BASHIRU GARBA

RESEARCH METHODOLOGY FA C U LT Y O F M E D . & H E A LT H

S C I . , S I M A D U N I V. M O G A D I S H U ,
BMED06 SOMALIA
Course Outline

Lesson 1. General concept of health research and the

research process

Lesson 2. Identifying a research problem

Lesson 3. Reviewing the literature and referencing

Lesson 4. Generating research question and

hypothesis

Lesson 5. Study design, data collection & analysis

Lesson 6. Final report, discussion, conclusion and

recommendation

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Health research
& the research
process
We will cover these topics:
▪ Definition & importance of
health research
▪ Classification of research
▪ Six major research steps
▪ Ethical consideration in
research
▪ Qualities & skills of a good
researcher

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 Definition and characteristics of research
• Research is a scientific inquiry aimed at learning
new facts, testing ideas, etc.
• It is the systematic collection, analysis and
interpretation of data to generate new knowledge
and answer a certain question or solve a problem.
• Provide important information about disease
trends and risk factors, outcomes of treatment or
public health interventions, functional abilities,
patterns of care, and health care costs and use.

Characteristics of research
✓ It demands a clear statement of the problem.
✓ It requires a plan (it is not aimlessly “ looking”).
✓ It builds on existing data, (positive and negative).
✓ New data should be collected as required and be organized
in such a way that they answer the research question(s)

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 Types of research

▪ Basic and applied research ▪ Classification based on the type of inquiry

▪ Basic research is conducted to generate new knowledge ▪ Exploratory (investigation for better understanding).
and technologies to deal with major unresolved health ▪ Descriptive (describe population, situation or
problems. Eg constituents of Moringa oleifera phenomenon).
▪ Applied research answers questions that lead to direct and ▪ Explanatory (Why crises in country A and not B).
practical applications in the world. It is designed to
answer specific questions aimed at solving practical
problems. New knowledge acquired from applied research
has specific commercial objectives in the form of products,
procedures or services.

▪ Quantitative and Qualitative researches

▪ Quantitative research analyzes large amounts of data that
can be readily expressed in numbers.
▪ Qualitative research generates data using conversational
methods (open-ended questions).

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Steps in conducting a research

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 Qualities & skills of a good researcher
▪ An analytical mind: identify problems, extract key information from data and
develop workable solutions for the problems
▪Knowledgeable and skills: Knowledge: “facts, information, and skills acquired
by a person through experience or education
▪ Curiosity: desire to know, inquisitive interest
▪ Commitment: the state or quality of being dedicated to a cause, activity, etc
▪Excellent verbal and writing communication skills

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 Identifying the research
problem/formulating a research topic

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Problem identification/research topic selection

Research begins with asking questions

“What are the

strategies for • The initial series of questions
increasing COVID-19 maybe due to your curiosity
awareness?”
following some casual
observations you’ve made
• Mentors or supervisors
• Theories

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 Topic selection

▪ Ask a question. 5 W’s and H

▪ It’s not enough to just have a topic of interest; research relies on
questions.
▪ Questions give you a focused reason for study.
▪ Good research questions are unanswered, appropriate in scope and
empirical.
▪ Whether a problem/question requires research depends on;
▪ Perceived DIFFERENCE or DISCREPANCY between what it is
and what it should be?
▪ The reason(s) for this difference should be UNCLEAR (so that it
makes sense to develop a research question).
▪ There should be more than one possible and plausible answer
to the question (or solution to the problem).

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Topic selection

Example 1: In district “ Y “ a report showed that in the first month there were 500 children under
one year old who started immunization, but at the end of the year it was found out that there
were only 25 children who completed their vaccination.
Discrepancy: All the 500 children at district “Y “should have completed their vaccination but
only 5% out of those who started vaccination have completed.
Problem (research) question: why only 5% of the children completed their vaccination?
Definite answer: Out of the 13 health centers located in district “Y” only 2 health stations were
functioning, the rest were closed due to insecurity in the area.

