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!