1. HIA Capacity Building: comparisons and contrasts Debbie Abrahams, Director, International Health Impact Assessment Consortium, Public Health, 9 th International HIA Conference, 9 th -10 th October 2008

2. Presentation Overview  Capacity Building  United Kingdom  Europe  International  Making an Impact: Capacity Building for Health Impact Assessment in Liverpool  Comparisons/contrasts  Enablers/disablers

3. Capacity Building 1 Spectrum of HIA Capacity Building programmes: Comprehensive development of the organisation and workforce, enabled by leadership, resources and partnerships Training and skills development HIA Capacity Building contributes to HIA institutionalisation

4. Capacity Building 2 “Capacity building provides specific input for the HIA system. Key aspects are: production and training of practitioners establishment of support units close links to health intelligence” Wismar et al 2007

5. United Kingdom  National policy drivers, e.g. - ‘Choosing Health’, 2004 - ‘Health Inequalities: progress and next steps’, 2008 - ‘Global health 2008-2013’, 2008 - Planning Guidance (PPS 12)  Established training, e.g., - public and private - international  Support Units  Association of Public Health Observatories (APHO)  Developing evidence base for HIA

6. Examples Ireland  All-island of Ireland  Government support  Institute of Public Health in Ireland - Guidelines - Training - Evidence England  DH Impact Assessment support  ‘Making an Impact’ Project – Liverpool  Healthy Communities Learning Network – North East  Yorkshire & Humberside PHO  NW HIA CB programme 2008

7. Scotland  Lothian Health Board: - Scottish HIA Network - On-line training resource - Guidelines - Evidence Wales  Welsh Assembly support  Welsh Health Impact Assessment Support Unit  Local Government Association support e.g. mandatory for waste - Guidelines - Training

8. Europe  20/21 Countries endorse HIA either national, regionally or at locality level  Most HIA activity in England, Wales, Finland and Netherlands – “centres”  Most of the 21 countries have a lead agency identified  Funding variability – “develop” or “do” Health Impact Assessment  Few “centres”, some embedded CB, e.g. Sweden, Lithuania 16/17 CB programmes at national level EC funded CB

9. International 1  Cambodia  Vietnam  Thailand  Lao PDR  Australia  Japan  New Zealand  India  Bhutan  South Korea 1 st South East Asia and Oceania HIA Conference 2007 HIA legislation – Thailand, Lao PDR HIA national support unit – New Zealand Professionally-led HIA – Australia WHO, Commission on SDH report

10. International 2 Some 15 other countries involved in HIA including:  USA – 38 case studies 1999-2008; seminars/workshops, 2004 onwards; some training e.g. San Francisco, Berkeley, CA., petroleum and gas  Canada – rise, fall and rise again!  China – case studies, training  Brazil – WHO training with Ministry of Health, June 2008  Africa – Libreville Declaration, June 2008

11. Making an Impact: Capacity Building in Liverpool 1  Vision – Health in All Policies  Aims - Develop HIA culture -Integrate HIA into policy planning  Objectives -Build HIA capacity / capability -Support HIAs -Undertake HIAs -Monitor and evaluate

12. Making an Impact: Capacity Building in Liverpool 2  Baseline Survey  Declaration of Commitment 2005  HIA ‘Champions’  Resources  HIA Officer  Network and webpage  Training - courses, action learning sets  HIA Strategic Group

13. Making an Impact: Capacity Building in Liverpool 3  HIA Policy & Screening Toolkit  Embed health into Core Strategy of Local Development Framework (PPS 12)  Healthy Urban Planning  Healthy Cities, including Phase lV HIA  Facilitating Community HIA

14. Comparisons/contrasts Political context – regulation averse Economic context Political & professional advocates Central, regional, local Public, private & academic Resourcing

15. Enablers  Political commitment  Endorsement at policy level  High level sign-up by partner organisations  History of HIA - academic / methodology - training - practice and implementation  Central Policy drivers - Health Inequalities - European Directives  Continuing support / stewardship  Resources

16.  Challenge of institutionalisation  Re-structuring of organisations  Commitment at operational level, e.g. time  Changes in priorities / personnel  Commitment of resources  Implementation of recommendations  Understanding of HIA language Flexibility of the methodology Number of other “assessments” Disablers