
of each and necessary contacts to confirm their participation.
2- Necessary field contacts and preparations for field activities.
3- Preparation of logistical support for field activities (transport
-food – drinks – refreshers).
4- Preparation of needed tools for data collection.
5- Regulate flow of data from field to office for analysis.
6- Clear financial regulations for payment of perdiems and
logistical support.
 8. Budget

Realistic estimation of budget is a fundamental part of the

research proposal. Realistic detailed budget estimation convince authorities
for release. Detailed budget should include all requirements for the study.
missing to estimate budget for minor activities e.g. meeting with
community leaders, letters for concerned local authority, fuel for such
contacts may severe the research activities .
An example of budget estimation for the research on assessment of
validity and applicability of syndromic approach for management of STDs
at primary level, Mayo Hay El Nasr 1998 – 1999 is presented below:
Budget :
a- Total budget for the study 9,978,000 Sudanese’s pounds

1- Manuals 216,000
2- Stationeries 150,000
3- Training 252,000
4- Salaries 1,660,000
5- Medicines 4,200,000
6- Lab testing fees 2,000,000
7- Transportation 1,000,000
8- Consultancy 1,000,000
Total 9,978,000
b- Budget justification

1- Manuals:
Each manual consist of 60 pages printing 60 x 600 3600
Photocopying of 1200 pages x 150 180000
Total 216000

2- Stationeries:
- Photocopying papers 80000
- Box files 30000
- Transparencies 30000
- Writing pens 10000
Sub total 150000
3- Training:

- Perdiems for trainee 10 x 2000 x 7 140,000

- Perdiems for trainers 800 x 2 x 7 112,000
- Manuals (above)
- stationeries (above)
- Rent of the hall, video, tel, overhead projector, slide projector donated
- Refreshers, breakfast (included in perdiems)
- Prep of video tape for training donated
Sub total 252,000
4- Salaries:
Three month work / (M.A) 1000 x 10 x 90 900,000
Two month work / 2 (assistants for analysis) x 2 x 90 180,000
Three month work / 3 (lab assistants ) 2000 x 2 90 360,000
Eleven month work / 1 driver 11 x 20000 220,000
Total 1,660,000
5- Medicines:
Minimum sample of 600 patients 7000 each for the medicines
4200,000
6- Lab invest. :
Sample of 400 (u.s0 for C/S, 5,000 each
2,000,000

7- Transportation:
Fuel, engine oil, break oil
8- Consultancy ;qualified
Consultant statistician will work on data analysis, designing and data
 9. Finalizing the research proposal

A final draft of research proposal should include the following headings:

1. Introduction
1.1. Background information.
1.2. Statement of the problem.
1.3. Literature review

2. Objectives:
2.1. General objectives.
2.2. Specific objectives.
3. Methodology:

3.1. Study type.

3.2. Study area.
3.3. Study population.
3.4. Variables under study.
3.5. Data collection techniques.
3.6. Sampling procedure and sample size.
3.7. Plan for data collection.
3.8. Plan for data processing and analysis
3.9. Ethical consideration.
3.10. Pre-test.
4. Project management:

4.1. Staffing and work-plan

4.2. Administration and monitoring
4.3. Plan for utilization and dissemination of results

5. Budget:
5.1. Total budget.
5.2. Budget justification (details)

Annexes:
1. References
2. List of abbreviations
3. Questionnaires (data collection tools)
 Cont.

A one page summary containing essential information is usually prepared as a

cover. This include:

- Title
- Duration
- Total budget
- Contributions
- Research team
- Name of principals researcher
Brief summary a problem statement. Objectives and methodology.