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Topic selection

Example 2: In district “Z” (population 150,000) there are 17 health centers and all of them
function smoothly. However, at the end of the year it was found that the Expanded Program on
Immunization (EPI) coverage was only 25%.
Discrepancy: Although district “Z” had 100% availability of health services and at least 80% of
the children should have had full vaccinations, the EPI coverage was only 25% as seen above.
Problem question: What factors influence the low EPI coverage in district “Z”?
Possible answers:
◦ Mothers might have problems for not attending in the EPI sessions.
◦ The EPI program might not have been integrated; hence children might have missed opportunities in
getting immunization.
◦ The follow up of defaulting children might not be effective and other reasons.

Thus, the above problem situation is researchable.

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 Criteria for selecting a research topic
▪ 1. Relevance: The topic you choose should be a priority problem: Questions to be asked include: How
large or widespread is the problem?, Who is affected?, How severe is the problem?
▪2. Avoidance of duplication: Investigate whether the topic has been researched. 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.
▪3. Feasibility: Consider the complexity of the problem and the resources you will require to carry out the
study. Thought should be given first to personnel, time, equipment and money that are locally available.
▪4. Political acceptability: It is advisable to research a topic that has the interest and support of the
authorities. This will facilitate the smooth conduct of the research and increases the chance that the results
of the study will be implemented.
▪5. Urgency of data needed: How urgently are the results needed for making a decision? Which research should be
done first, and which can be done late?
▪6. Ethical acceptability: We should always consider the possibility that we may inflict harm on others, while carrying
out research. Therefore, it will be useful to review the proposed study

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Exercises 1

In a certain district X with population of 150,000, the sanitary conditions are very poor (only 5% of households
have toilets/latrines) and diseases connected with poor sanitation, such as, gastroenteritis and worms are very
common.
The Ministry of Health has initiated a sanitation project that aims at increasing the number of households with
latrines by 20% each year. The project provides materials, and the population should provide labour.
Two years later, less than half of the target has been reached.
1. What is the exact number of houses that have toilets?
2. What is the number of toilets targeted by the ministry of health after 2 years?
3. State the discrepancy?.
4. What is the research question?
5. What are the possible answers?.
6. Is this problem situation researchable?

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 Group exercise
▪ Go to any nearby hospital (excluding Dr Sumait) Problem 2 Problem 3
and identify three health problems. Criteria Problem 1
▪Discuss about these health problems as a group and Relevance
rate them based on the criteria below.
Avoidance of duplication
Which topic do you select for research? Defend
your first choice in a group session. Feasibility
Acceptability
Presentation guide: Urgency od data needed
hospital visited; departments visited; Ethical acceptability
consultations made; severity of case; etc

Relevance Avoidance of duplication Feasibility Acceptability Urgency Ethical acceptability

1 = Not relevant 1 = Enough information 1 = Not feasible 1 = Not acceptable 1 = Not urgently needed 1 = Major ethical problems
2 = Relevant 2 = Some info. available 2 = Study feasible 2 = Somewhat acceptable 2 = Somewhat needed 2 = Minor ethical problems
3 = very relevant 3 = No information 3 = Study very feasible 3 = Topic fully acceptable 3 = Data urgently needed 3 = No ethical problems

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Writing a problem statement

▪ Put the problem in context (what do we already know?): The problem statement should frame
your research problem in its context and give some background on what is already known
about it.
▪ Focus on the concrete details of the situation: Where and when does the problem arise?, Who
does the problem affect?, What attempts have been made to solve the problem?
▪ Describe the precise issue that the research will address (what do we need to know?)
▪ Show the relevance of the problem (why do we need to know it?)
▪ Set the objectives of the research (what will you do to find out?)

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Analyzing the problem

A systematic analysis of the problem, completed jointly by the researchers, and health workers,
is a very crucial step in designing the research because it:
• Enables those concerned to bring together 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.

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Formulating the problem statement
Why is it important to state and define the problem well?
Because a clear statement of the problem:
a. Is the foundation for the further development of the research (research objectives, methodology,
work plan, etc.)
b. Makes it easier to find information and reports of similar studies from which your own study
design can benefit.
c. Enables the researcher to systematically point out why the proposed research on the problem
should be undertaken and what you hope to achieve with the study results.

