Whose bed?Real time HIA Capacity Building

Hilary Dreaves

Research Fellow (HIA)

IMPACT, University of Liverpool, UK

Definition of Capacity Building

“an approach to the development of sustainable skills, organisational structures, resources and commitment to health improvement in health and other sectors, to prolong and multiply health gains many times over”

(Hawe, P et al 1997)

HIA organisational competence is....  

‘a combination of organisational dimensions (policies, practices and behaviours) which together create and sustain an organisational culture in which the health impacts and implications of all its activities are routinely and systematically considered; this could also be referred to as an HIA culture.’

Abrahams,D., Scott-Samuel,A. (2009)

Case Study 1:North East Healthy Communities Learning Network. North East England, 2008/9.

•80 people Municipal, Health, Community. •3 Stage programme:

• Introductory workshops x 4• Comprehensive course x1 • Evaluation 6 months later

•Workshop evaluations very positive•High residual interest after Stages 1& 2; additional introductory sessions; planned delay of follow-up•On-line follow-up via local co-ordinator.

Outputs:• 65 (81%) participated in Stages 1&2 • Included elected representatives, senior municipal

officers, planners, public health, epidemiologists, health promotion, third sector, etc.

Stage 3 on-line evaluation:• 23 responses (39%)• Before: 17 (74%) had heard of HIA

2 ( 9%) had taken part in a HIA.• After: 23 (100%) discussed with their peers

4 presentations to staff groups 4 HIAs underway 1 person advising commissioners 1 had HIA included in their role Evidence that “old” prior training was

connected to the “new” programme

Enablers:•Inequalities Review required a HIA working group•HIA role identified in a new unitary authority•Screening tool in development for systematic use•Senior management sign-up •2 people funded to do HIA in their role

Barriers:•No HIA policy•No senior sign-up•“Old” organisation HIA literate, new not.•Not mandatory or statutory•Insufficient resource

Case Study 2:North West HIA Capacity Building (CB) Programme. North West England 2008/10.

•Target population: Municipal, Health and Community•Geographical footprint 4 workforce areas•Programme scoped by Steering Group:

• On-line baseline assessment• Training programme• Good practice guide to capacity building• Capacity building literature review• Organisational benchmarking tool• Evaluation

Baseline Assessment :• Target Group estimated at 1500.• 1200 “Officers” Questionnaires• 130 “Community” Questionnaires• Response rates 21% and 30% • Evidence of onward distribution beyond

target group in Local Authorities• Fewer responses beyond Public Health

from Primary Care Trusts

Programme delivery to date ..................

Phase 1: Leadership SeminarsPhase 2: Practitioner Training

Phase 1 Phase 2 Total to date

Leadership Seminar 11 events 3 events 144 people

Introductory Day - 3 events 51 people

HIA Policy & Screening - 11 events 162 people

Comprehensive course - 3 courses 57 people

Action Learning Sets - 2 sets 25 people

439..........

Effects of “difficult times”:•Disestablishment of Steering Group•Programme reduced to training delivery•Postponements due to low numbers•Externalities, e.g flooding and serial killing incident

Outputs to date:•1 known HIA screening delivered•1 HIA co-ordinators role extended •2 Action Learning Sets to report•Co-ordinator secondment extended

Overall Enablers:• Local co-ordination• Good and frequent communications• Senior level commitment• HIA Policy in development/in place• Willpower and tenacity

Overall Disablers:• Organisational cultures/language/ethos,

i.e. Municipal v. Health v. Community• Political drivers, with unresolved lack of

clarity regarding transition to localism

Whose Bed?

IMPACT,International Health Impact Assessment Consortium,Division of Public Health, Whelan Building, University of Liverpool, Liverpool.L69 3GB

Tel: +44 (0)151 794 5004Fax: +44 (0)151 794 5588impact@liv.a.c.uk