Linking Knowledge and Action in Global Health - Current Concepts, Approaches, and Institutions

There is a new interest in the role that research and knowledge play in improving health in developing countries. In particular, the question of how knowledge can be better linked to policy and action has been receiving increasing attention. This paper surveys approaches to linking knowledge and action as they appear in the global health literature and attempts to draw them together in a more systematic way. Two concepts are prominent – the know-do gap in health and the 10/90 gap in health research, both intended to draw attention to global inequities in health and health research. Beyond these two basic metaphors, numerous other approaches to and debates about linking knowledge and action can be found in the literature. Underlying these different streams and debates are two competing notions of what constitutes “knowledge”. The first one assumes that knowledge is largely independent of context and easily transferable. The second one conceptualizes knowledge as something that is place-bound and subject to negotiation, requiring the engagement of different stakeholders in its production and use. The paper concludes with the notion that the way in which we conceptualize the relationship between knowledge and action has important implications for current debates about governance in global health, but that the connections between these two discourses are rarely made. Considerations of knowledge-action linkages in global health must be made together with considerations of governance, and vice versa.