Health Impact Assessment in New Zealand

HIA e-News
Issue 21, June 2009

In This Issue Welcome Profile: Greg Morton, Waikato District Health Board All Systems Go - External Evaluation of the HIA Support Unit Position Vacant: HIA Project Officer, Christchurch Report Back from the 2nd HIA Practitioners' Workshop - Evaluation of HIA New Resource for Public Health Service Providers Review Package for HIA Reports of Development Projects Upcoming Conference: 10th Annual HIA Conference Current / Future HIA's Future Training Opportunities 2009 - Reminder Contact Us

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Welcome

Nau mai, haere mai ki te HIA e-News.

It has been a busy time for the HIA Support Unit as we have been gathering together all of the great HIA work you have been doing over the last year as well as planning for the next year of operation. We're pleased to have been able to support some of your work through funding and advice and together we now have a really good body of evidence for HIA practice in New Zealand. We are hoping to summarise this in evidence bulletins over the next 12 months. There will also be many more HIA reports up on the HIA webpage in the next few months and we look forward to supporting your mahi in this area. Whanau Ora HIA has also had a big boost in the past 12 months too.

We’ve also been busy developing our business plan for the next financial year. As soon as we have our plan signed off, we will be able to let you know about the HIA Support Unit’s Learning by Doing Fund, so watch this space.

In this issue we feature a new HIA-specific position that has been established in Christchurch. The creation of this position reflects the commitment of a number of organisations in Christchurch who value the benefits of HIA. It also reflects the way that District Health Boards and public health services are focusing resources on proven and effective tools, such as HIA, that improve health outcomes.

In our profile, we hear from Greg Morton who has been leading a lot of HIA development work in the Waikato region. The Waikato District Health Board has also recently advertised an HIA position to build on their existing success.

As we continue to maintain the momentum of building HIA capacity across the country, we look forward to working with you again in 2009/10 to embed HIA into public policy development.

Matt Soeberg and Christine Stewart, Ministry of Health HIA Support Unit
Robert Quigley, Quigley and Watts Ltd.

Welcome to HIA e-News funded by the Ministry of Health (MoH). This bi-monthly newsletter is a way of keeping people up to date with the latest developments in health impact assessment in New Zealand and abroad.

Profile: Greg Morton, Waikato District Health Board

I have been working as a policy analyst for the Waikato District Health Board Population Health (Public Health Unit) since 2007. My role includes the planning and development of HIA in the Waikato region, coordinating local government and public health service activity, and contributing to the development of public health planning.

My experience in HIA

I was introduced to HIA while working for Regional Public Health in Wellington where I participated in the development of the Greater Wellington Regional Land Transport Strategy HIA (2006). During this process, I was involved in the discussions regarding strengthening HIA development in New Zealand, which lead to the establishment of the HIA Support Unit within the Ministry of Health.

Since moving to Waikato I have participated in HIA training and have also coordinated HIA training on behalf of the Waikato and Bay of Plenty District Health Boards. The training was funded by the HIA Support Unit's Learning by Doing Fund.

I have also been involved with the Tokoroa Warm Homes Clean Air HIA. Over the past five years Waikato District Health Board Population Health has been working collaboratively with Environment Waikato, South Waikato District Council, South Waikato Pacific Island Health Committee and the Raukawa Trust Board on a project to improve air quality and home heating in Tokoroa.

The health and wellbeing impact assessment report was a joint effort from both Environment Waikato and Population Health. Recommendations from the draft report were fed through to Environment Waikato to support their policy development process. The final report has recently been shared with the HIA Support Unit and is available along with other case studies on the HIA Support Unit's website.

Capacity for HIA in Waikato

When I first moved to Waikato, regionally, the capacity for HIA was limited. An introductory HIA training had been facilitated in 2006 with the target audience being Waikato District Health Board and council planners. This occurred at a time when HIA was still at an early stage of development nationally.

We have taken the following steps to increase capacity for HIA in Waikato:

• Developed a regional HIA development plan
• Organised HIA training - both internal and external
• Increased local participation in HIA
• Raised expectation that Population Health staff are aware of, and participate in HIA

Capacity for HIA has increased within the District Health Board, the Council and the community. Through attending local area HIA training (2008 / 09), staff from both Waikato and Bay of Plenty District Health Boards increased their awareness of how the HIA approach can positively contribute to policy development.

As a direct result of raised awareness and understanding of HIA within local and regional government, HIA has been included as an action for Regional Land Transport Programme review and within the Future Proof Waikato Sub-regional Growth Strategy and Implementation Plan 2009.

The Tokoroa Health and Wellbeing Impact Assessment appraisal was community focused. The HIA workshop involved 22 community participants including Tokoroa Māori and Pacific Island community leaders, health services and Regional Council staff. The community involvement has resulted in many members being more aware of the approach and the key role they can have within it.