Points that need to be considered for justifying the selected research problem
- Being a current and existing problem, which needs solution;
-Being a widely spread problem affecting a target population;
-Being a problem that affects the health service programs, concerns the planners, policy makers
and the communities at large.

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 Formulating the problem statement

Information included in the statement of a problem

➢A brief description of socioeconomic and cultural characteristics and
an overview of health status;
➢A more detailed description of the nature of the problem
➢Basic description of the research problem
➢The discrepancy between what is and what should be
➢Its size, distribution, and severity (who is affected, where, since when, etc.)
➢An analysis of the major factors that may influence the problem and
a convincing argument that available knowledge is insufficient to
answer a certain question and to update the previous knowledge.
➢A brief description of any solutions that have been tried in the past,
how well they have worked, and why further research is needed.
➢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
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Hypotheses

Hypotheses are testable statements that provide the researcher’s best guess at an answer to a
research question.

Less exercise
Null Hypothesis
It states a negative statement to support the researcher’s findings that there is no relationship
between the two variables.
Alternative Hypothesis
It states that there is a relationship between the two variables of the study and that the results
are significant to the research topic.

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 The literature review

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Literature review

A literature review is a survey of scholarly sources on a specific

topic.
It provides an overview of current knowledge, allowing you to
identify relevant theories, methods, and gaps in the existing
research.
In the literature review, the task is to learn as much as you can from
the efforts and work of others – which is published in the “scientific
literature

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Literature review

Writing a literature review

involves finding relevant
publications, critically analysing
them, and explaining what you
found.

YOU DON’T NEED TO READ EVERYTHING –

you can’t!

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Purposes of the literature review

➢Provide the researcher with an understanding of literature about the

proposed research.
◦ This includes the strengths and weaknesses!

➢The research problem is the focus of the literature review.

➢Research that addressed a similar problem or had similar objectives is
relevant – you should know how others approached their problem and
objectives.

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 Benefits of a literature review

❑Prevents duplication of what has already been

done (Some duplication or confirmation of
research is necessary, but excessive duplication
is wasteful).
❑Help to identify new areas where research is
needed (and how new research can contribute).
❑Provides ideas and direction for, techniques,
sources of data, novel approaches for the
research.

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The Literature Review Process

❖Not all literature should be included in the

review (peer review process).
❖These include journals articles, research reports,
university-affiliated bulletins, reports and
monographs.
❖Before you begin searching for literature, you
need a clearly defined topic.

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Search for relevant literature

✓ Start by creating a list of keywords related to your research

question (zoonotic bacteria, antimicrobial resistance, hepatitis B,
Somalia etc.)
✓ You can also use boolean operators (and, or, not) to help narrow
down your search.
✓ Popular internet databases you can use are, PubMed, PubMed
Central, Cochrane library, EBSCO, MedLine, Embase, Medscape,
Google Scholar, Scopus, etc.
✓ Read the abstracts to find out whether an article is relevant to your
question.
✓ Check the bibliography to find other relevant sources (while taking
note of recurring citation).

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Evaluate and select sources

oEvaluate which sources are the most relevant.

◦ Taking into consideration the problems addressed, the concepts, the strength and weakness of the
articles.

o Pay attention to more recent literature (last 5-10 years).

oAs you read, you should also begin the writing process.
oTake notes that you can later incorporate into the text of your literature review.
oTake note of all references/citations to avoid plagiarism.
oAlternatively, you can use reference manager (RefWorks, Mendeley, EndNote, Zotero, etc)

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 Write your literature review
Literature review should comprise; introduction, the main body, and a conclusion.
What you include in each depends on the objective of your literature review.
Introduction
Establish the focus and purpose of the literature review (thesis/dissertation or stand-alone literature review).
Body
Depending on the length of your literature review, you might want to divide the body into subsections.
It is important to summarise and synthesize the main points and combine them into a coherent whole.
Write in well-structured paragraphs transiting between words and topic sentences to draw connections, comparisons and
contrasts.
Conclusion
Summarize the key findings obtained from the literature and emphasize their significance.
Describe how your research addresses gaps and contributes new knowledge.
Also discuss the overall implications of the literature and offer suggestions for future research.
Finally, revise and proofread thoroughly.

