Annual Meeting of the CARMEN Observatory on Chronic Non-Communicable Disease Policy: “Mobilizing for Action” May 12-13, 2008 Hilton Montreal Bonaventure Hotel Cristina Puentes-Markides Public Policy, Regulation and Health Financing Area of Strengthening Health Systems and Services PAHO/WHO Report on the Workshop on Policy Analysis and Decision-Making with Emphasis on Chronic Non-Communicable Diseases, Bridgetown, Barbados, October 15-17, 2007.

CPM/SHD/HP/20072 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

CPM/SHD/HP/20073 Generic Structure of the Workshop Products Themes Introduction to methods and tools Policymaking, Politics and Policy Argumentation Policy development Policy analysis Issue Paper Policy Brief Policy Memo Policy analysis Agenda-setting Political analysis Strategic planning, foresight, strategic thinking, strategy making Anticipatory methods (e.g. scenarios) Monitoring, evaluation and performance measurement Ethical analysis Ethics in decision-making Evaluation (types, designs, logic models). Economic evaluation (impact, cost-effectiveness and cost benefit analyses) Use of “evidence” in decision-making Competencies Qualitative methods Critical, systemic and anticipatory thinking Argumentation and communication Interpersonal relations Integration of interdisciplinary knowledge Collaborative leadership Search and management of information for decision-making

CPM/SHD/HP/20074 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 Workshop on Policy Analysis and Decision-Making with Emphasis on Chronic Non-communicable Diseases Bridgetown, Barbados October 15-17, 2007

CPM/SHD/HP/20075 Workshop Policy Analysis and Decision-Making with Emphasis on Chronic Non-communicable Diseases Goal  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.

CPM/SHD/HP/20076 DAY 1 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 (Workshop, continued)

CPM/SHD/HP/20077 Workshop (Continued) DAY 2 Agenda-setting  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 ControlCase 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 DAY 3 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)Instruments of public accountability (also performance measurement) Role of advocacy and organized groups.Role of advocacy and organized groups. Strategic Thinking and Anticipatory Approaches Understanding and creating the future.Understanding and creating the future. Foresight, strategic thinking and the advantages of peripheral visionForesight, strategic thinking and the advantages of peripheral vision Relevance of futures approaches to health policy analysis.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

CPM/SHD/HP/20078 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

CPM/SHD/HP/20079 Methodology  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

CPM/SHD/HP/ Highlights ↑ 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

CPM/SHD/HP/ 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

Thank you