5.X.1. Co-designing for policy impact: Belgium’s monitoring & evaluation framework for cancer care & control
Authors:   Organised by: Sciensano (Belgium), EUPHAnxt, EUPHA-PHPP,   Chair persons: Damir Ivankovic (Netherlands)
Published: October 2024

Abstract

Cancer is one of the main public health challenges, and the second leading cause of mortality in the EU. It is Belgium’s second leading cause of adult death after circulatory diseases and has been an increasing burden of disease in recent years. Recognizing the urgency of tackling the entire disease pathway, the European Commission (EC) has launched Europe’s Beating Cancer Plan (EBCP), a policy-driven strategy, and the Mission on Cancer, a research-focused undertaking. In Belgium, Sciensano’s Cancer Centre has been charged with the coordination and implementation of these programs, pioneering the setup of a dedicated structure to coordinate them. While Belgian public, academic, private and non-for-profit entities have been highly involved in these EU initiatives since their launch, there is currently no mechanism to monitor the impact of EBCP’s uptake and implementation in Belgium. Moreover, in contrast to the investment and momentum at the European level, the last Belgian Cancer Plan dates from 2008, with its most recent evaluation being published in 2013, highlighting an important gap. To address this gap, the Cancer Centre was asked by the Federal Cabinet to develop a new monitoring and evaluation (M&E) framework for cancer care and control in Belgium. With a view to avoiding traditional top-down approaches, it was decided that the framework would be designed co-creatively, by engaging patients and experts in the field. The aim was to enable the iterative and flexible monitoring of Belgian policies related to the EBCP’s implementation, while generating buy-in from stakeholders. To achieve this goal, a modified Delphi process was used, with complementary qualitative data collection in the form of focus group discussions with experts across the cancer continuum. A Steering and Patient Committee were put in place to provide stewardship over the process, and based on their feedback, additional patient workshops were run to ensure M&E priorities for patients were taken into account. The framework will cover the entire spectrum of cancer prevention and control, as well as transversal themes such as inequalities and patient-centeredness. It will also anticipate future evolutions and undergo adjustments when needed. This workshop will use a Pecha Kucha approach, with panelists sharing insights from the Belgian case study. The session will guide the audience through a story of the strengths and pitfalls of co-creating an M&E framework in the field of public health monitoring. Topics covered will include challenges of monitoring cancer care and control policies, approaches taken in Belgium to overcome these challenges, and the importance of involving diverse stakeholders in the process. A moderated discussion will allow participants to share their perspectives and ask questions. Attendees will walk away with a real-world example on how to challenge top-down paradigms of population-level M&E frameworks and identify transferable elements for adaptation in their own settings.

Key messages
• Europe’s Beating Cancer Plan (EBCP) provides opportunities to tackle the second leading cause of disease in the EU but will require innovative approaches to monitor uptake and impact.
• Development of Belgium policy-actionable monitoring & evaluation framework shows how co-creation can challenge top-down paradigms in public health monitoring and assess the uptake and impact of EBCP.

Speakers/Panelists
Gabrielle Schittecatte
Sciensano, Brussels, Belgium
Jinane Ghattas
Sciensano, Brussels, Belgium
Robbe Saesen
Sciensano, Maaseik, Belgium