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Citation and Referencing

▪The aim of a citation is to provide enough bibliographic information for the reader to be able to
identify and, if necessary, obtain the original resource.
▪You may reference a wide variety of resources in your assignment, including books, e-journal
articles, and websites.
▪By using citations and references, you acknowledge the work of others and show how their
ideas have contributed to your own work.
▪It is also a way of demonstrating that you have read and understood key texts relating to the
area you are writing about.

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 Citation and Referencing

What are references and citations?

Appears in the text of your essay, wherever you use a quote or incorporate an idea
Citation
you have picked up from another source

American Psychological Association (APA); Vancouver; Harvard; Modern

Examples of
reference styles
Languages Association; Chicago etc

Hint: Book Hint: Journal article Hint: Web report/database

- (Author/authors (surname, and
initials);
- Publication date (year);
- Title (Book, journal article, report);
- Edition (for book);
- Publisher (name of publisher)
- (Author/authors (surname, and initials); - Author/authors (surname, and
- Publication date (year); initials);
- Title (journal article); - Publication date (year);
- Name of journal (italicised); - Title (report);
- Volume and issue numbers (in brackets) - Web address (url);
- Page range (xx-xx) - Date accessed
- DOI number

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APA (in-text citation)

Example (APA style):

The global burden of visceral leishmaniasis
(VL) is estimated at 0.2 to 0.4 million cases,
resulting in 50,000 deaths every year
(Abdallah, 2022). Eastern Africa is the
second-highest-burdened region, after the
Indian subcontinent (Abdallah, 2022a;
Abdallah, 2022b). VL suppresses the
immune response, and epidemics in
populations affected by malnutrition or
displacement can be severe (Hamdi &
Sumayyo 2022). This deadly parasitic
disease has been mainly reported in parts
of southern Somalia (Ali et al., 2022),
though data from Somalia are scarce and
the true magnitude of the VL burden
remains unknown

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 Citation and Referencing

Appears at the end of your essay or chapter, or sometimes at the bottom of each page,
Reference
and gives full details of the source of your information

Journal article (last name, initials, (year). Title of article; Journal; volume; issue; pages)
Noor, A. M., Rage, I. A., Moonen, B., & Snow, R. W. (2009). Health service providers in Somalia: their
readiness to provide malaria case-management. Malaria Journal, 8(1), 1-8.

Book (Last name, Initials. (Year). Book title (Editor/translator initials, Last name, Ed.) (Edition). Publisher.
Chris Carter & Joy Notter (2021). Covid-19: A Critical Care Textbook, 1st Edition. Elsevier

Website (Author name, initials, (year). Title of article/report, web address; date accessed
Slat, B. (2019, April 10). Whales likely impacted by Great Pacific garbage patch. The Ocean
Cleanup. https://www.theoceancleanup.com/updates/whales-likely-impacted-by-great-pacific-garbage-patch/.
Accessed 16/04/2022

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Statements requiring citations

Citation required No citation required

You are quoting directly from another source X

Mention a fact that is commonly known X

Present the results of your own survey or experiment X

You are writing about another researcher’s theory or idea using your own words, as X
a paraphrase or a summary
You use an image from the web X

You are using facts and figures from another writer to support your idea X
You use a diagram from a book X
You include some statistics that your lecturer has given you in a lecture X
Study aim (general objectives)
After deciding what to study, and
knowing why you want to study it, the
investigator can now formulate his study
objectives.
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- Objectives should be closely related to the statement of the problem.
- For example, if the problem identified is low utilization of health
stations in a rural district,
- The general objective of the study could be “to assess the
reasons for this low utilization.
- If we break down this general objective into smaller and
logically connected parts, then we get specific objectives
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Specific objectives

▪Research objectives
▪ Outline the specific steps that you will take to achieve your research aim.
▪ If we break down this general objective into smaller and logically connected parts, then we
get specific objectives.
▪ Properly formulated, specific objectives will facilitate the development of research
methodology will help to orient the collection, analysis, interpretation, utilization of data.