The best way to build capacity

I believe the best way to build capacity for HIA is to persevere in strengthening relationships and building awareness across sectors. Start small and seek out opportunities to weave HIA into the development of planned policy. Understanding of HIA comes with getting involved.

Know that sometimes things will take longer than you anticipated, as you are often dependent on other external processes. Raising awareness of HIA with others also means having the capacity to support them to use HIA.

Also, suggest to other organisations that HIA is an effective tool to help increase community engagement and participation in policy development to create policy that can be both effective, and practically implemented.

Greg Morton
Waikato District Health Board Population Health, Hamilton
Email: mortong@waikatodhb.govt.nz

All Systems Go - External Evaluation of the HIA Support Unit

The Ministry of Health is pleased to announce that Health Outcomes International Pty Ltd has been selected as the organisation that will be carrying out the external evaluation of the Ministry's HIA Support Unit between July and December this year. They were selected through a Request for Tender process carried out by the Ministry earlier this year. The Ministry received 12 tenders.

The HIA Support Unit evaluation will seek to establish how, and to what extent, the HIA Support Unit is addressing and meeting its key goals and objectives. The intervention logic developed as part of the Unit's implementation will be used as the basis for the evaluation.

Julian King, Sue Jansen and Russell Holmes are the key staff at Health Outcomes International who will be working with us over the next few months to run the external evaluation.

Health Outcomes International will use three different types of stakeholder engagement as the basis for the evaluation:
• Surveys of HIA users as well as people identified as stakeholders but who have not undertaken HIAs
• Key informant interviews to gain additional depth of feedback about the effectiveness of the HIA Support Unit's work
• Case studies to provide an in-depth focus on the application of HIA to significant policy issues and the extent to which HIA has become embedded within the case study organisations.
As a reader of HIA e-News, you may be asked to participate in one of these three evaluation activities.

Within the next 1-2 months, the Ministry will send an email out to key stakeholders, including you, our readers of HIA e-News, asking you to participate in the external evaluation either as an HIA user or as one of our key stakeholders.

For more information about the evaluation contact:

Julian King, Associate Director, Health Outcomes International
Email: julian@hoi.co.nz

Position Vacant: HIA Project Officer, Christchurch

Community and Public Health in Christchurch are advertising a newly established position for a Health Impact Assessment Project Officer. The position is full time for 2 years and the closing date for applications is 26 June 2009.

Community and Public Health are seeking a person with demonstrated effectiveness in leadership, project management, relationship building, and collaboration. Experience in or knowledge of HIA would be an advantage. Appropriate training in HIA will be provided to the successful applicant.

The HIA Project Officer position is a joint venture aimed at building the capacity of agencies to undertake HIAs and utilise HIA as a tool to promote healthy public policy.

For further information, please contact:

Joan Mechen
Phone: 03 378 6801
Fax: 03 379 6482
Email: joan.mechen@cdhb.govt.nz

Report Back from the 2nd HIA Practitioners' Workshop - Evaluation of HIA

On the 23rd March day, nearly 40 people converged from around New Zealand - along with a leading HIA practitioner from Australia - to take part in the second HIA Practitioners' workshop in Auckland. The event was hosted by the Auckland Regional Public Health Service (ARPHS) at their Greenlane offices.

The workshop focused on the challenges and opportunities for evaluating HIA, and drew on the knowledge and experience of many involved the field. Sunil Kushor of ARPHS provided an overview of HIAs conducted in the Auckland region and the directions ARPHS are planning to take HIAs forward. Ruth Cunningham presented on current practice in HIA evaluation, drawing on a report she recently completed for the Ministry of Health. Kaaren Mathias presented on learnings from the evaluation of the Christchurch Urban Development Strategy HIA, which has recently been accepted for publication in a leading academic journal (see the next item for the link).

Ben Harris-Roxas from the University of New South Wales, led an engaging participative session on evaluating HIAs, drawing on a real-life example of an HIA in a small rural Australian community. The final presentation of the day focused on the Hastings Graffiti Vandalism Strategy, covering both its process and findings (presented by Maree Rohleder, Ana Apatu and Rob Quigley) and the evaluation of the HIA (presented by Louise Signal).

All presenters were asked to identify three take home messages to assist people with undertaking HIA evaluation. Key messages were:

• clarity about the purpose and values of the HIA are essential for evaluation
• evaluation activity doesn't have to be complex or resource intensive
• process and impact evaluation should be the focus... but don't forget about health outcomes
• HIAs are rarely either effective or ineffective (decision making and implementation are usually more complicated than that)
• it's important to evaluate the direct and more indirect impacts
• evaluating HIAs is important to justify your involvement and investment, as well as to the field of HIA as a whole
• begin evaluation from the start of an HIA, with an internal evaluator if necessary
• use a range of research methods
• evaluation provides way to reflect on HIA and learn from it
• find a friend to work with
• get your hands dirty
• make the HIA fit for purpose; do what you can with the resources you've got.

