Synthesising evidence across health and development


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Dr Richard Smith of the London School of Hygiene and Tropical Medicine introduces the joint LSHTM, LIDC and IDS event entitled 'Synthesising evidence across health and development' held at Woburn House on 19 September 2012.

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Synthesising evidence across health and development

  1. 1. Synthesising evidenceacross health anddevelopmentGerry Bloom, IDSLawrence Haddad, IDSRichard Smith, LSHTMJeff Waage, LIDC
  2. 2. Background• Huge challenges facing those policy makers concerned with health and those concerned with development – Urbanization, demographic shifts, food production and consumption etc• Require integration of our understanding of health with our understanding of development processes• There are instances of this – such as WHO CMH and CSDH – but they are rare
  3. 3. Background• Such instances are not reflected in mainstream policy and practice – MDGs represent separate, sector-specific interventions with unlinked targets, each ‘owned’ by its associated sector, which has concentrated largely on sector-specific approaches• To better integrate we need to look closely at factors contributing to current ‘silo mentality’.• Here interest is upon role of evidence generation, synthesis and dissemination
  4. 4. Problem• Several features currently endemic to academic life which discourage integration – high-impact peer-reviewed journals tend to not be multidisciplinary – research funding is mostly streamed within disciplinary areas – few serious multidisciplinary post-graduate programmes• In addition to these ‘generic features’, there are two specific factors we identify here
  5. 5. 1. Perspectives• Health is defined narrowly - Quality/Disability Adjusted Life Year at best• Development focus on reducing poverty through improving income – Countries are even classified by as ‘developed’ or ‘developing’ according to income• Narrow agendas maintained by silos between development and health across government departments and development agencies• May result at worst in a decrease in societal welfare and at best missed opportunities
  6. 6. 2. Evaluation paradigms• Principle obstacle not lack of evidence for integrated interventions, but difference in evaluative paradigms which makes evidence in one sector less accessible and convincing to the other• Health – scientific, reductionist model for evaluating interventions. Emphasis upon RCT• Development – rare to find a RCT. Greater focus on ‘why and how’ and less on ‘result’• These different approaches make it difficult to measure and integrate ‘strength’ of evidence
  7. 7. Solution?• These factors at best make an integrated approach to the design and evaluation of interventions difficult, and at worst means that these worlds simply collide. So, how can we move from a state of collision to coalescence?• The papers forming the basis of this session were effectively experiments in bringing together perspectives and evaluative paradigms across these communities to examine the evidence base for a more integrative approach, exploring different ways in which these policy and research communities frame problems, pose research questions and evaluate evidence
  8. 8. Overview of project• UK Department for International Development funded these papers to test hypothesis….• … that inter-sectoral working may be encouraged and stimulated through: – consideration of how to synthesise evidence – provide vehicle for outputs (ie journals)• Thus, focus on undertaking: – systematic reviews of health and development literatures around specific issues – co-publication in leading health and development journals (The Lancet and World Development)
  9. 9. Purpose of symposium• This symposium brings together experts from both health and development sectors to explore the interaction between health and development and identify new opportunities and methods for taking forward the integrated evaluation of interventions and policies• It is hoped by the end of the symposium to have identified some concrete next steps to ensure that positive synergies can be designed, identified and assessed
  10. 10. Programme• Session 1: case studies – Four case studies in evidence synthesis – Panel discussion of author reflections• Session 2: invited panel – Panel discussion of how to improve inter- sectoral evidence environment for research funding, publication and policy• Session 3: future – Wrap up and next steps – Informal discussion over drinks