23 August 2014

The Impact and Effectiveness of Equity Focused Health Impact Assessment in Health Service Planning


This free ebook looks at the use of equity focused health impact assessment (EFHIA) on health service plans. It examines:
  1. What are the direct and indirect impacts of EFHIAs conducted on health sector plans?
  2. Does EFHIA improve the consideration of equity in the development and implementation of health sector plans?
  3. How does EFHIA improve the consideration of equity in health planning?

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For Whispernet transfer N.B. Costs US $0.99

About the ebook

This ebook describes the use and evolution of health impact assessment (HIA) and EFHIA internationally and in Australia, how it has been used in relation to health service plans, examines its effectiveness and impacts on decision-making and implementation and examines several EFHIAs using case study and interpretive description methodologies.

This research shows that EFHIA has the potential to have both direct and indirect impacts on health service planning. These impacts are influenced by a broad range of factors however. The case studies in this ebook show that engagement with the EFHIA process and the extent to which EFHIA is regarded as a broader learning process are important factors that mediate the extent to which EFHIAs influence subsequent activities.
This research suggests that it is not possible to adequately describe the full range of impacts of EFHIA on decision-making and implementation without looking at perceptions about EFHIA’s effectiveness, in particular the perceptions of those involved in the EFHIA and those responsible for acting on its recommendations. These perceptions change over time, suggesting that future research on the effectiveness of HIA should look at the mechanisms by which this change occurs.

The ebook makes two theoretical contributions in the form of (i) a typology for HIAs and (ii) a conceptual framework for evaluating the impact and effectiveness of HIAs. This conceptual framework is tested for its applicability and refined.

The ebook and the accompanying publications were written to fulfil the requirements for a Doctor of Philosophy in Public Health at the University of New South Wales.

13 August 2014

The Lessons and Benefits of Health Equity Impact Assessment

Erika Espinoza, is the Knowledge Exchange Lead for the North Region of Ontario within CAMH's Provincial Systems Support Team. The interview was recorded as part of the Health Equity Impact Assessment (HEIA) Tool Community of Interest with funds from the Evidence Exchange Network (EENet).

8 August 2014

HIA of Treatment Instead of Prison



Great news in the latest Human Impact Partners' email update:
In 2012, HIP partnered with WISDOM, a statewide congregation-based network, to assess the public health impacts of increasing funding for Wisconsin’s treatment and diversion programs for non-violent drug offenders. HIP’s study has had a tremendous impact on the conversation around treatment over incarceration in Wisconsin and helped win a four-fold increase in funding for treatment alternatives. Legislators from both parties have pledged continued support for future increases. Watch our video to learn more about this HIA success story.
Find out more here

6 August 2014

Brazilian guide to HIA

The first Brazilian guide to HIA has been released. From José Braz D. Padilha:
The first publication in Brazil about the use of Health Impact Assessment (HIA) has been released. 
The material was prepared by as part of technical advice for the Ministry of Health of Brazil, through the Pan American Health Organization (PAHO). Among the supporters and collaborators of publication are Dr Guilherme Franco Netto, former director of the Department of Environmental Health Surveillance and Occupational Health of the Ministry of Health, Dr. Simone Miraglia, UNIFESP (Federal University of São Paulo), among others. 
The publication is available on the Virtual Health Library (BVS), the Ministry of Health of Brazil, at the link below. 
http://bvsms.saude.gov.br/bvs/publicacoes/avaliacao_impacto_saude_ais_metodologia.pdf 
This is a detailed guide for implementing HIA through partnerships with different institutions and professionals.
A terrific resource for Portuguese speaking HIA practitioners.

9 May 2014

Request for Expressions of Interest: Short term WHO consultancy

Short term consultancy to develop guidance and training materials on addressing health in environmental impact assessments - with a specific application on mining projects
World Health Organization, Geneva, Switzerland 

WHO is implementing a project to develop global guidance on ensuring adequate coverage of health issues as part of environmental impact assessment s (EIA) undertaken on mining projects.

Provisions related to the coverage of human health issues are included within environmental assessment regulations in many countries. In practice, however, coverage of health within EIA is often limited and predominantly only addresses physical environmental considerations (e.g. air, water soil and pollution/emissions related issues). Other factors that influence health, for example related to the social and human environment, are not often included or are considered separately as part of other types of assessments. The resulting picture of health that emerges can therefore be incomplete.

