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In the context of a fragile health system, the application of these protocols may be expected to prove to be difficult to undertake and the impact may also be expected to vary [2].
Therefore, studies in this area are experimental and difficult to undertake and may cause discomfort to patients.
It has been said that the European Clinical Trials Directive (in force since 2004) makes drug trials more difficult to undertake and has specifically decreased the number of trials sponsored by non-commercial actors [ 16, 24- 26].
Several reasons may explain the lack of policy relevant research summaries for health systems: first, research on health systems interventions with internal and external validity is difficult to undertake and the methods to conduct this type of research are not well established.
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In older people, multi-morbidity is common and a strict dichotomisation between degenerative and vascular dementing disorders at both pre-clinical and dementia stages is difficult to undertake, possibly artificial and perhaps not the most useful approach.
Some of the CJFs in Mtwara claimed to have difficulties getting the co-operation of village officials and therefore found it difficult to undertake counselling or sensitization meetings and thus to link the institutions responsible for legal enforcement.
Venipuncture blood collection can be difficult to undertake due to cost, organizational complexity, and shipping and storage requirements.
While technically and socially difficult to undertake en masse, automated backporting of much scientific software is possible, and efforts to provide such packages either officially within the distribution (http://backports.debian.org) or through external repositories (http://neuro.debian.net/) will continue to grow in importance.
Since the area is vast and is difficult to undertake a survey in all the kebeles, four kebeles (the lowest administrative units of Ethiopia) namely Gerarge, Jenda, Seraba-dablo and Tana woyena were selected using simple random sampling technique.
Access to administrative collections such as hospital records, health registries and birth and death information enables research which would otherwise be very expensive and organisationally difficult to undertake [ 2].
Slap the label of "humanitarian crisis" on a situation and it becomes difficult to undertake development work.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com