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Question topics covered in a rapid HIA workshop

Question topics covered in a rapid HIA workshop. Rob Quigley, Director, Quigley and Watts Ltd rob@quigleyandwatts.co.nz. Background. Information collection in the appraisal stage can use many methods

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Question topics covered in a rapid HIA workshop

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  1. Question topics covered in a rapid HIA workshop Rob Quigley, Director, Quigley and Watts Ltd rob@quigleyandwatts.co.nz

  2. Background • Information collection in the appraisal stage can use many methods • One is a rapid appraisal workshop, where information is provided to stakeholders beforehand and during the workshop, and then information is collected from them. • With limited time, which questions are asked? • What key features are present in many tools?

  3. Assessing the positive and negative impacts. • A feature of all tools: • The impact assessment matrix and the Merseyside guidelines have a separate column for each; • Ison’s RAT and PHACs determinants and inequalities matrices asks if the impact is positive, negative or neutral. • Some don’t mention the words ‘positive or negative’, just ‘identify the impact’ or something similar (PPP; HEAT, Health Lens).

  4. Addressing inequalities • Most tools are explicit about this, with a question something like: • ‘what are the potential effects on inequalties (Health Lens) • Are there differential impacts on particular groups (Determinants matrix; impact matrix) • Focusing on Maori (PPP); • Focusing on inequalities (inequalities matrix; HEAT) • Whom will it affect, the whole community or various groups (Ison’s RAT) • Who is most advantaged and how; who will benefit most (HEAT) • For Merseyside Guidelines, it’s in the supporting documentation only

  5. Evidence • Some don’t ask about this (Health Lens; PPP; impact matrix; HEAT; Merseyside) • Others ask it in a roundabout way – identify any measurable indicators; How measurable is the impact; (determinants matrix, inequalities matrix, • Explicit – what is the basis for identifying this impact: evidence base, experience base, personal experience (Isons RAT)

  6. Mediating factors • Not covered in the Health Lens, PPP, inequalities matrix, impact matrix, • Included in determinants matrix (what external factors may interact with the policy being assessed?) • Included in Ison’s RAT (which of the factors affecting health/determinants are key to mediating that impact) • What are the determinants of this inequality (HEAT)

  7. The principles of the Treaty of Waitangi • Included in the Health Lens (How will the proposal address the principles of partnership, participation and protection) • Included in HEAT (How will you address the Treaty of Waitangi in the context of the NZ Public Health and Disability Act 2000) • Not in the determinants matrix, Ison’s RAT or Merseyside • The sole purpose of the four PPP questions • Ethnicity is included in the inequalities matrix • Impact on Maori has it’s own row in the impact matrix

  8. Scale of impact • Not included in Health Lens, determinants matrix, PPP, inequalities matrix, merseyside, HEAT. • Sole purpose of the impact matrix – likelihood, severity/significance, number affected, time to take effect, measurability of impact. • Included in Ison’s RAT – magnitude, frequency, time of occurrence, point of occurrence, likelihood, severity/benefit

  9. Recommendations • Not covered in determinants matrix, PPP, inequalities, Merseyside. • How will the unintended consequences be addressed (Health Lens) • Where/how will you intervene to tackle this issue? (HEAT) • Possible actions to enhance positive or diminish negative impacts (Impact matrix) • Whole section in Ison’s RAT

  10. A scenario • Imagine you are running a rapid appraisal workshop with multiple stakeholders – community, policy writers, public health experts, other stakeholders. • You have 4.5 hours in total, of which much of the time is taken up in introducing the policy, the evidence and describing the population affected • You have about three hours left for small group or plenary session work

  11. Questions to consider for each determinant: How is the proposed Arts Centre likely to affect this determinant of health? • Will this impact on health directly, or will it affect health (indirectly) after affecting other factors in a pathway leading to [poor health?] • What is the existing evidence for the answers you have given above– e.g. past experience, facts, research & existing data sources

  12. Possible enhancements/mitigation • Will the impact affect some Youth more than others? Who will benefit/suffer most? Will inequalities increase or decrease? • What key factors might encourage or prevent the health impact? • What recommendations do you suggest? Who are the recommendations directed at?

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