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Hannu Vuori

Hannu Vuori. From Evidence To Action An international perspective. Starting point. Own background UN/WHO orientation Information theory Focus on action rather than evidence Crisis situation Developing countries Examples. Contents. Basic notions of information theory

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Hannu Vuori

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  1. Hannu Vuori From Evidence To Action An international perspective

  2. Starting point • Own background • UN/WHO orientation • Information theory • Focus on action rather than evidence • Crisis situation • Developing countries • Examples

  3. Contents • Basic notions of information theory • Finding evidence • Assessing evidence • Producing evidence • Using evidence • Evidence and crisis situation

  4. Information Theory

  5. From Data to Knowledge Adoption Acceptance Knowledge Grouping Selection Elimination Information Generation Capture Data (Noise)

  6. From Data to Action • Generation • Capture • Organization • Analysis • Interpretation • Transmission • Adoption • Use

  7. From Data to Action • Facilitators • Barriers

  8. Actors • Producers of data • Daily activities • Researchers • Analysts • Intermediaries • Decision makers • Implementers

  9. Finding Evidence

  10. Finding Evidence – 1 (UN) • WHO • World Health Report • HFA Data Base • Highlights on Health • Health Policy Profiles • UNICEF • UNHCR • UNFPA • WFP • World Bank

  11. KOSOVO OFFICE OF STATISTICS INVITATION Population and Reproductive Health Survey Presentation of the Preliminary Results KOSOVO OFFICE OF STATISTICS Conference Room 26 April 2000, 14:00

  12. Projected life expectancy at birth Selected sub-Saharan countries 65 60 55 50 45 40 35 years Kenya Botswana Zimbabwe Zambia Uganda Malawi 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 Source: World Population Prospects: The 1996 revision, United Nations Population Division, 1996 10 GE-98001/10 – 1 December 1997

  13. Finding Evidence – 2 (other) • NGOs • Save the Children • International Planned Parenthood Federation • Many others • National Development Agencies • National Information Systems • Ad Hoc Reports

  14. Health Policy for Kosovo Department of Health and Social Welfare Pristina, February 2001

  15. Health And Health Care Of Kosovo Pristina February 2004

  16. Assessing Evidence

  17. Existing Data: Issues • Availability • Existence • Sensitivity • Reliability • Coverage • Data Capture • Timeliness • Topicality

  18. Existing 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

  19. Assessing Evidence Factors to consider • Skills and resources • Mechanism of data collection • Definition • Purpose of data collection • Purpose of data presentation • Etc.

  20. Effect of war in Sarajevo

  21. OPV Vaccination Coverage in Kosovo

  22. Producing Evidence 90 % perspiration, 10 % inspiration Thomas Alva Edison

  23. Producing Evidence: Issues • Need-to-know vs. nice-to-know • Action vs. understanding • Forum of presentation • Style of presentation

  24. Using Evidence

  25. Action: Barriers • Ideology • Preconceived ideas, prejudices • Vested interests • Pride • Short attention span • Narrow attention span • Pork barrel politics • Risk aversion • Etc.

  26. Decision-makers Don’t confuse me with facts; I have made up my mind.

  27. Decision-makers In politics, a day is a long time.

  28. Action: Facilitators • Compatibility with ideology • Compatibility with existing plans • (Immediate) political gain • Existing technology and know-how • Existing resources • Ease of implementation

  29. Politician vs. Scientist Politician Scientist Tomorrow Probability Options Scientifically sound True priority True priority True priority • Now • Certainty • (Single) action • Understandable • Easy to sell to people • Resources available • Easy to implement

  30. Different politicians National level Local level Details How does my county fare? Does it ensure my re- election? • Broad picture • How does my country fare? • Does it ensure my re- election?

  31. Evidence Under Crisis

  32. Most wars nowadays are civil wars , and in many of today’s conflicts civilians have become the main target of violence. Kofi Anan

  33. Today’s War • Health as target • Public utilities as a weapon • Psychological warfare • Anonymity • Technology • Duration of impact

  34. Health Consequences of War • Direct • Biological • Mental • Indirect • Health infrastructure • Environmental infrastucture • Human resources • Programme implementation • Information and intelligence • Economy

  35. War 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

  36. Why Info is Needed • When information lacks, rumors spread – and wrong action ensues • Authorities • Donors • Priorities: An ounce of prevention …

  37. Crisis 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”

  38. Lessons 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- back

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