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Aim and objectives

▪Your research aim and objectives should be SMART:

◦ Specific – be precise about what you are going to do
◦ Measureable – what evidence will you have that you have reached your goal?
◦ Achievable – Don’t attempt too much. A less ambitious but completed objective is better than an over-
ambitious one that you cannot possibly achieve.
◦ Realistic – do you have the necessary resources (time, money, skills etc) to achieve the objective?
◦ Time constrained – determine when each stage needs to be completed. Is there time in your schedule to
allow for unexpected delays?

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Study objectives

General objectives/aim of the study: Main purpose of the study in general term

▪ Example: In a study on prevalence of AMR Salmonella in chicken meat in Mogadishu; the general objective will be: “to
determine the AMR profile of Salmonella isolated from chicken in Mogadishu”.

Specific objectives:

Example: In the study of “Prevalence of AMR Salmonella in chicken meat in Mogadishu”, the specific objectives could be:

- To evaluate the level of awareness and usage of antimicrobial drugs among poultry farmers

- To isolate and characterize the bacterial from chicken samples.

- To determine the antimicrobial susceptibility of the bacterial isolates.

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Study objectives

▪Examples of action verbs that are commonly used in stating research objectives are:
- To determine
- To compare

- To describe.

- To find out.

- To establish

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Research methods

▪The materials are simply the raw materials, tools and/or important chemicals used in your experiments and data
collection. Basically, it is the important details of WHAT you use in your research.
▪The methods section is HOW you conduct the research. Here, you describe all the steps or procedures you've done
in order to achieve the research objectives, including the experimental design and data analysis.
▪Generally, this section should include a concise description of the materials, procedures, and equipment used,
including;
▪ How the study will be conducted (study design).
▪ The number of samples/data that will be collected and how you arrive at it (sample size).
▪ How samples and data will be collected (sampling methods).
▪ What type of samples/data will be collected (primary- e.g. blood samples/questionnaires or secondary data- death records).
▪ The population and location your samples/data will be collected (study location and study population).
▪ What statistical analyses will be done (descriptive statistics-e.g. percentages; inferential statistics-e.g. Chi-square).

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Materials and methods cont’d

▪The materials and methods outline WHAT WILL BE DONE and HOW IT WILL BE DONE.
▪There should be enough detail so that someone else could repeat your study.
▪It should be arranged in a logical manner (i.e., keep related ideas together and write
chronologically where possible).
▪This section must be written in past tense (e.g. “We weighed the tissue ….” and “The tissue was
weighed), paragraph form (no list except for materials) and relatively brief, usually 1-3 pages
(can be longer or shorter)

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Methods

Study designs
▪A study design is the process that guides researchers on how to collect, analyze and interpret.
observations. It is a logical model that guides the investigator in the various stages of the research.
▪The two most common research approach are; Quantitative and Qualitative research designs.

Considerations in choosing research designs

▪Time and the resources available.
▪Consider your skill level.
▪Funding.

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 Quantitative study designs
▪Quantitative designs are used in studies involving
large amounts of numerical data on large number of
cases.
▪Quantitative approaches include;
▪ Experimental designs: Controlled experiments, with
controls, and treatments, allowing the researcher to be
very precise about the connections between your
variables.
▪ The main application of experimental studies, however,
is in evaluating therapeutic interventions. Example
randomized controlled trials.
▪ A randomized controlled trial of a video
intervention shows evidence of increasing
COVID-19 vaccination intention

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 Quantitative study designs
▪ Cross-sectional: Examine a set of cases
at a single point in time.
▪ A cross sectional study measures the
prevalence of health outcomes or
determinants of health, or both, in a
population at a point in time or over a
short period.
▪ For example, an OBG physician planning
a STD prevention programme might wish
to know the prevalence of different risk
factors in the population so that he could
tailor his intervention accordingly.

