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Steps in data analysis and report writing

* These steps need not be in the sequence in this diagram. The sequence may be adjusted according to the needs of the research teams.

** These elements are optional and may be omitted if not relevant for research teams

Module 32: WRITING A RESEARCH REPORT

1. Steps in preparing the report: preliminary considerations
2. Writing the research report
   1. Introduction
   2. Main components of a research report
   3. Style and layout
   4. Common weaknesses in writing
   5. Revising and finalising the text

I. PREPARING A RESEARCH REPORT: Preliminary considerations

Who will read your research report? How will they read it?

HSR studies have different audiences: health managers, researchers, and concerned community members. These groups will read your report from different perspectives.

Health managers and community members will ask:

• How will this ‘new information’ help improve the health of the community? (i.e., What is the problem and how will this information help solve/reduce the problem?)

Researchers, on the other hand, will want to know:

• Can I ‘believe’ these findings? (i.e., Are the findings valid and reliable?) The research design, sampling, methods of data collection and the data analysis will have to substantiate the validity and reliability.

II. WRITING THE RESEARCH REPORT

1. Introduction

HSR reports need to

• have a logical, clear structure,
• be to the point, and
• use simple language and have a pleasant lay-out.

Like an architect who designs a house has to draw a plan, you first have to make an OUTLINE for your report. This outline will contain a head, a body and a tail. The head consists of a description of your problem, within its context (the country and research area), the objectives of the study and the methodology followed. This part should not comprise more than one quarter of the report, otherwise it becomes top-heavy. The body will form the bigger part of your report: it will contain the research findings. The tail, finally, consists of the discussion of your data, conclusions and recommendations.

Then you will have to make your report attractive and user-friendly with a creative title page, a preface with acknowledgements, a table of contents, perhaps a list of tables, figures and/or abbreviations. Of course, the references you used for your study will have to be added, and annexes (including, at minimum, your data-collection tools).

Before you start writing, it is therefore essential to group and review the data you have analysed by objective. Check whether all data has indeed been processed and analysed as you planned in the group work of Module 21.

Draw major conclusions and relate these to the literature read. Again you may be inspired to go back to your raw data and refine your analysis, or to search for additional literature to answer questions that the analysis of your data may evoke.

2. Main components of a research report

The research report should contain the following components:

TITLE and COVER PAGE
SUMMARY OF STUDY DESIGN, FINDINGS AND RECOMMENDATIONS
ACKNOWLEDGEMENTS
TABLE OF CONTENTS
List of tables, figures (optional)
List of abbreviations (optional)

1. INTRODUCTION (statement of the problem in its local context, including relevant literature)
2. OBJECTIVES
3. METHODOLOGY
   
4. RESEARCH FINDINGS
   
5. DISCUSSION
6. CONCLUSIONS AND RECOMMENDATIONS

REFERENCES

ANNEXES (data collection tools; tables)

The findings, discussion of findings, conclusions and recommendations will form the most substantial part of your report, which has to be written from scratch.

We, therefore, strongly advise that you start with the findings, discussion and conclusions. Nevertheless we will briefly elaborate on each component in the sequence in which it will finally appear in your report.

• Cover page

The cover page should contain the title, the names of the authors with their titles and positions, the institution that is publishing the report, (e.g., HSR Unit, Ministry of Health) and the month and year of publication. The title could consist of a challenging statement or question, followed by an informative subtitle covering the content of the study and indicating the area where the study was implemented. (See Module 6.)

• Summary

The summary should be written only after the first or even the second draft of the report has been completed. It should contain:

— a very brief description of the problem (WHY this study was needed)— the main objectives (WHAT has been studied)
— the place of study (WHERE)
— the type of study and methods used (HOW)
— major findings and conclusions, followed by
— the major (or all) recommendations.

The summary will be the first (and for busy health decision makers most likely the only) part of your study that will be read. Therefore, its writing demands thorough reflection and is time consuming. Several drafts may have to be made, each discussed by the research team as a whole.

As you will have collaborated with various groups during the drafting and implementation of your research proposal, you may consider writing different summaries for each of these groups. For example, you may prepare different summaries for policymakers and health managers, for health staff

of lower levels, for community members, or for the public at large (newspaper, TV). In a later stage you may write articles in scientific journals. (See Module 33.)

