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Thursday, May 30, 2013

Cross-country analysis of the institutionalization of Health Impact Assessment.

A new just-published and very valuable publication:

Cross-country analysis of the institutionalization of Health Impact Assessment.
Social Determinants of Health

Jennifer h. lee, Nathalie Röbbel and Carlos Dora
Discussion Paper Series 8 (Policy & Practice). Geneva, World Health Organization, 2013

“…..There has been increasing international attention on the potential for using Health Impact Assessment as a way to mainstream health into sector policies, as evidenced during the World Conference on Social Determinants of Health (Rio de Janeiro, October 2011) and the United Nations Conference on Sustainable Development (Rio de Janeiro, June 2012).  The institutionalization of HIA is a clear indicator of a country's implementation of a Health in All Policies agenda. 
A number of countries have adopted legislative frameworks and governance mechanisms to consider the impact of policies, programmes or projects on health. 
However, differences in the political, socioeconomic and institutional settings may lead to substantial variations in the use and institutionalization of HIA
This report presents the findings of a cross-country study that describes and compares the institutionalization of HIA in nine (mainly middle- and high-income) countries and the European Union.  It aims to provide greater insight to the enabling and limiting factors of HIA implementation and institutionalization and concludes with recommendations to increase and improve HIA practice.

The key factors enabling institutionalization of HIA were legislation; political willingness; involvement of research communities; awareness of the inadequacy of Environmental Impact Assessment or other assessments in considering health; capacity and resources; availability of international committal documents and tools; and public participation.
Challenges to institutionalization and systematic implementation included lack of clarity around methodology and procedures; narrow definitions of health; lack of awareness of relevance to other sectors; and insufficient funding and tools. 
Based on their experiences, key informants proposed these core recommendations: embed HIA in national normative systems; clarify definition and operationalization of HIA and develop guidelines and methodological criteria; strengthen and build capacity for HIA practice; and improve cooperation between sectors….”

….Dissemination of the report findings to relevant audiences, mainly policy-makers and public health practitioners, is essential for them to benefit from the implementation and institutionalization experiences of other countries….”

Executive summary
3.1 Degree of and mechanisms for institutionalization
3.1.1 Degree of institutionalization
3.1.2 Mechanisms for institutionalization
3.1.3 Factors that led to institutionalization
3.2 Political setting and context
3.2.1 Political support and commitment
3.2.2 Opposition
3.2.3 Triggers for HIA
3.2.4 Where in the policy cycle does HIA fit?
3.3 Framing: forms and types of HIA used
3.3.1 Stand-alone Health Impact Assessment (HIA)
3.3.2 Environmental Impact Assessment (EIA)
3.3.3 Strategic Environmental Assessment (SEA)
3.3.4 Integrated Impact Assessment (IIA)
3.3.5 Health Lens Analysis (HLA)
3.3.6 Scope of the health impacts assessed
3.3.7 What HIA covered
3.3.8 Comprehensiveness of HIA
3.4 Implementation, resource requirements and structures
3.4.1 Implementation
3.4.2 Actors and stakeholders
3.4.3 Capacity and pool of experts
3.4.4 Funding
3.4.5 Data availability and monitoring
3.4.6 Knowledge transfer
3.4.7 Public participation
3.5 Outcomes and conclusions
3.5.1 Factors that led to institutionalization
3.5.2 Integration of HIA through other assessments
3.5.3 Limiting factors
4.1 Embed HIA in national normative systems
4.2 Clarify definition and operationalization of HIA and develop guidelines and methodological criteria
4.3 Strengthen and build capacity for HIA practice
4.4 Improve cooperation between sectors
5.Next steps

Annex A. Analytical framework: key dimensions and questions addressed
Annex B. S ummary of country findings by dimensions of the analytical framework

The whole book can be found in pdf format:


Sunday, May 26, 2013

The first Country Cooperation Strategy in the European Region of WHO signed

WHO and Switzerland sign country cooperation strategy

From left, Zsuzsanna Jakab, WHO Regional Director for Europe, Alain Berset, head of the Federal Department of Home Affairs of Switzerland, and Margaret Chan, WHO Director-General, signing a country cooperation strategy. Photo: WHO/Chris Black

On 20 May 2013, Switzerland and WHO signed a country cooperation strategy (CCS), highlighting opportunities and challenges for stronger cooperation between Switzerland and the WHO Secretariat.
Mr Alain Berset, head of the Federal Department of Home Affairs of Switzerland, thanked WHO for its work, and Dr Margaret Chan, WHO Director-General, congratulated Switzerland for making this important commitment.

