Division of Information, Evidence, Research and Innovation ...€¦ · European action plan on evidence for policy making: Local knowledge and evidence for local policy . Presentation

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Date of presentation

Division of Information,

Evidence, Research and

Innovation

– what can we do for you?

Meeting of the WHO European

Healthy Cities Network and National

Network Coordinators

4th April 2016, WHO Regional Office for Europe,

Copenhagen, Denmark

Dr Claudia Stein MD, PhD, FFPH

Director


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European Health Information Initiative (EHII)

• Provides overarching

guidance for health

information activities

WHO Europe;

• Multi-partner network;

• Goal: Integrated health

information system for

Europe

• 4 Steering Group

meetings held to date.


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Why do we need this initiative?

• Health information and evidence in

Europe is fragmented and expertise

scattered;

• Member States’ information often

incomplete, not harmonized with

international standards and not

always reported;

• Networks are often ad-hoc and

based on personal relationships.


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Malta: Chairing Small

Countries Health

Information

Network

… and we have grown!

Turkey: 1. Hosted first autumn

school Oct 2013

2. Chairing strategy sub-

group

Poland: Hosted autumn school

Oct 2014

Russian Federation: 1. New WHO Collaborating

Centre on health information;

2. Hosted Autumn School 2015

Kazakhstan &

Kyrgyzstan: Staff & infrastructure for

regional health information

network in CARK countries

European

Commission (4 DGs)

OECD

Lithuania: Established PhD

programme in EIP

Ireland

Germany

Andorra

Bulgaria

UK: 1. WHO Collaborating

Centre on Health 2020

indicators

(Manchester)

2. Public Health England

Switzerland: WHO Collaborating

Centre Swiss

Tropical & Public

Health Institute


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EHII key areas


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European Health 2020 policy

• Emphasis on health and well-being

• The right to health and access to care

• People at the centre

• Addressing the determinants of health

• Whole of society approach

• Whole of government approach

• Importance of partnerships


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19 core and 17 additional

indicators for 6 targets


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Headline target Indicator

Age adjusted mortality from diseases of digestive system, ages 30-70 years, per 100 000, disaggregated by sex

1. Reduce premature

mortality in Europe by

2020

Age-standardized prevalence of overweight and obesity in people aged 18 years and over, disaggregated by and and sex

Proportion of children of official primary school age not enrolled, disaggregated by sex

Life expectancy at birth (years), disaggregated by sex

5. Universal coverage

and the "right to

health"

Gini coefficient on income distribution

Private households' out-of-pocket payments on health as % of total health expenditure

Total health expenditure as % of GDP, WHO estimates

Age adjusted mortality from malignant neoplasms, ages 30-70 years, per 100 000, disaggregated by sex

Age adjusted mortality from diseases of circulatory system, ages 30-70 years, per 100 000, disaggregated by sex

Age adjusted mortality from diseases of respiratory system, ages 30-70 years, per 100 000, disaggregated by sex

Life satisfaction, disaggregated by age and sex (subjective well-being)

Percentage of population with improved sanitation facilities (objective well being)

Social support available, disaggregated by age and sex (objective well-being)

2. Increase life

expectancy in Europe

3. Reduce inequities in

Europe (social

determinants)

4. Enhance well-being of

the European

population

Total per capita alcohol consumption among people aged 15 years and over, within a calendar year, disaggregated by sex

Percentage of children vaccinated against measles, polio and rubella

Unemployment rate (%)

Infant deaths per 1000 live births, disaggregated by sex

Age adjusted mortality from external causes of injury and poisoning, all ages, per 100 000, disaggregated by sex

Age-standardized prevalence of regular tobacco use among people aged 18 years and over, disaggregated by sex

Wellbeing –

subjective &

objective


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The SDGs and Health 2020

are fully aligned


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Headline target Indicator

Age adjusted mortality from diseases of digestive system, ages 30-70 years, per 100 000, disaggregated by sex

1. Reduce premature

mortality in Europe by

2020

Age-standardized prevalence of overweight and obesity in people aged 18 years and over, disaggregated by and and sex

Proportion of children of official primary school age not enrolled, disaggregated by sex

Life expectancy at birth (years), disaggregated by sex

5. Universal coverage

and the "right to

health"

Gini coefficient on income distribution

Private households' out-of-pocket payments on health as % of total health expenditure

Total health expenditure as % of GDP, WHO estimates

Age adjusted mortality from malignant neoplasms, ages 30-70 years, per 100 000, disaggregated by sex

Age adjusted mortality from diseases of circulatory system, ages 30-70 years, per 100 000, disaggregated by sex

