1RESEARCH ENQUIRY Introduction It is seen that there is high prevalence of anemia among the women in Australia who belong to the reproductive age (Fitzpatrick et al., 2015). The percentage of the women who are in the age of reproduction that is 15 to 49 years and are suffering from anemia was very high in the past. However the percentage decreased significantly in the past decades due to the use of a number of steps that is the collective effort of the Australian Government as well as the citizens of the country (Leonard et al., 2018). As per World Health Organization or WHO, the prevalence of anemia among the women belonging to the reproductive age is referred to as the sum of both the pregnant and the non-pregnant women is below 11 g/dL. However, this is not the concern of the research as the research proposal highlights the social impact on the women who are suffering from anemia at the time of pregnancy (Kline et al., 2013). The social impact that is prevalent on the healthcare issues is a big concern on the healthcare research as that acts as a big obstacle for the complete and unbiased research that is supposed to take place in the healthcare research (Smithers et al., 2014). The social impact that is seen among the women who are suffering from anemia is the prevalence of certain comorbid factors like household work, poverty, food insecurity, lower education among the women who are suffering from anemia regarding the health issues and the inability to purchase the supplements for the deficiency of iron (McAullay et al., 2018).A lot of research has been conducted that emphasizes the link of anemia and the psychological status of the women due to the social impact and pressure on the women about reproduction. Thus, the statement of purpose of the study is to highlight the social impact that anemia has in the society. The research is aimed at focusing on the various ways to aid the anemic women socially along with reducing the psychological pressure on women who are pregnant as well as anemic (Smithers et al., 2014).
2RESEARCH ENQUIRY Research Aim and Objectives The aim of the study is to know the importance of the various ways that can reduce the pressure on the pregnant women who are anemic by reducing the social impact and the psychological pressure on these women. The research design will emphasize on the following. 1.To know the role of the society in reducing the psychological pressure on the pregnant women suffering from anemia. 2.To analyse various means that can help to reduce the social impact on the anemic women who are either pregnant or have already delivered and are now suffering from anemia. 3.To suggest a number of methods that can act as a probable means to reduce the social impact on the lives of the pregnant women. Research Questions The research questions are as follows: 1.What is the role of the society in building up the psychological pressure amongst the women who are suffering from anemia or have been anemic after the delivery of their child? 2.What are the various ways in order to reduce the social impact on the anemic women who are either pregnant or have already delivered and are now suffering from anemia? 3.What are the methods that can act as a probable means to reduce the social impact on the lives of the pregnant women?
3RESEARCH ENQUIRY Research Hypotheses H0: The involvement of the various social factors that do not increase the psychological burden on the women who are pregnant and are suffering from anemia. H1:The involvement of the various social factors that increase the psychological burden on the women who are pregnant and are suffering from anemia. Research Plan Methodology The study methodology is correlation of data which involves the use of the quantitative data that will comprise the use of the interviews and surveys that will help in determining the percentage and the rate of involvement of the Aboriginal women who are actually suffering from societal stress and pressure after pregnancy due to prevalence of anemia (Smith, 2015). The research design is usually of three types like descriptive or analytical, explanatory and the exploratory out of which the systematic investigative design of the research helps in understanding along with evaluating the study in a more descriptive way. The investigative design is conducted to know the meanings of the concept at the very initial stage and he explanatory design is used for the development of a relationship of a between the two research variables that are being considered at the research design (Flick, 2015; Simonsohn, Nelson & Simmons, 2017). Thus, it is beneficial to use the analytical research design for this research design in order to gain a detail idea and knowledge of the pre-existing theories and concepts regarding the prevalence of the anemia among the Aboriginal women in Australia (Ledford & Gast, 2018). Sampling The method of sampling that will be used for the research will involve both the non- probability and the probability technique along with simple random sampling method
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4RESEARCH ENQUIRY (Panneerselvam, 2014). This will help in the better understanding of the research topic. It is seen that around 100 women who fall under the age group of 15-35 years will be asked to take part in the survey and the interview. Data Collection The collection of data for this study will include both primary along with secondary data sources (Leonard et al., 2017). Collection of the primary data would be done by a number of ways like surveys, and interviews (Udovicich, Perera & Leahy, 2017). The secondary data will include all kinds of data such as the information that is available either in the printed form in addition to online platform. Both these type of data will be used in order to carry out the particular study (Foley, Schubert & Denaro, 2013). Data Analysis To carry out the research and the evaluation of quantitative data which has been collected by the use of the surveys and interviews will be converted into