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Quantitative study designs

▪ Longitudinal studies: Study cases over time. They let you study trends and changes over
time by gathering multiple points of data about a case over a period.
▪ In a longitudinal study subjects are followed over time with continuous or repeated monitoring of risk
factors or health outcomes, or both.
▪ An example of longitudinal study is COHORT study.
▪ In cohort the study population is composed of individuals classified as exposed and not- exposed to
a particular agent or condition.
▪ Both groups are followed for a specific time period to estimate the occurrence of an outcome or
development of a health problem.
▪ Cash-based intervention and risk of acute malnutrition among children in internally
displaced persons camps.

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Quantitative study designs

▪In Survey research survey research, questionnaires are distributed to large numbers of people
to determine their characteristics, behaviors, attitudes, values, or beliefs.
▪Surveys allow selection of a relatively large sample of people, followed by collection of data from
those individuals, and may be exploratory, descriptive, or explanatory.
▪Surveys could be online, paper-based, telephonic or one-on-one interview.
▪Based on frequency of collection, survey could be cross sectional, longitudinal or retrospective in
nature.

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Qualitative study designs

▪ Typically looks at a smaller number of cases more in depth, using data that can’t
always be reduced to numbers.
▪ Qualitative research methods include observations, one-on-one interviews, case study
research, focus group discussion.
▪ They are in-depth studies of one or a small number of cases—which might be
individual or groups of people. The goal is to engage in extensive and in-depth
description, interpretation, and/or explanation of the case or cases.

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Sample size determination

Sample
▪Sample is the number of observations taken from a population. It is the part of the population
chosen for a survey or experiment.
▪The larger the sample size, the more accurate the findings from a study.

Reason why sampling is important

▪Research is time consuming, expensive and occasionally impractical.
▪Research is cumulative.
▪Sometimes population may be too large to study or inaccessible.

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Methods of sample size calculation

1. Arbitrary approach: Assume a fixed percentage of the population as sample size (at least 5%)
though 10% is the ideal.

2. Conventional approach: Adopt average sample size of similar studies.

3. Confidence interval approach: Uses statistical formula based on variability, sampling

distribution and standard error or mean. A confidence interval is the likely range for the true
score of your entire population.

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Sample size calculation using confidence interval approach

Sample size formula for infinite population size (unknown).

no= Sample size

Z= 1.96 (95% confidence interval)
P= Estimated prevalence (previous studies or assuming 50% prevalence)
q= 1-p
e = Desired absolute precision/margin of error-5% (0.05)

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Sample size calculation using confidence interval approach

Example
Let us assume that a researcher wants to estimate the proportion of patients having hypertension
in among pregnant women in Mogadishu. According to previously published studies the
number of hypertensive women may not be more than 15%.
The researcher wants to calculate this sample size with the margin of error of 5% and confidence
interval of 95%.

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Sample size calculation using confidence interval approach

Sample size formula for finite population size (known population size)

n= Desired sample size

N= population size
(e)2= Desired absolute precision/margin of error-5% (0.05)

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Sample size calculation using confidence interval approach

Let us assume that a researcher wants to estimate the proportion of SIMAD university students
having hypertension. According to previously published studies the number of hypertensive
student in Somalia 5%. The researcher wants to calculate this sample size with the
precision/error margin of 5% and confidence interval of 95%.

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What is sampling

◼ A sample is some part of a larger body specially selected to represent the whole.
◼ Sampling is the process by which this part is chosen.
◼ Sampling is the process by which any portion of a population is collected as a representative
of that population.

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Sampling concepts and terminologies

➢Target Population
➢Is the collection of all individuals, families, groups, organizations or events that we are interested in finding out
about.
➢Is the population to which the researcher would like to generalize the results. For example, all adult population of
Mogadishu aged 65 or older

➢ Sampling unit
➢ Sampling unit is the unit about which information is collected. For example, each member of a population
is a unit (e.g., a child under 5) or sometimes it is household, e.g., any death in the household in the last
three months?
➢Sampling Frame
➢The actual list of sampling units from which the sample is collected.
➢It is simply a list of the study population (e.g., the households).

