W1L1

INTRODUCTION TO HEALTH CARE DATA

Health Care Data

  • Definition and importance of health research highlighted.
  • Aim: To improve care and treatment globally.

HEALTH RESEARCH

  • Health research contributes to understanding human health and enhancing global health care effectiveness.
  • Addresses significant public health challenges:
    • Tackling diseases linked to poverty.
    • Responding to the rise of chronic diseases.
    • Ensuring safe delivery practices for mothers.

GENERIC AREAS OF HEALTH RESEARCH ACTIVITY

Five generic areas of activity identified:

  1. Measuring the magnitude and distribution of health problems.
  2. Understanding the determinants of health problems.
  3. Developing solutions to mitigate health issues.
  4. Implementing solutions via policies and programs.
  5. Evaluating the impact of these solutions on the level and distribution of health problems.
    Reference: World Health Organization (WHO)

HEALTH RESEARCHERS BY INCOME GROUP

  • Data based on 81 countries:
    • High income: 349 researchers per million inhabitants.
    • Upper middle income: 117 researchers.
    • Lower middle income: 55 researchers.
    • Low income: 7 researchers.
  • Gender findings: Female health researchers constitute 50% of total FTE health researchers.

RESEARCH PROCESS

Steps involved in the research process:

  1. Conceptualization of Research.
  2. Data Collection and Analysis.
  3. Dissemination of Findings.

CONCEPTUALIZATION OF RESEARCH

  • The process involves:
    • Broad view of the topic.
    • Narrowing down to a specific research question through initial exploration.
  • Essential tools in conceptualization:
    • Problem Statement.
    • Purpose Statement.
    • Research Question.
    • Hypotheses.

PROBLEM STATEMENT

  • Definition:
    • A problem statement summarizes a condition or problem to be addressed in the study.
  • Addresses various aspects:
    • Area of concern.
    • Condition to be improved.
    • Difficulty to be eliminated.
    • Troubling questions in scholarly literature or practice.
  • Importance of specificity:
    • Problems must be manageable within the project timeline.
    • Contextualizes the basic issue under investigation.

ASPECTS OF A PROBLEM STATEMENT

  1. What?
  2. Where?
  3. When?
  4. To what extent?
  5. How do I know?
  • Each aspect explores the depth and breadth of the problem under consideration.

EXAMPLE CASE

  • Health insurance coverage in India is reported to be low:
    • Only 20% of households covered by health insurance schemes.
    • Poor households often resort to out-of-pocket expenditure, leading to a poverty trap.

ESSENTIAL ELEMENTS OF A PROBLEM STATEMENT

  1. Specify and describe the problem.
  2. Provide evidence of the problem's existence.
  3. Explain consequences of not addressing the problem.
  4. Identify knowledge gaps about the problem.

TIPS FOR WRITING A PROBLEM STATEMENT

  • Focus solely on the problem, not potential solutions.
  • Single problem focus; keep it concise (1-2 sentences).
  • Distinguish between symptoms of the problem and the actual problem itself.
  • Suggested starter sentence: "The problem to be addressed through this project is…"

LOCATION OF THE PROBLEM STATEMENT

  • Can span several paragraphs or be concise in the introduction of documents such as research papers or theses.

PURPOSE STATEMENT

  • Defines the objectives, intent, or major idea of the study.
  • Connects with the identified problem and translates into specific research questions.

CHARACTERISTICS OF A PURPOSE STATEMENT

  1. Concise.
  2. Specific.
  3. Informative.
  • Considered the core statement of the research.

COMPONENTS OF A PURPOSE STATEMENT

  1. The purpose of the study is….
  2. Action verb (what you will do): identify, describe, compare, evaluate, determine.
  3. Key words identifying the research focus.

SAMPLE PURPOSE STATEMENTS

  1. Study to determine the status of health insurance in India and its associated factors.
  2. Evaluate if an increase in health insurance coverage offers financial protection to vulnerable Indian households.

RESEARCH TYPES

  1. Descriptive Research:
    • Describes individuals based on characteristics/variables.
    • Approaches: surveys, case observations, qualitative methods, normative assessments.
  2. Exploratory Research:
    • Examines phenomena and explores their dimensions.
    • Approaches: correlational studies, cohort studies, secondary data analysis.
  3. Explanatory/Experimental Research:
    • Compares conditions and controls extraneous factors.
    • Approaches: randomized controlled trials, clinical research, meta-analysis.