Age adjusted mortality from diseases of respiratory system, ages 30-70 years, per 100 000, disaggregated by sex

Life satisfaction, disaggregated by age and sex (subjective well-being)

Percentage of population with improved sanitation facilities (objective well being)

Social support available, disaggregated by age and sex (objective well-being)

2. Increase life

expectancy in Europe

3. Reduce inequities in

Europe (social

determinants)

4. Enhance well-being of

the European

population

Total per capita alcohol consumption among people aged 15 years and over, within a calendar year, disaggregated by sex

Percentage of children vaccinated against measles, polio and rubella

Unemployment rate (%)

Infant deaths per 1000 live births, disaggregated by sex

Age adjusted mortality from external causes of injury and poisoning, all ages, per 100 000, disaggregated by sex

Age-standardized prevalence of regular tobacco use among people aged 18 years and over, disaggregated by sex


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AREA TARGET QUANTIFICATION CORE INDICATORS

Healthy

people,

well-

being

and

deter-

minants

4.

Enhance

the well-

being of

the

European

population

To be set as a result of

the base-line of the

core well-being

indicators

Life satisfaction

Availability of social support

% of population with

improved sanitation facilities

GINI coefficient (income

distribution)

Unemployment rate

Proportion of children of

primary school age not

enrolled

Still work in

progress,

including

additional

indicators on

subjective

well-being

Subjective well-being

Objective well-being DIR conducting

detailed mapping of all

SDG indicators, H2020

and NCD framework


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Cultural contexts of health (CCH)

• Tackling the challenge of measuring and

reporting on subjective health

experiences;

• Health 2020 emphasises resilience, well-

being, life-course, patient centeredness;

• New demands of whole-of-government

and whole-of-society approaches;

• WHO must get better at engaging with

cultural contexts of health and well-

being;

• WHO Euro launches CCH project.

“The neglect of culture is the single biggest

obstacle to developing equitable health care”.

- UCL-Lancet Commission Report

on Culture and Health


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CCH in Healthy Cities

More research into the effects of cultural factors in

relation to the environment and health is needed:

• How does cultural capital contribute towards a

healthy life in a healthy city? And how do we measure

this?

• How can cultural practices be better harnessed to

promote health-enhancing behaviours on the local

level? How do these vary throughout the life-course?

• In what ways do cultural values influence how citizens

relate to urban spaces? How does this play out in

relation to migrants?


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Setting targets for Health 2020 –

a European or national issue?

Austria Health Objectives

• Objective 1. Healthy living and working conditions

• Objective 2:Health equity between the sexes and socio economic

groups

• Objective 3:Increase health literacy

• Objective 4:Secure a healthy environment

• Objective 5: Strengthen Social Cohesion

• Objective 6:Healthy childhood

• Objective 7:Healthy diet with high quality food

• Objective 8:To encourage healthy movement and safe environment

• Objective 9:Increase Psychosocial health

• Objective 10:High quality and efficient health care for all

Overarching Health 2020 targets

1. Reduce premature mortality in Europe by

2020

2.Increase life expectancy in Europe

3.Reduce inequities in health in Europe

(social determinants target)

4. Enhance well-being of the European

population (to be further elaborated

during 2012/13)

5. Universal coverage and “right to health”

6. Member States set national targets/goals

Sub-

national

and city

targets!


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Austrian Objective 2 : Health equity between socio economic groups

Income level and life expectancy at birth differences by Austrian regions

Source: WHO/Europe, Atlas of Health Inequalities, 2012

Salzberg

Tirol

Vorarlberg

Kärnten Oberösterreich

Wien

Steiermark

Burgenland

Niederösterreich

Need for more detailed data & targets

How do you monitor these indicators…?


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Regional Profile Comparisons

WHO tools can be adapted to any setting

WHO preparing additional tools for 2016

Local

evidence

for local

action!


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How does eHealth contribute to

Healthy Cities?

• Self-management

• Healthy ageing

• Mental health

• Literacy

• Empowerment

• Evidence


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mHealth and what it means for

Healthy Cities

• Cost savings

• Patient-centred

• Health apps


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eHealth and innovation

within the local context

• Improves Health for All and reducing health

inequalities;

• Improves participatory governance;

• Expands community resources and enables

mutual support;

• Promotes intersectoral collaboration.


