Building Capacity for HIA

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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
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Context for NSW HIA Project

• NSW Health and Equity Statement In All Fairness
• CEOs concern with two strategies
• Rapid appraisals
• Health impact assessment from an inequalities
  perspective

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NSW HIA ProjectA 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

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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

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Phase 1 Findings

• Clarity needed in
• Scope of HIA
• Triggers
• Who
• Anxiety about talking rather than acting

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Issues arising from Phase 1

• 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

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Phase 1 Take Home Messages

• LISTEN
• Remember the roots of HIA
• Engage others
• Be cautious maybe its not something we want to
  do
• SLOWLY, SLOWLY

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Stages of organisational change

• Building on awareness
• Moving towards adoption
• Getting read for implementation
• And
• Institutionalisation

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Capacity Building Framework
Build Capacity
Source NSW Health. A Framework for Building
Capacity to Improve health. Sydney New South
Wales Department of Health, 2001.
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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

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Phase 2 pioneers
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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

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A mix of skills backgrounds

• Health promotion
• Clinical
• Allied health
• Policy
• Epidemiology
• Planning
• Some with post-graduate quals, e.g. MPHs

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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

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About learning by doing
Best way to learn - but time consuming Takes
time, needs digesting
2004 Developmental Sites

• Its 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.

chetre.med.unsw.edu.au
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Learning by Doing

• Were 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
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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

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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

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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?)

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Phase 3 Whats 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

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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

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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?

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Acknowledgements

• 2004Developmental Sites
• Centre for Chronic Disease Prevention and Health
  Advancement
• IAHS
• MNCASH
• Primary Health and Community Partnerships Branch
• MWAHS
• 2005 Developmental Sites
• HNEAHS, Premiers 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
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More Information

• HIA Connect
• http//chetre.med.unsw.edu.au/hia

chetre.med.unsw.edu.au
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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
doi10.1371/journal.pmed.0020166
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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

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Get Involved!