Dr. Wolfgang Munar Research Professor Milken Institute School of Public Health Feb 28 - 2018
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Dr. Wolfgang MunarResearch Professor
Milken Institute School of Public Health
Feb 28-2018
MMR (per 100k live births)
NMR (per 1k live births)
1990 2016 2035
Tension for change - the stagnation of
maternal survival in Honduras
Adapted from Hovmand et al. 2016 – Washington University in St Louis
Political decision to redesign MNCH
policy• SMI and System Dynamics simulation modeling
• Participatory redesign process
• Conventional strategic planning (SWOT, epi & institutional assessments)
• Scenario planning (Imagining plausible futures in the context of a very dynamic environment)
• Using system thinking tools for policy design
MMR (per 100k live births)
NMR (per 1k live births)
1990 2016 2035
Adapted from: Hovmand et al. 2016 – Washington University in St Louis
How can Honduras accelerate
maternal survival?
Confluence of domestic and external
factorsSMI’s focus on population-level
outcomes brought MNH issues to
evidence-informed policy dialogue
agenda
Photo credit: Janko Ferlic
Confluence of domestic and external
factorsSMI’s focus on population-level
outcomes brought MNH issues to
evidence-informed policy dialogue
agenda
Development of a System
Dynamics MNH Simulation Model
using group model-building (GMB)
Photo credit: Janko Ferlic
Photo credit: Peter Hovmand
Confluence of domestic and external
factorsSMI’s focus on population-level
outcomes brought MNH issues to
evidence-informed policy dialogue
agenda
Development of a System
Dynamics MNH Simulation Model
using group model-building (GMB)
Photo credit: Janko Ferlic
Photo credit: Peter Hovmand
At BMGF, a growing interest in
understanding how to achieve global
impact at scale
Group model building and system dynamics - “seeing” own system; negotiating meaning about system elements, inter-
relations, and system boundaries
Several high leverage points were identified
through the participatory modeling process
Mapping policy options and experimenting with high-leverage points
Leverage point in the model
Increasing accessibility
Increasing affordability
Quality improvement (QI)
Increasing quality improvement capabilities (QI+)
Increasing women’s health status
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Best case
All QI+
ID QI+
ID QI
All Aff. and Acc.
PPC QI
MCP QI
Base case
MMR NMRHovmand et al. 2016
Honduras - Simulation model scenarios for
MN survival
Peter Hovmand– Washington University in St Louis
InterventionsID: Institutional deliveryANC: Antenatal carePPC: Postpartum carePNC: Postnatal careQI: Quality improvementQI+: Continuous QI +System learning for QI
Page-3-
MaternalMortalityRatio
Year
Pe
r1
00
kliv
eb
irth
s
0
150
300
1990 2001 2013 2024 2035
1
2
3
4
51
23
45
12
3
4
5
1
2 34
5
Basecase1
AllQI+2
IDandPPCQI+3
IDandPPCQI+,IDAff.andPPCAcc.4
Bestcasescenario5
Scenarios
Hovmand et al. 2016
Peter Hovmand– Washington University in St Louis
InterventionsID: Institutional deliveryANC: Antenatal carePPC: Postpartum carePNC: Postnatal careQI: Quality improvementQI+: Continuous QI +System learning for QI
Page-3-
NeonatalMortalityRate
Year
Per
1kliv
eb
irth
s
0
20
40
1990 2001 2013 2024 2035
1
2
3
4
5
12
34
51
23
4
5
1
2 34 5
Basecase1
AllQI+2
IDandPPCQI+3
IDandPPCQI+,IDAff.andPPCAcc.4
Bestcasescenario5
Scenarios
Hovmand et al. 2016
Peter Hovmand– Washington University in St Louis
InterventionsID: Institutional deliveryANC: Antenatal carePPC: Postpartum carePNC: Postnatal careQI: Quality improvementQI+: Continuous QI +System learning for QI
Complementing evidence-informed policy design with SD models and GMB
System thinking-informed policy dialogue brought new perspectives: multi-sectorial approaches, adolescents and girls, improvement and system learning
The result: A new inter sectorial MNCH policy,with a strong focus on girls and adolescents
Promise and risks
Related Documents
