Monica O’Mullane Institute of Public Health Ireland 11 th November 2008 m.omullane@ucc.ie

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Prioritising health in policy and project appraisal: Are HIAs used for policy in Ireland? Research findings. Monica O’Mullane Institute of Public Health Ireland 11 th November 2008 m.omullane@ucc.ie. Today’s presentation. Rationale for this area of research HIA and Policy Appraisal - PowerPoint PPT Presentation

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  • Prioritising health in policy and project appraisal: Are HIAs used for policy in Ireland? Research findingsMonica OMullaneInstitute of Public Health Ireland11th November 2008m.omullane@ucc.ie

    HIA Forum, Institute of Public Health

  • Todays presentationRationale for this area of researchHIA and Policy AppraisalWork done already on the link between HIA & PolicyUse of HIAs in Policy: The Irish experienceFindings & Conclusions

    HIA Forum, Institute of Public Health

  • Rationale for this area of researchRecent debate and commentary on the feasibility of HIAMove away from a concern about design of HIA, towards current issues..Community involvement and role within the HIA processPolicy and the link between HIA and decision makers (Kemm, 2006)

    HIA Forum, Institute of Public Health

  • Purpose of HIATo influence decision making so that policies, projects and programmes can improve pop health or mitigate risksIntended and unintended consequences can be foreseen3 ways to influence decision making with HIABy raising awareness among decision makersBy helping decision makers identify and assess possible health consequencesBy helping those affected by policies to participate in policy formation and to contribute to decision making

    HIA Forum, Institute of Public Health

  • HIA and Policy AppraisalSeparate conceptual root for policy appraisalPotential for analysis of HIA drawing from the policy sciences (Lasswell & Positivism 1951;Lindblom, 1959; Lowi, 1972; Walt, 1994)Policy is rather like an elephant- you can recognize it when you see it but cannot easily define it (Cunningham, 1963)Policy-oriented approach

    HIA Forum, Institute of Public Health

  • Work done already on the link between HIA & PolicyAlthough policy sciences have much to offer, IAs have been marginalised in the field (Weston, 2002)IA: Bridge between policy-makers and scienceBekker et al, (2004): Rational, Incremental, Mixed scanning modelsPutters 1996: Rational v incrementalPutters 2005 must spend less time defining HIA, and more time understanding the policy process which must assimilate HIA knowledgeHow to evaluate HIA as a policy-aiding tool? European Observatory on Health Systems and Policies (Wismar, 2004; Wismar et al. 2007)

    HIA Forum, Institute of Public Health

  • Some Irish HIAs

    HIA Forum, Institute of Public Health

  • HIA: What Irish Health Strategies say..SouthNational Health Strategy (2001) HIA will be introduced as part of the public policy development process (Objective 1.1)NorthInvesting for Health (2002) This programme (of HIA) will address issues of coordination, capacity building, tool development and quality assurance

    HIA Forum, Institute of Public Health

  • Use of HIAs in Policy: The Irish experience (case studies)Housing HIA of Northern Ireland Housing Executive Proposal toRedevelop Dove Gardens Estate (2005)HIA of Travellers Accommodation Programme in Donegal, (2005- 2008)(06)Physical EnvironmentHIA of the Draft Air Quality Action Plan for Belfast (2006)HIA of Traffic and Transport in Ballyfermot (2004)

    HIA Forum, Institute of Public Health

  • Study questionHow and why do structures and values influence the use of HIAs in policy?

    HIA Forum, Institute of Public Health

  • HIA Forum, Institute of Public Health

  • Research conclusions: Dimensions of useInstrumental: Ballyfermot, Belfast, Derry Conceptual: Ballyfermot, Donegal, Belfast, Derry Persuasive: Donegal, Belfast, Derry

    HIA Forum, Institute of Public Health

  • Barriers & Enablers to the use of HIAsIrish HIAs in Practice: The time has come?Enablers and Barriers of the Place of HIA in the Policy Process (Hayes, 2006)Check-list approach; Snowballing

    HIA Forum, Institute of Public Health

  • Enablers and Barriers of the Place of HIA in the Policy Process (Hayes, 2006)EnablersInvolved in planning and conduct of HIAInput from outside decision-making processClear organisational commitmentSubject non-controversialRealistic recommendationsBarriersLack of awareness of health by other sectorsLack of knowledge of policy-making environment

    HIA Forum, Institute of Public Health

  • Research findings: Additional EnablersInstitutional leadershipPolitical willInvolvement of the community sector

    HIA Forum, Institute of Public Health

  • Research findings: Additional BarriersLack of institutional leadership and support for HIALack of understanding of HIA and of what decision makers require from the processInstitutional values and normsLack of willingness of engage in cross-sectoral working

    HIA Forum, Institute of Public Health

  • Overall conclusionsCombining theoretical & empirical findings HIAs are used in policy developmentPractically, HIA use is influenced by the tier of government (local)the involvement of key partners (planning services)the conceptualisation healththe role of the policy-makers and the community receiving the policy product.The mainstreaming of the tool is important into the future. Its incorporation into an Integrated Impact Assessment (IIA) is one feasible route for it attaining a legislative footing.

    HIA Forum, Institute of Public Health