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Impact Evaluation of Three Health Equity Impact Assessments

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Presentation for IAIA'10 International Association for Impact Assessment Conference in Geneva. http://iaia.org/iaia10/

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Impact Evaluation of Three Health Equity Impact Assessments

  1. 1. Impact Evaluation of Three Health Equity Impact Assessments B Harris-Roxas, P Bazeley, L Kemp Centre for Health Equity Training, Research and Evaluation (CHETRE) Part of the UNSW Research Centre for Primary Health Care and Equity Sydney, Australia
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  3. 3. <ul><li>But little is known about its effectiveness and the circumstances under which it is effective </li></ul>
  4. 4. <ul><li>Impact of three health equity impact assessments (HEIAs) on subsequent decision-making and implementation </li></ul>
  5. 5. <ul><li>Rapid </li></ul><ul><li>Health sector proposals </li></ul>
  6. 6. <ul><li>Impact evaluation 18-24 months following completion </li></ul>
  7. 7. <ul><li>Narrative interviews </li></ul><ul><li>Document analysis </li></ul>
  8. 8. <ul><li>Analysis: Approach outlined by Colaizzi* </li></ul>* Colaizzi PF. Psychological Research as the Phenomenologist Views It . In: Valle RS, King M, editors. Existential Phenomenological Alternatives for Psychology . New York: Oxford University Press, 1978:48-71.
  9. 9. <ul><li>Evidence of changes to decision-making and implementation, but these were hard to attribute solely to the HEIAs </li></ul>
  10. 10. Parameters Decision-making processes Decision-makers Type of HIA Broader Context Inputs Proposal Capacity and experience Resources Time Organisational arrangements Process Procedural fidelity Involvement of decision-makers and stakeholders Transparency Trade-offs Review Proximal Impacts Informing decisions Changing decisions and implementation Changes in health determinants Predictive efficacy Achieving goals Distal Impacts Understanding Participatory learning Influencing other activities Engagement Perception of HIA Values, Purpose and Goals
  11. 11. Parameters Decision-making processes Decision-makers Type of HIA Broader Context Inputs Proposal Capacity and experience Resources Time Organisational arrangements Process Procedural fidelity Involvement of decision-makers and stakeholders Transparency Trade-offs Review Proximal Impacts Informing decisions Changing decisions and implementation Changes in health determinants Predictive efficacy Achieving goals Distal Impacts Understanding Participatory learning Influencing other activities Engagement Perception of HIA Values, Purpose and Goals
  12. 12. <ul><li>All three HEIAs identified potential health inequity impacts that had not been previously identified in planning </li></ul>
  13. 13. <ul><li>But it was hard for people to recognise that their understanding of potential health equity impacts had changed </li></ul>
  14. 14. <ul><li>&quot;I’m not convinced that [the HEIA] made people do things differently, because I think that they probably, should’ve, would’ve, hopefully would’ve, done those things anyway.&quot; </li></ul>
  15. 15. <ul><li>The things we don’t know we didn’t know? </li></ul>
  16. 16. <ul><li>Lack of consensus about the purpose of doing of doing the HEIAs </li></ul>
  17. 17. <ul><li>&quot;We didn’t have a shared understanding of why we were undertaking it. Our purposes were probably different from [the other stakeholders’] purposes, and maybe that’s where they don’t work, but if you have two differing purposes, unless you can fully appreciate what those two different purposes are, maybe it doesn’t work out as well as it could.&quot; </li></ul>
  18. 18. <ul><li>More explicit conflict, discussion of values and desired outcomes </li></ul>
  19. 19. <ul><li>More information </li></ul><ul><li>http://bit.ly/g0CDI </li></ul><ul><li>[email_address] </li></ul>

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