The HIAP Approach in South Australia

Discuss about the Health In All Policies In South Australia.

Health has always been a key building stone in the economy of every country.  Healthier countries make much progress economically, socially and politically. The fact that healthy populations work far much better than unhealthy ones is undeniable as the ability to work highly relies on the bodily conditions. Many countries lay more focus towards ensuring that their citizens are healthy majorly by addressing the social determinants of health. Over the past decades, this approach has been proved to work especially in the cases when an intersectoral dimension is engaged (Eyk, et al., 2017). Involving all sectors in promoting health helps to create an ideal health system free from discrimination. The progress of this approach is highly dependent on the policies made within the sectors outside the health units. Ideally, public policies are vital levers that can be used to address key social matters such as inequality. Policies constitute the problems in a given institution and the strategies put in place to address them (Bacchi, 2016).

Health in All Policies (HIAP) was a prime recommendation in South Australia in 2007 by Professor Kickbusch, a globally renowned health expert (SA Health, 2017). The most fundamental problem that the policy was raised to address the inequity depicted by many health institutions in the region. The HIAP approach was believed to bring forth an improving in the health facilities and aid in achieving the overall goals of South Australia’s Strategic Plan (SASP) (Peña, 2018). The innovation was introduced to further South Australia’s commitment to a joined-up ruling system. More importantly, the HIAP policy is an extension of the greater European HIAP strategy in a bid to better health systems through the achievement of targets in the other sectors (Peña, 2018). Generally, HIAP helps in loosening the bonds between theory and practice.

HIAP is grounded on the presupposition that health is not a sole product of the actions performed in healthcare facilities (Delany, et al., 2016). It is rather influenced by a range of economic, political, environmental, social and cultural practices. Thus, in order to curb the multifaceted, complicated problems such as avoidable chronic illnesses and high healthcare expenditures, it is necessary to structure co-joined policy responses. The HIAP is expected to work in close relationship with the government to achieve the desired outcomes and benefit all the agencies involved as well as to improve the health and the well-being of the population (Bacchi, 2015).

Relationship Between HIAP and Other Policies

HIAP was established in South Australia in 2007 and has been highly backed up by the central government (Baum, 2008). Since its establishment, the policy has greatly evolved to remain relevant despite the changing trends. Although the contexts have been changing, the core principles and goals of the approach have remained constant and unchanged over the years (SA Health, 2016). The HIAP policy in South Australia seeks to anchor and build a solid relationship between all sectors across the government. This strategy will facilitate a state of mutual benefits both in the health departments and the partnering sectors. The incorporation health focus in the development of policies in different sectors will enable the government to address the social, political and economic determinants of health more systematically and with much ease.

Although the goals of the HIAP have remained constant over time, the South Australian Cabinet on February 2011 approved a number of strategic key priorities to be propelled by the policy (Kickbusch, Williams, & Lawless, 2014). The priorities were however structured under the greater objectives of the policy. Some cabinet Task Forces were also established to propel the coordinated implementation. The priorities created were in alignment with creating a vibrant environment, promoting affordable housing, enhancing the lives of children, discovering the benefits of mining, creating safer communities and advancing manufacturing industries (SA Health, 2016).

For the span of time that HIAP has been in existence in SA, it has been a key pillar in framing equity, especially for the vulnerable groups. Initially, tackling inequalities posed challenges both to the policymakers and the government. Thus, solving the dilemmas required shifting of not only the existing economic, social and political interests but also the dominant ideologies. Structuring equity as a problem of the minority groups and their right to services has given some familiar and tangible parameters to equality as a controversial and distal aspect or the South Australian HIAP. It has also helped the partnering agencies to gain a better understanding how the health sector could help in the achievement of certain benefits which were of mutual benefit and interest. However, the structuring of equity in this manner drew away the focus on the most fundamental aspects through which social structures and power create inequalities.

A research conducted in 2017 by a popular international journal publisher indicated that outside the general policy statements, HIAP in SA did not lay much focus on equality.  The research thus concluded that the main goal of the HIAP was never really on equality (Eyk, et al., 2017). The article published by the researchers went ahead to describe some of the profound institutional obstacles to finding a lasting solution to the problem of inequity, particularly the supremacy of neo-liberalism. Equality is a distal objective, and thus the functioning of the HIAP should solely prove the existence of equality and its impacts in the coming decades. Realistically, the HIAP policy in South Australia was less likely to improve equality under the adverse environmental and economic situations within which it was carrying out its duties. Also, the institutional restraints on its capability to establish equality unequivocally was a major challenge. Since equity was not an explicit focus of the partnering sectors and the HIAP, there is less likelihood that equity will translate into a priority for the partnering agencies.

The Aboriginal Health Policy

Apparently, the plans that HIAP has been pursuing up to date were hardly structured primarily with the intent to deal with inequalities explicitly. It is therefore unlikely that HIAP will improve equality. Over the past years, the priority of the policy has been increasingly transformed to suit the joined-up policy at the expense of equity. This transformation is more aligned to the response of the central government’s agenda to reform the public sector. Even though the dual goals of the HIAP were bettering health, equity and well-being, and a collaboration in all sectors, enabling cooperation to address the complicated policy matters within sectors became its overriding objective, with equality slipping out of grip.