At the signing, Dr Chan praised Switzerland for its “top political commitment, both as a host country for WHO, and in showing its support for the current WHO reform.”

The collaboration between WHO and Switzerland will follow four strategic areas:
  • exchange of information and expertise on noncommunicable diseases, nutrition and food policies, mental health and substance-use issues;
  • stronger cooperation on national health systems, with emphasis on health personnel;
  • support to WHO in strengthening its leadership in global health governance, in accordance with its constitutional mandate, by making use of the enabling environment available in Geneva; and
  • enhanced collaboration in countries given priority by the Swiss Agency for Development and Cooperation (SDC).
Ms Zsuzsanna Jakab, WHO Regional Director for Europe, thanked Mr Berset for the process through which the CCS was developed (including close collaboration with WHO at the global, regional and national levels, which demonstrated a coordinated approach among them) and for contributing to new guidelines for CCSs.

Ms Jakab underlined that this model gave WHO an opportunity to make collaboration agreements with countries without WHO country offices. This type of agreement fosters policy coherence and ensures WHO collaboration in strategic areas that benefits not only the Member State concerned but also countries to which it gives development aid.

The CCS with Switzerland is the first signed with a Member State in the WHO European Region.

More information  on

Saturday, May 25, 2013

Just published: A new valuable book of the European Observatory on Health Systems and Policies

Health in All Policies: Seizing opportunities, implementing policies

Health in All Policies (HiAP) is an approach to policies that systematically takes into account the health and health-system implications of decisions, seeks synergies, and avoids harmful health impacts to improve population health and health equity. It is founded on health-related rights and obligations and has great potential to improve population health and equity.

However, incorporating health into policies across sectors is often challenging and even when decisions are made, implementation may only be partial or unsustainable.

This volume published in collaboration with the National Institute for Health and Welfare of Finland (THL), the European Observatory on Health Systems and Policies, and the UN Research Institute for Social Development aims to improve our understanding of the dynamics of HiAP policy-making and implementation processes. Drawing on experience from all regions, and from countries at various levels of economic development, it demonstrates that HiAP is feasible in different contexts, and provides fresh insight into how to seize opportunities to promote HiAP and how to implement policies for health across sectors.

Part I sets the scene with five chapters on the concept and history of HiAP, links between socioeconomic development and health, the social determinants of health, and the importance of preserving national policy space for health in a globalizing world. Part II assesses progress in eight policy areas including early childhood development, work and health, mental health promotion, agriculture, food and nutrition, tobacco, alcohol, environment and development assistance. Part III draws together lessons for the health sector, as well as for politicians, policy-makers, researchers and civil society advocates.

The volume is available here:

The European Observatory on Health Systems and Policies supports and promotes evidence-based health policy-making through comprehensive and rigorous analysis of the dynamics of health care systems in Europe.
The Observatory is a partnership between the World Health Organization Regional Office for Europe, the Governments of Belgium, Finland, Ireland, the Netherlands, Norway, Slovenia, Spain, Sweden, and the Veneto Region of Italy, The European Commission, the European Investment Bank, the World Bank, UNCAM (French National Union of Health Insurance Funds), the London School of Economics and Political Science (LSE), and the London School of Hygiene & Tropical Medicine (LSHTM).

Thursday, May 23, 2013

Just published by WHO Regional Office for Europe: About Floods in Europe

Floods in the WHO European Region: health effects and their prevention

(Edited by Bettina Menne and Virginia Murray)
Book coverIn 2009–2011, the WHO Regional Office for Europe and the United Kingdom Health Protection Agency undertook a project to investigate the adverse health effects of floods and to understand how best to protect the health of populations during floods in the WHO European Region. The project had two main components. A questionnaire was sent to 50 of the 53 Member States of the WHO European Region to collect information on recent experience of floods, their health effects and current preparedness and response mechanisms. In addition, a systematic review was undertaken of the epidemiological literature on the global impact of flooding on health. Analysis of the returned questionnaires and the peer-reviewed literature brought to light many issues pertinent to Europe. These findings will help WHO to prepare evidence-based guidance for the European Region on health concerns before, during and after flooding incidents and the measures for prevention, response and recovery.
This publication is only available online.

