Systems theory to guide the implementation of health in all policies (1)
- 1. Systems theory to guide the implementation of Health in All Policies Shankardass K, Muntaner C, Kokkinen L, Shahidi FV, Freiler A, Oneka G, Bayoumi A, O’Campo P #passtheHPtorch
- 2. The immense challenge of addressing structural determinants of health (Solar and Irwin, 2007) harmonics-hiap.ca
- 4. HARMONICS systems theory • Interdisciplinary study with goal of discovering patterns and elucidating system principles • Implementation outcomes emerge from the interaction of social system components - Hard to manipulate the system and predict outcomes as the system operates in non-linear ways and are resistant to change • Permeable boundaries, so the external environment can be influential
- 5. Systems Framework of HiAP Implementation California Quebec South Australia Sweden Norway Finland Ecuador Thailand Scotland (Shankardass et al, Forthcoming)
- 6. Systems Framework of HiAP Implementation California Quebec South Australia Sweden Norway Finland Ecuador Thailand Scotland (Shankardass et al, Forthcoming)
- 7. Systems Framework of HiAP Implementation (Shankardass et al, Forthcoming)
- 8. Systems Framework of HiAP Implementation (Shankardass et al, Forthcoming)
- 9. Systems Framework of HiAP Implementation (Shankardass et al, Forthcoming)
- 10. What strategies should be used to engage policy sectors into HiAP? • The “win-win” approach (Ollila, 2011) aims for health gains without diminishing the primary intention of participating sectors • We find that the “win-win” approach is the most effective for facilitating the implementation of HiAP (Molnar et al 2016) harmonics-hiap.ca
- 11. How do you facilitate a “win-win” approach? • Development of a shared language across sectors • Use of scientific evidence for credibility • Integrating health into other policy agendas & dual outcomes • Use of tools (HIA) to facilitate policy coordination But why does this work? harmonics-hiap.ca
- 15. Benefits of systems approach (i) Theory to contextualize the complex and emergent processes of implementation to explain how and why HiAP to succeed or fail, (ii) Acknowledgement of the whole system, including interrelationships between government subsystems and specific components, (iii) Consideration of how external influences impact government systems in HiAP implementation (iv) Policy-makers can better understand their government systems and plan change strategies that anticipate potential challenges and synergies for HiAP implementation. harmonics-hiap.ca
- 17. • Molnar A, Renahy E, O'Campo P, Muntaner C, Freiler A, Shankardass K. Using win-win strategies to implement Health in All Policies: a cross-case analysis. PLOS One. 2016 DOI: 10.1371/journal.pone.0147003. • Freiler A, et al. Glossary for the Implementation of Health in All Policies (HiAP). J Epidemiol Commun Health, 2013. 67:1068-1072 • Shankardass K, Renahy E, Muntaner C, O’Campo P. Explanatory Case Studies to Strengthen the Implementation of Health in All Policies. Health Policy Plann. 2014 DOI: 10.1093/heapol/czu021. • Pinto AD, Molnar A, Shankardass K, O'Campo P, Bayoumi A. Economics of Health in All Policies in Sweden, Quebec and South Australia. BMC Public Health. 2015 15:171 DOI: 10.1186/s12889-015-1350-0. • Shankardass K, et al. A scoping review of intersectoral action for health equity involving governments. Int J Public Health, 2012. 57(1):25-33 Thank you! harmonics-hiap.ca