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DESIGN AND DELIVERY OF HEALTH IMPACT ASSESSMENT PILOT PROJECT Margit OHR [1] Project overview Aim:
Objectives:
(ii) To work with senior staff at the “Dél-Dunántúl” Region of ÁNTSZ to identify an emerging regional policy that would be appropriate as the focus of a pilot HIA at regional level. (iii) To coordinate the design of the pilot study with input from key stakeholders: Prime Minister’s Office, MoHFSA, Netherland’s School of Public and Occupational Health, Dutch HIA experts, National Institute for Health Development, ÁNTSZ, Debrecen School of Public Health and Semmelweis Medical University. (iv) To coordinate delivery, analysis and reporting of the findings of the study including detailed recommendations for operationalising HIA in the policy process across all Government spending Minstries. (v)To lead implementation of other recommendations contained in the applicant’s IPF Policy paper which will be necessary to ensure the longer term relevance and sustainability of HIA in Hungary. Rationale: As a result of the interest promoted in the findings from the applicant’s IPF study (including at the Prime Minister’s Office) there is an opportunity to utilise the existing MATRA project to provide support for a HIA pilot during the remaining period of the MATRA project. Unfortunately, it is exactly over this period that the National Institute for Health Development is being reorganised in line with new Public Health priorities; this will also delay mobilisation of financial resources available for HIA which will be part of the remit of a new National Institute. So, at present there are no financial resources available to support the input of the applicant in designing and delivering a HIA pilot study and driving implementation of the recommendations of her Policy Paper. Note: the MATRA project supports the costs of Dutch experts (with whom the applicant developed contacts during her Fellowship year). but not ‘local costs’. 1. INTRODUCTION Development of HIA as part of mainstream policy design and delivery is a priority identified as part of the new EU Public Health Programme (under ‘cross-cutting themes’) and reflects the wider competency for health that Government’s need to address as set out in Article 152 of the Treaty of Amsterdam. The goal of the IPF Fellowship project that provides the foundation for this Continuing Fellowship Project proposal was to develop understanding of factors that could influence the use of HIA in Hungary and to take first steps to build capacity within the Hungarian system to conduct health impact assessment of any relevant policy or programme at national level [2] . The project outlined in this proposal would significantly help to maintain the drive to implement HIA in Hungary. It would mobilise international ‘expert’ resources available through an existing Dutch funded initiative in Hungary in collaboration with Hungarian Government and academic stakeholders to deliver the recommendations contained in the applicant’s Policy Paper. The project presented in this proposal would cover a period of organisational change at national level in Hungary during which HIA will be institutionalised but during which it can be delayed to mobilise financial resources. 2. FOUNDATIONS FOR CONTINUING FELLOWSHIP PROJECT The foundations for this project proposal have been created by work undertaken by the applicant during her Fellowship year. The main relevant research findings and policy recommendations are set out in this section. 2.1 Research paper: key findings The assumption informing this research was that EU Accession would stimulate some of the changes necessary to modernise policy making/public administration and enable the adoption and development of relevant methods such as HIA. In Hungary, the research found that:
However, so close to EU Accession, this research shows that in Hungary commitment to and investment in dealing with policy and public administration development e.g. as a platform for applying HIA methodology, is not obvious. Effective capacity building will need educational, institutional and strategic level investment, not least to tackle all the political and more seriously, the institutional-cultural barriers to development. 2.2 Policy paper: main recommendations As part of the process to build HIA capacity and understanding, detailed findings from the applicant’s research paper were presented and policy implications discussed at a workshop for key Hungarian stakeholders. There was agreement that the following areas should be addressed in developing action at political, institutional and professional levels.
3. THE CONTINUING FELLOWSHIP PROJECT The applicant has pursued a clear stepped approach to undertaking her IPF study and to influencing the circumstances in which the policy recommendations can be addressed. A Continuing Fellowship would provide support to leverage in and realise the added value of other work being funded in Hungary (i.e. a Dutch funded MATRA initiative [3] ) in support of these policy recommendations. This is at a time when organisational changes mean that ‘local’ financial resources mobilisation can be delayed in the short-term to enable the necessary coordination of policy and practice stakeholders to ensure the take up of HIA in Hungary. 3.1 Aim To design and deliver a national and regional Health Impact Assessment pilot project in partnership with Dutch HIA experts in order to promote confidence and build capacity in HIA. 3.2 Objectives
3.3 Delivering a HIA pilot project The aim and objectives of this project can be achieved by taking the opportunity to work in partnership with the Dutch funded MATRA initiative currently running in Hungary and due to complete in January 2004. During the period when this proposal is being considered by IPF and with the agreement of all relevant stakeholders, the applicant will work (i) to identify a suitable emerging national and regional policy as the subject of a HIA pilot project (ii) with MATRA project staff to develop terms of reference for inclusion of the HIA pilot project in the wider MATRA initiative. If funding for a Continuing Fellowship is approved, the applicant will work with stakeholders to deliver the remaining objectives and disseminate and institutionalise findings from the HIA pilot project. The applicant has worked hard to build commitment to this process and this means that representation from the various stakeholders will be available to support the delivery of the proposed pilot project (See Appendix 1). The timescale for this Continuing Fellowship project would be approximately June 2003 to February 2004 to enable the HIA pilot project to be delivered and findings applied. 3.4 Widening impact of this project within Central and Eastern Europe There are three opportunities for widening the impact of this project in the region:
APPENDIX 1: PROPOSED MEMBERSHIP OF WORKING GROUPS Pilot Project Steering Group > National Advisory Group (NAG) + Working Group on Capacity Building (WGCB)
Policy recommendations ‘2’ and ‘3’. The NAG/WGCB will lead on strategic, institutional and professional development issues. During the pilot project it will act as the Project Steering Group. International experts will take part in this group during the proposed pilot project period. The NAG will meet at least two times a year, having its first meeting after finalisation of the Policy Paper. It will be able to co-opt other stakeholders to form specific sub-groups for each of the above 3 issues. Working Group for Legal Framework (WGLF)
Policy recommendation ‘1’.The working group for Legal Framework will be responsible for the overall guidance and development of the legitimisation of HIA into the decision making process and to evaluate this progress against the pre-determined parameters. The WGLF will meet at least two times a year, having its first meeting after finalisation of the Policy Paper and will have some cross-over membership with the NAG/WGCB. APPENDIX 2: Abbreviations
[1] 2002-03 International Policy Fellow (Public Health) [2] Further information about and outputs of the study can be found at www.policy.hu/ohr [3] Further information on this MATRA work is provided in the Project Overview above.
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