the numerals and percentage so that a comprehensive and compact data can be obtained (Panneerselvam, 2014). This will help in the better comparison of the obtained data. The data can then be converted into charts and graphs or even in pictorial presentation. In order to analyze and evaluate the data thematic approach will be considered. The gathered information from the interview as well as the survey will be written as per the number of themes that are related directly to the topic of research (Udovicich, Perera & Leahy, 2017). Literature Review Leonard et al. (2018) has shown that the deficiency of iron in the pregnant women can cause a number of adverse effects that are even related to the death at the time of pregnancy. It also causes the preterm birth and the low weight of the baby at the time of birth along with lower cognitive development in the child at the time of birth. It is seen that the supplement of
5RESEARCH ENQUIRY the pregnant women with iron tablets that help to regain the lost amount of the iron due to increased demands at that time (Clarke & Boyle, 2014). Despite all these efforts the iron deficiency anemia is seen to be increasing among the Aboriginal women for several decades. This is due to a number of associated factors like the poor nutrition among the Aboriginal women, lower use of the supplementation tablets, poverty, inadequate medicine intake, and low level of education (Browne, Hayes & Gleeson, 2014). It is seen that there are a number of social and demographic factors that are associated with the deficiency of iron and other micronutrients in the women. Thus, it can be clearly linked to the presence of social impact on the women (Bar-Zeev et al., 2014). The women who have or are suffering from anemia at the time or after pregnancy often face a number of depression and atrocities from the society that creates a huge impact on the mental health of the pregnant women. The gap in the literature is created due to the inadequate linking of the potential mechanism that can link the psychological impact on the pregnant women (Fitzpatrick et al., 2015). The research shows that a lot of associated factors are present that are linked to the anemic women who are either pregnant or have already delivered (Smithers et al., 2014). Thus, this research proposal will bridge the gap that exists between the literature regarding the antenatal depression and the behavior of the healthcare activity among the high income group and among the Aboriginal community (Browne, Hayes & Gleeson, 2014). It is also seen that the mothers who suffer from depression due to the social trauma that is prevalent as they suffer from anemia have severe impact on the child development as they often lack behind in the process of vaccination or the child visits (McAullay et al., 2018). These factors are anyhow less among theAboriginal and Torres Strait Islander due to poor healthcare services along with this the reduced concern of the mother regarding the health of the child deteriorates it further (Smithers et al., 2014).
6RESEARCH ENQUIRY Identification of the gaps in the society The research suggests that approximately one-fourth of the total population is suffering from anemia. The burden of the population who are suffering from anemia is high among the native or the indigenous populations as compared to the common population (Bar- Zeev et al., 2013).The existence of anaemia that is due to deficiency of iron at the time of pregnancy is usually low that is approximately less than 20% among the developed countries and is much higher in the developing countries and the countries who are facing disadvantage in the socioeconomic areas (Browne, Hayes & Gleeson, 2014). Reports show that the prevalence of anaemia is higher among the Aboriginal women than the indigenous women. The prevalence of anaemia among the Aboriginal women is higher by 50% as compared to the non-indigenous women (McAullay et al., 2018). There are a number of data that shows that the anaemia due to the deficiency of iron at the time of pregnancy among the adolescentAboriginal women is higher (Clarke & Boyle, 2014). Thus, the significance of the research proposal is that it highlights on the fact that despite the developing health services the Aboriginal community especially the women are suffering from anaemia. All these women has to suffer from a number of social and psychological pressure if they are suffering from anaemia at the time of pregnancy (Leonard et al., 2018). Research has shown that the reason for anaemia can be infections, genetic conditions and the inflammation that are also prevalent among the Aboriginal women (Browne, Hayes & Gleeson, 2014). The other reasons are iron deficiency and the deficiency due to lack of proper nutrition that can arise due to a number of factors such as the poverty, lack of enough resources as well as the lack of proper healthcare services (McAullay et al., 2018). In order to prevent the adverse damage that can be due to the deficiency of iron supplements should be taken. There is strong regulation of the deficiency of iron, however at the time of pregnancy the demand is increased thus, the deficiency is also increased that leads conditions of anaemia