New Resource: Evaluation of HIA in New Zealand

The Greater Christchurch Urban Development Strategy HIA is one of New Zealand's most ambitious and substantial HIAs. It has led to a number of positive outcomes for HIA regionally and nationally. During 2008/09, the HIA Support Unit funded an impact evaluation of this HIA. The evaluation was led by Dr Kaaren Mathias.

The evaluation was recently written up by Kaaren and Ben Harris-Roxas from the University of New South Wales and, the paper titled 'Process and impact evaluation of the Greater Christchurch Urban Development Strategy Health Impact Assessment', has been published in BMC Public Health.

This is an excellent evaluation resource for HIA practitioners, particularly with the increasing interest in the evidence for HIA.

New Resource for Public Health Service Providers

Another new important development for HIA has been a revision of the public health service specifications the Ministry uses to purchase public health services.

The review has been completed and the final service specifications are now available. HIA is a recent addition to the service specifications. The final service specifications state that District Health Boards, public health services, non-governmental organisations, iwi and local Maori communities, Local Authorities and other public policy making bodies can apply HIA methods and approaches.

The major change from the previous service specifications is that there is now a comprehensive set of HIA-specific activities providers can choose from to support a learning by doing approach for HIA. The main areas of activity are:

• undertake HIA activities (screening, scoping, appraisal and reporting, evaluation) using HIA tools available in New Zealand and internationally
• build partnerships across a range of sectors to support the development and effective use of HIA methods and approaches
• develop an organisational commitment to the adoption of HIA (ie. embedding HIA into an organisation's decision-making)
• provide awareness raising presentations, training sessions in the use of HIA, its value and benefits within and across organisations.

Each of these areas gives examples of specific actions that can be undertake to support HIA approaches at a local or regional level.

The public health service specifications are now publicly available on the Nationwide Service Framework Library website.

Review Package for HIA Reports of Development Projects

Mette Winge Fredsgaard and Ben Cave of Ben Cave Associates Ltd and Alan Bond of InteREAM, University of East Anglia have developed a review package for HIA reports. They were advised and assisted by a panel of experts, and by participants on their training courses.

The review package consists of a short introduction, some guidance notes and then a series of questions. It enables a commissioner or reviewer of an HIA report to reach an opinion as to the quality of the completed report in a simple, quick and systematic manner.

The users of this review package include commissioners of HIA both in the public and private sector and those who may be asked to review HIA reports. The review package is for HIA reports which are submitted as evidence associated with an application for development consent. With some modification, the review package may be applicable to a wider range of HIAs.

Whilst considerable effort has gone into the production of this HIA review package, the authors acknowledge that experience gained through its application will be essential to ensure it covers all that it should, and that it continues to promote best practice in HIA.

The authors are interested in receiving comments on this review package. If you have comments on the HIA Review Package and would like to be kept up to date with its use and development please email hiareview@bcahealth.co.uk.

The review package is available on the following webpage: http://www.bcahealth.co.uk/news.html

Upcoming Conference: 10th Annual HIA Conference

The 10th annual conference on HIA is being held in the vibrant city of Rotterdam, The Netherlands from the 14th - 16th of October 2009.

This year's conference theme is 'On the move'. The following will be discussed:

• how to move health higher up on the policy agendas
• how to move on from incidental HIA's to institutionalisation
• how to move on to better integration of HIA in a Health In All Policies approach, trying to create win-win situations for health as well as for other sectors.

Contributions relevant to the theme `movement` such as transport, physical exercise or migration, are especially welcomed, as well as any other HIA related contributions.

All HIA practitioners, researchers and others involved in, or with an interest for HIA are invited to join us in the vibrant environment of the city of Rotterdam to enjoy networking, learning and sharing experiences.

For further information, registration and submission of abstracts please visit the HIA '09 conference website.

Current / Future HIA's

If you have an HIA underway or have just finished one then please get in touch with us and we will post information about it here. This could provide you and your team with useful information / pointers / support to assist you as you go through your HIA.

Future Training Opportunities 2009 - Reminder

Introductory and Advanced HIA training courses and courses on specific topics related to health, well-being and equity impact assessment can be organised for you. If you would like training to be held in your area or within your organisation please contact Louise Signal or Rob Quigley to discuss tailoring dates and training to your requirements. If appropriate, Rob can discuss the possibility of joint training sessions with other organisations in your area or even with others from other regions. Notices or invitations for training courses can be included here in HIA e-News.

Ph: (04) 472 0139 or email:
rob@quigleyandwatts.co.nz
or
louise.signal@otago.ac.nz

Contact Us

Ministry of Health:
Matt_Soeberg@moh.govt.nz
or
Christine_Stewart@moh.govt.nz

Quigley and Watts Ltd:
kate@quigleyandwatts.co.nz

This newsletter is funded by Ministry of Health and brought to you by Quigley and Watts Ltd. We welcome your feedback via the above email addresses or through the New Zealand HIA Support Unit website http://www.moh.govt.nz/hiasupportunit