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 Types of sampling
✓Probability sampling (or Random)
✓Non- Probability sampling (or non-Random)

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 Sampling methods

Probability sampling (random sampling)

• Every unit in the population has equal opportunity
of being selected.
• Increases sample's representativeness of the
population.
• Decreases sampling error and sampling bias.

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Simple random sampling

◦ To select a simple random sample, you need to make a numbered list of all the units in the
population from which you want to draw a sample.
◦ Each unit on the list should be numbered in sequence from 1 to N (Where N is the Size of the
population).
◦ Decide on the size of the sample and select the required number of sampling units, using a
“lottery.
◦ This method is used when the whole population is accessible, and the investigators have a list
of all subjects in this target population.
◦ The list of all subjects in this population is called the “sampling frame”. From this list, we
draw a random sample using lottery method or using a computer-generated random list.

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Stratified random sampling

◦ This method is a modification of the simple random sampling therefore, it requires the
condition of sampling frame being available, as well.
◦ However, in this method, the whole population is divided into homogeneous strata or
subgroups according to a demographic factor (e.g., gender, age, religion, socio-
economic level, education, or diagnosis etc.).
◦ Then, the researchers select a random sample from the different strata.
◦ The advantages of this method are:
◦ (1) it allows researchers to obtain an effect size from each strata separately, as if it
was a different study. Therefore, the between group differences become apparent,
and
◦ (2) it allows obtaining samples from minority/under-represented populations.

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 Cluster sampling (multi-stage sampling)

◦ It is used when creating a sampling frame is nearly impossible due to the large size of the
population.
◦ In this method, the population is divided by geographic location into clusters. A list of all
clusters is made, and investigators draw a random number of clusters to be included.
◦ Then, they list all individuals within these clusters, and run another turn of random
selection to get a final random sample exactly as simple random sampling.
◦ This method is called multistage because the selection passed with two stages: firstly, the
selection of eligible clusters, then, the selection of sample from individuals of these clusters.
◦ An example for this, if we are conducting a research project on medical students from
Mogadishu. It will be very difficult to get a list of all medical students all over Mogadishu.
In this case, a list of Universities is made, and the researcher randomly picks up a number
of schools, then pick a random sample from the eligible schools

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Systematic sampling (interval sampling)

▪Individuals are chosen at regular intervals (for example, every

▪In this method, the investigators select subjects to be included in the sample based on a
systematic rule, using a fixed interval.
▪For example: If the rule is to include the last patient from every 5 patients. We will include
patients with these numbers (5, 10, 15, 20, 25, ...etc.).
▪In some situations, it is not necessary to have the sampling frame if there is a specific
hospital or center which the patients are visiting regularly. In this case, the researcher can
start randomly and then systemically chooses next patients using a fixed interval

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 Non-probability sampling (non-random sampling)

▪Not every unit of the population has

equal chance of being selected.
▪More likely to produce bias.

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Convenience sampling
▪ Selection of the most readily available sample/unit for a study. Is a method in which for
convenience, sake the study units that happen to be available at the time of data collection are
selected.
▪ Although it is a non-probability sampling method, it is the most applicable and widely used
method in clinical research.
▪ In this method, the investigators enroll subjects according to their availability and accessibility.
▪ Therefore, this method is quick, inexpensive, and convenient. It is called convenient sampling as
the researcher selects the sample elements according to their convenient accessibility and
proximity.
▪ For example: assume that we will perform a study on Somali patients with Hepatitis C (HCV)
virus. The convenience sample here will be confined to the accessible population for the research
team. Accessible population are HCV patients attending in Dr Sumait University Hospital.
Therefore, within the study period, all patients attending these two hospitals and meet the
eligibility criteria will be included in this study

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Quota sampling

▪ It is a method that ensures that a certain number of sample units from different categories
with specific characteristics appear in the sample so that all these characteristics are
represented.
▪ Quota sampling method is a non-probability sampling, and it can be defined as a sampling
method of gathering representative data from a group.
▪ Application of quota sampling ensures that sample group represents certain characteristics of
the population chosen by the researcher.
▪ The major difference between quota and stratified random sampling is how the samples are
selected.

