22-26 September 2008 White Sands Hotel, Dar es Salaam, Tanzania

Transcription

1 INDEPTH NETWORK Better Health Information for Better Health Policy 8 th AGM INDEPTH@10 Osman@1 Dr. Osman Sankoh Executive Director September 2008 White Sands Hotel, Dar es Salaam, Tanzania

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3 Reportìng period January December 2007 Please see 2007 annual report in print and on the INDEPTH website. January September 2008 Update will be included. Annual report 2008 will be made available.

4 Some Reminders

5 Some INDEPTH products Papers in international journals... More products in the pipeline Migration and Urbanisation, Fertility, Mortality Monograph

6 INDEPTH Bibliometric Analysis of Papers based on HDSS work Family Planning Programs Family planning program services quality assessment Abortion Contraceptive use Fertility intentions / behavior Breastfeeding and Nutrition Social dynamics of HIV transmission Programmatic Applications Breastfeeding and diarrhoea Diarrhoeal disease epidemiology Anemia, pregnancy, and malaria Nutrition and malaria HIV/AIDS HIV mortality trends Long-term mortality trends following measles infection Small scale/ Short term Rotavirus typing Cholera vaccine trials STD treatment and prevention STD awareness Diarrhoeal Disease Socioeconomic assessment tools Socioeconomic correlates of health Health equity Malaria Malaria vaccine development ITNs: trials and distribution methods Malaria drug trials Sickle cell/alpha thalassemia protection Popular perceptions of malaria ITN cost -effectiveness analysis Willingness to pay analysis Adverse effects of measles vaccine Measles vaccine trials Measles transmission Vitamin A trials Long-term mortality trends following measles vaccination Measles Non-specific effects of routine vaccinations Verbal autopsy methods Diagnostic methods Large scale/ Longitudinal Basic research methods Malaria antibody response Measles antibody response GIS technology Demographic surveillance methods Methods Methods Development 1551 Publications

7 INDEPTH Policy Briefs 21 briefs so far Focus on a single issue or a case study Intended to draw attention to the knowledge products and potential of the sites and the Network Available on the website

8 INDEPTH tools development Standardized Verbal Autopsy (VA) questionnaire VA ICD10 short list coding Wealth indexing tool for health equity Website development - assistance and tools INDEPTH Starter and Resource Kits

9 Some INDEPTH collaborators & partners

10 INDEPTH International Network for the Demographic Evaluation of Populations and Their Health and Demographic Surveillance System (HDSS) Health in Developing Countries

11 Prospective monitoring of demographic and health events 1. Who is included in the initial census? Children only? Everyone? We can now do birth cohorts? E.g. Peter Byass proposes a 1990 cohort analysis 2. How often is the update? 1x? 2x? 3x? 4x? (What do you miss? How do you compensate for that? Cost of running the system?

12 Currently 37 sites in 19 countries 21 sites in Africa 9 sites in Asia 1 site in Oceania 1 site in Latin America Over 2,000,000 people under surveillance Watch out 1. Nigeria is coming 2. China is coming

13 Ghana Health Service Health Research Centres Navrongo, Kintampo & Dodowa (HDSS sites) Burkina Faso ote d'ivoire Co Togo Dangbe West Kassena-Nankana Kintampo Kilometers

14 INDEPTH s Mission To harness the collective potential of the world's community-based longitudinal demographic surveillance initiatives in resource constrained countries to provide a better, empirical understanding of health and social issues, and to apply this understanding to alleviate the most severe health and social challenges. We are saying: We will do this work together to provide evidence to decision-makers

15 INDEPTH s Objectives 1. To initiate and facilitate cross-site, longitudinal health and social studies and impact assessments in the developing world. 2. To disseminate study findings with all external stakeholders to maximize impact on policy and practice. 3. To support capacity strengthening activities and crosssite collaborations among INDEPTH member sites. 4. To facilitate the process for funders to fund multi-site health and social research projects in the developing world and especially Africa and Asia.

16 Structure of Presentation Scientific Activities Capacity Strengthening Activities Collaborations/Partnerships The INDEPTH Secretariat Current Membership.. Auditors Report - KPMG

17 SCIENTIFIC ACTIVITIES Largely carried out by INDEPTH Working Groups and Interest Groups with support from the Scientific Advisory Committee (SAC) The groups can be suggested by - Site scientists - Secretariat - Collaborators The groups are reviewed regularly. The Secretariat stays in touch to support the groups.

