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 Seminars
Phase 2: Practitioner Training
Phase 1 Phase 2 Total to date Leadership Seminar 11 events 3 events 144 people Introductory Day -­‐ 51 people 3 events HIA Policy & Screening -­‐ 11 events 162 people Comprehensive course -­‐ 3 courses 57 people AcEon 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 5004
Fax: +44 (0)151 794 5588
[email protected]