introduction to health research
TRANSCRIPT
Introduction to Health ResearchJoint Program for Family & Community Medicine(Jeddah, January 16, 2010)
Ghaiath M.A. HusseinMBBS, MHSc. (Bioethics)
Acknowledgement
• Many the slides used in this presentation are used with permission from presentations by:
• Dr. Abdul Ghaffar (RPC Advisor, WHO/EMRO)• Dr. Sarah Abdul Rahman Dagash(MOH, Sudan)• Dr. Rania Hussein Al Amin (MOH, Sudan)
Outline of the presentation
• Where are we in research for health?• Definition of research.• Aim of research.• Classification of research.• Research problem Identification and selection.• The ‘Knowledge Management Cycle’• What we need to do?• Conclusion and Discussion
Where does a doctor work?
clinician
manager ً
Health facilityEducational
lecturer
Head dept./Dean
researcher
Managerial
planner
executive
Community
educator
advocate
promoter
But this how it really looks
manager
planner
Promoter
.) عام ) لكل مواطن لكل بالدوالر العالم في البحوث على إنفاقا دول عشر واقل وأكثر والتنمية البحوث على اإلنفاق حيث من العالم دول حجم توضح خريطةwww.worldmapper.org :المصدر
لعام السكان من مليون لكل المنشورة العلمية المقاالت عدد يوضح وجدول المنشورة، العلمية المقاالت عدد حيث من العالم دول حجم توضح خريطةالمصدرم. 2001 : www.worldmapper.org
The Knowledge Management CycleResearch
Policy makers
Statistics
Clinicians
Definition
Systematic Methodolic scientific approach for basic facts around a certain problem in order to find solutions based on these facts.
Systematic: The research developed, implemented and reported in a systematic manner.Methodolic: Adopt & use skillfully the research methods, materials ,approaches in order to ensure reliability of the results & findings.Scientific: The research should be scientifically sound through utilizing scientific approaches , tools & techniques.
Aims of Research• To solve a problem.• To provide Data for good clinical and policy
practice, through:• Generation of new knowledge• Synthesis of available information• Sharing good practices• Translation of knowledge (for improved policy
and management decisions)
Classification of Health Research
• Biomedical research.
• Clinical research.
• Epidemiological research.
• Health system research.
Diagnosis, treatment• Trained health workers• Clinical diagnostics• Treatment/medicines• Hospital services• Information
Health promotion, disease prevention• Information• Products• Services
Access to • Health products and services• Information• Conditions to gain/maintain good health
environment
work social conditions
economic conditions
Biomedical researchHealth policy and systems
researchSocial sciences andbehavioural research
Operational research
Basic research:physical and biological
sciences, includingchemistry, pharmacology,
toxicology, genetics, etc.
Research onpolicy formulation, relationship
to evidence,prioritization, etc.
Research and development for medicines, vaccines,
diagnostics, appliances, etc.
Research onhealth systems management,
functions, efficiency, effectiveness, system factors affecting access,
scale-up, monitoring and evaluation, etc.
Research onsocial and behavioral
factors influencing health and their relation to equity,
access, lifestyle and health-seeking behaviours,
etc.
Research onfactors affecting
functioning of programmes,
effectiveness of targeting, impact
on behaviour, disease burdens
and public health,etc.
Understanding the biological nature of diseases
Creating products to prevent or treat disease states
Understanding how to test, scale-up and follow through on the introduction of interventions to optimise their benefits
Impact
The spectrum of research for development
Biomedical Research
It considers the life cycle of the micro-organisms in the human body and the effects of the infection on the various systems of the body.
Clinical research
It determines the efficacy of preventive, diagnostic and therapeutic procedures.
Estimates the frequency, distribution, risk factors and causes of diseases.
Epidemiological Research
Health System Research
• Examines the way the health system functions to ensure that an effective treatment is delivered to those who need it.
• All health systems research can be used to inform policy-makers.
• It should focus on priority problems.• It should be action-oriented i.e., it should focus
on practical solutions.• It utilizes an integrated multi-disciplinary
approach.
Health System Research… cont.
• It should be participatory (policy makers, health care managers researchers and community members should be involved in all stages of the research).
• Health Systems research should be evaluated by how much it has influenced policy, improved services and ultimately led to better health.
Types of Health system Research
Health Systems Research is classified into : 1.Operational Research (OR) :
Provide decision-makers with information to enable them to improve the performance of their programs & helps to identify solutions to problems that limit programme quality, efficiency & effectiveness.
2. Health Policy Research:
It is research into resource allocation between levels of care or geographical areas.
Research Problem
The selected research problem should fulfill the following criteria:1. The problem should be an important major health problem.2. The problem should have some chance of being solved.3. The research should be feasible within the available time & one that requires reasonable resources.
The Criteria for Prioritizing Problems for Research1. Relevance.2. Avoidance of duplication.3. Feasibility.4. Political acceptability.5. Applicability of possible results & recommendations.6. Urgency of data need.7. Ethical acceptability.
How does research improve health?3/15/2010Research Ethics. Ghaiath
• Prevention and control of prevailing diseases, disease outbreaks and disorders,
• Development of new tools (e.g. rapid diagnostic tests);
• Cost-effective solutions (e.g. oral rehydration solution replacing intravenous fluids, ambulatory treatment of tuberculosis more effective than in-patient management and hospitalization); and
• Define options and opportunities in health systems
How research can help?
What makes a good research?
Steps to conduct research
Potential contribution of evidence to health service• Exposure to a wider range of validated clinical/policy
options• Evaluation of the success and failure of previous
interventions• Ability to identify relationships between seemingly
independent factors (e.g.. Health care reform and health outcomes)• Capacity to legitimize some policies while casting
doubt on others• Promote evidence based management practices
Science Decision-Making
A research institution is a "knowledge" factoryInput: information
Output: information
Processing
Knowledge
The policy and execution grinding mill
Information Policy and communication
Processing
Knowledge
Analyses of threats and benefits
Impact
Testing Evaluation
Many “Leaks” from research & practice
Aware Accept Target Doable Recall Agree Done
ValidResearc
h
If 80% achieved at each stage then0.8 x 0.8 x 0.8 x 0.8 x 0.8 x 0.8 x 0.8 = 0.21
Where am I?
You’re 30 metres
above the ground in a
balloon
You must be a
researcher
Yes. How did
you know?
Because what you told me is
absolutely correct but completely
useless
You must be a policy
maker
Yes, how did
you know? Because you
don’t know where you are, you don’t
know where you’re going, and
now you’re blaming me
The problem
35/30
Key Messages
• Research needs to address the real problems of the community
• Researchers should be action-oriented, even if it is done for academic purposes
• Always remember that the common and ultimate goal as researchers & policy makers is the health of people!