Research Application Management System
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Public Capture
Please select which Project you wish to Capture:
Research Protocol for submission to Provincial Health Research Committee
Completed Research Study to include on NHRDB
Research Study for NHRDB but not for PHRC submission
Conference Form
Research Protocol for submission to Provincial Health Research Committee
Researchers may apply on-line to have their research protocols approved.
001.
Captured for
Please select which committee should be responsible for this submission
Western Cape Health Research Committee
Kwazulu-Natal Health Research Committee
Mpumalanga Health Research Committee
Gauteng Health Research Committee
Eastern Cape Health Research Committee
Northern Cape Health Research Committee
Free state Health Research Committee
Limpopo Health Research Committee
North West Health Research Committee
001.
Title of the Applicant/Principal Investigator
Choose from drop down menu
Dr
Mr
Mrs
Miss
Ms
Prof
001.
First and middle names of Applicant/Principal Investigator
eg. Fred Harry
001.
Surname of Applicant/Principal Investigator
eg. SMITH (In capital letters)
001.
Qualifications of Applicant/Principal Investigator
Tertiary degrees or diplomas of the applicant/principal investigator
001.
Email Address of Applicant/Principal Investigator
Details as requested
001.
Title of the research proposal
Main title of the research protocol
001.
Name of Institution or Organization affilliated with
Details as requested
001.
Institution supporting the study
Institution or Organisation supporting the study.
001.
Associated Institutions
Partner or other institutions
001.
Address
Details as requested
001.
Town or City
Details as requested
001.
Province
Details as requested
KZN
GP
MP
NW
LP
FS
WC
NC
EC
Multi Provincial
001.
Post Code
Details as requested
001.
Telephone
Details as requested
001.
Fax
Details as requested
001.
Funding institution or Donor/Sponsor
Name of donor(s) providing financial support or whether the Researcher(s), Company, Institution or Organisation will be financing the research.
001.
Summary or Abstract
Brief summary or abstract outlining the aim and objectives of the study, the research methodology and data analysis.
001.
Introduction
Summary of literature relevant to the proposed research problem/ problem statement.
001.
Motivation
Outline of the relevance and benefits of the proposed research on Public Health.
001.
Aim or Purpose
The aim or purpose must be clear and feasible.
001.
Objectives
Objectives must be specific, achievable, realistic and time-bound and clearly describe the specific deliverables of the proposed study.
001.
Research Area
Classify the research area e.g. TB, HIV and AIDS, etc. or other specific research areas.
001.
Study Design
Specify the study design e.g. descriptive, analytical, intervention, etc.
001.
Study Population
Clearly describe the study population that will be sampled.
001.
Sampling
Specify the sampling strategy/ formulae that will be used to sample participants and include the sample size.
001.
Inclusion and Exclusion criteria
Clearly state inclusion & exclusion criteria that will be used.
001.
Data Collection
Specify data collection methods and instruments that will be used (if applicable) and include as appendices to the protocol.
001.
Data Analysis
Describe software and techniques that will be used for data analysis.
001.
Pilot Study
Indicate if a pilot study will be conducted and provide details (including the duration, sites, etc.).
001.
Research Sites
Identify Health Facilities where the research will be conducted i.e. specific Hospitals, Community Health Centres or Primary Health Care Clinics.
001.
Name of institution which gave Ethical Aproval
Health clearance required for health research studies involving human subjects
001.
Date of Ethical Clearance
(DD-MM-YYYY) Date on which above ethical committee provided clearance
001.
Ethical considerations
This section must clearly indicate what ethical issues were considered for the study including informed consent, confidentiality, etc.
001.
Feedback and Dissemination of Research Findings
Clearly outline a strategy for feedback/ dissemination of results and recommendations to relevant stakeholders. Note that research reports, presentations and publications must formally acknowledge the KwaZulu-Natal Department of Health.
001.
Budget
Indicate the global amount that is anticipated being spent on the research
001.
Human Resources
Specify who will be involved in conducting the research including Research Assistants and Statisticians.
001.
Time Frame
Provide a realistic time frame for the research i.e. specify the anticipated commencement and completion dates.
001.
References and Appendices
Literature used for the development of the research proposal must be clearly referenced in full version of the protocol which should be attached. Relevant appendices must be attached to the Research Proposal including data collection instruments/ tools and any other relevant documentation referred to in the research proposal.
001.
Permission from Facilities
Confirmation that written permission from District and/or Facility Managers granting permission for research to be conducted in facilities will be obtained before research may begin.
Accepted
Declined
N/A
Pending
001.
Appendices
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