Peter Furu

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 FuruSlide 2

DBL - Centre for Health Research and Development

DBL-Centre for Health Research and DevelopmentDept. of Veterinary Disease BiologySection 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])



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”



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

Crisis !!

Beyond 2010

Crisis !?Landscape

Official Development Assistance (ODA)

Organisation for Economic Co-operation and Development (www.oecd.org)


(1972-2012 - not exhaustive)

National Poverty Reduction Strategies in partner countriesAid 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)


LandscapeKey strategic and policy guidance for spending



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



- 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 !!

LandscapeHealth as a cross-cutting issue



Impact assessment landscape

Health Impact Assessment

Social Impact Assessment

Environmental Impact Assessment

Strategic Environmental Assessment

Biodiversity Impact Assessment

Poverty Impact Assessment

Sustainability Impact AssessmentHuman Impact Assessment

Health-systems Im

pact Assessment

Gender Impact Assessment

Climate Impact AssessmentEquality Impact Assessment

Health Inequalities Im

pact Assessment

Regulatory impact analysis

Some elements

Trade impact assessment

Mental Health Impact Assessment

Impact Assessment

Health Equity Impact Assessment

Integrated Environmental Health Impact Assessment

Environmental Health Impact Assessment

Poverty and Social Impact Assessment

Global Impact Assessment



From the donor perspective - does this diversity facilitate

aid effectiveness and resulting development

impact ??

Impact assessment landscape

?



Impact assessment landscapeNarrowing down to health

Health Impact Assessment

Integrated Environmental Health Impact Assessment

Mental Health Impact Assessment

Health Equity Impact AssessmentEnvironmental Health Impact Assessment

Health Inequalities Im

pact Assessment

Health-systems Im

pact Assessment



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

?



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?

?



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 CommissionWorld Bank Group




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 CommissionImpact Assessment Guidelines (2009) IFC of the World Bank GroupEnvironmental, Health and Safety Guidelines (2007)Performance Standards and Guidance Notes (2007)




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



Harmonization of IAsDonor 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 safetyEnvironmental (e.g. the climate; quality of air; water; soil; land use; waster management)



Harmonization of IAsIntegrated 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



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 !!!




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

2003-2011




Lao PDR:Training of MOH staff on essential HIA functionsIntersectoral 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 HIAProvincial 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




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



Capacity developmentSome 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.



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



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 ?

?

?



Thank you - Gracias

Acknowledgements:

Danida, DenmarkWorld Health Organization, GenevaInWEnt, GermanyMinistries of Health in Cambodia, Vietnam and Lao PDR

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