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7RESEARCH ENQUIRY (Clarke & Boyle, 2014). The more demand of iron at the time of pregnancy implies that the prevalence of anaemia can be strong reason for the prevalence of childhood anaemia in the remote Aboriginal and Torres Strait Islander (Bar-Zeev et al., 2014). Significance of the study The significance of the study is that it will help the researchers to know the factors that are causing the increased anaemia in the Aboriginal women at the time of pregnancy and the other social impact that can deteriorate their health condition (Smithers et al., 2014). It will also highlight the ways that can help to reduce the societal burden on these women that will help them to recover fast and also to reduce their psychological pressure (Leonard et al., 2018). The significance of this research is thus seen from the higher prevalence of the anaemia among the women and the impact it can have on the early childhood. The other significance is that despite the improvements in the healthcare services and the implementation of the services in the remote Aboriginal and Torres Strait Islander community there is still a huge gap between the accesses of those services (Aquino et al., 2018). Ethical Considerations The research will follow strict research ethics during the entire research timeline. In order to collect primary data, participants will not be forced to take the survey or the interview (Foley, Schubert & Denaro, 2013). Before the start of the survey or interview a consent form will be signed by each of the participants in order to make sure that the participants actively participated and were under no pressure from the researchers. The survey paper will not contain any kind of company logo or symbol that portrays any kind of advertisement but it should be understood that the research is completely based for the academic purpose only (Udovicich, Perera & Leahy, 2017). In case of any permission that is
8RESEARCH ENQUIRY required from the university and from any authority an authorization letter will be taken from the University that can be presented everywhere at the time of conducting the research especially at the time of survey and interview (Leonard et al., 2017). In order to carry out the secondary research, referencing is a very critical aspect that should be undertaken by the researcher in order to avoid any kind of plagiarized activity. Hence, the researcher should not take any kind of approach that violates the terms and conditions for the maintenance of the ethical guidelines (Foley, Schubert & Denaro, 2013). Study Limitations There has to be a number of research limitations in each research study irrespective of the well-structured and well-designed research methodology (Udovicich, Perera & Leahy, 2017). The first reason for the limitation of the study is the time frame that is always a problem in every research, along with this, the availability of the resources also becomes a limitation for the completion of the research study. It also might be the case that certain resources will remain unavailable and inaccessible that can delay the research study. The other limitations can be the responses from the participants that might not be enough in order to gain a particular result. Along with this the participants can also provide with incorrect or incomplete answers that will increase the biasness of the solution (Flick, 2015; Simonsohn, Nelson & Simmons, 2017). In addition to this, there might be also some problems regarding the grant of permissions from the various authorities that are either directly or indirectly related to the research. Another limitation in the research is the lack of proper literature that has focused on the Aboriginal health issues especially the women ((Foley, Schubert & Denaro, 2013). Thus, this limitation acts as a major barrier in the path of attaining complete solution for the social impact on the health of the pregnant Aboriginal women who are suffering from anemia. However, the research has been planned in the most correct way that will help in the completion of the research in the right way (Leonard et al., 2017).
9RESEARCH ENQUIRY Study Administration Activities1st to 3rd Week 4th to 10th week 11th to 13th Week 14th to 17th Week 18th to 21st Week 22nd to 23rd Week 24th Week Selection of topic Data collection from secondary sources Creating layout Literature review Analysis and interpretation of collected data Findings of data Conclusion of study Formation of draft Submission of final work Fig: Gantt Chart (Source: As created by author) Budget DescriptionYear cost incurred
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10RESEARCH ENQUIRY 1stmonth2ndand 3rd months 4thand 5th months 6thmonth Administrative cost Paper Printer and ink Miscellaneous stationary products 400202050 Research cost50020010050 Travel cost5020020050 Sub-Total $ 950$ 420$ 320$ 150 Total$ 1,840 Validity The promote internal validity of the research, proper selection of participants is essential along with randomization of the study once correct population of anaemic women have been selected along with ensuring that correct timeframe for the study has been selected. The inclusion and the exclusion criteria must be set properly and emphasized on to ensure proper validity of the study along with set calibrated rules to determine the accuracy of the
11RESEARCH ENQUIRY data. Psychological realism must be ensure to raise the confidence of the study and validity of the data therefore the anonymity of the participants must be rigorously followed. The external validity is threatened if the study is biased and features criteria which are not applicable in regular day to day setting. Therefore, recommendations must be made taking into account the ethnicity and demography of the population so as to maintain the external validity of the study. Conclusion Therefore, it can be concluded thatthe research will aid in establishing the factors that are causing the increased anaemia in the Aboriginal women at the time of pregnancy and the other social impact that can deteriorate their health condition. It will also highlight the ways that can help to reduce the societal burden on these women that will help them to recover fast and also to reduce their psychological pressure. The implication of this research is therefore seen from the higher prevalence of the anaemia among the women and the impact it can have on the early childhood. The other importance of the research is that despite the improvements in the healthcare services and the implementation of the services in the remote Aboriginal and Torres Strait Islander community, the research would be able to identify the gaps in accessing those services. Therefore, in conclusion, the research is extremely crucial for the upliftment of the overall health of the women in the society.
