[MUSIC] Health impact assessments, follow a systematic series of steps to make recommendations to optimize the health effects, proposals whose primary objectives are not health. While there is no single agreed framework or tool for undertaking health impact assessments, there is consensus about the core stages of the process. I will now share with you more details on those core stages so that you have a framework that you can use for conducting health impact assessments yourself or as part of a team. This diagram gives an overview of the health impact assessment process, which includes the stages within the WHO framework. Screening, scoping, appraisal, reporting, and monitoring, let's explore the five stages of the process in more detail. It is not possible to carry out a health impact assessment on every policy, strategy, program, or project. Therefore, screening is used to systematically decide when to do a health impact assessment. Questions to consider include, will the policy have a direct impact on health, mental health and wellbeing? For example, would it cause ill-health or affect social inclusion, independence and participation? Will the policy affect an individual's ability to improve their own health and well-being? For example, will this affect their ability to be physically active, choose healthy food, reduce drinking and smoking? Once you've considered these questions, you should have the information you need to decide whether it is appropriate to conduct a health impact assessment for the proposal under consideration. If you've decided that a health impact assessment is needed, then the next stage is scoping. This stage sets the boundaries for, and considers how, the subsequent appraisal stage should be undertaken. Setting and agreeing the aims and objectives and establishing the terms of reference for the health impact assessment are often done at this stage. to clarify exactly what's expected and from whom. Questions to consider include, who will do a health impact assessment, and who will be in charge? When does the health impact assessment have to be done by, to influence key decision makers? What is your population or communities of interest? When you have the answers to these questions, you will have a clearer idea of the scope and some of the logistical aspects of conducting the health impact assessment. You are then ready for stage three of the process. Stage three is the appraisal. This includes the key set of activities to investigate, appraise, and qualitatively or quantitatively rank the impacts that proposal is likely to have on the health of the defined communities. Normally, the best available qualitative and quantitative evidence would be collated at this stage. Using a range of methods, including literature reviews, interviews, focus groups, surveys and community profiling. When profiling the existing health of the community, it is important to include data about health outcomes and determinants of health desegregated by income. Race, gender, age and place when possible. Evaluating potential health impacts using the best available evidence. A health impact assessment should present reasoned predictions of the ways in which a proposed decision could impact population health The spectrum of potential impacts, their relative importance, and at what level they are expected to occur is determined at this stage. A key output of a health impact assessment is a set of evidence based recommendations to mitigate negative and maximize positive health impacts of the proposal. This takes place at the reporting stage. Your recommendations should be responsive to predict impacts, specific, measurable and actionable, technically feasible, and experience and/or evidence based. Engagement with decision makers to encourage adoption of recommendations or adaptation in the proposal is also a crucial aspect in this stage. This should include a communication plan to disseminate findings and develop consensus among decision makers and other stakeholders regarding key conclusions and recommendations. The final stage is monitoring. To assess if the health impact assessment recommendations were implemented, if they contributed to positive effects on health and equity, and if not, why not? Monitoring is critical to ensure that any recommendations that decision makers agree to actually occur and whether actions based on those recommendations improved health or health promoting behaviors of the community. One final point I want to mention, you have to be realistic about the time and resources that you have to conduct a health impact assessment. Sometimes, you can only conduct a quick or a rapid health impact assessment if you only have a few days or weeks. This doesn't mean you can't be thorough. But you have to be transparent about the evidence you use and the level of depth of the assessment. If time and resources permit, it is always better to conduct a comprehensive health impact assessment, which will involve an extensive appraisal stage. When you information is generated, significant literary views undertaken and comprehensive involvement of stakeholders often occurs. In summary, I have now introduced to you a framework for conducting health impact assessments with five core stages. These stages are screening, scoping, appraisal, reporting and monitoring. Systematically working through these five stages will give you the best possible chance of successfully conducting and completing your health impact assessment in a robust and logical way. [MUSIC]