A new publication of WHO Regional Office for Europe on health effects of particulate matter

Health effects of particulate matter. Policy implications for countries in eastern Europe, Caucasus and central Asia
bBok coverDespite some improvements, current levels of air pollution still pose a considerable risk to the environment and to human health in the WHO European Region. One issue of concern is that monitoring of particulate matter is very limited in the countries of Eastern Europe, the Caucasus and central Asia. This paper summarizes the evidence about the health effects of air pollution from particulate matter and presents the policy implications, the aim being to stimulate policy-makers to develop more effective strategies to reduce air pollution and its health effects in those countries.

The 26th Issue of the Regional Cooperation Council´s (RCC) for South East Europe Newsletter is out: In focus

Two days ago the RCC uploaded the 26th Issue of its Newsletter.

This issue is entirely dedicated to the ongoing process of developing the SEE 2020 Growth Strategy.

This is a response of the countries of the region, members of the South East Europe Cooperation Process and the Regional Cooperation Council to deal with their outstanding economic, social and development challenges.

Within this process the RCC has established the Social Agenda 2020 Regional Working Group with well specified objectives, functions and outputs. The objective of the working group is to build on current national and regional social development priorities and actions to prepare a regional long term social development strategy and action plan for the Western Balkans, the so called Social Agenda 2020.

The Social Agenda 2020 regional Working Group is expected to:

·    Develop Social Agenda 2020, as a strategic document composed of a set of regionally coordinated social development priorities;
·    Map current interventions against the priorities and assess the extent to which these priorities are appropriately addressed;
·    Identify actions to address challenges, advising on regional and sub-regional cooperation to advance the implementation;
·    Develop key performance indicators;
·    Advise on the monitoring and evaluation of actions that contribute to the implementation of Social Agenda 2020;
·    Identify means of improving data collection and the ongoing measurement and evaluation
·    Meet annually to review the implementation of the strategies, gauge success and recommend adjustments to the strategies or goals-

At the end of the process and prior to the endorsement of the SEE 2020 Strategy as a whole in November 2013, the following outcomes are expected:
·    Social development framework that sets out strategic objectives and headline targets for social development until 2020;
·    Priorities at the policy and initiative level;
·    Key performance indicators and expected results;
·    An implementation plan;
·    A budget framework;
·    An international support strategy that incorporates the roles and responsibilities of partners;
·    Organizational and institutional arrangements.

The SEE Health Network is an active partner in this process.

It is also currently in an intensive process of developing the health aspects of inclusive growth to be an unseparable part of the SEE 2020 Strategy´s Growth pillar.

Additionally, the SEE Health Network is developing its own SEEHN Health 2020 Strategy and Action Plan. These document will be fully aligned to its own as well as to the global and European policies and commitments, namely:
  • the SEEHN Banja Luka Pledge of 2011 "Health in All Policies: A Shared Goal and Responsibility!;
  • the WHO Europe Health 2020 Policy and the European Action Plan for Strengthening Public Health Capacities and Services;
  • the EU 2020 Strategy.
To learn more on the why, what, how and when questions, please, read the articles of the 26th Issues of the RCC Newsletter.

You can find them following the link:
Newsletter 26/2013
May 21, 2013
Nand Shani, Expert on Economic and Social Development, RCC Secretariat (Photo: RCC)
The unemployment rates in the Western Balkan countries, already at precarious levels at the onset of the global economic crisis, have deteriorated sharply...
Political consensus, economic and social prosperity depend on close cooperation with neighbouring countries
Unemployment, skills and jobs mismatch on labour markets, poor labour mobility, inadequate education systems, insufficiently developed life-long learning systems, etc. are just some of the common issues that seek attention...
The RCC has put forth education as a key strategic priority in South East Europe (Photo:
Health issues are very sensitive in every society. Providing good health services to citizens in budget-conscious environments, such as South East European (SEE) countries, is a rather ‘painful’ agenda,..
Ensuring health equity is an important priority for the region (Photo:
Will Bartlett, Senior Research Fellow in the Political Economy of Southeast Europe, The London School of Economics and Political Sciences (LSEE), Social Cohesion Research Network (Photo: Courtesy of Mr. Bartlett)
"Economic growth in South East Europe has been interrupted by both the global economic crisis and the deepening crisis in the Eurozone... "
read more
Will Bartlett
Senior Research Fellow, London School of Economics