• Acknowledgements

It is good practice to thank those who supported you technically or financially in the design and implementation of your study. Also your employer who has allowed you to invest time in the study and the respondents may be acknowledged. Acknowledgements are usually placed right after the title page or at the end of the report, before the references.

• Table of contents

A table of contents is essential. It provides the reader a quick overview of the major sections of your report, with page references, so that (s)he can go through the report in a different order or skip certain sections.

• List of tables, figures

If you have many tables or figures it is helpful to list these also, in a ‘table of contents’ type of format with page numbers.

• List of abbreviations (optional)

If abbreviations or acronyms are used in the report, these should be stated in full in the text the first time they are mentioned. If there are many, they should be listed in alphabetical order as well. The list can be placed before the first chapter of the report.

The table of contents and lists of tables, figures, abbreviations should be prepared last, as only then can you include the page numbers of all chapters and sub-sections in the table of contents. Then you can also finalise the numbering of figures and tables and include all abbreviations.

Chapter 1: Introduction

The introduction is a relatively easy part of the report that can best be written after a first draft of the findings has been made. It should certainly contain some relevant (environmental/ administrative/ economic/ social) background data about the country, the health status of the population, and health service data which are related to the problem that has been studied. You may slightly comprise or make additions to the corresponding section in your research proposal, including additional literature, and use it for your report.

Then the statement of the problem should follow, again revised from your research proposal with additional comments and relevant literature collected during the implementation of the study. It should contain a paragraph on what you hope(d) to achieve with the results of the study.

Global literature can be reviewed in the introduction to the statement of the problem if you have selected a problem of global interest. Otherwise, relevant literature from individual countries may follow as a separate literature review after the statement of the problem. You can also introduce theoretical concepts or models that you have used in the analysis of your data in a separate section after the statement of the problem.

Chapter 2: Objectives

The general and specific objectives should be included as stated in the proposal. If necessary, you can adjust them slightly for style and sequence. However, you should not change their basic nature. If you have not been able to meet some of the objectives this should be stated in the methodology section and in the discussion of the findings. The objectives form the HEART of your study. They determined the methodology you chose and will determine how you structure the reporting of your findings.

Chapter 3: Methodology

The methodology you followed for the collection of your data should be described in detail The methodology section should include a description of:

• the study type;
• major study themes or variables (a more detailed list of variables on which data was collected may be annexed);
• the study population(s), sampling method(s) and the size of the sample(s);
• data-collection techniques used for the different study populations;
• how the data was collected and by whom;
• procedures used for data analysis, including statistical tests (if applicable).

If you have deviated from the original study design presented in your research proposal, you should explain to what extent you did so and why. The consequences of this deviation for meeting certain objectives of your study should be indicated. If the quality of some of the data is weak, resulting in possible biases, this should be described as well under the heading ‘limitations of the study’.

Chapter 4: Research findings

The systematic presentation of your findings in relation to the research objectives is the crucial part of your report.

The description of findings should offer a good combination or triangulation of data from qualitative and quantitative components of the study. There are two different ways in which you can present your findings:

(1) An integrated presentation of all data by objective

As you listed all data by objective (see Module 21) this should be easy.

For example, in a study of factors associated with high maternal mortality, the interviews with relatives of mothers who died during delivery revealed that 90% of the mothers had attended antenatal care. Only 45% had ever given birth in a health facility, and only 25% had done so during the delivery that became fatal. Analysis of antenatal cards with the local health staff indicated that roughly 35% of mothers who visited ANC for their last baby had given birth in a hospital or HC. The analysis of cards therefore confirmed the overall low use of delivery care in a health facility, although in general the utilisation of delivery care appeared slightly better than that of the mothers who died. Interviews with the relatives of the deceased mothers presented distance and costs as major factors for not attending the delivery facilities. FGDs with mothers, however, also revealed concerns about lack of privacy in health facilities, carelessness of health staff and the young age of midwives. One woman (40 years) stated: In that hospital, midwives are very young, they have not yet given birth themselves. How can I be delivered by my daughter, how can I let her see me in that state?

