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We often assume that carrying out a ‘good’ HIA will lead to better (healthier) decisions but at the same time we are aware that HIAs are just one part of the decision making context. We know that the world is more complex than this—what works in one place doesn’t necessarily work somewhere else. Proposals are implemented within complex open systems affected by pre-existing structures and changed by people with agency. Political theory can provide useful frameworks for understanding and mapping out decision making contexts and identifying ways of influencing the consideration of health.
Our workshop began with participants discussing their own experiences of adapting the HIA process to fit with the political context surrounding the decision the HIA was assessing. We explored what is it about the approach that made it work (or not) and how context affected this. We then had a short presentation on policy theory, which included some examples of policy-making theory. We then made links between policy theory and our own practice and developed a preliminary framework for how policy theory could be used at different HIA stages.
We are planning to develop the initial framework into a paper using illustrative case studies. This paper would explore the links between policy theory and HIA practice and include suggestions for how to progress this work in the field. Part of this will also involve clarifying what we mean by policy theory.
We would also like to begin identifying tools and approaches that could be utilized within HIA to understand/influence decision making processes (e.g. network analysis, frameworks, using decision support tools based on online gaming technology).
We want to explore opportunities for making links between this working group and the work of other working groups. For example, we thought some of the learning from this group could potentially be incorporated into the HiAP toolkit.
Our next step is to use the discussion points from the practitioners’ workshop to inform an upcoming workshop at the International Union for Health Promotion and Education Conference (May, Curitiba, Brazil), which considers advanced methods for HIA. This will provide a forum to test out, with an international audience, some of what is developed in the working group.