The effectiveness of many interventions to improve health in poor populations
in the developing world remains untested and therefore unproven. It is sometimes
assumed that what works is known and that the only challenge is to make interventions
widely available to underserved populations worldwide, the so-called know-do
gap. However, other than vaccination, few global health interventions are
Evidence-based global health requires use of the evidence from randomized
controlled trials and other scientifically valid studies to evaluate global
health interventions and to measure progress in improving global health. Randomized
controlled trials of global public health interventions are often cluster
trials, randomizing groups or communities.1,2 When
evidence from randomized trials is not available or is difficult to generalize,
observational studies provide useful information but must be carefully interpreted.2 Global health needs assessment and monitoring also
rely on observational studies. This issue of THE JOURNAL illustrates the different
approaches used in evidence-based global health research, with 1 individual
and 3 cluster randomized controlled trials conducted in resource-poor communities
to evaluate essential interventions aimed at preventing diseases and disorders
prevalent in the developing world,3- 6 and
4 observational studies measuring or estimating the frequency of specific
health problems and associated risk factors for a number of important worldwide
public health concerns.7- 10
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