These integrated presentations will be a compilation of tables, graphs, narrative interpretation and illustrative quotes from in-depth interviews or FGDs.

(2) Presentation of data by research instrument

Sometimes it is easier to analyse the data by instrument and integrate the findings only in the discussion. Separate analysis is indicated for objectives that are covered by distinct study populations using specific instruments.

For example, in the study on reasons for non-compliance of patients with TB treatment presented in Module 4, four different research tools were used. Through analysis of TB cards of a cohort of patients, the proportion of irregular- and non-attendees for treatment could be defined (objective 1).

FGDs with different groups of community members provided data on community perceptions of the disease (objective 2). Interviews with patients (regular and irregular/non attendees) shed light on different reasons for non-compliance with treatment (objectives 3 and 4). Interviews with health staff revealed weaknesses in the services that could be contributing to non-compliance of patients (objective 5). Parts of the data which required integration (e.g., community members and patients had opinions on weaknesses or strengths of the services as well, whereas staff and community members complemented patient data on economic and socio-cultural reasons for defaulting) were highlighted in the discussion.

The list of data by objective will help you to decide how to organise the presentation of data. The decision concerning where to put what can best be made after all data have been fully processed and analysed, and before the writing starts.

When all data have been analysed, a detailed OUTLINE has to be made for the presentation of the findings. This will help the decision-making on how to organise the data, and is an absolute precondition for optimal division of tasks among group members in the writing process.

At this stage you might as well prepare an outline for the whole report, taking the main components of a research report (p.5) as a point of departure.

An outline should contain:

• The headings of the main sections of the report,
• The headings of subsections,
• The points to be made in each section, and
• A list of tables, figures and/or quotes to illustrate each section.

The outline for the chapter on findings will predictably be the most elaborate.

The first section under findings is usually a description of the study population. When different study populations have been studied, you should provide a short description of each group before you present the data pertaining to these informants.

Then, depending on the study design, you may provide more information on the problem you studied (size, distribution, characteristics). Thereafter, in an analytic study, the degree to which different independent variables influence the problem will be discussed.

For example: In a study on malnutrition, the chapter ‘Findings’ may look like this:

This system of numbering is flexible and can be extended according to need with further headings or subheadings. It allows you to keep an overview of the process when different group members work on different sections of the report at the same time.

If your findings are very elaborate so that you have sub-sub-subheadings with 4 or 5 digits, you might decide to split up the findings into several chapters. In addition, you may consider leaving off some of the numbering on sub-sections, if it is clear under what major heading they belong. However, keep all the numbering until the final draft, as it helps you keep your report in order when various members of the group are working on different sections.

TABLES and FIGURES in the text need numbers and clear titles. It is advisable to first use the number of the section to which the table belongs. In the last draft you may decide to number tables and figures in sequence.

Include only those tables and figures that present main findings and need more elaborate discussion in the text. Others may be put in annexes, or, if they don’t reveal interesting points, be omitted.

Note that it is unnecessary to describe in detail a table that you include in the report. Only present the main conclusions.

Chapter 5: Discussion

The findings can now be discussed by objective or by cluster of related variables or themes, which should lead to conclusions and possible recommendations. The discussion may include findings from other related studies that support or contradict your own.

Chapter 6: Conclusions and recommendations

The conclusions and recommendations should follow logically from the discussion of the findings. Conclusions can be short, as they have already been elaborately discussed in chapter 5. As the discussion will follow the sequence in which the findings have been presented (which in turn depends on your objectives) the conclusions should logically follow the same order.

It makes easy reading for an outsider if the recommendations are again placed in roughly the same sequence as the conclusions. However, the recommendations may at the same time be summarised according to the groups towards which they are directed, for example:

• policy-makers,
• health and health-related managers at district or lower level,
• health and health-related staff who could implement the activities,
• potential clients, and
• the community at large.

Remember that action-oriented groups are most interested in this section.

In making recommendations, use not only the findings of your study, but also supportive information from other sources. The recommendations should take into consideration the local characteristics of the health system, constraints, feasibility and usefulness of the proposed solutions. They should be discussed with all concerned before they are finalised.

