Elements for making flowcharts etc

Elements for making flowcharts etc

Evidence to Action: Bringing the evidence revolution to Ghana Howard White CEO, Campbell Collaboration Evidence to Action 2019 ISSER, University of Ghana 11th July 2019 @campbellreviews @HowardNWhite The rise and rise of evidence The four waves of the evidence revolution 1990s

Results agenda (Outcome monitoring) 2010s 2000s Rise of RCTs Rise of systematic reviews But data are not evidence Knowledge brokering

This approach supports the institutionalization of the use of evidence Ch Evidence portals Evidence maps Databases Systematic reviews Studies Data More heavily brokered knowledge Knowledge brokering platform

pyramid ec kli st Guidance s & guidelines Impact evaluations in 3ie database by year of publication 200 studies funded by 3ie Source: Shayda Mae Sabet & Annette N. Brown (2018) Is impact evaluation still on the rise? The new trends in 20102015, Journal of Development Effectiveness, 10:3, 291-304

Increasing secondary education RCT of removing secondary fees: 2000 students admitted SHS but not enrolled; 680 given four year scholarship. Removing fees for secondary education: Large effect on enrolment Significant but small effect on test scores females only Reduced sexual activity and more likely to practice safe sex Fewer unwanted pregnancies Source: Estimating the impact and cost-effectiveness of expanding access to secondary education in Ghana https://www.3ieimpact.org/evidence-hub/publications/impact-evaluations/estimating-im pact-and-cost-effectiveness-expanding

Policy lessons from the study Scholarship raised enrolment from 50% (in control) to 75% 25% still did not attend so fees not the only constraint 50% went without scholarship (but many delayed a year), so means testing might be considered Social benefit of reduced fertility justifies subsidy But impact on learning outcomes low quality issues to be addressed

Impact evaluations in Ghana: no. of studies in selected countries Source: 3ie database No. of studies normalized by population 1 study per 2 million people 1 study per 80 million people What should we do with these impact evaluations?

Impact evaluati on just one s are pa the evid rt of ence puzzle Prevalence data identify priorities & target group The evidence -driven

project cycle Synthesize evidence across all studies Keep testing as roll out to new populations / contexts / design features Proposed programme

Consult evidence base to inform design Go to scale with promising components: effectiveness studies Formative research

Formative evaluation in local context Pilot programme: Efficacy studies The Evidence Peter Principle Monitoring Factual data of what happened. Especially useful at lower reaches of causal chain. Outcome data identify problems. But used to (1) measure impact, and (2) identify programmes

Process evaluation Factual analysis of programme management / implementation. Useful for improving programme performance. But use to measure outcomes. Impact evaluation Counterfactual analysis of effectiveness. Useful for determining which e.g. RCTs programmes work to inform finding and design decisions for the programme being evaluated. But used to make global recommendations. Systematic Summarizes all available high-quality evidence on a reviews particular issue. Useful deciding on for new programmes or programmes redesign to try and test.

Politicians syllogism Something must be done This is something Therefore we must do this Thats the fallacy of the undistributed middle Prevalence data identify priorities & target group The evidence -driven

project cycle Synthesize evidence across all studies Keep testing as roll out to new populations / contexts / design features Proposed programme

Consult evidence base to inform design Go to scale with promising components: effectiveness studies Formative research

Formative evaluation in local context Pilot programme: Efficacy studies Prevalence data identify priorities & target group The evidence -driven

project cycle Proposed programme Formative research Prevalence data identify priorities & target group The evidence -driven

project cycle Synthesize evidence across all studies Keep testing as roll out to new populations / contexts / design features Proposed programme

Consult evidence base to inform design Go to scale with promising components: effectiveness studies Formative research

Formative evaluation in local context Pilot programme: Efficacy studies Unwanted and teenage pregnancy An example of various data sources: teenage pregnancy in Ghana Is it an issue? Over 30% teenagers pregnant or have a child (Preference data from DHS) Teenage pregnancy linked to dropping out of school, early first birth (bad

for baby and mother), and higher fertility (Correlational and prevalence data from DHS) Identifying target groups: Highest girls primary or less, Savannah belt, second quintile (lowest in highest) (prevalence data from DHS) Implication: we need to Programme design: do something (probably Systematic review evidence suggests few multicomponent). But notably programmes effective, weprogrammes

have to test most promising. abstinence for teenagers. Multi component we do. (Systematic review evidence). Though seewhatever also http://cshcawpengine.netdna-ssl.com/wp-content/uploads/2011/10/WhatWorks.pdf See also Stepup http://stepup.popcouncil.org/ (Research resource) Rise of systematic reviews: international development (no. of reviews published per year) Source: 3ie database This approach supports the institutionalization of the use of evidence Ch

Evidence portals Evidence maps Databases Systematic reviews Studies Data More heavily brokered knowledge Knowledge brokering platform pyramid ec kli st

Guidance s & guidelines Evidence-based medicine is based on systematic reviews The World Health Organization (WHO) follows a guideline development process, described in detail in the WHO Handbook for Guideline Development (2nd edition), overseen by the Guidelines Review Committee (GRC) established by the Director-General in 2007. The WHO Guidelines Review Committee ensures that WHO guidelines are of a high methodological quality, developed using a transparent and explicit process, and are informed on high quality systematic reviews of the evidence using state-ofthe art systematic search

strategies, synthesis, quality assessments and methods. But FAILURE of global community to invest in evidence architecture (apart from health) Impact evaluations Review of education RCTs found 1,017 3ie database has 4,735 impact evaluations with 1,980 RCTs Cochrane trials registry has 1.5 million Systematic reviews ERIC has around 1,000 education systematic reviews 3ie database has 692 systematic reviews Epistemonikos has over 35,000 health reviews In absence of that Ghanaian makers can use existing evidence resources

Databases (e.g. 3ie database, Campbell Library) Evidence and Gap Maps Local evaluations Prevalence data identify priorities & target group The evidence -driven project cycle

Synthesize evidence across all studies Keep testing as roll out to new populations / contexts / design features Proposed programme Consult evidence base to

inform design Go to scale with promising components: effectiveness studies Formative research Formative evaluation in local context

Pilot programme: Efficacy studies Findings from education review of over 200 studies The Uganda country evidence and map 269 process evaluations, 207 impact evaluations and 7 formative evaluations Uganda country evidence and gap The Ghana Evaluation Map

V E E ID E C N Join the evidence revolution Building the evidence architecture

Demand generation Use of evidence workshops Knowledge brokering platform pyramid Evidence needs assessment Evidence-based budgeting Aw ard s Ch ec

kli st Guidance s & guidelines Evidence portals Where do you fit in? Evidence maps Databases Systematic reviews Studies Data

Supply of evidence and evidence products Thank you Become an evidence revolutionary today Visit www.campbellcollaboration.org

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