Cristina Puentes-Markides Public Policy, Regulation and Health Financing Area of Strengthening Health Systems and Servic

1. Annual Meeting of the CARMEN Observatory onChronic Non-Communicable Disease Policy: “Mobilizing for Action”May 12-13, 2008Hilton Montreal Bonaventure Hotel Report on the Workshop on Policy Analysis and Decision-Making with Emphasis on Chronic Non-Communicable Diseases, Bridgetown, Barbados, October 15-17, 2007. Cristina Puentes-Markides Public Policy, Regulation and Health Financing Area of Strengthening Health Systems and Services PAHO/WHO

2. Why Capacity Building in these Areas? • Policy increasingly complex and important • Policy perspective as problem-oriented research, client-oriented advice informed by social values, “speaking truth to power” • Limitation of rational perspectives on policy • Advisory capacity to influence/persuade stakeholders and relevant clients is uneven. • MOH and PAHO staff may lack formal training in the social sciences, including public policy and policy analysis. • Understanding the role of policy and politics in health system development may be weak. • Need to improve skills to use policy tools for argumentation, decision—making, planning and assessment of progress and performance CPM/SHD/HP/2007

3. Generic Structure of the Workshop CPM/SHD/HP/2007

4. Workshop on Policy Analysis and Decision-Making with Emphasis on Chronic Non-communicable DiseasesBridgetown, BarbadosOctober 15-17, 2007 Participating Countries • Eastern Caribbean and Barbados • United Kingdom Territories • Anguilla, British Virgin Islands , Montserrat • Antigua and Barbuda • Barbados • Dominica • Grenada • Saint Vincent and the Grenadines • Saint Kitts Nevis • Saint Lucia CPM/SHD/HP/2007

5. WorkshopPolicy Analysis and Decision-Making with Emphasis on Chronic Non-communicable Diseases Goal • To enhance skills and competencies of the participants in the fields of knowledge and practice as analysts and advisors Learning Objectives • Familiarity with general concepts of design, implementation and evaluation of public policy, including the roles played by politics, evidence and rationality in the decision-making process. • Enhance abilities to critically conceptualize policy problems, generate policy alternatives and provide effective advise to decision-makers. • Be acquainted with economic evaluation (cost-effectiveness analysis, cost benefit analysis and impact evaluation) as a critical tool for policy analysis. • Recognize the relevance of strategic thinking, foresight and better peripheral vision to optimize analysis, design and implementation. • Understand the applicability of policy tools for the prevention and control of chronic non-communicable diseases. CPM/SHD/HP/2007

6. (Workshop, continued) DAY 1 Opening Remarks • Introduction of Participants and Expectations • Objectives of the Workshop The Health Agenda Chronic Non-Communicable Diseases in the English-Speaking Caribbean: An Update Public Policy Perspectives • The policy capacity of governments. • Explanatory models: technical and political rationalities.. The Analysis of Public Problems • Overview of policy analysis: features, phases, contents. • Health policy example. Products of the Analysis • The “ issue paper”, the policy memorandum, the policy brief • Evidentiary bases of public policy: opportunities and risks. • The craft of policy advice CPM/SHD/HP/2007

7. Workshop (Continued) DAY 3 Policy Adoption and Implementation • Approaches, models and strategies to translate decisions into policies. • Pitfalls of policy design in implementation. Policy Monitoring and Evaluation • Instruments of public accountability (also performance measurement) • Role of advocacy and organized groups. Strategic Thinking and Anticipatory Approaches • Understanding and creating the future. • Foresight , strategic thinking and the advantages of peripheral vision • Relevance of futures approaches to health policy analysis. Plenary Discussion: How Countries can Lead to Better Health Policy Outcomes for All. Evaluation of the Workshop and Closing DAY 2 Agenda-setting • The “political” in public policy: actors and windows of opportunity. • The social construction of target populations: political and policy implications. • Case Study and Discussion: The Framework Convention for Tobacco Control Policy Options • Generating policy options • Evaluation criteria: types, methods, matrices. Assessing Policy • Economic evaluation: An Introduction • Economic impact of obesity. • Cost Effectiveness, Cost Benefit and Impact Evaluation Special Evening Session: Moving Forward the NCD Policy Agenda: A Dialogue CPM/SHD/HP/2007

8. According to EEC Staff • Timely • Captured interest • Demystified policy process • Addressed the relevance/impact of policy to the health agendas • Prepared participants to move from policy to action • Examined the role of health care practitioners in the policy process • Policy application to expanded agenda of CNCD ( advocacy, planning , financing and evaluation ) • Identified skills and competencies required to design, implement and evaluate the performance of policies • Open policy debate • Helpful to build and sustain capacity to use policy development and policy analysis to strengthen health system CPM/SHD/HP/2007

9. Methodology • Team approach • Policy/decision-makers • Planners • Managers • Practitioners • Multidisciplinary (skill mix) • Presentations included theory and practice • Analysis of the policy environment in country reference to CNCD • Group discussions: blend of country experiences with theory, practice and methods • Resources: • Documentation folder, CD-Rom • Websites and databases • Software packages CPM/SHD/HP/2007

10. Highlights • Recognize role of professional experience in the policy process and benefit from it to discuss workshop topics. • Discuss the importance of policy and politics • Review tools of policy analysis • Debate the policy environment, share experiences and solutions • Expanded emphasis on monitoring and evaluation, including economic evaluation methods and model building. • Direct interactive approach • Limited time frame • Inability to actually manipulate the tools in simulation exercises CPM/SHD/HP/2007

11. Future Steps • Sustain Response • View policy analysis as interactive and participatory • Involve planers, managers, practitioners, researchers • Integrating/institutionalising policy into health system strengthening • Capacity building at the country level using champions • Support systems and structures CPM/SHD/HP/2007

12. Thank you