If your recommendations are short (roughly one page), you might include them all in your summary and omit them as a separate section in Chapter 6 in order to avoid repetition.

References

The references in your text can be numbered in the sequence in which they appear in the report and then listed in this order in the list of references (Vancouver system). Another possibility is the Harvard system of listing in brackets the author’s name(s) in the text followed by the date of the publication and page number, for example: (Shan 2000: 84). In the list of references, the publications are then arranged in alphabetical order by the principal author’s last name. (See Module 5.)

You can choose either system as long as you use it consistently throughout the report.

Annexes or appendices

The annexes should contain any additional information needed to enable professionals to follow your research procedures and data analysis.

Information that would be useful to special categories of readers but is not of interest to the average reader can be included in annexes as well.

Examples of information that can be presented in annexes are:

• tables referred to in the text but not included in order to keep the report short;
• lists of hospitals, districts, villages etc. that participated in the study;
• questionnaires or check lists used for data collection.

3. Style and layout

(1) Style of writing

Remember that your reader:

• Is short of time
• Has many other urgent matters demanding his or her interest and attention
• Is probably not knowledgeable concerning ‘research jargon’

Therefore the rules are:

• Simplify. Keep to the essentials.
• Justify. Make no statement that is not based on facts and data.
• Quantify when you have the data to do so. Avoid ‘large’, ‘small’; instead, say ‘50%’, ‘one in three’.
• Be precise and specific in your phrasing of findings.
• Inform, not impress. Avoid exaggeration.
• Use short sentences.
• Use adverbs and adjectives sparingly.
• Be consistent in the use of tenses (past or present tense). Avoid the passive voice, if possible, as it creates vagueness (e.g., ‘patients were interviewed’ leaves uncertainty as to who interviewed them) and repeated use makes dull reading.
• Aim to be logical and systematic in your presentation.

(2) Layout of the report

A good physical layout is important, as it will help your report:

• make a good initial impression,
• encourage the readers, and
• give them an idea of how the material has been organised so the reader can make a quick determination of what he will read first.

Particular attention should be paid to make sure there is:

• An attractive layout for the title page and a clear table of contents.
• Consistency in margins and spacing.
• Consistency in headings and subheadings, e.g.: font size 16 or 18 bold, for headings of chapters; size 14 bold for headings of major sections; size 12 bold, for headings of sub-sections, etc.
• Good quality printing and photocopying. Correct drafts carefully with spell check as well as critical reading for clarity by other team-members, your facilitator and, if possible, outsiders.
• Numbering of figures and tables, provision of clear titles for tables, and clear headings for columns and rows, etc.
• Accuracy and consistency in quotations and references.

4. Common weaknesses in writing

Writing is always a challenging job, which requires courage. Starting is usually most difficult. Don’t be afraid to make mistakes, otherwise you will never begin! However, it is good to be aware of common pitfalls, which you might try to avoid.

An almost universal weakness of beginning report writers is omitting the obvious. Hardly ever does the description of the country or area contain sufficient data to permit outsiders to follow the presentation of findings and discussion without problems. On the other hand, some data (e.g., exact geographical location on the globe) could be left out which are usually in.

Endless description without interpretation is another pitfall. Tables need conclusions, not detailed presentation of all numbers or percentages in the cells which readers can see for themselves. The chapter discussion, in particular, needs comparison of data, highlighting of unexpected results, your own or others’ opinions on problems discovered, weighing of pro’s and con’s of possible solutions. Yet, too often the discussion is merely a dry summary of findings.

Neglect of qualitative data is also quite common. Still, quotes of informants as illustration of your findings and conclusions make your report lively. They also have scientific value in allowing the reader to draw his/her own conclusions from the data you present. (Assuming you are not biased in your presentation!)

Sometimes qualitative data (e.g., open opinion questions) are just coded and counted like quantitative data, without interpretation, whereas they may be providing interesting illustrations of reasons for the behaviour of informants or of their attitudes. This is serious maltreatment of data that needs correction.

5. Revising and finalising the text

When a first draft of the findings, discussion and conclusions has been completed, all working group members and facilitators should read it critically and make comments.

