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Flowchart: Steps in the development of a health systems research proposal

NB: Development of a research process is a cyclical process. The double-headed arrows indicate that the process is never linear.

Module 18: FINALISING AND REVIEWING THE RESEARCH PROPOSAL

1. Finalising the research proposal
2. Writing a summary of the research proposal
3. Presenting the research proposal to the relevant authorities and potential funding agencies

I. FINALISING THE RESEARCH PROPOSAL

When you have finished the methodological section of your research proposal and have pre-tested the methodology or at least reviewed it thoroughly (Module 14), you can start preparing the final draft of various parts of your research proposal.

If relevant to the problem, you should first review again whether major cross-cutting issues have been addressed in a consistent way. These may include:

• Gender;
• Equity (e.g. in access to services and quality of care provided);
• Participation of the target group in formulating the problem, major findings (through giving feedback) and recommendations.

You should have considered these issues when analysing and prioritising your research problem (see Module 4); when developing your research objectives (see Module 6), when developing your data collection techniques (see Module 10), when selecting your study populations (see Module 11), and when planning for data analysis and utilisation of results, which should be reflected in your work plan and budget (Modules 13, 15, 16, 17).

You can start working on part I of Module 18 any time after the group work of Module 14 has been completed.

The outline of your research proposal, as presented in Module 1, is as follows:

SUMMARY

TABLE OF CONTENTS

1. INTRODUCTION

1.1 Background information (context of the problem)

1.2 Statement of the problem

1.3 Literature review (partly or fully integrated into 1.1 and 1.2)

2. OBJECTIVES

3. METHODOLOGY

3.1 Study type, data collection techniques used. Variables or research themes can either be annexed or (if succinct) included in the text after study type

3.2 Sample and sampling procedures

3.3 Plan for data collection

3.4 Plan for data processing and analysis

3.5 Ethical considerations

3.6 Pre-test

4. WORK PLAN(including description of project staff)

5. BUDGET (including explanatory note on major budget posts)

6. PLAN FOR ADMINISTRATION, MONITORING, AND UTILIZATION OF RESULTS

REFERENCES

ANNEXES

Annex 1. List of abbreviations, if applicable (can also go to the beginning of the proposal).

Annex 2. Interview guides/ questionnaires (and/or other data collection tools).

How should you proceed?

1. The first section of your proposal contains background information, the statement of the problem and literature review. This section should convince the reader of the relevance of the study (magnitude, severity of the problem). It should provide enough background data for an outsider to understand the different aspects of the problem, or the different factors influencing the problem and the context in which it occurs. Your review of available literature and reports should further illustrate why the problem is important, not only in your own working area but probably also beyond.

   Remember that, if your problem has a strong global dimension, (e.g., HIV/AIDS, family planning) you might consider a separate section for reviewing international literature as an introduction to your statement of the problem (see Module 5). However, in many cases (especially if you are focussing on smaller, local research problems) it will be possible to include all literature you consulted in the ‘Background information’ and ‘Statement of the problem’ sections.

   Note:

   Remember that review of literature is an ongoing activity that will continue during fieldwork, data analysis and even report writing.

   You can justify your study by pointing to the gaps in available information, which you hope to fill in with the data from your planned research. Finally, you can increase the interest of your readers by summarising what results you hope will emerge from your study and how you plan to use them to help solve or alleviate the problem on which your study concentrates.

   You now have to thoroughly review the various pieces of text that you have produced during earlier sessions of the workshop, and rewrite them to form a coherent study design.

   Note:

   When developing your research methodology you may have somewhat revised the focus on your research problem; you may have become more specific as you proceeded, adding certain factors, or omitting others. Any adjustments should be included throughout the text of your proposal because all parts of the study should be consistent and logically connected to each other.

   When revising your proposal you can best work backward, from the data collection tools to the objectives and then to the statement of the problem, to check for consistency.

