From Evidence to Policy to Action
  - and from Action to Evidence
             Tore Godal,
       Freiburg 6 October, 2008...
Examples:

•   Malaria – insecticide treated nets;
•   Riverblindness – Ivermectin;
•   Leprosy - Chemotherapy;
•   Vaccin...
Distribution of bed nets
The figure shows the number of
insecticide treated mosquito nets
(ITN) distributed by the Global
...
Multi-country studies for onchocerciasis control
 Community trials    Effect of ivermectin          PH importance of      ...
PERSONS TREATED
40 000 000   BETWEEN 1997 - 200437,307,000
35 000 000                                                     ...
Treatment coverage by ComDT and
          by the regular health services (HST)
                     100 %



             ...
APPROACH: BUILD INCENTIVE TO
REACH THE POOREST

 • The GAVI ‘Share’ system
 • $20 per additional child
 • Creates incentiv...
Vaccination coverage in GAVI countries
Vaccination coverage by vaccination type
in GAVI countries
Elimination of Hib meningitis in Uganda, 2002-07
Millennium Development Goals 4 & 5 Strategy
Child mortality progress by age
When do children die in India?
Comparison of 1990 and 2005
maternal mortality, world total
The highest risk of mortality for mothers and babies
occurs when coverage of health interventions is lowest
Skilled attendance and facility based delivery
Beneficiaries of the JSY Safe Motherhood Scheme




The number of beneficiaries (in millions) of the Janani Suraksha Yojan...
Additional health systems and programme costs needed 2009-2015 in 51 countries
Task force established at UN 25 September to raise
   additional funds through innovative finance.
                Chairs:...
Main Conclusions:
• Decision for action is often made rapidly
  when evidence is insufficient;
• Therefore need a strong d...
Bottomn line:

• Bottomn line: We would welcome a strong
  Cochrane participation in the MDG 4&5
  endeavour:
• both in th...
Evidence to policy to action – the view of a decision maker
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Evidence to policy to action – the view of a decision maker

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Cochrane Colloquium 2008 - Plenary 5

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Evidence to policy to action – the view of a decision maker

  1. 1. From Evidence to Policy to Action - and from Action to Evidence Tore Godal, Freiburg 6 October, 2008 16th Cochrane Colloquium
  2. 2. Examples: • Malaria – insecticide treated nets; • Riverblindness – Ivermectin; • Leprosy - Chemotherapy; • Vaccination – GAVI health service support; • Maternal and child health;
  3. 3. Distribution of bed nets The figure shows the number of insecticide treated mosquito nets (ITN) distributed by the Global Fund for AIDS, TB and Malaria between December 2004 and December 2006. The G8 target for 2010 is 100 million nets distributed.
  4. 4. Multi-country studies for onchocerciasis control Community trials Effect of ivermectin PH importance of Economic and social of ivermectin on skin disease onchocercal skin disease cost of skin disease Rapid assessment Rapid Epidemiological Community-directed Community-directed studies Mapping of onchocerciasis treatment with ivermectin interventions (ongoing)
  5. 5. PERSONS TREATED 40 000 000 BETWEEN 1997 - 200437,307,000 35 000 000 33,207,000 30 000 000 28,452,663 25,459,554 25 000 000 21,992,346 20 000 000 16,988,596 14,079,654 15 000 000 10 000 000 5 000 000 1,457,742 0 1997 1998 1999 2000 2001 2002 2003 2004
  6. 6. Treatment coverage by ComDT and by the regular health services (HST) 100 % 80 % 88 % Treatment coverage 76 % 60 % HST 40 % 44 % 47 % ComDT 20 % 0% Ghana Kenya
  7. 7. APPROACH: BUILD INCENTIVE TO REACH THE POOREST • The GAVI ‘Share’ system • $20 per additional child • Creates incentives to put money where it is most needed - low-coverage districts receive more funding
  8. 8. Vaccination coverage in GAVI countries
  9. 9. Vaccination coverage by vaccination type in GAVI countries
  10. 10. Elimination of Hib meningitis in Uganda, 2002-07
  11. 11. Millennium Development Goals 4 & 5 Strategy
  12. 12. Child mortality progress by age
  13. 13. When do children die in India?
  14. 14. Comparison of 1990 and 2005 maternal mortality, world total
  15. 15. The highest risk of mortality for mothers and babies occurs when coverage of health interventions is lowest
  16. 16. Skilled attendance and facility based delivery
  17. 17. Beneficiaries of the JSY Safe Motherhood Scheme The number of beneficiaries (in millions) of the Janani Suraksha Yojana (JSY) Safe Motherhood scheme in India. The scheme promotes institutional deliveries by providing cash assistance, both to the pregnant women living under the poverty line and to the health workers, who motivate and accompany these women to the institutions for the deliveries. Since 2005 there has been a remarkable 10-fold increase in the number of women who received assistance under the scheme.
  18. 18. Additional health systems and programme costs needed 2009-2015 in 51 countries
  19. 19. Task force established at UN 25 September to raise additional funds through innovative finance. Chairs: PM Brown, & Bob Zoellick,WB. • Save close to 3 million mothers; • Over 7million newborn babies; • Train over a million professional health workers (Midwifes; Nurses; Doctors);
  20. 20. Main Conclusions: • Decision for action is often made rapidly when evidence is insufficient; • Therefore need a strong dose of common sence: sound biology, sound sociology; sound qualitative research and observations; • Building evidence during implemenation is very important.
  21. 21. Bottomn line: • Bottomn line: We would welcome a strong Cochrane participation in the MDG 4&5 endeavour: • both in the observational, qualitative area, • review of formal evidence; • and methodology development.

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