The overall aim of the WHO initiative is to enhance coverage of health in environmental impact assessment, in particular through the development of WHO guidance materials on health in EIA and through the development of training materials for environmental assessment regulators and their health sector counterparts.

WHO seeks an independent consultant(s) to support the above.

The Scope of Work for this consultancy consists of the following tasks:

1. Conduct a literature review of existing materials (including training materials) on health in environmental impact assessment. The primary focus will be on project level application of health in EIA and on the analysis of the extent to which health issues (and health determinants) are covered in current EIA practice. Key enabling factors and barriers influencing coverage of health in EIA should also be considered. To the extent possible, this literature review should take stock of publications available in multiple languages and reflective of experiences/practices in different regions around the world.

2. Develop three (3) guidance notes on health in EIA. These guidance notes should be formulated on the basis of the findings of the above literature review, and on the expertise and experience of the consultant. One of the guidance notes should be oriented towards environmental and health impact assessment regulators - i.e. those responsible for quality control of impact assessments undertaken; one should be orientated towards impact assessment practitioners; and one should be orientated towards project proponents - or entities that would normally commission an impact assessment study.
3. Develop training materials on health in EIA, based on the above guidance notes and on the findings of the literature review. These training materials should take the form of a 3 day course for environmental and health impact assessment regulatory authorities and should address issues related to the quality of coverage of health issues (i.e. what adequate health impact assessments should look like), as well as process related considerations (i.e. how and at what points in the EIA process health issues should be considered). Guidance on evaluation of core competencies of impact assessment practitioners should also be included. 
4. Delivery of the training materials/course in a low to middle income country host to large scale mining activities. Case examples used as pilot training should be based on actual examples from the pilot country. (A national consultant will be engaged to assist with the adaptation of both the guidance notes and training materials, including oversight of translation activities).

5. Updating of the training materials based on feedback from the course participants. 
6. Development of a case study based on the pilot - i.e. documenting lessons learned and
insights from the country experience.

Expected deliverables include: 
  • Report detailing results of the initial literature review.
  • Guidance notes on health in EIA: one for regulators, one for practitioners, and one for project proponents.
  • Training materials on health in EIA, which should include presentations, participant materials, training/instructor materials, and case examples for use in practical exercises.
  • Case study of the experience and lessons learned from the pilot. 
The World Health Organization Headquarters Offices in Geneva now invites eligible individuals firms/to indicate their interest in undertaking this work. Interested parties must provide information indicating that they are qualified to perform the above tasks: curriculum vitae, description of similar assignments, experience in similar conditions, examples of relevant reports or publications, etc. The consultant(s) will be selected through a competitive process in accordance with WHO's operating policies and procedures on procurement of services.

The expected start date of this consultancy is 01 June 2014 (or as soon as reasonably possible after that). The training activities are expected to be piloted in Q3 of 2014.

The consultancy will largely be home-based, apart from travel required to deliver the pilot training course.

The consultant will be remunerated at a daily rate that is commensurate with his/her experience and based on the UN common salary scale.

Qualifications and Experiences required: 
  • Advanced university degree in public health or a related field. 
  • At least 7 (seven) years of international experience working on public health and 
  • development issues; 
  • Demonstrated experience with the conduct of HIAs and/or integrated EIAs on mining 
  • projects; 
  • Experienced trainer and facilitator with demonstrated experience in designing and 
  • delivering training courses for audience not specialized in public health; 
  • Excellent analytical, written and verbal communication skills in English are required; 
  • Excellent interpersonal skills 
Expressions of interest must be received no later than 16:00 o'clock on Monday 19 May 2014. 
Please include copies of your CV as well as a description of the kinds of issues you would 
consider as part of this work (i.e. what framing you would take to address health in EIA). The 
expressions of interest are to be delivered electronically to Ms Sophie Schmitt at the following 
email address: schmitts@who.int.

[Via Michaela Pfeiffer, WHO]

25 March 2014

Would you do health impact assessments if you didn't have to?

Carrot and Stick by Bruce Thomson
There's an interesting article by Elsa João and Anna McLauchlan in the latest issue of Impact Assessment and Project Appraisal. They asked 187 Scottish Strategic Environmental Impact Assessment (SEA) practitioners "if SEA was not compulsory, would you do it?"