2. Critically review your objectives. Check whether they still cover what you have planned to study, and whether they are specific enough.
3. The next section presents the methodology. You have already prepared small sections focusing on various aspects of your methodology. You should now check the text for clarity of wording and logical coherence. (An outsider must be able to understand what you mean)
4. Discussion of various ethical issues affecting your study may be scattered in different parts of your draft. Identify the most important issues and discuss them in a separate section. (Include, for example, issues relative to the selection of your topic, your methodology, and the collection of your data, where you will have to pay attention to by asking consent and avoiding any harm to your informants.)
5. The last sections of the research proposal, which will focus on project management, the work plan, the budget and the plan for administration, monitoring and utilisation of results, are quite clear-cut. When writing them, consult the directions presented in the GROUP WORK sections of the respective modules.
6. References should follow in a separate section at the end of the research proposal. Take care that you list the references in a consistent way. (Author(s), year, title, place, publisher, etc., see Module 5.)
7. Annexes. You should add a list of abbreviations, if there are many, here or after the summary. Your data collection tools should be annexed, each with a number, so that you can easily refer in the text to the various instruments.
8. Finally, prepare a title page, summary, table of contents and, if appropriate, acknowledgements.

II. WRITING A SUMMARY OF THE RESEARCH PROPOSAL

When you have completed writing your research proposal, there is usually a need for the protocol to be reviewed by senior authorities and policy makers or funding agencies. For the purpose of obtaining approval from policy makers or very busy administrators it is advisable to add a summary (of no more than two pages) to the proposal.

A summary usually includes:

One page containing essential information such as:

• Title of the research proposal
• Duration (proposed dates of onset and completion of the project)
• Total budget (in local currency and US$)

  — Contribution of Ministry of Health

  — Contribution of donor

  — Additional resources to be mobilised

• Research team (names and functions)

  — Team leader

  — Research team members

• Name of the project administrator

  A brief narrative summary of one page that could contain the following elements:

  — One paragraph on the statement of the problem

  — General objective

  — Study populations, sample sizes and data collection techniques used

  — Indications concerning what major results may be expected from the study and their possible contribution for solving the problem being researched.

You should put the summary at the beginning of the proposal, although it is the last thing you prepare.

After the summary, a table of contents should follow. Adding numbers to the pages of your report and including them in your table of contents is one of the last activities involved in preparing your proposal.

Then a title page should be prepared, containing the title of your study, the names of the researchers with their titles, the name of the institution that has organised the course (Ministry of Health, or Health Research Unit of the Ministry of Health, for example) and date of issue. Add also this is a research proposal in order to distinguish it clearly from the research report that will later appear, probably under the same name and with the same authors. Finally you may add a page of acknowledgements, thanking all who enabled you to develop and implement this study.

III. PRESENTING THE RESEARCH PROPOSAL TO THE RELEVANT AUTHORITIES

Before a research project can be implemented, the health systems research proposal usually has to be:

• approved by the relevant health authorities,
• approved by the appropriate research committee or council, and
• given the funding.

In certain circumstances some of the above steps may be combined.

The procedure for approval may require that the research proposal be submitted with an accompanying letter or prescribed form for the relevant authority. In addition, the researchers may be requested to make a brief verbal presentation or ‘defend’ the proposal in person.

At the end of the proposal development workshop, participants will make 7-10 minutes presentations of their research proposals to a panel so they will gain an appreciation for the concerns of the various approving agencies and acquire the skills to respond briefly and succinctly to questions relating to particular aspects of the proposal.

Presentation to a panel

The panel should consist of experienced researchers who will comment on the research aspects of the proposal and, on the other hand, health managers who are familiar with the problem that is being investigated and will therefore be competent to comment on the focus, scope and usefulness of the proposed study. The panel members should be given a copy of the summary of the research proposal before the presentation begins.

Each participant group should prepare a presentation covering briefly the salient points in each section of its proposal. Participants should be encouraged to use the overhead projector and to practice and time their presentation prior to the actual presentation to the panel. (See Trainer’s Notes on ‘Course Management during the Workshop’ for further details on presentation skills that should be stressed.)