Tuesday, May 21, 2013

The WHO e-Atlas of disaster risk for the European region

Floods are the most common natural disaster in the WHO European Region, with effects on health ranging from drowning and injuries to infectious diseases and mental health problems. There are many more, however.

WHO Regional Office for Europe has developed an excellent e-Atlas which has just been launched on its public website. It provides maps of the level of risk of five natural types of disasters in Europe. One can see the risk for earthquakes, floods, heat waves, etc, for the whole European region as well as for individual countries.

For all countries of the SEE Health Network this e-Atlas will help, while using, to strengthen the capacities of the health system and their public health preparedness.

Please find the link to the WHO Europe e-Atlas:

Monday, May 20, 2013

Sixty-sixth World Health Assembly opens today

Today, 20 May 2013, the Sixty-sixth World Health Assembly opens in Geneva, as officials from 194 Member States begin their annual review of the activities of WHO and set new priorities for the future.

The World Health Assembly is the supreme decision-making body of WHO. It is attended by delegations from all WHO Member States and focuses on a specific health agenda prepared by the Executive Board.

The main functions of the World Health Assembly are to determine the policies of the Organization, appoint the Director-General, supervise financial policies, and review and approve the proposed programme budget. The Health Assembly is held annually in Geneva, Switzerland.

The Health Assembly will discuss specific health topics like noncommunicable diseases with a draft Action Plan till 2020, mental health with a draft Action Plan till 2020, universal health coverage, the Millenium Development Goals, the implementation of the International Health regulations, women and children’s health, as well as the programme budget, administration, reform and management matters of WHO.

The programme and all working documents can be downloaded using the link to the World Health Organization website which provides full coverage of the WHA.

Follow the link:

Friday, May 17, 2013

WHO Global status report on road safety

The World Health Organization (WHO) has just published the

Global status report on road safety

The Global status report on road safety 2013 presents information on road safety from 182 countries, accounting for almost 99% of the world’s population. The report indicates that worldwide the total number of road traffic deaths remains unacceptably high at 1.24 million per year. Only 28 countries, covering 7% of the world’s population, have comprehensive road safety laws on five key risk factors: drinking and driving, speeding, and failing to use motorcycle helmets, seat-belts, and child restraints.
This report serves as a baseline for the Decade of Action for Road Safety 2011-2020, declared by the UN General Assembly. Made possible through funding from Bloomberg Philanthropies, this is the second in a series of Global status reports.

This information comes timely for the SEE Health Network and the Regional Cooperation Council who are in the process of developing the SEE 2020 Strategy.

You can find the full report on the following link:

Wednesday, May 15, 2013

Formalizing an old partnersip: the South-eastern Europe Health Network (SEEHN) and the International Organization for Migration (IOM) will sign a Memorandum of Undertsnading in June 2013

On 20 June 2013, at its 31st Plenary Meeting in Chisinau, Republic of Moldova, the South-eastern Europe Health Network (SEEHN) will sign a Memorandum of Understanding for partnership and cooperation with the International Organization for Migration (IOM), under its Moldovian Presidency .

The history of cooperation between the SEEHN and IOM is long-standing since 2005 immediately after the SEE Second Health Ministers Forum "Health and Economic Development in SEE", November 2005, Skopje, Republic of Macedonia.

Family photo of all participants
of the SEE Third Health Ministers Forum,
October, 2011, Banja Luka,
Bosnia and Herzegovina
The signed Banja Luka Pledge, October 2011


The Signatories of the Banja Luka Pledge,
the IOM Reptresentative amidst
In 2011, at the SEE Third Health Ministers Forum "Health in All Policies: A Shared Goal and Objective", 2011, Banja LUka, Bosnia and Herzegovina, the IOM committed itself to the SEEHN political pledge by signing it.

