Randomized Controlled Trial Designs for Operations Research in Low-Income Countries: Reality or Delusion?
An opinion article discussing the relevance of randomised controlled trials (RCTs) in operations research in low-income countries. Operational research studies have commonly used cross-sectional, case-control, or cohort designs, but the authors based on their experience in Uganda, put forward the case for including RCTs. Key elements of the RCT conducted in Uganda included generation of the research questions based on challenges identified within the National AIDS Control Program, involvement and engagement of program staff right from the outset, use of data being collected under routine care conditions, and making use of existing usual program staff and other resources. Developmental activity included modification of educational materials and data-collection tools already available and training of health workers to implement interventions. A competent research officer was employed to work alongside the program staff to facilitate the whole study.
In operational research studies where the intervention is at the district level or several facilities are involved, the authors state that a cluster RCT is to be preferred to the individual RCT design.
Kunutsor, S.K.; Walley, J. Randomized Controlled Trial Designs for Operations Research in Low-Income Countries: Reality or Delusion? Frontiers in Public Health (2013) 1: [DOI: 10.3389/fpubh.2013.00014]