18 The SAC

19 The SAC

20 Adult Health and Ageing Working Group Aims to improve empirical understanding of ageing and older persons within and across countries Eight INDEPTH sites involved in WHO/SAGE study Agincourt (South Africa), Ifakara (Tanzania), Filabavi (Vietnam), Matlab (Bangladesh), Purwerojo (Indonesia), and Vadu (India). Group raised its own resources: NIA through WHO INDEPTH-WHO Data Analysis workshop was hosted by Umea University in Sweden. Working on scientific papers. Presentation/Working Group Session at the AGM

21 Working Group led by Steve Tollman (Agincourt HDSS, South Africa)

22 Adult Health Group in Umea, May 2008

23 Migration and Urbanization WG The relationship between migration, health and poverty at INDEPTH sites Monograph: Households Unfolding: INDEPTH Network Perspectives on the Dynamics of Migration, Health and Livelihoods. Draft presented at the AGM. Meetings at the PAA 2007 and in Arusha, Tanzania in December 2007 Group raised some of its funds Led by Mark Collinson (Agincourt HDSS, South Africa - pictured) with Kubaje Adazu (Kisumu HDSS, Kenya) Presentation and session at the AGM

24 INDEPTH Data System Aims to improve efficiency of data management and analytical dataset production at the individual site level. Presented at the AGM; PI Kobus Herbst (Africa Centre, South Africa) Planning grant from the Wellcome Trust Several meetings in 2007/2008 Collaboration with Makerere University and University of Southampton

25 INDEPTH Data System IDS meeting at the Africa Centre, South Africa; Feb/March 2007 IDS meeting at the University of Southampton, UK August 2008

26 Pilot data sharing on the INDEPTH website Pacesetter sites: Vadu (India), Kanchanaburi (Thailand) and Wosera (Papua New Guinea) IT support from I2IT in Pune, India Several meetings/workshops in 2007/2008 Sites need not bother about the formats of their data Quality of source data responsibility of the site IDS, on the contrary, ensures quality of source data A call for 3 sites in Africa to come on Board. Hewlett Foundation will provide funds to make this possible.

27 INDEPTH at I2IT in Pune

28 NCD Monitoring in Asia Led by Filabavi (Vietnam), Vadu (India) and Purworejo (Indonesia) 8 Asian sites involved in study One paper published: Self-Reported Prevalence of Chronic Diseases and Their Relation to Selected Sociodemographic Variables: A Study in INDEPTH Asian Sites, 2005 in Preventing Chronic Disease. Group met in Bangkok in August 2008 Group has submitted proposal to AusAid. Positive step!

29 Vaccinations WG Led by Peter Aaby (Bandim, Guinea Bissau) Objective is to look broadly at the impact of vaccinations on child survival at INDEPTH sites Several INDEPTH sites have contributed data to examine issues related to vaccinations and child survival In March 2008, WHO funded participating INDEPTH sites to meet at the London School (organised by Peter Smith), to develop analytical techniques to examine the data. INDEPTH funded the vaccinations group to hold a oneday meeting in London after the London School meeting.

30 INDEPTH Epilepsy Studay Key actors: Charles Newton (Kilifi, Kenya) and Victor Doku (Kintampo, Ghana) Scientists wrote the concept; got sites interested; a proposal was developed; INDEPTH provided a support letter. Funding secured. Group is proud to brand the study as an INDEPTH study Others to mention: Kenya sites working on a proposal and invite INDEPTH Sites in Ghana and Burkina Faso working on a consortium and invite INDEPTH

31 INDEPTH Epilepsy Study takes off at Agincourt, South Africa

32 Anti-Retroviral Therapy Study Aims to look at impact of anti-retroviral therapy (ART) rollout on individuals, populations and health systems Bandim (Guinea Bissau), Ifakara (Tanzania), Nairobi (Kenya), Kisumu (Kenya) and Agincourt (South Africa) PI: Nyovani Madise, Southampton Proposal submitted to Wellcome Trust; $5M offer from Wellcome subject to successful peerreview. Looking for additional funding of $8M.

33 ART-Rollout Rollout group met in Accra

34 INDEPTH Monograph on fertility levels and trends Editors - Jean-Christophe (Nairobi); William (Africa Centre); Razzaque (Matlab); Clifford, (Agincourt/Wits) 17 sites participating in monograph; call for more. Several meetings of editors held Presentation of results and draft monograph at the AGM.

