Health in All Policies: evaluating the South Australian approach to intersectoral action for health.

OBJECTIVES: Health in All Policies (HiAP) has been promoted as a means of embedding concern for health impacts in the policy-making process. In South Australia, specific structures and processes to achieve this have been developed and tested. PARTICIPANTS: The HiAP approach is designed to engage policy officers and managers in all sectors of government. SETTING: South Australia, one of six Australian states, which operates under a system of cabinet government. There are 15 government departments. INTERVENTION: The primary mechanism of the South Australian HiAP approach is the health lens analysis (HLA) - an intersectoral, partnership process drawing on public health research methods. It has been applied to three separate public policy issues: water security, digital technology and migration. OUTCOMES: Evaluation findings to date suggest that the HLAs have resulted in the following: increased understanding by policy-makers of the impact of their work on health outcomes; changes in policy direction; development and dissemination of policy-relevant research; greater understanding and stronger partnerships between health and other government departments; and a positive disposition toward employing health lens analyses in future work. CONCLUSION: There have long been calls for intersectoral action in order to achieve public policy supportive of positive health outcomes. Evaluation to date suggests that the HLA is a promising means of moving the agenda from policy rhetoric to policy action.

Building an evidence base for community health: a review of the quality of program evaluations.

An assessment of the quality of program evaluations conducted in South Australian community health services investigated how effective evaluation reporting is in producing an evidence base for community health. Evaluation reports were assessed by a team of reviewers. Practitioner workshops allowed an understanding of the uses of evaluation and what promotes or acts as a barrier to undertaking evaluations. Community health services do undertake a good deal of evaluation. However, reports were not generally explicit in dealing with the principles that underpin community health. Few engaged with program theory or rationale. Typically, reports were of short-term projects with uncertain futures so there may seem little point in considering issues of long-term health outcomes and transferability to other settings. The most important issue from our study is the lack of investment in applied health services research of the sort that will be required to produce the evidence for practice that policy makers desire. The current lack of evidence for community health reflects failure of the system to invest in research and evaluation that is adequately resourced and designed for complex community settings.