12RESEARCH ENQUIRY References Aquino, D., Leonard, D., Hadgraft, N., & Marley, J. V. (2018). High prevalence of early onset anaemia amongst Aboriginal and Torres Strait Islander infants in remote northern Australia.Australian Journal of Rural Health,26(4), 245-250. Bar-Zeev, S. J., Kruske, S. G., Barclay, L. M., Bar-Zeev, N., & Kildea, S. V. (2013). Adherence to management guidelines for growth faltering and anaemia in remote dwelling Australian Aboriginal infants and barriers to health service delivery.BMC health services research,13(1), 250. Bar-Zeev, S., Barclay, L., Kruske, S., & Kildea, S. (2014). Factors affecting the quality of antenatal care provided to remote dwelling Aboriginal women in northern Australia.Midwifery,30(3), 289-296. Browne, J., Hayes, R., & Gleeson, D. (2014). Aboriginal health policy: is nutrition the ‘gap’in ‘Closing the Gap’?.Australian and New Zealand Journal of Public Health,38(4), 362-369. Clarke, M., & Boyle, J. (2014). Antenatal care for Aboriginal and Torres Strait Islander women.Australian family physician,43(1/2), 20. Fitzpatrick, J. P., Latimer, J., Ferreira, M. L., Carter, M., Oscar, J., Martiniuk, A. L., ... & Elliott, E. J. (2015). Prevalence and patterns of alcohol use in pregnancy in remote W estern A ustralian communities: The L ililwan P roject. Drug and alcohol review, 34(3), 329-339. Flick, U., (2015).Introducing research methodology: A beginner's guide to doing a research project.Sage.
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13RESEARCH ENQUIRY Foley, W., Schubert, L., & Denaro, T. (2013). Breastfeeding experiences of Aboriginal and Torres Strait Islander mothers in an urban setting in Brisbane.Breastfeeding Review,21(3), 53. Kline, K., McCarthy, J. S., Pearson, M., Loukas, A., & Hotez, P. J. (2013). Neglected tropical diseases of Oceania: review of their prevalence, distribution, and opportunities for control.Plos neglected tropical diseases,7(1), e1755. Ledford, J. R., & Gast, D. L. (2018).Single case research methodology: Applications in special education and behavioral sciences. Routledge. Leonard, D., Aquino, D., Hadgraft, N., Thompson, F., & Marley, J. V. (2017). Poor nutrition from first foods: A cross‐sectional study of complementary feeding of infants and young children in six remote Aboriginal communities across northern Australia.Nutrition & dietetics,74(5), 436-445. Leonard, D., Buettner, P., Thompson, F., Makrides, M., & McDermott, R. (2018). Linking ‘data silos’ to investigate anaemia among Aboriginal and Torres Strait Islander mothers and children in Far North Queensland.Australian and New Zealand journal of public health,42(5), 456-462. Leonard, D., Buttner, P., Thompson, F., Makrides, M., & McDermott, R. (2018). Anaemia in pregnancy among Aboriginal and Torres Strait Islander women of Far North Queensland: A retrospective cohort study.Nutrition & Dietetics,75(5), 457-467. McAullay, D., McAuley, K., Bailie, R., Mathews, V., Jacoby, P., Gardner, K., ... & Edmond, K. (2018). Sustained participation in annual continuous quality improvement activities improves quality of care for Aboriginal and Torres Strait Islander children.Journal of paediatrics and child health,54(2), 132-140.
14RESEARCH ENQUIRY Panneerselvam, R., (2014).Research methodology. PHI Learning Pvt.Ltd.. Simonsohn, U., Nelson, L., & Simmons, J. (2017). Research Methodology, Design, and Analysis.Annual Review of Psychology,69(1). Smith, J.A. ed., (2015).Qualitative psychology: A practical guide to research methods. Sage. Smithers, L. G., Gialamas, A., Scheil, W., Brinkman, S., & Lynch, J. W. (2014). Anaemia of pregnancy, perinatal outcomes and children's developmental vulnerability: a whole‐ of‐population study.Paediatric and perinatal epidemiology,28(5), 381-390. Smithers, L. G., Gialamas, A., Scheil, W., Brinkman, S., & Lynch, J. W. (2014). Anaemia of pregnancy, perinatal outcomes and children's developmental vulnerability: a whole‐ of‐population study.Paediatric and perinatal epidemiology,28(5), 381-390. Udovicich, C., Perera, K., & Leahy, C. (2017). Anaemia in school‐aged children in an Australian Indigenous community.Australian Journal of Rural Health,25(5), 285- 289.
15RESEARCH ENQUIRY Appendix Survey Questions 1.What are the main factors linked to the prevalence of anemia? 2.What is the behavior of the family after receiving the news of pregnancy? 3.How the news of anemia is at the time of pregnancy is received by the family? 4.What are the societal factors that contribute to the depression at the time of pregnancy? Interview Questions 1.What is the total family income? 2.How frequently do they visit the healthcare center at the time of pregnancy? 3.Do they buy the iron supplements? 4.Do they face any kind of pressure at home due to anemia at the time of pregnancy?