health impact assessment and healthy...
TRANSCRIPT
Health Impact Assessment and Healthy Development: Health as an issue in donor supported poverty and sustainability impact assessments
Peter Furu
PLENARY SESSION III
15 April 2011, Peter Furu Slide 2
DBL - Centre for Health Research and Development
DBL-Centre for Health Research and Development Dept. of Veterinary Disease Biology Section for Parasitology, Health and Development University of Copenhagen, Denmark
WHO Collaborating Centre for Health and Environment in Sustainable Development WHO Collaborating Centre for Integrated Control of Helminth Infections WHO Collaborating Centre for Research and Training on Neglected and ccccccccccccccccccccccccccccc other Parasitic Zoonoses
Peter Furu ([email protected])
15 April 2011, Peter Furu Slide 3
DBL - Centre for Health Research and Development
Overview
The rough landscape of aid for development, potential impact assessment overload and aid effectiveness
Harmonization of IAs – health in PIAs and SIAs
Demand-driven HIA capacity development – an area for donor support towards “healthy development”
15 April 2011, Peter Furu Slide 4
DBL - Centre for Health Research and Development
USD 128.7 billion (highest ODA level ever)
2010
Global country programmable aid is planned to grow at a real rate of 2% per year from 2011 to 2013, compared to 8% per year on average over the past three years.
Bilateral aid to health amounted to USD 10.9 billion and multilateral agencies’ aid to USD 4.7 billion (2007)
Health sector
Beyond 2010
Crisis !? Landscape
Official Development Assistance (ODA)
Organisation for Economic Co-operation and Development (www.oecd.org)
15 April 2011, Peter Furu Slide 5
(1972-2012 - not exhaustive)
National Poverty Reduction Strategies in partner countries Aid agencies’ national and sector specific policies and strategies
Rio +20 (2012) Accra Agenda for Action (2008) Paris Declaration on Aid Effectiveness (2005) Rome Declaration on Harmonization (2003) Rio +10 (2002) UN Millennium Development Declaration (2000) Rio Declaration on Environment and Development (1992) UN Conference on Human Environment, Stockholm (1972)
DBL - Centre for Health Research and Development
Landscape Key strategic and policy guidance for spending
15 April 2011, Peter Furu Slide 6
DBL - Centre for Health Research and Development
Landscape
The health sector is considered one of the most fragmented and complex sectors with around 100 global health partnerships (OECD-DAC)
OECD-DAC (2006): In 29 countries in sub-Saharan Africa between 18-23 donors active in the health sector
- in addition – because health is a cross-cutting issue
Sector level
15 April 2011, Peter Furu Slide 7
DBL - Centre for Health Research and Development
- and exposed to even more different impact assessment guidelines with different procedural approaches and their varied (and often inconsistent) use of definitions, terms and indicators !
Donors, developers and authorities are confronted with scores of mandatory or optional thematic impact assessments to facilitate safe spending of aid !!
Landscape Health as a cross-cutting issue
15 April 2011, Peter Furu Slide 8
DBL - Centre for Health Research and Development
Impact assessment landscape
Health Impact Assessment
Social Impact Assessment
Environmental Impact Assessment
Strategic Environmental Assessment
Biodiversity Impact Assessment
Poverty Impact Assessment
Sustainability Impact Assessment Human Impact Assessment
Gender Impact Assessment
Climate Impact Assessment Equality Impact Assessment
Regulatory impact analysis
Some elements
Trade impact assessment
Mental Health Impact Assessment
Impact Assessment
Health Equity Impact Assessment Environmental Health Impact Assessment
Poverty and Social Impact Assessment
Global Impact Assessment
15 April 2011, Peter Furu Slide 9
DBL - Centre for Health Research and Development
From the donor perspective - does this diversity facilitate
aid effectiveness and resulting development
impact ??
Impact assessment landscape
?
15 April 2011, Peter Furu Slide 10
DBL - Centre for Health Research and Development
Impact assessment landscape Narrowing down to health
Health Impact Assessment
Mental Health Impact Assessment
Health Equity Impact Assessment Environmental Health Impact Assessment
15 April 2011, Peter Furu Slide 11
DBL - Centre for Health Research and Development
Impact Assessment landscape
Will this diversity potentially confuse more than create thematic and procedural clarity for the users (e.g. the donor community)??
Health related
?
15 April 2011, Peter Furu Slide 12
DBL - Centre for Health Research and Development
Impact Assessment landscape
What has some of the key donor partnerships done to facilitate the use of integrated impact assessment and is health an issue addressed?
?