RESEARCH APPROACHES

  1. Quantitative/Qualitative.
  2. Applied/Basic.
  3. Deductive/Inductive.

RESEARCH DESIGN

  • Components include:
  1. Purpose.
  2. Strategies.
  3. Time framing.
  4. Research environment.
  5. Unit of analysis.
  6. Sampling design.
  7. Data collection methods.
  8. Measurement techniques.
  9. Data analysis process.
  10. Interpretation and report writing.

VARIABLES IN RESEARCH DESIGN

  • Dependent and Independent Variables: Relationship analysis.
  • Extraneous Variables: Unrelated independent variables that may affect the dependent variable.
  • Control: Techniques to minimize extraneous variable effects.
  • Confounded Relationships: When the dependent variable is influenced by extraneous factors.
  • Research Hypotheses: Predictive statements linking independent to dependent variables.

RESEARCH METHODOLOGIES

  • Different methodologies include:
    • Positivism, Realism, Interpretivism.
    • Various techniques like action research, grounded theory, ethnography, case studies.
    • Approaches spanning mono-methods to multi-methods within diverse time horizons.

RESEARCH DESIGN ELEMENTS

Types of Study:

  1. Exploratory/Formulative.
  2. Descriptive/Diagnostic.
  3. Flexible/Rigid design categories.
  4. Sampling Design: Non-probability vs. Probability sampling.
  5. Statistical Design: Pre-planned vs. No pre-planned analysis design.
  6. Observational Design: Structured vs. Unstructured data collection instruments.
  7. Operational Design: Fixed vs. flexible operational procedures.

STEPS IN QUANTITATIVE RESEARCH

  1. Theory formulation.
  2. Hypotheses development.
  3. Research Design planning.
  4. Operationalizing concepts.
  5. Selecting research sites.
  6. Selecting respondents.
  7. Data collection.
  8. Data processing.
  9. Data analysis.
  10. Findings/conclusions.
  11. Publishing results.

LOCATION OF PURPOSE STATEMENT

  • Included at the introduction end as a final statement or can stand alone as a section in research papers.

RESEARCH QUESTIONS

  • Research questions further narrow the purpose statement into predictive inquiries for the study.
  • They categorize the problem statement into specific topics/issues.
  • Ideally, the research question should be balanced - neither too broad nor too narrow.

FEATURES OF A GOOD RESEARCH QUESTION

  1. Relevant.
  2. Manageable.
  3. Specific.
  4. Clear and simple.
  5. Interesting.
  6. Legitimate.
  7. Answerable.

ELEMENTS TO INCLUDE IN RESEARCH QUESTIONS

  1. Construct: What you're investigating.
  2. Applicability: Broad relevance.
  3. Importance: Addresses the ‘so what?’ question.

DRAFTING RESEARCH QUESTIONS

  • Examples of framing research questions:
    • What is the relationship between…?
    • What factors affect…?
    • How do effects of… influence…?
    • How does… relate to…?
    • What is the impact of… on…?

SAMPLE RESEARCH QUESTIONS

  1. What is the relationship between health insurance and out-of-pocket spending?
  2. What factors affect health insurance choice?
  3. What is the impact of health insurance awareness programs on coverage?
  4. How does health insurance assure financial protection?

STEP-BY-STEP RESEARCH DESIGN STRATEGY

  1. Identify health specifics (nutrition, service delivery, insurance status, funding, infrastructure).
  2. Analyze health insurance specifics (coverage, out-of-pocket impacts).
  3. State the purpose of the study: to determine health insurance status and influencing factors in India.
  4. Formulate focused research questions.

SUGGESTED READINGS FOR THE COURSE

  1. "Research Design: Qualitative, Quantitative, and Mixed Methods Approaches" by John W. Creswell.
  2. "Health Research Methodology: A Guide for Training in Research Methods" by World Health Organization, 2nd Edition.
  3. National Ministry of Health: "Health Research Methodology: A Guide for Researchers, Part I" in collaboration with WHO and University of Khartoum, 3rd Edition.
  4. "A Practical Guide for Health Researchers" by WHO, Regional Office for the Eastern Mediterranean.