impact evaluation of three health equity impact assessments
DESCRIPTION
Presentation for IAIA'10 International Association for Impact Assessment Conference in Geneva. http://iaia.org/iaia10/TRANSCRIPT
Impact Evaluation of Three Health Equity Impact Assessments
B Harris-Roxas, P Bazeley, L KempCentre for Health Equity Training, Research and Evaluation (CHETRE)
Part of the UNSW Research Centre for Primary Health Care and EquitySydney, Australia
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But little is known about its effectiveness and the circumstances under which it is effective
Impact of three health equity impact assessments (HEIAs) onsubsequent decision-making and implementation
Rapid
Health sector proposals
Impact evaluation 18-24 months following completion
Narrative interviews
Document analysis
Analysis: Approach outlined by Colaizzi*
* 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.
Evidence of changes to decision-making and implementation, but these were hard to attribute solely to the HEIAs
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
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
All three HEIAs identified potential health inequity impacts that had not been previously identified in planning
But it was hard for people to recognise that their understanding of potential health equity impacts had changed
"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."
The things we don’t know we didn’t know?
Lack of consensus about the purpose of doing of doing the HEIAs
"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."
More explicit conflict, discussion of values and desired outcomes
