Dr Richard Smith of the London School of Hygiene and Tropical Medicine introduces the joint LSHTM, LIDC and IDS event entitled 'Synthesising evidence across health and development' held at Woburn House on 19 September 2012.

1. Synthesising evidence
across health and
development
Gerry Bloom, IDS
Lawrence Haddad, IDS
Richard Smith, LSHTM
Jeff Waage, LIDC

2. Background
• Huge challenges facing those policy makers
concerned with health and those concerned
with development
– Urbanization, demographic shifts, food production
and consumption etc
• Require integration of our understanding of
health with our understanding of development
processes
• There are instances of this – such as WHO CMH
and CSDH – but they are rare

3. Background
• Such instances are not reflected in mainstream
policy and practice
– MDGs represent separate, sector-specific
interventions with unlinked targets, each ‘owned’
by its associated sector, which has concentrated
largely on sector-specific approaches
• To better integrate we need to look closely at
factors contributing to current ‘silo mentality’.
• Here interest is upon role of evidence
generation, synthesis and dissemination

4. Problem
• Several features currently endemic to academic
life which discourage integration
– high-impact peer-reviewed journals tend to not be
multidisciplinary
– research funding is mostly streamed within
disciplinary areas
– few serious multidisciplinary post-graduate
programmes
• In addition to these ‘generic features’, there are
two specific factors we identify here

5. 1. Perspectives
• Health is defined narrowly - Quality/Disability
Adjusted Life Year at best
• Development focus on reducing poverty
through improving income
– Countries are even classified by as ‘developed’ or
‘developing’ according to income
• Narrow agendas maintained by silos between
development and health across government
departments and development agencies
• May result at worst in a decrease in societal
welfare and at best missed opportunities

6. 2. Evaluation paradigms
• Principle obstacle not lack of evidence for
integrated interventions, but difference in
evaluative paradigms which makes evidence in
one sector less accessible and convincing to the
other
• Health – scientific, reductionist model for
evaluating interventions. Emphasis upon RCT
• Development – rare to find a RCT. Greater
focus on ‘why and how’ and less on ‘result’
• These different approaches make it difficult to
measure and integrate ‘strength’ of evidence

7. Solution?
• These factors at best make an integrated
approach to the design and evaluation of
interventions difficult, and at worst means that
these worlds simply collide. So, how can we
move from a state of collision to coalescence?
• The papers forming the basis of this session
were effectively experiments in bringing
together perspectives and evaluative paradigms
across these communities to examine the
evidence base for a more integrative approach,
exploring different ways in which these policy
and research communities frame problems,
pose research questions and evaluate evidence

8. Overview of project
• UK Department for International Development
funded these papers to test hypothesis….
• … that inter-sectoral working may be
encouraged and stimulated through:
– consideration of how to synthesise evidence
– provide vehicle for outputs (ie journals)
• Thus, focus on undertaking:
– systematic reviews of health and development
literatures around specific issues
– co-publication in leading health and development
journals (The Lancet and World Development)

9. Purpose of symposium
• This symposium brings together experts from
both health and development sectors to
explore the interaction between health and
development and identify new opportunities
and methods for taking forward the integrated
evaluation of interventions and policies
• It is hoped by the end of the symposium to
have identified some concrete next steps to
ensure that positive synergies can be designed,
identified and assessed

10. Programme
• Session 1: case studies
– Four case studies in evidence synthesis
– Panel discussion of author reflections
• Session 2: invited panel
– Panel discussion of how to improve inter-
sectoral evidence environment for research
funding, publication and policy
• Session 3: future
– Wrap up and next steps
– Informal discussion over drinks