35 Monograph on Mortality Levels, Patterns and Trends at INDEPTH Sites Sam Clark (U Washington/Agincourt), Momodou (Farafenni), Eliya Zulu (Nairobi), Sureeporn Punpuing (Kanchanaburi) 27 INDEPTH sites submitted data Editors have met several times Preliminary analysis and data cleaning in progress Draft monograph to be presented in this AGM

36 Demographic and Health Transitions New area of research Working with IDRC Canada to conduct a study that will look at demographic and health transitions in the developing world based on HDSS data Concept was presented at an Adult Health Working Group meeting in Umea, Sweden Dodowa proposal development workshop in August Proposal submitted

37 Cost of Illness Growing interests in determining the cost of illness. Interest group led by Filabavi (Vietnam) and Agincourt (South Africa) Draft proposal ready AGM presentation Funding sought

38 Educational outcomes and transitions Workshop held July in Burkina Faso Scope of work defined Preliminary analysis of existing data commenced Further work recommended Progress report to be presented at AGM

39 Participants at the Education Workshop in Ouaga

40 Environment and Health Dialogue with the Google Foundation - a cross-site study on climate variability and transmission of infectious diseases framework for -Data collection -GIS and remote sensing -Data visualisation -Data sharing

41 Reproductive Health A wake-up call for the network. Dr. Aree Jampaklay of Kanchanaburi HDSS is helping the Secretariat Session at the AGM Reproductive Health agenda for INDEPTH Hewlett Foundation has agreed to support the process. That s a big challenge to us all!

42 Phase IV Effectiveness studies of new of antimalarial drugs in 8 field sites in 4 countries in Africa Presented on Monday by our Project Officer Dr Patricia Akweongo The main product of the platform is a longitudinal evidence base to allow assessment of efficacious drugs in real life settings. The good news is

43 Phase IV And the good news is The Gates Foundation has approved for funding our $28.8M proposal Activities to commence immediately. First planning meeting in Accra October.

44 Working groups and the challenges Leadership issues Effective contribution from participating sites The data issue Can the sites submit what is required? The capacity strengthening issue The human capacity issue

45 Our AGMs 2007 September, Nairobi, Kenya 193 participants 10 scholarships for young scientists 2 funders represented Hosts Nairobi UHDSS Kilifi HDSS Kisumu HDSS 2008 September, Dar es Salaam, Tanzania 250 participants 17 scholarships for young scientists 9 funders represented Hosts Ifakara HDSS Rufiji HDSS Magu HDSS

46 Our AGMs 2007 Theme: The Role of DSS in monitoring progress on the Millennium Development Goals (MDGs) Topics: HIV/AIDS, malaria, childhood mortality, maternal health, education and poverty, all attempting to measure progress towards the MDGs Theme: From Knowledge Generation to Improved Health Policy and Practice Topics: Health Systems, Clinical Trials, Demographic and Health Transitions, Child and Adult Mortality, Reproductive Health Online registration and submission of abstracts

47 Participants at the Nairobi AGM September 2007

48 9 th AGM, October 2009 Pune, India To be hosted on behalf of INDEPTH Secretariat by Vadu and Ballabgarh HDSS sites

49 CAPACITY STRENGTHENING Activities...

50 Malaria Clinical Trials Alliance Presented by MCTA Project Manager at AGM Facilitates the development of sufficient near- team research capacity for the conduct of GCP-compliant malaria drug and vaccine trials Facilitates progression towards selfsustaining clinical trial centres.

51 MCTA sponsored GCP Training at Lambarene, Gabon

52 Capacity strengthening Efforts for sites Scientific writing workshops for young scientists Training workshop for data managers Training in longitudinal Data Analysis Data Managers workshop Training workshop for finance managers Workshop for administrators of HDSS sites Training workshop on GIS applications MSc Leadership training at WITS University

53 INDEPTH Data Managers Dodowa, Ghana; May 2008

54 Administrators Workshop July 2008, Rakai, Uganda

55 Finance Managers Workshop, August 2008; Agincourt, South Africa

56 Communication Skills Workshop, August 2008; Accra, Ghana

57 Longitudinal Data Analysis Workshop, August 08; Ho, Ghana

58 Using GIS in HDSS work August 2008, Bangkok, Thailand

59 Who else is very important? - The Field Workers - The Field Supervisors 5 are with us at this AGM! - The Data Entry Clerks - Everyone who contributes to the data generation process

60 INDEPTH Fellows Under the HDSS-Universities collaboration, we have introduced an INDEPTH Fellowships Programme Fellowship programme seeks to identify young, bright and promising recently MSc/MA graduates to be posted to sites in the participating countries Fellows will have defined scope of work to be determined by the site based on site needs Three fellows have been placed.

