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Building Capacity for HIA

Building Capacity for HIA. Health Impact Assessment Colloquium Bondi, 9th December 2005 Ben Harris-Roxas & Patrick Harris The Centre for Health Equity Training, Research and Evaluation (CHETRE). Centre for Health Equity Training, Research & Evaluation. Context for NSW HIA Project.

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Building Capacity for HIA

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  1. Building Capacityfor HIA Health Impact Assessment ColloquiumBondi, 9th December 2005 Ben Harris-Roxas & Patrick Harris The Centre for Health EquityTraining, Research and Evaluation (CHETRE) Centre for Health Equity Training, Research & Evaluation

  2. Context for NSW HIA Project • NSW Health and Equity Statement: In All Fairness • CEO’s concern with two strategies: • Rapid appraisals • Health impact assessment from an inequalities perspective

  3. NSW HIA Project:A Phased Approach • Phase 1 (2002-3) • Awareness raising & exploration • Phase 2 (2003-2004) • Expanded awareness & early adoption • Phase 3 (2005-2008) • Implementation of HIA • Moving towards institutionalising the consideration of health impacts • Working more with other sectors on ‘health’ impacts

  4. Phase 1: What we did • 2 x one day workshops with range of NSW Health staff • Introduction to HIA • Exploring pros & cons of HIA • Review of literature • Establishment of HIA e-News

  5. Phase 1: Findings • Clarity needed in: • Scope of HIA • Triggers • Who • Anxiety about talking rather than acting

  6. Regulatory or Developmental Tight or Broad Health Focus Health or Non-Health Developments Triggers: where is the value add? Scientific or Decision Making Tool Valuing Evidence Prospective, Retrospective or Concurrent Issues arising from Phase 1

  7. Phase 1: Take Home Messages • LISTEN • Remember the roots of HIA • Engage others • Be cautious – maybe it’s not something we want to do • SLOWLY, SLOWLY

  8. Stages of organisational change • Building on awareness • Moving towards adoption • Getting read for implementation And … • Institutionalisation

  9. Organisational Development CONTEXT Workforce Development • Infrastructure • Sustainability • ProblemSolving Resource Allocation Partnerships Leadership Capacity Building Framework Build Capacity Source: NSW Health. A Framework for Building Capacity to Improve health. Sydney: New South Wales Department of Health, 2001.

  10. Phase 2: What We Did • 5 Developmental Sites • Undertook HIAs on health proposals • CHETRE training & support • Strategic Engagement • GWSHUDG • Steering Committee • Communication • HIA E-News ongoing • HIA Connect est

  11. Phase 2 pioneers

  12. The focus of their HIAs • Social marketing campaign for chronic disease prevention • Transport for Health Policy Framework • Foreshore development plan • Services delivery plan for health promotion • Innovative aged care program

  13. A mix of skills & backgrounds • Health promotion • Clinical • Allied health • Policy • Epidemiology • Planning • Some with post-graduate quals, e.g. MPHs

  14. What did we (the team) do? • Help-desk • Site visits • Before • Towards the end of the HIA • One afterwards • Ongoing support & assistance • Stg Committee for Illawarra HIA • Reviewing reports • Assessment & decision-making stages

  15. About learning by doing: • “Best way to learn - but time consuming” • “Takes time, needs digesting” “It’s great if we have organisational commitment.” “It is a very appropriate approach to adopt for this subject matter. It mobilises resources for real work, rather than theory.” 2004 Developmental Sites chetre.med.unsw.edu.au

  16. Learning by Doing • We’re committed to doing HIA rather than just talking about it • To build technical knowledge and practical expertise in HIA • To identify structural and contextual uses and impediments • Need an active & structured process of support for sites • Builds a cohort of advocates for HIA chetre.med.unsw.edu.au

  17. Phase 2: Some Learnings • Need to be able to do HIA: • Rapidly (but may be difficult when learning) • on bigger projects/proposals • Learning by doing builds confidence • An active & structured approach to future developmental HIA sites: • Screening & scoping etc reports • Participant observers

  18. Phase 3 • 3 Year Project • Key Features: • 2 x Developmental Sites • Develop HIA Manual for NSW • Develop Masters Module on HIA • Liaison & Engagement • Introduction to HIA for Senior Staff • Continue E-News & HIA Connect • Colloquium and conference • Special Issue of NSW Public Health Bulletin (and further dissemination) • PHO Placements

  19. Phase 3: Context • NSW Health – a system in stress • Area Health Service mergers • Departmental restructure & cutbacks • Potential for no takers for HIA • Urban development aplenty in Sydney metro & regional NSW • National and International context of interest in PA, urban form and prevention of CDs – search for interventions (HIA?)

  20. Phase 3: What’s Happening? • 8 months into it • Call for developmental HIA sites for 2005 • 6 HIAs Underway • Overwhelming response • HIA gaining ground • Questions are different • Health and Urban Development Workshop • 2006 Developmental Sites • Expanding communication strategy

  21. Outcomes to Date • Larger assessments • Assessing Impacts Project – PHO Placement at CHETRE • Discussion Paper on Impact Assessment for NSW Health Futures Planning • Engagement with enHealth, environmental health sectors – learning where we can • HIA Blog

  22. Concluding Thoughts • Context makes a difference • A phased approach has worked for us (so far…) • Worthwhile beginning ‘in-house’ before branching out • HIA – a useful tool, a conversation starter … • Need to start integrating, implementing & institutionalising • Pre-Screening?

  23. Acknowledgements • 2004Developmental Sites • Centre for Chronic Disease Prevention and Health Advancement • IAHS • MNCASH • Primary Health and Community Partnerships Branch • MWAHS • 2005 Developmental Sites • HNEAHS, Premier’s Dept & Hunter RCMG • GSAHS & Palerang Council • WSAHS, Dept of Housing and Parramatta City Council • NCAHS • NSCCAHS • Greater Western Sydney HUD group • Steering Committee • CCDPHA • SEIAHS chetre.med.unsw.edu.au

  24. More Information HIA Connect http://chetre.med.unsw.edu.au/hia chetre.med.unsw.edu.au

  25. What Capacity Might be Required? • Individual level • Personal qualities, knowledge, skills, resources, partnerships • Organisational Level • Policies, processes procedures, partnerships, leadership, knowledge, skills • System Level • Values, ideology, economics, politics What capacity would be required in your organisation/work? Source: Bowen S, Zwi A. Pathways to evidence Infomred Policy and Practice: A framework for action, Plos Medicine 2(7), e1166 doi:10.1371/journal.pmed.0020166

  26. Who Could/Should Be Doing HIA? • Who has the capacity to do HIA? • How could/should we be developing this? • How could we achieve this? • Challenges • Opportunities • Ways forward

  27. Get Involved!

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