This made me wonder about this question in relation to HIA. In many, if not most settings, there is not a requirement that makes HIA's use compulsory. For most HIA practitioners this question is not a hypothetical one. We encounter it in relation to every HIA.

Some recent  research I was involved in found that only 7% of HIAs conducted in Australia and New Zealand between 2005 and 2009 were done to meet a legal or regulatory requirement.

The overwhelming majority of Scottish survey respondents said they would do SEA even if it was not compulsory. In HIA practice we rarely have to wonder, which is a luxury in some ways. Most HIAs are done freely and to learn something. The link between voluntary involvement and the ability to learn something from HIAs is not theoretical. As my colleagues and I found in this study, the extent to which participants had a degree of choice or control over their involvement in an HIA had an impact on their receptiveness to learning from the HIA process and acting on its recommendations.

Interestingly, even though the survey was looking at SEA in Scotland where its use is mandated, the themes identified through the survey resonate with those we encounter in promoting HIA's use:

  • the perception that a similar process are already being done;
  • a lack of resources;
  • the need for a ‘leaner process’; and
  • the difficulties that can arise when external conditions or many decisions have already been determined.
The article is well worth reading, here's the abstract:
Strategic environmental assessment (SEA) is undertaken in more than 60 countries worldwide. Support to the SEA process can range from formal legal requirements to voluntary ‘ad hoc’ approaches. In the cases where SEA is legally required, such as in Europe where the SEA Directive sets a framework for SEA legislation in 28 countries, practitioners may engage with SEA but in a reluctant way. This paper reports on a unique survey of 203 key people responsible for implementing the SEA legislative requirement in Scotland. The majority (53%) of the 187 practitioners who answered the hypothetical question ‘If SEA was not compulsory, would you do it?’ said ‘Yes’. However, results suggest that the responses were much nuanced. Practitioners were asked to explicate their reasoning and, irrespective of whether the answer was ‘yes’ or ‘no’, common themes were evident in accompanying remarks. This paper enables reflection on reasons for acceptance or rejection of the SEA process by discussing: the perception that a similar process to SEA is already being done, the problem with lack of resources, the call for a ‘leaner process’ and the difficulties of undertaking SEA when conditions are already determined at a higher ‘tier’.

24 March 2014

From Katie Hirono on behalf of the US Society of Practitioners of Health Impact Assessment:
The Society of Practitioners of Health Impact Assessment (SOPHIA) seeks recommendations for exemplary HIA reports for the 2014 list of outstanding HIA reports. The SOPHIA Model HIA Reports Library functions as a periodically updated repository of exemplary HIA reports. The library is intended for:
  1. People who are unfamiliar with HIA and want to understand what a high caliber HIA report product might look like (for example, people thinking of commissioning an HIA)
  1. HIA practitioners seeking above average HIA reports as a reference
You may recommend HIAs done by yourself or other practitioners. The HIA can be on a project or policy, done in any location both in the U.S. and abroad, and be either stand-alone or done as part of an integrated assessment.  As we have already selected reports from 2009 – 2012, ideally these reports would have been released within the past 2 years. 
You must be a member of SOPHIA to submit a recommended HIA report (but can join easily here: http://hiasociety.org/?page_id=48). Or, click here to submit a recommendation: http://hiasociety.org/?page_id=29

20 March 2014

The effectiveness of HIAs conducted in Australia and New Zealand



It occurred to me that I haven't posted a link to the final report on the Australian Research Council-funded study on the effectiveness of HIAs conducted in Australia and New Zealand between 2005 and 2009. The report has lots of information in it. Download it here.


San Francisco Department of Public Health's annual Health Impact Assessment Practitioners' Training

We are excited to announce that registration is now open for the San Francisco Department of Public Health's annual Health Impact Assessment Practitioners' Training (July 14-17, 2014). Register early at the link http://bit.ly/1mhK7lh

What is Health Impact Assessment?
Health impact assessment (HIA) is most often defined as “a combination of procedures, methods and tools by which a policy, program or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population” (World Health Organization, 1999).  

The field of HIA and the process of getting health into decision-making continues to evolve and grow http://www.healthimpactproject.org/hia/us

How will you and your team enhance skill sets, leverage big data, meaningfully engage communities, and have collective impact? HIA is one of many tools that may be considered for health-protective policy and action.

