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Annual Meeting of the CARMEN Observatory on Chronic Non-Communicable Disease Policy: “Mobilizing for Action” May 12-13, 2008 Hilton Montreal Bonaventure Hotel

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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


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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


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Generic Structure of the Workshop


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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


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WorkshopPolicy Analysis and Decision-Making with Emphasis on Chronic Non-communicable Diseases


  • 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.


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(Workshop, continued)


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


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Workshop (Continued)


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



  • 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


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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


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  • 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


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  • 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


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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