61 Scientific Development and Leadership Programme 12 scholarships provided by the Secretariat in 2007

62 COLLABORATIONS

63 Building/Maintaining partnerships Linking local universities to HDSS sites Collaborating with Health Metrics Network Linking HDSS sites to national statistical systems Integrating HDSS into comprehensive National Health Information Systems Pursuing New collaborations (DHS, IHME etc)

64 INDEPTH-HMN HMN Monitoring Vital Events Resource Kit INDEPTH and Health Metrics Network (HMN) jointly produced kit Kit published on CD and distributed through WHO and partners To all Health Ministries, health and statistics institutions around the world, health and medical libraries, WHO regional and country offices, etc Jointly published guidelines for improving vital information in developing countries

65 Institute for Health Metrics and Evaluation The Institute for Health Metrics and Evaluation (IHME) is pursuing avenues for collaboration with INDEPTH on development of tools and methodologies for analysing mortality data INDEPTH was invited to the launched and was one of the key institutions to make a presentation at the launch. Dr. Alex Ezeh (APHRC/Nairobi UHDSS) has just returned from representing INDEPTH at an IHME meeting Dr. Rafael Lozano is with us at this AGM

66 INDEPTH at IHME in Seattle

67 Macro International Measure DHS INDEPTH visited Macro International (Measure DHS) in April 2008 to learn from experience on data archiving and accessibility in order to inform our IDS Measure DHS and INDEPTH are pursuing a collaboration on data visualization

68 New Strategic Plan for INDEPTH: The current strategic plan ( ) will end in 2009 Secretariat has started the process to develop a new Strategic Plan for the period Consultant recruited to help with the process. Emerging research opportunities will be highlighted for cross-site activities Health systems Linking health services data with our HDSS data Evaluating interventions Antibiotic resistance Reproductive health...

69 The INDEPTH Secretariat The new Executive Director organised a retreat immediately after taking over office Dalberg, site scientists and others helped

70 The new INDEPTH website

71 The Board

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75 INDEPTH Business Plan for greater efficiency and effectiveness

76 The INDEPTH Business Plan 1 Scientific research and publication is the realm of 1)SAC, 2) Working Groups and 3) Sites Weighted Responsibility Research Define and recommend priority thematic areas to study Identify cross-site questions to study Write proposal for funding Gather, enter and clean data Pool and analyse data Publish results Site S S S P S S WG S P P S P P SAC* P S S T T S Board T T T N/A N/A T Secretariat** T T T T T T P S T N/A Primary actor Secondary actor Tertiary actor Not applicable Scientists who are primary members of sites, WGs and SAC should drive the science and the research Role for Board and Secretariat should be limited - Reduces potential conflict of interest for board members who are also site leaders * SAC proposes through the Secretariat to the Board which ratifies ** Secretariat can opportunistically lead some of the work especially in reaction to requests from interested entities e.g., funders 6

77 INDEPTH Business Plan 2 All should contribute in translating research findings into policy changes at the various levels, with the Secretariat playing a facilitating role Weighted Responsibility Site WG SAC Board Secretariat Link research output with policy change at a local level P P S T S Policy Linkage Link research output with regional/cross-country policy changes S P S S S Link research output with global policy changes T S S P P P S T N/A Primary actor Secondary actor Tertiary actor Not applicable Policy work can unlock new public financing, key in maintaining 501 (c)3 status Significant opportunity to grow INDEPTH s profile globally Policy changes promoted by sites in local context should not just be limited to the research they do, but also include research done by broader Network 13

78 INDEPTH Business Plan 3 Governance is the primary responsibility of the Board with the Secretariat as its executing arm Weighted Responsibility Site WG SAC Board Secretariat Provide direction to Secretariat activity T T S P N/A Access new network funding and partners T T S P P Provide political visibility and connections T T S P S Govern ance Ensure Network compliance w/regulations (e.g., tax exemption status) T T S P P Ensure network compliance with funder requirements (e.g., prompt reporting) T S S P P P Primary actor S Secondary actor T Tertiary actor N/A Not applicable Ultimate decision making lies with Sites but its not their day to day function Board membership should be expanded to bring in new members, skills and networks e.g., law, tax, industry, foundations, public sector players, political credibility, strategy 14

79 Some highlights of INDEPTH visits to sites

80 At Iganga/Mayuge, Uganda

81 At Kanchanaburi, Thailand

82 Vadu and Ballabgarh in India

83 INDEPTH next 5 years INDEPTH will be top of mind when policy makers and donors/funders are looking for empirical information to guide health and socioeconomic policy in the developing world.

84 Acknowledgements Site Leaders and their various teams Field workers Field supervisors Data entry clerks Administrators Finance Managers etc. etc. etc. Our collaborators/partners Site-specific INDEPTH-wide The Board, the SAC and the Secretariat team

85 Current Funders Core Hewlett Foundation Sida/SAREC Rockefeller Foundation Gates Foundation Wellcome Trust Project NIA / WHO Andrew Mellon Foundation DFID (thru LSHTM / Uni Sussex) Previous funders The World Bank Eagles Project, EU VW Foundation, FRG New Funders CIDA, Canada IDRC, Canada All potential funders

86 INDEPTH s Tagline: Better Health Information For Better Health Policy

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88 The three main HDSS subjects Homestead / Compound Our wealth is that we generate information at the individual level over time!

89 Thank you! Asante Sana!