Post on 12-Jan-2016
Hannu VuoriHannu Vuori
From Evidence
To Action
An international perspective
Starting pointStarting point
Own background UN/WHO orientation Information theory Focus on action rather than evidence Crisis situation Developing countries Examples
HVV/130908
ContentsContents
Basic notions of information theory Finding evidence Assessing evidence Producing evidence Using evidence Evidence and crisis situation
HVV/130908
HVV/130908
Information
Theory
From Data to KnowledgeFrom Data to Knowledge
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Information
Data
(Noise)
Grouping
Selection
Elimination
Adoption
Acceptance
Generation
Capture
Knowledge
From Data to ActionFrom Data to Action
Generation Capture Organization Analysis Interpretation Transmission Adoption Use
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From Data to ActionFrom Data to Action
Facilitators Barriers
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ActorsActors
Producers of data Daily activities
Researchers Analysts Intermediaries Decision makers Implementers
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Finding
Evidence
Finding Evidence – 1 (UN)Finding Evidence – 1 (UN)
WHO World Health Report HFA Data Base Highlights on Health Health Policy Profiles
UNICEF UNHCR UNFPA WFP World Bank
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KOSOVO
OFFICE OF STATISTICS
INVITATIONPopulation and
Reproductive Health Survey
Presentation of the Preliminary Results
KOSOVO OFFICE OF STATISTICS
Conference Room26 April 2000, 14:00
Projected life expectancy at birth Selected sub-Saharan countries
Source: World Population Prospects: The 1996 revision, United Nations Population Division, 1996
1955 1960 1965 1970 1975 1980 1985 1990 1995 2000
years65
60
55
50
45
40
35
Zimbabwe
ZambiaUganda
Botswana
Kenya
Malawi
GE-98001/10 – 1 December 1997
10
E SI u n it
1970 1972 1974 1976 1978 1980 1982 1984 1986 1988 1990 1992 1994 199665
70
75
80 European Region
EU
CCEE
NIS
Year Source: data from the W HO Regional O ffice for Europe
L ife expectancy a t b irth in subreg iona l g roups o f countries in the European R eg ion, 1970–1996
RPF/RC48/lifex1.GRF14 : 08 : 98
Finding Evidence – 2 (other)Finding Evidence – 2 (other)
NGOs Save the Children International Planned Parenthood Federation Many others
National Development Agencies National Information Systems Ad Hoc Reports
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Health Policy for Kosovo
Department of Health and Social Welfare
Pristina, February 2001
Provisional Institutions ofSelf-Government of Kosovo
Ministry of Health
Health And Health Care Of
Kosovo
Pristina February 2004
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Assessing
Evidence
Existing Data: IssuesExisting Data: Issues
Availability Existence Sensitivity
Reliability Coverage
Data Capture
Timeliness Topicality
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Existing Date: IssuesExisting Date: Issues
Purpose of data collection Prediction and action vs. control
Focus Infectious vs. chronic diseases Morbidity vs. system performance
Generalizability Population based vs. episodic
Time series Concept of indicator
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Assessing EvidenceAssessing Evidence
Factors to consider Skills and resources Mechanism of data collection Definition Purpose of data collection Purpose of data presentation Etc.
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Effect of war in SarajevoEffect of war in Sarajevo
Indicator 1990 1993 Change (%)
Infant mortality 15.8 26.9 + 70
Stillborn rate 7.5 12.3 + 64
Perinatal mortality
15.8 36.0 + 128
Congenital anomalies
0.4 3.0 + 650
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OPV Vaccination Coverage in OPV Vaccination Coverage in KosovoKosovo
Vaccination round Coverage rate
1st 87
2nd 92
3rd 95
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Producing
Evidence
90 % perspiration, 10 % inspiration
Thomas Alva Edison
Producing Evidence: IssuesProducing Evidence: Issues
Need-to-know vs. nice-to-know Action vs. understanding Forum of presentation Style of presentation
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Using
Evidence
Action: BarriersAction: Barriers
Ideology Preconceived ideas, prejudices Vested interests Pride Short attention span Narrow attention span Pork barrel politics Risk aversion Etc.
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Decision-makersDecision-makers
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Don’t confuse me with facts; I have made up my mind.
Decision-makersDecision-makers
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In politics, a day is a long time.
Action: FacilitatorsAction: Facilitators
Compatibility with ideology Compatibility with existing plans (Immediate) political gain Existing technology and know-how Existing resources Ease of implementation
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Politician vs. ScientistPolitician vs. Scientist
Politician Now Certainty (Single) action Understandable Easy to sell to people Resources available Easy to implement
Scientist Tomorrow Probability Options Scientifically sound True priority True priority True priority
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Different politiciansDifferent politicians
National level Broad picture How does my country
fare? Does it ensure my re-
election?
Local level Details How does my county
fare? Does it ensure my re-
election?
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Evidence
Under
Crisis
Most wars nowadays are civil wars , and in many of today’s conflicts civilians have become the main target of violence.
Kofi Anan
Today’s WarToday’s War
Health as target Public utilities as a weapon Psychological warfare Anonymity Technology Duration of impact
HVV/16 May 2003
Health Health Consequences of WarConsequences of War
Direct Biological Mental
Indirect Health infrastructure Environmental infrastucture Human resources Programme implementation Information and intelligence Economy
War and informationWar and information
Truth is the first victim of a war.
Information we get during a war is often contradictory, usually false and almost always unreliable
Clausewitz: On Warfare 1832
Why Info is NeededWhy Info is Needed
When information lacks, rumors spread – and wrong action ensues
Authorities Donors Priorities: An ounce of prevention …
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Crisis and Info: IssuesCrisis and Info: Issues
Denominator population Deaths, displaced, refugees
Chronic diseases often forgotten Extent of mental problems Claims vs. reality Sensitivity of information Data collection (research) Communication “Enforced health”
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Lessons from BosniaLessons from Bosnia
Build on the local system Support the locals, don’t do things for
them Nuts and bolts (paper and pencils) are
important Invest in communication Reporting presumes motivation: feed-
backHVV/130908