The art of data collection in health system research: Lessons learned from the field.
Data collection is the most important aspect any research endeavour. Poor quality of the data will have impact on the results of the research study.Therefore it is vital for the researchers to adopt appropriate data collection methods to ensure quality data.Here is a blog by Meena Putturaj which highlights the practicalities of data collection in health systems research based on the field experiences.
Data collection is a crucial aspect of any research project. Depending on the nature and scope of the research question, collecting quality data requires considerable investment of time and resources. Indeed, any research endeavour is handicapped without the relevant data.
During a recent health systems research project, I had to collect a lot of information from government agencies, which turned out to be no cake walk. There were occasions when I had to wait for hours at a time to collect documents, to meet officials, and to conduct interviews. Those waiting periods gave me sufficient time to observe and reflect on the functioning of some of the government agencies in India.
Health systems research often requires data from, and cooperation by, the state sector authorities. So, as a rule of thumb, the health systems researchers work closely with government officials and will require data from them, the interpretation of which might reflect negatively upon those state sector authorities. This can, I think, make some officials and other employees feel that they are being cross examined or interrogated when researchers go to collect data from them. The various situations that I’ve been in while collecting data from government officials have enabled me to develop skills to deal with this tension and the struggle of getting relevant data. The following strategies have worked well for me while trying to obtain data:
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Dr Vijayashree Yellappa, PhD article titled, ” Private practitioners’ contributions to the Revised National Tuberculosis Control Programme in a South Indian district” published in the International Journal of TB and Lung Disease
This paper demonstrates the meagre involvement of private practitioners in the Indian National TB Program, even after ffifteen years after the starting the Public Private Mix in the National TB control programme.
SETTING: Tumkur District, South India.
OBJECTIVE: To assess the participation of for-profit, formal private practitioners (PPs) under the Revised National Tuberculosis Control Programme’s (RNTCP’s) public-private mix (PPM) schemes and document their contribution to RNTCP pulmonary tuberculosis (TB) case finding.
DESIGN: RNTCP reports at district TB centre were reviewed. PPs were mapped and their referrals of presumptive TB cases to the RNTCP during 2011 were assessed using laboratory registers at designated microscopy centres (DMCs).
RESULTS: None of the 424 PPs had signed up for any PPM scheme. However, 22% made at least one referral to a DMC in 2011. PP referrals constituted 15% of the presumptive TB cases examined at the DMCs, and PPs contributed to 23% of the sputum smear-positive TB cases detected. Among PP referrals, the proportion of confirmed smear-positive cases was high (24%).
CONCLUSION: Fifteen years after the start of PPM, formal engagement of PPs with RNTCP was non-existent. However, PPs do refer cases to the RNTCP and contribute to a fraction of TB case detection. The high proportion of confirmed sputum smear-positive cases suggests that PPs tend to make selective referrals. More efforts are needed to promote the engagement of PPs in the RNTCP.
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‘Even doctors feel generic drugs are sub-standard’
Many patients are denied affordable treatment, as they prefer to buy branded drugs that sometimes cost as much as 7 to 8 times more and deny
A 67-year-old woman in Tumakuru visited a private doctor for a chronic ailment. She was advised some expensive drugs. Even though she was short on funds and struggling to make ends meet, she set aside money to buy medication for two months. Two months later, when she ran out of money, she stopped taking the medicines and discontinued treatment.
Another woman in her fifties in K.G. Halli, Bengaluru, takes her medicine for hypertension only when ‘her legs swell’, something she has noticed happens every time her blood pressure shoots up. Once the swelling stops, she stops taking medicines, because she cannot afford them regularly.
Branded drugs sometimes cost as much as 7 to 8 times as generic drugs. But in spite of their low cost, the public remains suspicious of the effectiveness of generic medicines.
“There is a strong perception among the public, and to our surprise, even practitioners and pharmacists, that generic medicines are of sub-standard quality,” said Praveenkumar Aivalli, Research Officer, Institute of Public Health (IPH), Bengaluru. A team of researchers from IPH, including Dr. Aivalli, have conducted a three-year study on access to generic medicines for non-communicable diseases, the results of which will be published shortly.
As part of the study, three taluks in Tumakuru district were randomly chosen and around 1,000 to 1,200 houses surveyed. The team found that public awareness of generic drugs was very low and people hesitated to visit primary health centres (PHCs), preferring private hospitals even when they could barely afford to. They found a similar poor perception of generic drugs among residents in K.G. Halli, Bengaluru.ÿ Comparing figures from 2013 to 2016, the availability of drugs in PHCs had greatly improved in the period.
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Dr Praveenkumar Aivalli blog titled, ” What I learnt from my first health system research project ” published in BioMed Central
Starting my first research project
Back in 2013, I just stepped out of my university after getting my Master of Public Health degree, in no time I was given an excellent opportunity to work on a World Health Organization (WHO) funded health system research project in one of the reputed public health research institutes in Bangalore. It was the first research project of my public health career and as a new bee, I was buzzing with excitement and enthusiasm about the study.
The project was on improving NCD (Non Communicable Diseases) care at primary health centers in one of the districts in south India. It was a quasi experimental study trying to understand the impact of health system interventions through a baseline and end line household and facility surveys.
For better coordination, exposure and learning, I was placed in the study district. Having completed most of my education in the country, it was not that difficult for me to understand our country’s health system.
We visited more than 1000 families to get data on NCD care at the rural level, health seeking behaviors of NCD patients and their out pocket expenditures for NCD care.
The theoretical explanations from classrooms started fitting in its notches when I got exposed to the field during the early days of the project. I got the hang of the project fairly quickly and began preparing for the baseline survey in the year of 2013.
We visited more than 1000 families to get data on NCD care at the rural level, health seeking behaviors of NCD patients and their out pocket expenditures for NCD care. We also visited primary health centers and private pharmacies in the area to collect information on medicine availability.
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Erlyn Macarayan, an Emerging Voice of 2014 shares her reasons as to why you should apply for Emerging Voices for Global Health 2016! Apply now! Last date for application: March 20th 2016
Emerging Voices for Global Health (EV4GH) is an innovative multi-partner blended training program for young, promising and emerging health policy & systems researchers, decision makers and other health system professionals with an interest in becoming influential global health voices and/or local change makers. See http://www.ev4gh.net for details.
See http://www.ev4gh.net for details.
In 2016, continuing with the tradition of partnering with significant health systems research symposium, we have a new edition of EV4GH in close association and partnership with the 4th Global Symposium on health systems research, organised by Health Systems Global. See http://healthsystemsresearch.org/hsr2… for details.
See http://healthsystemsresearch.org/hsr2… for details.
The symposium will take place from 14-18 November, 2016 at Vancouver, Canada.