About the SFDPH HIA Training

What:  
7th Annual Health Impact Assessment Practitioners Summer Training Course

Where:
TCE Oakland Conference Center, 1111 Broadway, 7th Floor, Oakland, CA

When:
July 14-17, 2014 (attendance all four days is mandatory)

Instructors:
HIA practitioners at the San Francisco Department of Public Health and community, academic, and local government partners

Cost:
$960 (includes the cost of course materials, breakfast and lunch; accommodations and travel not included).  We are working to raise funds to support attendance of organizations facing financial hardship. We STRONGLY encourage applications from community-based organizations who are actively planning, considering, or doing HIA to apply.

13 February 2014

When is an HIA not an HIA?


Guest post from Karen Bauer from the Denver HIA Collaborative:

Yesterday I attended a seminar given by the Denver Regional Council of Governments entitled Prescription for a Healthy Community.  The main speakers were the Colorado Health Foundation and Urban Land Institute.  To give you some idea of the influence that these organizations have, consider that the Colorado Health Foundation is the third largest health-focused foundation in the country, with $2.2 billion in assets, and ULI is a worldwide nonprofit representing land use and real estate development.  Its membership dues are $1200 annually.    
In 2013 ULI announced that their new initiative would be building healthy places.  Along with $4.5 million funding from the Colorado Health Foundation, they chose three locations in Colorado to receive the ULI treatment.  That means that ULI developed a TAP (technical advisory panel) that spent one week in each community to meet with stakeholders.  During that week they developed a report of opportunities and recommendations, which was then presented to the community. (I requested to see these reports, as they are not online).  After that, the community has the opportunity to apply for up to $1 million from the Foundation to implement their plans. 
I took a look at the ULI website to learn more about their initiative.  You can see that they are working completely outside of the world of HIA and its years of research, capacity building and expertise.  
A number of questions come to mind:
  1. Does the HIA community need to do more to gain recognition as the go-to organization for research, tools, assessments?
  2. Should we need a certification to go into a community to do a health assessment?
  3. Does this help or hurt our field?
  4. Maybe HIA has it wrong.  Is there something to be said for a one-week process? 
I would like to hear your comments, questions, concerns about this topic.

11 February 2014

Urban HEART Report

The WHO Centre for Health Development has published a report on the Expert Consultation on Urban HEART held in November 2013. It's a worthwhile read for anyone with an interest in HIA, health equity and urban planning issues at the city level.

29 January 2014

EPA Review of HIAs in the U.S

THE US EPA has published their review of HIAs in the U.S. Definitely worth reading:


Rhodus J, Fulk F, Autrey B, O’Shea S, Roth A: A Review of Health Impact Assessments in the U.S.: Current State-of-Science, Best Practices, and Areas for Improvement. In. Cincinnati: Office of Research and Development, National Exposure Research Laboratory, U.S. Environmental Protection Agency; 2013.

Description

A systematic review was conducted of health impact assessments (HIAs) from the U.S. to obtain a clear picture of how HIAs are being implemented nationally and to identify potential areas for improving the HIA community of practice. The review was focused on HIAs from the four sectors that the U.S. Environmental Protection Agency’s (EPA’s) Sustainable and Healthy Communities Research Program has identified as target areas for empowering communities to move toward more sustainable states. These four sectors are Transportation, Housing/Buildings/ Infrastructure, Land Use, and Waste Management/Site Revitalization. The review systematically documented organizations involved in conducting the HIAs; funding sources; the types of community-level decisions being made; data, tools, and models used; self-identified data needs; methods of stakeholder engagement; pathways and endpoints; characterization of impacts; decision-making outcomes and recommendations; monitoring and follow-up measures; prioritization methods employed; HIA defensibility and effectiveness; attainment of the Minimum Elements of HIA; areas for improvement; and identification of best practices. The results of the HIA reviews were synthesized to identify the state of the HIA practice in the U.S., best practices in HIAs, and areas in the overall HIA process that could benefit from enhanced guidance, strategies, and methods for conducting community-based risk assessments and HIAs. While HIAs have helped to raise awareness and bring health into decisions outside traditional health-related fields, the effectiveness of HIAs in bringing health-related changes to pending decisions in the U.S. varies greatly. The review found that there are considerable disparities in the quality and rigor of HIAs being conducted. This, combined with the lack of monitoring, health impact management, and other follow-up in the HIAs could be limiting the overall utilization and effectiveness of this tool in the U.S.

