Evidence-Based Advocacy

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Evidence-Based Advocacy

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

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(No Transcript)
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Interdependence of Evidence, Policy Analysis and
Advocacy
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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

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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

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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

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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

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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

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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

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• Use of evidence for influencing policies
• Some examples

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

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Bringing Evidence about Population Growth Trends

• 2 3 4 - 5
• All India Urban
  areas Large cities Slums

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Bringing Evidence Regarding Sharp Health
Disparities in Urban Areas
Source NFHS 2, 1998-99 reanalysis EHP USAID
Urban Health Program, India
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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 Indias policies
  related midwifery lifesaving skills/skilled birth
  attendance
• Identified gaps in policies
• Advocated for change

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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