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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.

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Peter Furu

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  1. Health Impact Assessment and Healthy Development: Health as an issue in donor supported poverty and sustainability impact assessments Peter Furu PLENARY SESSION III

  2. DBL - Centre for Health Research and Development DBL-Centre for Health Research and Development Dept. of VeterinaryDiseaseBiology Section for Parasitology, Health and Development University of Copenhagen, Denmark WHO Collaborating Centre for Health and Environment in SustainableDevelopment WHO Collaborating Centre for IntegratedControl of HelminthInfections WHO Collaborating Centre for Research and TrainingonNeglected and cccccccccccccccccccccccccccccotherParasitic Zoonoses Peter Furu (pfu@life.ku.dk)

  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”

  4. DBL - Centre for Health Research and Development Landscape Crisis !? Official Development Assistance (ODA) 2010 USD 128.7 billion (highest ODA level ever) Health sector Bilateral aid to health amounted to USD 10.9 billion and multilateral agencies’ aid to USD 4.7 billion (2007) Beyond 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. Crisis !! Organisation for Economic Co-operation and Development (www.oecd.org)

  5. DBL - Centre for Health Research and Development Landscape Key strategic and policy guidance for spending (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)

  6. DBL - Centre for Health Research and Development Landscape Sector level 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

  7. DBL - Centre for Health Research and Development Landscape Health as a cross-cutting issue Donors, developers and authorities are confronted with scores of mandatory or optional thematic impact assessments to facilitate safe spending of aid !! - 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 !

  8. DBL - Centre for Health Research and Development Impact assessment landscape Some elements EnvironmentalImpactAssessment Health ImpactAssessment Trade impactassessment Regulatoryimpactanalysis Environmental Health ImpactAssessment StrategicEnvironmentalAssessment Health-systems ImpactAssessment Health EquityImpactAssessment Health InequalitiesImpactAssessment Social ImpactAssessment Poverty and Social ImpactAssessment BiodiversityImpactAssessment GenderImpactAssessment Global ImpactAssessment Mental Health ImpactAssessment IntegratedEnvironmental Health ImpactAssessment ImpactAssessment SustainabilityImpactAssessment Human ImpactAssessment PovertyImpactAssessment ClimateImpactAssessment EqualityImpactAssessment

  9. DBL - Centre for Health Research and Development Impact assessment landscape ? From the donor perspective - does this diversity facilitate aid effectiveness and resulting development impact ??

  10. DBL - Centre for Health Research and Development Impact assessment landscape Narrowing down to health Health ImpactAssessment Environmental Health ImpactAssessment Health-systems ImpactAssessment Health EquityImpactAssessment Health InequalitiesImpactAssessment Mental Health ImpactAssessment IntegratedEnvironmental Health ImpactAssessment

  11. DBL - Centre for Health Research and Development Impact Assessment landscape Health related ? Will this diversity potentially confuse more than create thematic and procedural clarity for the users (e.g. the donor community)??

  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?

  13. DBL - Centre for Health Research and Development Harmonization of IAs Donor co-operation OECD-Development Assistance Committee (DAC) 24 members (largest funders of aid) 3 observers (WB, IMF, UNDP) “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) European Parliament, Council and Commission World Bank Group

  14. DBL - Centre for Health Research and Development Harmonization of IAs Donor co-operation OECD-DAC 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. DBL - Centre for Health Research and Development Harmonization of IAs Donor co-operation OECD-DAC 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)theMDGs and other strategic goals

  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)

  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

  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 !!!

  19. DBL - Centre for Health Research and Development Capacity development One example of donor supported HIA CB 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 2003-2011 Creating an enabling environment for HIA !

  20. DBL - Centre for Health Research and Development Capacity development Some results 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.

  21. DBL - Centre for Health Research and Development Capacity development 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

  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.

  23. DBL - Centre for Health Research and Development In conclusion For discussion ? 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 ??

  24. DBL - Centre for Health Research and Development In conclusion For discussion ? What has key donor partnerships done to facilitate the use of integrated impact assessment and is health an issue addressed ? 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? ?

  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

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