health impact assessment qu é bec ’ s experience clémence dallaire, laval u, geneviève hamel,...
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Health Impact Assessment Québec’s experience
Clémence Dallaire, Laval U, Geneviève Hamel, MSSSGeneviève Lapointe, INSPQ
Québec
Population (2004) :
7,5 millions hab. Territory : 1,7 million km2
Province in a confederation Federal health law with 5 principles
Fiscal money transfert
Health: provincial jurisdiction Provincial health law Ministry of Health and Social Services
Public Health within Québec's Health and Social Services System
18 regional agencies/ PHRA
Hospitals Health and social services centers
Minister
Ministry of Health and Social Services
NPHD/ADM
Administratives (RAMQ)
Councils
National Public Health Institute
Public Health Law (2001)
Putting in place the conditions for public health main functions • Protection
• Promotion
• Prevention
• Surveillance
Divide responsabilities between national, regional and local level
Legal framework to act on public policy
three articles: 53-54-55
Québec Public Health Act Article 54
« The Minister is by virtue of his or her office the advisor of the Government on any public health issue. The Minister shall give the other ministers any advice he or she considers advisable for health promotion and the adoption of policies capable of fostering the enhancement of the health and welfare of the population.
In the Minister's capacity as government advisor, the Minister shall be consulted in relation to the development of the measures provided for in an Act or regulation that could have significant impact on the health of the population. »
Application strategies Intra-gouvernmental HIA process
NIPHQ: expertise Research
NIPHQ
Health & WelfareMinistry
Health & WelfareMinistry
Ministries
Executive Council
Ministers Council
GÉPPS
Research
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3
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Intra-gouvernmental HIA process
MHSS
What has been done to implement and to apply article 54 since 2002 ?
Elaboration of practical guide and tools for HIA A network of interministerials respondents
Horizontal mechanism to mobilize partners within Health ministry
1
Since 2002, it appears that
The other ministry's preoccupation with HIA differ: • along social or economic mission
Little use of the tools produced
Consultation if any • towards the end of the policy decision making process
• Consultation on very short notice
(ENAP, 2003; MSSS, 2005)
Executive Council : act as a security net
3 permanent ministerials committee social, economic and regional
The ministerial committee of social development: make sure that the best process to support decision making are used
93% of the demand for consultation to the Health ministery (62/67) during 2005 were send by the Executive Council in about half of those, there has been informal consultation between civil servants of different Ministries and the Health Ministry
At the very end of the process: security net
1’
Overview of the decision–making process
LegislativeAssembly
Council
of
Minister
ministerials
Committee
Minister
of Health
Elaboration of laws, regulation or program
Minister's power
Brief to C of M
Analysis
Decision to proceed
Autorization to send it to Legislative Assembly
Analysis in
Parliamentary
commission
AdoptionRecomman-dations to
C of M
1st step 2nd step 3rd step
NIPHQNIPHQ
Health Ministry
other ministries
Executive Council
Council of Ministers
GÉPPS
Research
… …
MHSS and NIPHQ
• Produce synthesis of public policies and brief for the Health Minister
• To facilitate access to expertise and scientific knowledge repertoire of experts conference and scientific meetings Data Base
Web site: Portail
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Portail Politiques publiques et santé
Launched in november 2004
Veille : 750 information sources
Content and utilization :- Visitors : 2 000 /month- Bimonthly bulletin ( 30 issues + 400
subscribers)- Publications database (800 items)
· Health determinants and risk factors · Healthy public policy · HIA
- Links (26 sites)- List of ressources (under development )
- http://politiquespubliques.inspq.qc.ca
Beyond article 54
NPHIQNPHIQ
National Collaborative Center on Public Policy and Risk Assessment
1 of 6 Canadian Centers in a newly established Public Health Network
Based on Quebec's experience
• Policy and knowledge transfert
• Pan canadian and international networking:
research , knowledge transfert, healthy public policy and HIA
CCN-PR
CCN-PR
NIPHQ
Health Ministry
Other ministries
Executive Council
Council of Minister
GÉPPS
ResearchResearch
… …
Research
Objectives
• To increase research and expertise capacity • To support tools development for HIA• To support knowledge transfert to policy makers
Exemples: GÉPSS
Concours projet: politiques publiques / saines habitudes de vie
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GÉPPS - Program of research
To increase understanding of the healthy public policy process
To increase understanding of ethical and analytical issues related to healthy public policy process
To develop and implement a strategy of knowledge transfert and utilization that support healthy public policy process
To test new processes and tools for knowledge transfert and utilization
Axes de recherche
1) Decision-making process of a subsystem of public policy
(Sabatier,1999)
2) Prospective evaluation process of public policy
3) Transfert and knowledge utilization process
Program of research : 6 projects
s Projects Objectives
1-2-3 1. Collaborative reseach and partnership
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1-2-3 2. Litterature review 1-2-3
1 3. Analysis of public policy subsystem
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1-2 4. Analysis of policy-makers and decision-makers's values and beliefs
1
2 5. Analysis of HIA experiences and policy transfer
1
2-3 6. Integration of a prospective assessment process
3-4
What's next ?
Common goal To ensure an evidence-based policy decision-making
process
How?
By developing useful knowledge on policy-making and by using knowledge on health determinants
By sharing this knowledge with policy-makers
By supporting the HIA process within Ministries and Organisms
THANK YOU
Jean Turgeon, Enap, Responsable et chercheur principal
France Gagnon, Téluq, Chercheure principale Clémence Dallaire, ULaval, Chercheure principale
Jacques Auger, Oap/Enap, Collaborateur
Danielle Blondeau, ULaval, Co-chercheure
Jacques Bourgeault Enap/Uqam, Co-chercheur
Louis Côté, Oap/Enap, Co-chercheur
Louis Demers, Enap, Co-chercheur
Lucie Richard, UdeMontréal, Collaboratrice
Mélanie Michaud, Enap, Professionnelle de recherche