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Evidence-Based Advocacy

Evidence-Based Advocacy. Workshop on Evidence-Based Advocacy to Improve MNCHN 26-28 Aug 08 Agra. Conduct New Research. No. Evidence Exists?. Policy Changes are Needed. Advocate for Evidence-Based Changes in Policy and Resource Allocation. Analyze Existing Data. Yes. No.

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Evidence-Based Advocacy

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  1. Evidence-Based Advocacy Workshop on Evidence-Based Advocacy to Improve MNCHN 26-28 Aug 08 Agra

  2. Conduct New Research No Evidence Exists? Policy Changes are Needed Advocate for Evidence-Based Changes in Policy and Resource Allocation Analyze Existing Data Yes No Share Best Practices and Knowledge from Other States and Countries Best Practices Exist? Provide Technical Assistance to Improve Programs Yes Program Changes are Needed Advocate for Changes in Program Strategy and Implementation Identification of Impediments to Program Implementation Interdependence of Evidence, Policy Analysis and Advocacy

  3. Research and data by themselves do not change policy — advocacy and leadership do • Researchers help by providing credible analysis and data that advocates and policy leaders use

  4. Data and research in policy process • Agenda Setting • First step is to get issue on policy agenda • Getting policy-makers and leaders to pay serious attention to issue • Help make case and make it credible • “No Data, No Problem?!” • Data and research help make health problems visible to public and policy makers • Absence of data keeps issue invisible or seen as “unworthy” of public policy

  5. Data and research in policy process • Translational research helps answer important policy and political questions • How big a health problem is it? — how many people it affects • How severe a problem is it? — its health effects, social consequences, and economic costs • Who is most affected? — characteristics of groups at greater risk • What causes or contributes to problem? — factors that contribute to problem or increase risk • Individual characteristics? • Individual behavior or actions? • Institutions or systems or policies? • Frame issue to emphasize important policy perspectives and values

  6. Data and research in policy process • Specifying policy alternatives • Provide evidence about relative effectiveness of different policy options • Research, data and publications that • Discuss explicit policy implications • Show extent that policy options address problem • Show extent that they are feasible

  7. Using data effectively! Choose data ...Relevant to policy/decision-maker ... from a credible source and definitive …and present it according to different audience needs …make sure it reach target audiences from multiple sources ...in which the “findings” are clear to policy makers

  8. Choosing Data for Maternal Health Advocacy: Choose data to show: …Severity and trends ...Gains made through SBAs and EmOC (What works) and what does not work (ANC alone) ...Why maternal health matters ….Spin-offs/additional benefits ...What will happen without action

  9. Use of evidence for influencing policies: Some examples

  10. UHRC- Bringing information and evidence to describe challenge of urban health and its importance before policy makers and key stakeholders

  11. Data on numbers of urban poor and the rate at which this segment was growing was collated from Census and other sources • NFHS-II data was reanalyzed to show that the health condition of the urban poor is comparable and worse at times than the rural population • City level primary research on health condition of the urban poor was carried out in select cities Outcome: • Evidence helped acknowledgment of the issue by Govt and other stakeholders • Urban Health scenario reports for select states prepared, widely circulated among Government departments, state governments and key stakeholders for information, awareness to facilitate program planning and implementation

  12. Bringing Evidence about Population Growth Trends 2 – 3 – 4 - 5 All India Urban areas Large cities Slums

  13. Bringing Evidence Regarding Sharp Health Disparities in Urban Areas Source: NFHS 2, 1998-99 reanalysis EHP USAID Urban Health Program, India

  14. Safe Motherhood – WRAI example • Started with NFHS-2 which indicated an increase in MMR • Used MMR and other maternal health data from NFHS-2 to present facts to media and GOI on maternal health: • numbers of mothers affected/dying daily, • number of newborns who die when their mother dies • Low incidence of deliveries by health personnel • The three delays • Identified global/regional evidence-based practices – midwifery life saving skills/skilled birth attendance • Did a policy analysis to compare India’s policies related midwifery lifesaving skills/skilled birth attendance • Identified gaps in policies • Advocated for change

  15. No one right place/way to start the process • Evidence can be global or local • Many places to start but should be backed by evidence: • policy analysis • data findings • problem/barrier identified at the individual, family, community, district or national level • But advocacy issues and recommendations should be evidence-based and not just opinion

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