Akademi Ilmu Pengetahuan Indonesia (AIPI): Evidence Summit on Reducing Maternal and Neonatal Mortality in Indonesia 2016-2017 1
Outline of Presentation 1. Profile of Indonesia Academy of Science (AIPI) 2. Background of Evidence Summit as an Initiation of AIPI 3. Profile Evidence Summit Indonesia 4. Roles of Stakeholders in Evidence Summit Peran 5. Challenges and Opportunities 2
2. Background of Evidence Summit as an Initiation of AIPI 3
About AIPI The Indonesian Academy of Sciences (AIPI) was established in 1990, by a Law of the Republicof Indonesia (No. 8/1990) Indonesian Academy of Sciences, as an independent body, provides opinions, suggestions, and advice to the government and society on the acquisition, development and application of science and technology 4
Tentang AIPI AIPI promotes science through scientific conferences and policy discussion forums, publications, national and international relations, and other activities AIPI currently has five commissions: 1. Commissions on Basic Sciences, 2. Commissions on Medical Sciences, 3. Commissions on Engineering Sciences, 4. Commissions on Social Sciences, and 5. Commissions onart and Culture 5
2. Latar Belakang Evidence Summit : Inisiasi AIPI 6
Latar Belakang Evidence Summit In 2013, AIPI (Indonesian Academy of Sciences) alongside the US National Academy of Sciences formulated a review report on Reducing Maternal and Neonatal Mortality in Indonesia. The major finding of the review is the lack of valid data/information, which is essential to indicate the actual occurrences in Indonesia over the last few decades Sumber: National Research Council. 2013. Reducing Maternal and Neonatal Mortality in Indonesia: Saving Lives, Saving the Future. Washington, DC: The National Academies Press. doi:https://doi.org/10.17226/18437. 7
Current conditions on Maternal and Neonatal Mortality in Indonesia Coverage of maternal health care services increased as were reported increasing ( according to MDGs report 2015, 80% of pregnant women received complete ANC, 80% of delivery were assisted by health professional) There was a stagnant decreasing of neonatal mortality throughout 2003-2012 and there is no new evidence has been identified about neonatal mortality According to MDGs report 2015, the maternal mortality was identified off track from the target. It was reported as 305 per life birth as it is assumed that 40 maternal deaths occurred per day. Why and How this condition could be happened? 8
Evidence Summit di Indonesia : Framework of Evidence based Policy 9
A Quality Level of Information & Evidence for Evidence-based Policy Indonesia Evidence Summit 10
3. Profile Evidence Summit (ES) di Indonesia 11
Evidence Summit Overview OBJECTIVES 1. Assemble all existing evidence relevant to maternal and neonatal mortality in Indonesia 2. Organize and summarize evidence in a framework that allows clear understanding of current evidence and prioritization for action 3. Build consensus among major stakeholders on the evidence base, interpretation of existing evidence, and priorities for action Komisi Ilmu Kedokteran Convener : Akmal Taher Co-Convener : Irawan Yusuf SCOPE EVIDENCE SUMMIT 7 Topic Areas 22 Focal questions 1 2 3 4 LUARAN Bibliography of Evidence accessible on-line to the broad array of interested parties Recommendations for specific topic area where evidence is sufficient to support decisions where evidence is insufficient to support decision where there are major gaps of evidence Final Report ES Manuscripts 12
Stuktur Organisasi Program Evidence Summit 72 institutions (need to scale up the stakeholders engagement) Stakeholders Group Inputs/Recommendations Steering Commi ee Inputs/Recommendations Execu ve Commi ee Secretariat* (Convener + Co-Convener) Core Technical Group Topic Area 0-6 7 group of Evidence Review Team (40) Associate Evidence Reviewer (6) Command pathway Coordination pathway 13
Timeline Evidence Summit June 2016 Maret 2017 (1) Protocol development Accomplished protocol: October 2016 (2) Evidence Gathering Bibliographic database/call for evidence November 16, 2016 December 14, 2016 (3) Selection/sorting Title/abstract screening; Full Text Screening November 16, 2016 December 14, 2016 (4) Evidence review/assessment Quality asessment : January 11, 2017 (5) Data extraction/analysis Data analysis : January - February 2017 (6) Body of Evidence Draft report / draft of bibliography February - March 2017 14