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Purposive sampling

▪ Researcher uses judgement to select subjects. Strategic selection based on certain

characteristics.
▪ In this method, the subjects are selected by the choice of the investigators. The researcher
assumes specific characteristics for the sample (e.g. IDP camps with more than 10,00 members)
and therefore, they judge the sample to be suitable for representing the population.
▪ This method is widely criticized due to the likelihood of bias by investigator judgement

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Snowball sampling

▪This method is used when the population is not easily accessible or cannot be located in a specific
place.
▪In this method, the investigator asks each subject to give him access to his colleagues from the same
population.
▪This situation is common in social science research, for example, if we running a survey on
HIV/AIDS patients, there will be no list with the patients, and it will be difficult to locate this
population in one place e.g., hospital.
▪Here, the investigators will deliver the survey to one patient then, ask him to take them to his
colleagues or deliver the surveys to them

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Data collection and analysis

▪Once the data have been collected and checked for completeness and accuracy, a clear
procedure should be developed for handling and storing them.
▪The most used methods of collecting information are;
▪ Documentary sources (records): Clinical records and other personal records, death certificates,
published mortality statistics, census publications, etc. Documents can provide ready made information
relatively easily, but have disadvantage of reliability and validity (because the information is collected
by a number of different persons who may have used different definitions or methods of obtaining data
▪ Interviews: A public health worker conducting interviews may be armed with a checklist of topics to be
used as guide.
▪ Self-administered questionnaires: The respondent reads the questions and fills in the answers by
himself (sometimes in the presence of an interviewer who “stands by” to give assistance if necessary).
▪ In-depth interviews and focused group discussion: This is used in qualitative approaches to data
collection usually involve direct interaction with individuals on a one to one basis or in a group setting

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Questionnaire design
❖A questionnaire is a document designed for the purpose of seeking specific information
from the respondents.
❖The questionnaire may be self-administered or administered by interviewers. The self-
administered questionnaire approach is cheap, less susceptible to interviewer bias and can be
administered by mail. At the same time, the rate of non-response may be high, and may bias
the results. Also, answers may be incomplete.
❖There are two major question formats:
❖Closed-response question: the respondent is provided with a list of pre-determined response options.
❖Open-ended questions: elicit more detailed responses, but the responses require more effort to encode
for data analysis.
❖Questions should be simple and clear.
❖The questionnaire should always be pre-tested in a pilot study before the main survey.
❖Interviewers should be trained to make sure that the questionnaire is administered in a
uniform way.

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Questionnaire design

❖A questionnaire typically includes the following components:

❖An introductory statement by the interviewer to introduce
herself/himself and explain the purpose of the questionnaire.
❖The respondents should also be informed about the confidentiality of
their responses.
❖Demographic questions to collect relevant information about the
background of the respondent.
❖Factual questions about the subject matter (e.g., disease information)

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Data processing and analysis

• Categorizing the data (gender; age; occupation; level of education etc.)

• Coding (SMED-SIMAD Dept. of Surg etc. ).
• Summarizing the data in data master sheets, manual compilation (Excel or MS word).
• The identification of an appropriate statistical package is the first step when using a computer.
Some examples of packages commonly used are Epi Info, SPSS, STATA.
• Analysis of data involves the production and interpretation of frequencies, tables, graphs, etc.,
that describe the data.
• Cross-tabulation: This requires the combination of information on two or more variables in
order to describe the problem or to arrive at possible explanations for it.

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Ethical considerations in research

Research ethics govern the standards of conduct for scientific researchers. Your task in research is to
uncover new ideas and information, but you must ensure that the benefits of that new information
outweigh the costs.
Ethical considerations for human subjects
- Researchers must solicit informed consent of their potential subjects.
- The proposed research must be justifiable as maximizing societal benefits and minimizing risks.
- There must be fair procedures and equitable outcomes in how subjects are selected for research.
Ethical behaviour of researchers
- Don’t makeup data. Falsifying or distorting data to make your results look better or support a story
you want to tell is an incredible ethical violation.
If you have any conflicts of interest or reasons for bias, disclose them.
- Be sure to properly attribute and protect the intellectual property of others.

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Thank You!!!
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