Health Impact Assessment and Healthy Development: Health as an issue in donor supported poverty and sustainability impact assessments

Transcription

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 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 Slide 2

3 The rough landscape of aid for development, potential impact assessment overload and aid effectiveness Harmonization of IAs health in PIAs and SIAs Overview Demand-driven HIA capacity development an area for donor support towards healthy development Slide 3

4 Crisis!? 2010 Official Development Assistance (ODA) Landscape USD 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. Organisation for Economic Co-operation and Development ( Slide 4

5 Key strategic and policy guidance for spending Landscape ( 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) Slide 5

6 Sector level 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 donors active in the health sector - in addition because health is a cross-cutting issue Slide 6

7 Health as a cross-cutting issue Landscape 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! Slide 7

8 Some elements Impact assessment landscape Environmental Impact Assessment Trade impact assessment Regulatory impact analysis Environmental Health Impact Assessment Strategic Environmental Assessment Health Equity Impact Assessment Social Impact Assessment Biodiversity Impact Assessment Global Impact Assessment Mental Health Impact Assessment Sustainability Impact Assessment Health Impact Assessment Poverty and Social Impact Assessment Gender Impact Assessment Impact Assessment Human Impact Assessment Poverty Impact Assessment Climate Impact Assessment Slide 8 Equality Impact Assessment

9 Impact assessment landscape? From the donor perspective - does this diversity facilitate aid effectiveness and resulting development impact?? Slide 9

10 Health Impact Assessment DBL - Centre for Health Research and Development Narrowing down to health Impact assessment landscape Environmental Health Impact Assessment Health Equity Impact Assessment Mental Health Impact Assessment Slide 10

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

12 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? Slide 12

13 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 ( ) is: - to promote development co-operation and other policies so as to contribute to sustainable development, including propoor economic growth, poverty reduction, improvement of living standards in developing countries, and to a future in which no country will depend on aid. ( European Parliament, Council and Commission World Bank Group Slide 13

14 OECD-DAC OECD DBL - Centre for Health Research and Development Harmonization of IAs Donor co-operation DAC Network on Poverty Reduction (POVNET) A Practical Guide to Ex Ante Poverty Impact Assessment (2007) 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) Slide 14

15 OECD-DAC DBL - Centre for Health Research and Development Harmonization of IAs 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 Slide 15

16 OECD Harmonization of IAs Donor co-operation 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) Slide 16

17 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? Slide 17

18 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!!! Slide 18

19 One example of donor supported HIA CB 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! Slide 19

20 Some results 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. Slide 20

21 Some results 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 Slide 21

22 Some challenges Capacity development - 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. Slide 22

23 For discussion 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?? Slide 23

24 For discussion In conclusion?? 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? Slide 24

25 Thank you - Gracias Acknowledgements: Danida, Denmark World Health Organization, Geneva InWEnt, Germany Ministries of Health in Cambodia, Vietnam and Lao PDR Slide 25