Prashanth, NSBhojani, UpendraSoors, Werner2019-09-252019-09-252011-03-142011-010975-5691http://hdl.handle.net/20.500.12424/176961"Health systems research (HSR) can be distinguished from conventional analytical research by its comprehensive approach that recognises and considers multiple non-linear interrelations among components of health systems. HSR can include the study of any constituent of a health system, but never in isolation and always in a unique context. HSR is focused on solving practical problems, with the aim of improving the system (2). The Gadchiroli trial shares several characteristics of health systems research: it tried to find a solution for “a hopeless case” (newborn mortality) in a specific context (Gadchiroli district, rural Maharashtra, 1993), and successfully “strived to influence policy at the state and national levels”, as explained by Bang in his response (1). Within all the limitations of time and context, the Gadchiroli trial’s design - non-randomised, but controlled - was even innovative (3). So far, so good.engWith permission of the license/copyright holderresearch ethicsBioethicsSocial ethicsSexual orientation/genderMedical ethicsHealth ethicsArticle