Plenary Session 1 — Developing Hi AP HIA to

Plenary Session 1 - Developing Hi. AP/HIA to reduce Health Inequalities in the context of current systemic crisis Granada 14 April 2011 The Need to Strengthen Health Governance to address the SDH and related Health Inequities: Lessons from Europe Erio Ziglio & Sarah Simpson European Office for Investment for Health and Development World Health Organization, Regional Office for Europe Venice XI HIA International Conference In Times of Crisis, Healthier Ways

Context Concept 3 Lessons XI HIA International Conference In Times of Crisis, Healthier Ways

Public Health in a fast changing world… Granada 2011

Climate change Source: Climate Change 2007: The Physical Science Basis http: //www. ipcc. ch/pdf/assessment-report/ar 4/wg 1/ar 4 -wg 1 -chapter 10. pdf XI HIA International Conference In Times of Crisis, Healthier Ways

A world of urbanized people Urbana Rurale Source: World Urbanisation Prospects | 2005 Revision http: //www. un. org/esa/population/publications/WUP 2005/2005 wup. htm XI HIA International Conference In Times of Crisis, Healthier Ways

By next time we are going to meet… There will be more people over 65 than under 5 Source: World Population Prospects: The 1996 Revision, Annex 2 (Low-Variant Projection) UN Population Division XI HIA International Conference In Times of Crisis, Healthier 1 Ways

A fast changing context for health XI HIA International Conference In Times of Crisis, Healthier Ways

Context Concept Issues 3 Lessons XI HIA International Conference In Times of Crisis, Healthier Ways

WHO Study on Governance by Professor Kickbusch “Governance is about how governments and other social organizations interact, how they relate to citizens, and how decisions are taken in a complex and globalized world” Source: Institute on Governance, Ottawa Policy Brief 15, 2003. XI HIA International Conference In Times of Crisis, Healthier Ways

Adelaide Statement on Health in All Policies moving towards a shared governance for health and well-being XI HIA International Conference In Times of Crisis, Healthier Ways

In HIA and in making Hi. AP working there is a need to better understand: “Governance principles, institutional arrangements and delivery instruments, including how progress is monitored and how accountability is defined and managed” Improved and more specific knowledge about these arrangements. XI HIA International Conference In Times of Crisis, Healthier Ways

Context Concept Issues 3 Lessons XI HIA International Conference In Times of Crisis, Healthier Ways

Key questions/issues from our work • What are the challenges of governance in different country contexts? • What are the core elements that construct good governance? • What promising practices are emerging in Europe? • What tools can be used to appraise and strengthen governance capacity in countries? XI HIA International Conference In Times of Crisis, Healthier Ways

In-depth analysis of implementation XI HIA International Conference In Times of Crisis, Healthier Ways

Sub-national level experiences Slovenia MURA Project Pomurje Czech Republic Liberec United Kingdom North West Region of England Italy Veneto South Moravia Tuscany South Bohemia Friuli Venezia Giulia XI HIA International Conference In Times of Crisis, Healthier Ways

The need for good governance The issue of health inequities needs to be a wholeof-government priority to be addressed through a coherent set of policies and interventions on a scale appropriate to the trends and magnitude of the problem in the country Source: http: //www. scotland. gov. uk XI HIA International Conference In Times of Crisis, Healthier Ways

1. Analyse the context • What trends can we identify in relation to governance for SDH/HI? • What factors determine whether or not SDH/HI are on the agenda? • What factors are associated with governance principles such as ‘whole of government approach or “policy consistency” among different levels of policy-making? XI HIA International Conference In Times of Crisis, Healthier Ways

2. A tool to assess and strengthen governance capacity A. B. C. D. E. F. G. H. I. J. K. L. Sustained policy commitment Robust and equity oriented Health System Active intersectoral working Sustained funding mechanism A high priority for health Social capital and cohesion for health Public engagement and community participation Accountability for health inequities Health intelligence Monitoring of system performance Communication and advocacy Other according to country context XI HIA International Conference In Times of Crisis, Healthier Ways

3. Know the different levels of governance Joint new policy Integrated Policies Coordination Cooperation Adjusted + more efficient sectoral policies More efficient sectoral policies Source: Adapted from Meijers E, Stead D. Policy integration: what does it mean and how can it be achieved? A multi-disciplinary review. Delft University of Technology OTB Research Institute fir housing, Urban and Mobility Studies. XI HIA International Conference In Times of Crisis, Healthier Ways

Give him charity, girl, as there is nothing worse in life than being blind in Granada. Francisco Alarcón de Icaza, Venezuelian writter. THANK YOU XI HIA International Conference In Times of Crisis, Healthier Ways