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One

vision

and goal

4 guiding

principles

4 key

action

areas Expected

results

Deliverables

Key

targets

and

indicators

Proposed

actions

Timeframe of 5 years

Monitoring and Evaluation

Regional Committee 2016: European action plan on evidence for policy making:

Local knowledge and evidence for local policy


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The 4 key action areas

1. Strengthening health information systems, harmonizing health indicators and establishing an integrated health information system for the European Region;

2. Establishing and promoting health research systems to support the setting of public health priorities;

3. Increasing country capacities for the development of evidence-informed policies (knowledge translation);

4. Mainstreaming the use of evidence, information and research in the implementation of Health 2020 and other major regional policy frameworks.

For

adoption

and

resolution

at RC 2016


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Thank you,

Danke, Merci,

Спасибо


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Extra slides


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Disseminating health information:

sources of evidence

Health Evidence

Network (HEN)

• 3-6 evidence syntheses annually;

• HEN report on culture and health in

preparation.


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Culture and Health in the

EURO public health journal

• Aimed at dissemination of good

practice and successful

implementation of

evidence-informed policies;

• Bi-lingual (English/Russian):

• Each issue has special theme

Special theme on Culture and

Health for 2017


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24-25 March 2015:

First meeting of the EHII

Steering Group

We’re

together

again!


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WHO/EU collaboration towards a single

integrated Health Information System

for Europe (53 Member States)

OECD

a partner since

2012

Vilnius Declaration 2015

Regional Committee 2015:

Strong support from Member States for

strengthening health information

Moscow Declaration 2010


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The SDGs and Health 2020

are fully aligned


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Special focus 2016:

Baseline reporting for

SDG 3 indicators and

other SDG health

indicators

One concrete starting point for countries


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Revitalizing: Country Profiles &

Highlights on Health and Wellbeing

New concept:

• Focus on Health 2020

• Country profile (detailed)

• Highlights summary


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Key features of the publications

Country Profiles Highlights on Health Format

Comprehensive and detailed Short, highlighting key issues for policy

Systematic, follow template Flexible format

Target audience: public health

professionals

Target audience: policy makers

Content

Demographic and economic information Health 2020 indicators & implementation

Health status and burden of disease Risk factors and determinants of health

Risk factors and determinants of health Health system

Health system Conclusions

Health 2020 implementation

Conclusions


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Publication

imminent:

Greece

Moldova

Slovenia

Next in

line:

Bulgaria

Ukraine


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Collaboration of WHO/EURO and Institute of

Health Metrics and Evaluation

• To collaborate on burden of disease assessments in European Region;

• To improve coherence of quantitative messages;

• To facilitate national burden of disease studies, including training.

WHO country profiles

Highlights on Health

revitalized & to include

burden information

Country interest increasing:

12 countries completed,

conducting or planning NBD

studies

(6 EU, 6 non-EU)

EURO and IHME joint

work: joint missions to

countries, training

events.


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Cultural contexts of well-being

Expert Group on Cultural Contexts

of Health and Well-being - main

recommendations:

• Explore different types of qualitative evidence more fully

• Commission further work in the area of culture and

health

• Adopt the UNESCO definition of culture

• Investigate cultural contexts of health more

systematically

• Use a multisectoral and multidisciplinary integrated

research approach.

Next meeting

of expert

group: April

2016


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Country

Profile

with H2020

indicators


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Launch of the European Regional eHealth Report:

From Innovation to Implementation


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European Regional eHealth Report:

Highlighting the importance of eHealth as a

national strategic asset

• Based on the results of the 2015 Global Observatory for eHealth

(GOe) survey (to which 47 of the 53 European Region Member States

responded – a response rate of 89%);

• Present findings across a range of thematic eHealth areas (eHealth

foundations, Electronic Health Records, Telehealth, mHealth,

eLearning in Health, Social media in Health, Health analytics and big

data, legal frameworks fro eHealth);

• Russian language report is due for publishing in early May, 2016.


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October 2014 in

Poland

Focus: Health 2020

monitoring (country case

studies, inequalities,

reporting)

2015 School in

Russian Federation

Capacity building:

Autumn school of health information and

evidence for policy making

‘Advanced

course’

added

annually

(June)

2016 School in

Ukraine

(collaboration with

World Bank)


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Health Information Networks in Europe

• Launched in

European

Region in 2012;

• Uses multi-

stakeholder

country teams

to translate

research

evidence in

policy-making;

• Now “live” in

19 countries.

Kazakhstan, Kyrgyzstan,

Tajikistan, Turkmenistan,

Uzbekistan


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Small Countries Health Information Network

• Initiative of the Minister of

Health, Malta;

• Countries agreed to establish

health information network;

• Terms of Reference and Scope

and Purpose for network

agreed;

• Malta chairing the network in

phase 1;

• First meeting held 3-4 March

2016 in Malta, and work plan

established.