The main points that should be emphasised in the presentation include:

1. Title of the study
2. A brief description of the problem, why the study is needed, what information is needed and how such information will be used
3. Objectives of the study
4. A brief statement on the type of study design, sample(s) and methods of data collection
5. A summary of how and when the study will be implemented (where, by whom, when, etc.)
6. A summary of how data will be analysed to provide the required information
7. A summary of the main resources required (e.g., manpower, budget, transport)
8. A brief summary of ethical considerations, and plan for project administration, monitoring and utilisation of results.

Although the presentation itself should be brief, participants should be prepared to respond to detailed questions on any of the aspects of the proposal that have been presented. Keep a list of research themes and/ or variables at hand for questions on content of the study.

Submission of the proposal

Accompanying letters should contain the title, the name of the team leader and project administrator, and the period over which the study will be carried out. If a letter is going to the national research council or a similar group you may briefly refer to your study’s methodology and expected results and mention where further details can be found in your proposal.

Prepare a letter of intent that clearly summarises your research proposal and the estimated resources required, to send to potential funding agencies. In letters to potential donors you should not only state the total amount required but also the account to which the money, if granted, should be credited. Furthermore, it may be advisable to develop a follow-up proposal with a budget line, if implementation of your research recommendations will require additional resources.

Trainer’s Notes

Module 18: FINALISING AND REVIEWING THE RESEARCH PROPOSAL

Introduction and discussion

• Part I of this module should be presented as soon as one or more of the groups is ready to start compiling their final document. Parts II and III may be presented in the same session or somewhat later in a separate session. The presentation of the proposal to the panel of relevant authorities, which will come near or at the end of the course, should be arranged early so that key authorities will not have scheduling conflicts.
• Stress, with the participants, the importance of preparing the final draft of their research proposal in such a way that it reads well to outsiders not fully familiar with their topic. It should be comprehensive, to the point, and coherent.
• A brief summary is required for decision-makers who have little time to study the whole research proposal. It is best to write this summary when the proposal is more or less finalised. The team should pay extra attention to writing the summary, as it is the ‘eye catcher’ for their proposal.

To ensure that the research proposals are prepared, word processed, and duplicated in time for the panel presentation, facilitators should monitor each group closely, making sure that the sections of the proposal that have been completed are promptly submitted to the secretariat or group members for word processing. Encourage groups to use the list of proposal sections presented in the group work as a checklist to keep production of the final draft co-ordinated.

Group work

The major task of the facilitator is to assist the team leader in distributing writing tasks among group members, in editing, in organising the word processing and making corrections in the different drafts. All group members should be involved in writing, either working in pairs or individually. They should read all sections written by others. The group as a whole should, in particular, discuss the summary.

If time allows, it is highly recommended that a draft of the proposal (or of the most important sections of the proposal) be given to a facilitator of one of the other groups for comments before the text is finalised.

Presentation of the research proposal to a panel

Trainers should use the presentations to the panel as an opportunity to establish interaction between participants, health managers and experienced researchers. This interaction will be beneficial to all parties. For example:

• The participants will acquire a better understanding of the concerns of managers and of research councils. Furthermore they will acquire confidence in presenting and defending research proposals.
• The managers will be exposed to a systematic approach to problem solving and acquire a better appreciation of research information.
• Experienced researchers will be exposed to the practical concerns of health systems research and acquire a better understanding of the approaches and potential of this type of research.

Briefing of panel members

The course facilitator should brief panel members so that they are familiar with the purpose of the presentation. It is useful to request that they behave as though they were members of a research committee that is responsible for approving the projects.

Time allocated

Allow 10 minutes for each presentation and 10-15 minutes for questions and discussion.

Role of facilitators

During the presentation, course facilitators should refrain, as far as possible, from intervening unless it is obvious that an important point is being misunderstood or overlooked. However, panel members or participants may require assistance on specific issues, and the facilitators should serve as resource persons for this purpose.

Document(s) 24 of 27