Timeline Evidence Summit March September 2017 (1) Protocol Development for Qualitative Evidences (2) Searching the Evidence : Qualitative Method Approved protocols : March 2017 April 2017 (3) Evidence review & Analysis Quality Assessment : May 2017 (4) Translating Evidence into Policy : Finalize Bibliography & Recommendation June - July 2017 (5) Evidence Summit (6) National Stakeholders Consultation & Manuscript August 2017 September 2017 15
7 Topic Areas 0. Evidence for problem description to frame the reviews with a focus on Indonesian specific implementation issues 1. Improved quality of care in public and private sectors 2. Improved referral system at community and facility levels 3. Implementation of UHC including increased utilization of MNH services and improved financial protection of the poorest and most vulnerable 4. Improved local governance systems influencing health 5. Improved utilization of evidence for decision-making in the public and private sectors 6. 16
22 Focal Questions from 7 Topic Areas 17
22 Focal Questions from 7 Topic Areas 18
Systematic Review A systematic and explicit approach colleting and summarizing all empirical evidence in order to answer a specific research question. Define 21 protocols Evidence Gathering Process 7078 literatures Evidence selection 376 eligible evidence Evidence Review Body of Evidence Maret September 2017 Sumber: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.2 [updated September 2009]. The Cochrane Collaboration, 2008. Available from www.cochrane-handbook.org. 19
Quality Assessment Method (grading) Eligible Literature A B C D E F G Sumber: Stevens B, Buettner P, Watt K, Clough A, Brimblecombe J, Judd J. The effect of balanced protein energy supplementation in undernourished pregnant women and child physical growth in low- and middle-income countries: A systematic review and meta-analysis. Maternal & Child Nutrition. Wiley-Blackwell; 2015 Apr 7;11(4):415 32. 20
4. Roles of Stakeholders 21
Peran dan Kontribusi Stakeholders Evidence Summit in Indonesia has unique approach compared with global evidence summit, because ES intends to engage more significant stakeholders including governments in national and regional levels. Roles of Stakeholders 1 2 Literature contribution: Contribute to provide the literatures related to the topic areas as representative of institutions, program, and group. Sustainable Policy Implementation Partners : As a target of Focus Group Dicussion, field visit, as well as participating in various arranged strategic forum to gather the feedback of the findings and recommendations. 22
Contribution of Higher Educatin Institutions in Literature Total contributions : 776 literatures from 30 Universities 23
5. Challenges and Opportunities 24
Challenges of Evidence Summit (1) Lacking of published and accessed evidences Abstinence of integrated information centre which provides the data about maternal and neonatal mortality. The available date and information are lacking of validity therefore they are excluded from the references and evidences in developing evidence-based policy Abstinence of collaborative forum among academia, researchers, providers and policy makers in exploring the core problem and developing the solution and policy in health related sectors. 25
Challenges of Evidence Summit (2) Insufficient roles of key stakeholders in literature contribution and monitoring the progress of program The appropriate communication pathway has not identified yet among internal and external stakeholders. Inadequate access to full text of articles for the evidences, particularly articles from local journal, scientific paper, thesis and dissertation. 26
Expectations of ES to the Stakeholders (participants of Rakerkesnas) for the sustainability of the program Contribute to provide the literatures related to the topic areas as representative of institutions, program, and group. Give the feedback and opinion in verbal or written about the initial findings and recommendations of Evidence Summit. Especially for the representatives of local government which are expected to give the contacts in accordance to upcoming qualitative study within local governments in April 2017. 27
Mari Peduli Dan Menjadi Bagian Dari Solusi Dalam Upaya Penurunan Angka Kematian Ibu Dan Bayi Baru Lahir Di Indonesia TERIMA KASIH Sekretariat Evidence Summit on Reducing Maternal and Neonatal Mortality in Indonesia Kantor Akademi Ilmu Pengetahuan Indonesia (AIPI) Jalan Hang Lekiu I No. 6A, Kebayoran Baru, DKI Jakarta 12120 T : +6221 7393065 HP : +62 812 8027 3367 E : secretariatesaipi@gmail.com W : http://aipi.or.id/index.php?pg=evidence 28