1) My work, investigating health and health care disparities for patients with ischemic strokes in low and middle income countries, is 1st to 2nd generation work, depending on the project. In some cases, I am able to combine databases and relate ischemic stroke mortality to changes in policy (health expenditure per capita, GDP, level of conflict/government corruption). Unfortunately, due to limited resources and even existing knowledge about the natural history of diseases in poorer countries, much of global health efforts tend to be 1st or 2nd generation work. However, the intention is always to lead to 3rd and 4th generation work because interventions on both individual and nationwide scales are what actually improve health. The ultimate goal of my work is to inspire more investment by poorer countries, who have mostly spent their health budgets on infectious disease prevention and treatment, in primary care efforts in order to lessen the growing threat of NCDs (non-communicable diseases).
2) Some interventions that I have seen be successful in a global health setting for other diseases that require long-term follow-up are similar to the barbershop hypertension intervention: a community health worker is empowered by the clinic doctors to go around the village and do simple vitals/blood tests to see how well a patient is; or a clinic enrollment booth is staged near a town-wide festival or the main market place to improve visibility. For my area of research, something similar could be done. Hypertension is one of the most dangerous risk factors for the development of strokes. If a community health worker could screen blood pressures, perform a risk assessment interview (salt in diet, exercise/activity level, family history), do simple blood tests (blood sugar and other evidence of comorbidities), and provide some guidance for lifestyle changes or a referral to a primary care clinic, I believe this could have a large impact in a community. The only issue is that, with these interventions, you are likely to reach a much smaller population than public health campaigns and policy changes might (4th generation).