The following questions should be kept in mind when reading the draft:

• Have all important findings been included?
• Do the conclusions follow logically from the findings? If some of the findings contradict each other, has this been discussed and explained, if possible? Have weaknesses in the methodology, if any, been revealed?
• Are there any overlaps in the draft that have to be removed?
• Is it possible to condense the content? In general a text gains by shortening. Some parts less relevant for action may be included in annexes. Check if descriptive paragraphs may be shortened and introduced or finished by a concluding sentence.
• Do data in the text agree with data in the tables? Are all tables consistent (with the same number of informants per variable), are they numbered in sequence, and do they have clear titles and headings?
• Is the sequence of paragraphs and subsections logical and coherent? Is there a smooth connection between successive paragraphs and sections? Is the phrasing of findings and conclusions precise and clear?

The original authors of each section may prepare a second draft, taking into consideration all comments that have been made. However, you might consider the appointment of two editors amongst yourselves, to draft the complete version.

In the meantime, other group members may (re)write the introductory sections (INTRODUCTION, OBJECTIVES and METHODOLOGY, adjusted from your original proposal).

Now a first draft of the SUMMARY can be written (see page 5 of this module).

Finalising the research report

It is advisable to have one of the other groups and facilitators read the second draft and judge it on the points mentioned in the previous section. Then a final version of the report should be prepared. This time you should give extra care to the presentation and layout: structure, style and consistency of spelling (use spell check!).

Use verb tenses consistently. Descriptions of the field situation may be stated in the past tense (e.g., ‘Five households owned less than one acre of land.’) Conclusions drawn from the data are usually in the present tense (e.g., ‘Food taboos hardly have any impact on the nutritional status of young children.)

REFERENCES

Gibaldi J (1995) MLA Handbook for Writers of Research Papers. New York: Modern Language Association of America.

Jen Tsi Yang et al. (1996) An outline of Scientific Writing: For Researchers with English As a Foreign Language. Singapore: World Scientific Publishing. www.amazon.com/exec/obidos (through internet, October 2000)

Lindsay D (1996) Guide to Scientific Writing. Australia: Addison & Wesley (paperback). www.amazon.com/exec/obidos (through internet, October 2000).

Trainer’s Notes

Module 32: WRITING A RESEARCH REPORT

Introduction and discussion

• Put the outline for research reports on an overhead sheet and discuss it point by point. Stress that the findings, discussion, conclusions and the recommendations will have priority.
• Take an example from one of the groups when presenting a possible outline for the chapter on Findings, with appropriate headings and subheadings.
• Explain the system of numbering and differentiation of font sizes, making sure that you are consistent in the layout of headings and subheadings so that you can use the example to illustrate appropriate layout later on.
• Ask the participants to suggest the criteria they would use to judge their first draft, before you give guidelines.
• Use examples from the research proposals prepared by various groups when discussing how the statement of the problem, objectives and methodology should be adapted for the final report.

Pay attention to the need for changing the future tense used in the proposal into the present and past tense, if you suspect that some groups may overlook this aspect.

Group work

• Make sure that all of the groups first make an outline for their reports, using the outline presented in the module as a starting point. Ask the groups to hang up the outlines so everyone in their teams can see them.
• The sections on findings, discussion, conclusions and recommendations will take the most time. Some groups may find that the presentation of these sections would work best ordered somewhat differently. Let them know that they can use the outline for presentation that is most appropriate for their own data, but let facilitators discuss with their groups how this part of their presentation can be structured most logically.
• Writing can best start with the findings and conclusions. Only when a reasonable draft is ready should the research-team members be advised to (re)write the introductory chapters.
• Make sure that all group members have some writing tasks, for example, by letting them write in pairs. If certain participants have never written they might need intensive support. You can let them write several paragraphs and then rewrite the text with them, to provide them with an example.
• If groups have no experience in writing reports they will need explicit guidance concerning what points they should check on when they review their first draft, including the basic layout of the report.
• It is advisable to discuss ideas for possible recommendations during the write up of the findings and discussion. These ideas should be recorded immediately (preferably on a flip chart) so they can be used when phrasing recommendations.
• All facilitators should comment on the summary section prepared by each group. Each facilitator should also read and comment on at least one complete draft report from another group before it is finalised.

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