HIAP is an umbrella policy which guards the other numerous policies which exist in South Australia. The policies under HIAP portray similar interests though within a limited scope. The Aboriginal Health Policy is one among these policies. It was approved in the last quarter of the year 2007. The policy was developed to address the challenges of poor indigenous health care systems which would greatly be attributed to unemployment, low income, exclusion, poor housing and sanitation and inadequate education. The Aboriginals were exposed to much less access to appropriate health care services. 

Basically, the policy outlines the South Australia’s commitment to enhancing the health of the “Aboriginal and Torres Strait Islander people through shared approach to policy development, planning and service across the health system and maintaining respect for cultural diversity” ( Department of Health, Government of South Australia, 2007, p. 1). The policy was a statement of the commitment by SA to deliver a sustainable and comprehensive healthcare system to ensure longer, better and healthier lives of the Aboriginals.  The key objectives of the policy were “reducing Aboriginal ill-health,

developing a culturally-responsive health system and promoting Aboriginal community health and wellbeing” (SA Health, 2018). SA acknowledges the fact that the fact that the Aboriginals are among the most vulnerable groups in the region (Australian Human Rights Commission, 2017). The Aboriginals are highly affected by the continued discrimination and exclusion and also faced most of the effects of post-colonization.

The Aboriginal Health Policy outlined the measures that the SA Health departments would work on in planning and implementing better health services to the Aboriginals. The strategies put in place would aid in integrating health systems with the native cultures with respect to diversity and reconciliation. Over the years that policy has been in existence, SA has made much success in reducing the rates of ill-health among the Aboriginals. SA has also been able to develop a substantially culturally responsive health care systems for the indigenous people. The policy is still relevant, and the health departments should continue engaging it for an ideal healthcare system for the aboriginal community.  The goals of the policy have always remained the same over the past years, and there is much likelihood that the policy will emerge a great success.

Conclusion

It is worth noting that our societies are all structured in a manner that everyone no matter their position plays a key role in overall development. Everyone has a specific role to play in ensuring good health for the populations. The minority groups should not be excluded from the agenda as they too have a contribution to make. They should speak up against the injustices rested upon them to create an equal society. We all have a right to diligent health care despite our conditions.

Conclusion

Policies are key tools for shaping reality into the desired state of things. They are accurate frameworks that if adhered to correctly can lead any institution to the realization of its full potential. Ideal policies in the health sector will definitely propel any country towards economic, political and social achievements. As long as all the needs in health are met, the other sectors will thrive well. A healthy population is a key to overall sectoral growth.

References

Department of Health, Government of South Australia. (2007, September 6). SA Health Aboriginal Health Policy – 2007. Retrieved from Department of Health, Government of South Australia: https://www.sahealth.sa.gov.au/wps/wcm/connect/8a46050043cabb78924ed326a3df42b9/directive_aboriginal_health_policy_sep2007_final.pdf?MOD=AJPERES&CACHEID=ROOTWORKSPACE-8a46050043cabb78924ed326a3df42b9-maTE1yW

Australian Human Rights Commission. (2017). Face the facts: Aboriginal and Torres Strait Islander Peoples. Retrieved from Australian Human Rights Commission: https://www.humanrights.gov.au/education/face-facts/face-facts-aboriginal-and-torres-strait-islander-peoples

Bacchi, C. (2015). The turn to problematization: Political implications of contrasting interpretive and poststructural adaptations. Open Journal of Political Science, 5, 1-12.

Bacchi, C. (2016). Problematizations in Health Policy. International Journal of Health Services, 1-34.

Baum, F. (2008). The New Public Health. Oxford University.

Delany, T., Jones, L., Lawless, A., Popay, J., Baum, F., McDermott, D., . . . Marmot, M. (2016). Health in All Policies in South Australia: what has supported early implementation? Health Promotion International, 31(4), 888–898.

Eyk, H. v., Harris, E., Baum, F., Crowe, T. D., Lawless, A., & MacDougal, C. (2017). Health in All Policies in South Australia—Did It Promote and Enact an Equity Perspective? International Journal of Environmental Research and Public Health, 14(1288), 1-25. Retrieved from file:///C:/Users/USE/Downloads/ijerph-14-01288.pdf

Kickbusch, I., Williams, C., & Lawless, A. (2014). Making the Most of Open Windows: Establishing Health in All Policies in South Australia. International Journal of Health Services, 44(1), 185-194.

Peña, S. (2018). Evaluating Health in All Policies; Comment on “Developing a Framework for a Program Theory-Based Approach to Evaluating Policy Processes and Outcomes: Health in All Policies in South Australia. International Journal of Health Policy and Management, 7, 1-32.

SA Health. (2016, November 22). A Health Lens Analysis across the South Australian Government’s Seven Strategic Priorities. Retrieved from SA Health: https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/health+reform/health+in+all+policies/a+health+lens+analysis+across+the+south+australian+governments+seven+strategic+priorities

SA Health. (2017, December 15). South Australia’s HiAP approach. Retrieved from SA Health: https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/health+reform/health+in+all+policies/south+australias+hiap+approach

SA Health. (2018, May 4). Aboriginal health. Retrieved from SA Health: https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/about+us/about+sa+health/aboriginal+healt