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Purpose of a South-eastern European Health

Information Network:

to promote coordination and collaboration among countries in the SEEHN,

in order to strengthen national health information systems, including data collection, processing,

analysis and dissemination.


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Health information strategies

• Member States requested practical

support tool

• Tool developed by Working Group (17

countries), co-chaired by Netherlands and

Russian Federation

• Based on WHO HMN tools and materials,

adapted to European context

• Available in English & Russian

• Currently implementing the tool in Member

States with view to evaluate this tool. Piloted in:

Bulgaria

Moldova

Albania


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One

vision

and goal

4 guiding

principles

4 key

action

areas Expected

results

Deliverables

Key

targets

and

indicators

Proposed

actions

Timeframe of 5 years

Monitoring and Evaluation

Regional Committee 2016: European action plan on evidence for policy making


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The 4 key action areas

1. Strengthening national health information systems, harmonizing health indicators and establishing an integrated health information system for the European Region;

2. Establishing and promoting national health research systems to support the setting of public health priorities;

3. Increasing country capacities for the development of evidence-informed policies (knowledge translation);

4. Mainstreaming the use of evidence, information and research in the implementation of Health 2020 and other major regional policy frameworks.

For

adoption

and

resolution

at RC 2016


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Expected outcomes of this meeting

• Review of progress with EHII activities;

• Revision of work plan;

• Guidance and next steps on EHII

strategy;

• Identification of any new EHII activities

and their actors.


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Housekeeping

• Declarations of Conflict of Interest → please submit missing forms;

• Queries relating to administrative issues:

– Logistic issues: Liliana

– Technical issues: Claudia, Khassoum.

• Meeting rooms:

• We will be in this room both days;

• Toilets are just outside to the right;

• Lunch vouchers – Liliana will distribute in the coffee break;

• Wireless: information on the walls;


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Housekeeping

• Bus from outside UN City does not operate in the afternoon! Instead take

S-train from Nordhavn station;

• Taxis can be requested from the reception desk;

• EHII members speak before WHO staff…. (the chair will be strict );

• Reception TONIGHT at 17:30-18:00 in Atrium 1 (ground floor to the right).


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Happy belated birthday to our Chair, Annemiek!

Housekeeping


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How will WHO report on these

indicators? • Annual report of the Regional

Director;

• Annual European ‘Core Health Indicators’;

• ‘European Health Statistics’ (mobile app);

• New EURO health information web-portal;

• The European health report (every 3 years).

Round 2 of

well-being

indicators:

2016/17


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What makes a good indicator for

Health 2020 – results from the expert group

• High validity and reliability;

• Available for majority of countries;

• Not already capture in other monitoring frameworks;

• Ideally should be routinely reported;

• One indicator that serves several targets;

• Data accompanied by meta-data;

• All rates age-standardized;

• Indicator data reported disaggregated, i.e. by age,

gender, ethnicity, socio-economic strata, vulnerable

groups, sub-national;

• Comparable across the region.


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Burden

of

disease

and risk

factors

1. Reduce

premature

(30-69 yrs)

mortality in

Europe by

2020

1.5% relative annual

reduction in overall

premature mortality

from CVD, cancer, DM

and chronic respiratory

disease

Premature overall premature

mortality rate for CVD, cancer,

DM and chronic respiratory

disease

Prevalence of current tobacco

use

Total per capita alcohol

consumption

Prevalence of overweight and

obesity

Elimination of selected

vaccine-preventable

diseases

% of children vaccinated

against measles, polio, and

rubella

Reduction of mortality

from external causes

Mortality rates from all

external causes and injuries


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Healthy

people,

well-

being

and

deter-

minants

2. Increase

life

expectancy

in Europe

Continued increase in

life expectancy at

current rate +

reduction of

differences in the

Region

Life expectancy at birth

3. Reduce

inequities in

Europe

Reductions in the

gaps in health status

associated with social

determinants within

the European

population

Infant mortality per 1000 live

births

Life expectancy at birth



enrolled

Unemployment rate

(Sub)national policy

addressing reduction of health

inequities established and

documented


distribution)


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AREA TARGET QUANTIFICATI

ON

CORE INDICATORS

Processes,

governanc

e and

health

systems

5. Universal

coverage and

“right to

health”

Moving towards

universal

coverage by

2020

Private household out-of-

pocket expenditure as a

proportion of total health

expenditure

% of children vaccinated

against measles, polio, and

rubella

Total gross expenditure on

health (as % of GDP)

6. National

targets/goals

set by

Member

States

Establishment of

processes for the

purpose of

setting national

targets (if not

already in place)

