Assessment and Prioritization of Actions to Prevent and Control Reproductive Tract Infections in the Third World

Reproductive tract infection—Lessons learned from the field: Where do we go from here?

“…Gross cost-effectiveness estimates may not be enough to convince program managers, public health decisionmakers, and providers that the interventions are worthwhile, given competing priorities for resources and the logistical difficulties associated with work in this area. While an efficacy study may show that an intervention can work, an effectiveness evaluation showing that it works outside of the research milieu and an efficiency study showing that it is worthwhile and feasible are essential prior to widespread introduction of the intervention (Ronald and Aral, 1992).…”

“…The validity of the scientific evidence for an intervention can be considered proven when it has shown positive effects following a prospective, randomized, controlled, and community-based study. This is a very high standard, extremely difficult to achieve (Ronald and Aral, 1992). Quasi-experimental designs are an acceptable alternative when comparability among experimental and control sites is adequate and all relevant variables that need to be controlled for in the analysis are measured; both conditions are necessary to ensure that such studies have sound internal validity.…”

“…Most evaluations of STD interventions fall into this category. The positive effects of an intervention can only be considered as assumed when there is no scientific evidence, but experts in the field think of it as worthwhile (Ronald and Aral, 1992).…”