Purpose/Objective

A review was conducted of 81 Health Impact Asessments (HIAs) from the U.S. to obtain a clear picture of how HIAs are being implemented nationally and to identify potential areas for improving the HIA community of practice. Improving HIAs across the US will lead to better informed decisions at the community level and ultimately to improvement in public health and the environment.


23 January 2014

Two online HIA courses from the Canadian National Collaborating Centre for Healthy Public Policy

The Canadian National Collaborating Centre for Healthy Public Policy is offering two online HIA courses in English and French:

Online Continuing Education Course – HIA Step by Step

A 12-hour online continuing education course on health impact assessment (HIA) of public policies will be offered by the NCCHPP starting in October 2013.
This online course will focus on the five steps of HIA and will take place over 4 weeks. It will allow you to become familiar with the HIA process applied to public policies, recognize its fundamentals, and think about the favourable conditions for successful HIA implementation.  
Next courses:
In English: March 3 to 28, 2014
In French: May 26 to June 20, 2014

Online University Course – Introduction to Health Impact Assessment

The Université de Montréal is offering a 45-hour online university course on health impact assessment (HIA) of public policies. This course has been developed by the NCCHPP in collaboration with Dr. Richard Massé, associate professor at the Department of social and preventive medicine at the Université de Montréal, and other partners.  
This course, launched in February 2013, aims to help participants to develop and improve their competencies for leading an HIA process relating to public policies, and to do this with partners from different sectors.  
The course takes place over the period of 6 weeks, for 1 graduate-level university credit.
Please note: This course is offered by the Université de Montréal, a francophone university. While the content of the HIA course and the online platform are entirely in English, all administrative tasks regarding this course must be done in French. This includes course registration and payment, retrieving grades and certificates, and asking for technical and administrative assistance.  
Next courses: March 19 to April 30, 2014 in French and May 1 to June 12, 2014 in English. 
More on their website

22 January 2014

IAIA14 Training Course: Health Impact Assessment of Industrial Projects

A really interesting and engaging two-day training program on HIA of industrial projects is being offered as part of IAIA15 in Chile. Find out more about the course and book early to avoid missing out.

You can find out more on the training program on the conference website.

3 December 2013

Global Health 2035


A really interesting and thoughtful piece by Dr Charles Clift at the Chatham House Centre on Global Health Security on the new Lancet commissioned report Global 2035: A World Converging Within A Generation (you will need to register to gain access to the full report).

He provides nice summary of the issues in the report and its historical context as a successor to the World Bank's 1993 Report Investing in Health.
My three take aways:
The report’s key innovation (akin to the DALY) is to support and popularize the concept of ‘full income’ – adding to conventional national income measures a valuation of the increase in life expectancy. On that basis it estimates that, between 2000 and 2011, 24 per cent of the growth in ‘full income’ in low and middle income countries was due to health improvements, equivalent to a 1.8 per cent per annum addition to GDP growth. Based on this methodology it concludes that ‘there is a very large payoff from investing in health’.
Its other big idea, captured in the title, is that with rising incomes in the developing world and continued improvements in health and delivery technologies, an achievable goal for nearly all countries in 2035 is to bring down infection, maternal and child mortality rates to the current levels of the four best performing middle income countries (Chile, China, Costa Rica and Cuba).
The Lancet also provides commentaries on the report by three global health leaders – Richard Horton (Lancet editor), Margaret Chan (WHO) and Mark Dybul (Global Fund) and heads of two key development institutions (Jim Kim of the World Bank and Helen Clark of the UN Development Programme). While the first group is largely favourably disposed, the latter two both focus on the commission’s failure to address the social and economic determinants of health. The report essentially argued that there are ‘complex and entrenched political obstacles’ to addressing them so it is better to focus on the health sector where a more immediate impact can be realized.
Kim and Clark argue strongly against this – they contend that there needs to be a balance between investments inside and outside the health sector if the goal of improving health is to be achieved. The global health community will need to heed these words if it wishes to find a proper place for health in the post-2015 development agenda.
I thought it ironic that the WB and UNDP (to a lesser extent) were advocating for a social determinants of health approach to the report (while the report authors were justifying why they didn't in the report)!

You can subscribe to the Global Health Security Newsletter produced by Chatham House by clicking this link.