15 April 2011, Peter Furu Slide 13
DBL - Centre for Health Research and Development
Harmonization of IAs
OECD-Development Assistance Committee (DAC)
Donor co-operation
“The overarching objective (2011-2015) is:
- to promote development co-operation and other policies so as to contribute to sustainable development, including pro-poor economic growth, poverty reduction, improvement of living standards in developing countries, and to a future in which no country will depend on aid.” (www.oecd.org)
24 members (largest funders of aid) 3 observers (WB, IMF, UNDP)
European Parliament, Council and Commission World Bank Group
15 April 2011, Peter Furu Slide 14
DBL - Centre for Health Research and Development
Harmonization of IAs
OECD-DAC Donor co-operation
DAC Network on Poverty Reduction (POVNET) A Practical Guide to Ex Ante Poverty Impact Assessment (2007)
OECD Guidance on Sustainability Impact Assessment (2010)
European Commission Impact Assessment Guidelines (2009)
IFC of the World Bank Group Environmental, Health and Safety Guidelines (2007) Performance Standards and Guidance Notes (2007)
15 April 2011, Peter Furu Slide 15
DBL - Centre for Health Research and Development
Harmonization of IAs
OECD-DAC Donor co-operation
DAC Network on Poverty Reduction (POVNET) A Practical Guide to Ex Ante Poverty Impact Assessment (2007)
Key focus: Assessment against 1) five capabilities required by people to escape from or avoid poverty: Economic (e.g having assets to pursue sustainable livelihoods) Human (e.g. health, education, shelter, water, nutrition) Political (e.g human rights, having a voice) Socio-cultural (e.g. member of social and cultural networks) Protective-security (e.g. issues that help lessen vulnerability) Environment and gender as cross cutting issues
-and assessment against 2) the MDGs and other strategic goals
15 April 2011, Peter Furu Slide 16
DBL - Centre for Health Research and Development
Harmonization of IAs Donor co-operation
OECD
Guidance on Sustainability Impact Assessment (2010)
Key focus: Assessment against three pillars of sustainable development: Economic (e.g. functioning of internal market and competition; trade and investment flows; consumer prices) Social (e.g. employment and labour markets; access to and effects on health systems and services, public health and safety Environmental (e.g. the climate; quality of air; water; soil; land use; waster management)
15 April 2011, Peter Furu Slide 17
DBL - Centre for Health Research and Development
Harmonization of IAs Integrated Impact Assessment
? How do we as an HIA community of researchers, practitioners and other stakeholders ensure that health is sufficiently covered in such types of integrated impact assessments - and thereby assist donors in becoming health focused and effective?
www.oecd.org
15 April 2011, Peter Furu Slide 18
DBL - Centre for Health Research and Development
Capacity development
Whether we want to promote HIA as a stand alone exercise or emphasize health as an element of integrated impact assessment we need awareness creation and capacity development !!!
Importantly:
HIA capacity development is needed in both development partner countries as well as in donor countries !!!
15 April 2011, Peter Furu Slide 19
DBL - Centre for Health Research and Development
Capacity development
Comprehensive intersectoral HIA capacity development in the Mekong Region, South East Asia supported by:
Danish Government (Danida) German Government (InWEnt (now GIZ)) World Health Organization
Creating an enabling environment for HIA !
One example of donor supported HIA CB
15 April 2011, Peter Furu Slide 20
DBL - Centre for Health Research and Development
Capacity development
Lao PDR: Training of MOH staff on essential HIA functions Intersectoral HIA training, Support to HIA guidelines development, Support to HIA policy formulation process, HIA Policy decreed by Lao PDR government, HIA Unit operational in MOH
Vietnam: Training of MOH staff, Training-of-trainers on HIA Provincial intersectoral HIA training (two provinces) HIA in “Law on communicable diseases control” HIA in National Environmental Health Action Plan (NEHAP) Technical assistance on HIA of hydropower dev.
Some results
15 April 2011, Peter Furu Slide 21
DBL - Centre for Health Research and Development
Capacity development
Cambodia: Training of MOH staff on essential HIA functions, Pilot blended (e-learning) course on Intersectoral HIA, Support to Department of Preventive Medicine, MOH on HIA policy formulation process including: -National strategy for environmental health protection -National Environmental Health Action Plan (NEHAP) -National HIA Policy
Some results
15 April 2011, Peter Furu Slide 22
DBL - Centre for Health Research and Development
Capacity development Some challenges
- to ensure continuous interest and commitment by both health and non-health sectors;
- still work to be done promoting and ensuring intersectoral collaboration;
- constraint for progress are limitations in funding.
15 April 2011, Peter Furu Slide 23
DBL - Centre for Health Research and Development
In conclusion
Does the diversity of IA facilitate aid effectiveness and resulting development impact ??
?
From the perspective of the donor (authority) - will this diversity potentially confuse more than create thematic and procedural clarity for the users ??
?
For discussion
15 April 2011, Peter Furu Slide 24
DBL - Centre for Health Research and Development
In conclusion For discussion
How do we as an HIA community of researchers, practitioners and other stakeholders ensure that health is sufficiently covered in such types of integrated impact assessments - and thereby assist donors in becoming health focused and effective?
What has key donor partnerships done to facilitate the use of integrated impact assessment and is health an issue addressed ?
?
?
15 April 2011, Peter Furu Slide 25
DBL - Centre for Health Research and Development
Thank you - Gracias
Acknowledgements:
Danida, Denmark World Health Organization, Geneva InWEnt, Germany Ministries of Health in Cambodia, Vietnam and Lao PDR