Establishment of process for

target-setting documented

Evidence documenting: a)

establishment of national

policies aligned with Health

2020, b) implementation plan,

c) accountability mechanism


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Target 6. Setting national targets

0% 10% 20% 30% 40% 50% 60% 70%

No

Yes, included elsewhere

Yes, stand alone

Policy addressing health inequity or social determinants of health existsAll answers (n=31 and 36 for 2010 and 2013, respectively)

2013

2010

0% 10% 20% 30% 40% 50% 60%

No, and not planned for the future

No, but planned for the future

Indicators defined

Targets defined

National or subnational target setting process exists

All answers (n=31 and 36 for 2010 and 2013, respectively)

2013

2010

0% 10% 20% 30% 40% 50% 60% 70%

No and not planned for the future

No, but planned for the future

Yes, another strategy

Yes, comprehensive health policy

National health policy is aligned with H2020All answers (n=31 and 36 for 2010 and 2013, respectively)

2013

2010

0% 10% 20% 30% 40% 50% 60%

No, and not planned for the future

Yes, in process

Yes, adopted

There is a health policy accountability mechanism in placeAll answers (n=31 and 36 for 2010 and 2013, respectively)

2013

2010

Source: WHO. Qualitative indicators for Health 2020 policy targets monitoring, 2014

On-line survey

Internet Explorer.lnk


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Expert group for the measurement and

target setting for well-being

How did the group define well-being?

“Well-being exists in two dimensions,

subjective and objective.

It comprises an individual’s experience

of their life (‘subjective’) as well as a

comparison of life circumstances

(‘objective’) with social norms and

values.”


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We’re mixing a hot cocktail


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Healthy

people,

well-

being

and

deter-

minants

4. Enhance

the well-

being of

the

European

population

To be set as a result of

the base-line of the

core well-being

indicators

Life satisfaction

Availability of social support

% of population with improved

sanitation facilities


distribution)

Unemployment rate



enrolled

Still work in

progress,

also still

working on

additional

indicators on

subjective

well-being

Subjective well-being

Objective well-being

Round 2 of

well-being

estimates:

2016/17


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Country

Profile

with H2020

indicators


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Exportability


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Reusable

interactive

graphs for

the web site,

the intranet

and beyond


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Researc

h

Pro

ble

ms

Good luck

with bridging

this gap….

IEA World Congress of Epidemiology

Plenary Session

7 August 2011

Researc

h

Pro

blem

s

http://www.oecd.org/


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Evidence and Intelligence for Policy-

making (EIP) (including Health

Evidence Network, Country Profiles

and European Health Report)

(SO*10)

Health for All Information Systems

and Dissemination (HFA) (SO10)

eHealth (including e-Learning) (EHL)

(SO10)

Library, Languages and Publications

(LLP) (SO12, 13)

Director’s Office (DIR)

Division of Information,

Evidence, Research and

Innovation (DIR)

Evi

dence a

nd

Rese

arc

hH

ealth I

nfo

rmation

, M

on

itori

ng

an

d A

naly

sis

Kn

ow

led

ge M

an

ag

em

en

t

an

d D

issem

ination

Research Policy and Coordination

(RPC) (SO10)

Innovations for Health (including

social networks) (INH) (SO10)

Knowledge Management (KNM)

(SO10)

Monitoring and Surveillance Systems

and Databases (MSD) (SO10)

Country Health Information Systems

(CHI) (SO10)

* Strategic Objective October 2010

Inn

ovation

an

d

eH

ealth

The Division of Information, Evidence,

Research and Innovation (DIR)

2. Health

information,

monitoring &

analysis

3. Health

informatics (incl.

gateway)

1.Translating

evidence into

policy and

Research

5. Translations

6. Publications

4. E-health and

Innovation


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DIR: Crossing the barrier between evidence & policy

Collect, & help

stakeholders to

collect, high-

quality evidence

Appraise &

interpret

information,

evidence &

research

Package and

share knowledge

in user-friendly

way

Provide innovative

mechanisms/tools/str

ategies for evidence

gathering & policy

translation

Evaluate translation

of evidence into

policy

Assess impact of

policy on health

outcomes & break

down barriers


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• Importance of partnerships


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• Solutions that work and make a difference

“Adopts….together

with a set of

regional goals as

set out in that

document and the

appropriate

indicators for the

European Region.”


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19 core and 17 additional

indicators for 6 targets


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Exportability

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Division of Information, Evidence, Research and Innovation ...€¦ · European action plan on evidence for policy making: Local knowledge and evidence for local policy . Presentation