Since 2005, IOM, though in the capacity of an observer, has played an important role and has contributed to many areas of the regional cooperation in the SEE regaion both, on a country or multi-country basis, in the following areas:

  • health of and health services for minority groups of the population;
  • cross-border heath services for migrants;
  • migration of health workforce;

About the IOM:

IOM is an International Organization committed to the principle that humane and orderly migration benefits migrants and society.
'The Organization was established in December 1951 and began its operations in early 1952 as the Intergovernmental Committee for European Migration. Its Constitution was adopted on 19 October 1953 and came into force on 30 November 1954. Amendments were made to the Constitution, effective 14 November 1989, and the Organization was renamed the International Organization for Migration. The Organization possesses full juridical personality and has its Headquarters in Geneva. It currently has 149 Member States.

The Organization's organs are the Council, the Executive Committee and the Administration.
As the leading international organization for migration, IOM acts with its partners in the international community to:
  • Assist in meeting the growing operational challenges of migration management.
  • Advance understanding of migration issues.
  • Encourage social and economic development through migration.
  • Uphold the human dignity and well-being of migrants.
IOM's Strategic Focus is:
  1. To provide secure, reliable, flexible and cost-effective services for persons who require international migration assistance.
  2. To enhance the humane and orderly management of migration and the effective respect for the human rights of migrants in accordance with international law.
  3. To offer expert advice, research, technical cooperation and operational assistance to States, intergovernmental and non-governmental organizations and other stakeholders, in order to build national capacities and facilitate international, regional and bilateral cooperation on migration matters.
  4. To contribute to the economic and social development of States through research, dialogue, design and implementation of migration-related programmes aimed at maximizing migration's benefits.
  5. To support States, migrants and communities in addressing the challenges of irregular migration, including through research and analysis into root causes, sharing information and spreading best practices, as well as facilitating development-focused solutions.
  6. To be a primary reference point for migration information, research, best practices, data collection, compatibility and sharing.
  7. To promote, facilitate and support regional and global debate and dialogue on migration, including through the International Dialogue on Migration, so as to advance understanding of the opportunities and challenges it presents, the identification and development of effective policies for addressing those challenges and to identify comprehensive approaches and measures for advancing international cooperation.
  8. To assist States to facilitate the integration of migrants in their new environment and to engage diasporas, including as development partners.
  9. To participate in coordinated humanitarian responses in the context of inter-agency arrangements in this field and to provide migration services in other emergency or post-crisis situations as appropriate and as relates to the needs of individuals, thereby contributing to their protection.1
  10. To undertake programmes which facilitate the voluntary return and reintegration of refugees, displaced persons, migrants and other individuals in need of international migration services, in cooperation with other relevant international organizations as appropriate, and taking into account the needs and concerns of local communities.
  11. To assist States in the development and delivery of programmes, studies and technical expertise on combating migrant smuggling and trafficking in persons, in particular women and children, in a manner consistent with international law.
  12. To support the efforts of States in the area of labour migration, in particular short term movements, and other types of circular migration.
1 Although IOM has no legal protection mandate, the fact remains that its activities contribute to protecting human rights, having the effect, or consequence, of protecting persons involved in migration.

You can learn more about IOM and its activities following the link:

SEEHN and its partnerships:

Since 2011, after its Third Health Ministers´Forum, Banja Luka, Bosnia and Herzegovina, October 2011 the South-eastern Europe Health Network, one of the initiatives of the Regional Cooperation Council (RCC) and the SEE Regional Cooperation Process (SEERCP) in the area of public health and health systems, has moved to a new stage of development.

To date partnerships and networking are amongst the most important of its major directions of work.

Since then the SEEHN has continued to expands its partnerships after having signed Memoranda of Understanding with EuroHealthNet, the International Network of Health Promoting Hospitals and Health Services, the European Health Forum Gadstein and Project Hope.

This is in addition to its traditional partneship, since its commencement in 2001, with the Council of Europe, the Council of Europe Development Bank and WHO Regional Office for Europe.

The European Commission, DG Sanco, has been an active observer since 2005.