Stakeholder engagement is a critical component of the HIA process, and successful stakeholder engagement can be challenging for even the most seasoned HIA practitioner, as it typically requires careful planning, communication and coordination, development of community relationships, and the application of social research practices. If experiential, personnel, and/or budgetary resources are limited, stakeholder engagement may be at risk of being curtailed or even eliminated within the HIA process, to the detriment of overall HIA quality and community development. This resource list is meant to help minimize this risk by providing a list of stakeholder engagement tools and materials for easy reference. The listed tools and materials are useful to any HIA practitioner involved in stakeholder engagement activities.
Understanding Stakeholder Engagement: In response to a gap in the literature regarding stakeholder engagement techniques in HIA, the Stakeholder Participation Working Group of the 2010 HIA of the Americas Workshop developed the document entitled Guidance and Best Practices for Stakeholder Participation in Health Impact Assessments, v1.0. On this page, you can find important definitions, rationale for stakeholder engagement, explanations of the participation process, and real-life stakeholder engagement examples. It is a great place to begin, particularly if you are new to stakeholder engagement in HIA.
Stakeholder Definition: Stakeholders are individuals or organizations who stand to gain or lose from a decision or process. More specifically, stakeholders can be defined as people who are affected by the prospective change (e.g., health or financial); have an interest in the health impacts of the policy or project under consideration because of their position; have an active or passive influence on the decision-making and implementation process of the project or policy under consideration; or have an economic or business interest in the outcome of the decision.
How to Use the Resources Below: Stakeholder engagement is a key component of every HIA and should be considered throughout the HIA process; however, the resources provided below will be most useful if considered during the planning and scoping stages.
Stakeholder analysis can be helpful when forming an HIA steering or advisory committee, and is most valuable when conducted no later than the scoping phase of an HIA. A stakeholder analysis collects and assesses information on relevant stakeholders, allowing the practitioner to develop a strategic view of the positions, intentions, interrelationships, agendas, and influence or resources stakeholders have brought, or can bring, to the HIA process (SPWG, 2011). You will find a worksheet for conducting a stakeholder analysis here.
Other Resources for Stakeholder Analysis:
A strategic plan for stakeholder engagement will aid in coordinating communications, preparing activities, promoting participation, integrating findings into the overall HIA process, identifying resource needs, and staying within your project budget. One example of an HIA Stakeholder Engagement Plan from the Cleveland, OH Healthy Hough HIA can be found here.
Other Resources for Developing a Stakeholder Engagement Plan:
Stakeholder engagement may occur throughout the HIA process, and a variety of activities and techniques can be applied. These activities and techniques are often adapted from established social research methodologies and used in many settings besides HIA. You can find descriptions of various engagement and facilitation techniques and how they can be applied in the BiodivERsA Stakeholder Engagement Toolkit, Part 5: Methods for Engagement.
Other Resources for Stakeholder Engagement Techniques:
Health impact assessments are concerned with a variety of health determinants (e.g., environmental, economic, social, and individual). Some types of determinants may be more familiar to stakeholders than others, and relationships between determinants are not always clear. Oftentimes, the social determinants of health (SDOH) are a new concept for stakeholders. One tool for discussing how health outcomes are a product of social determinants is the Health, Place, and Policy Tree Exercise.
Other Resources for Facilitating Conversations About SDOH:
If your stakeholders are unable to participate, it won’t matter how well-prepared you and your HIA team are to facilitate stakeholder engagement activities. Identifying and understanding root causes of stakeholder obstacles can help you strategize an approach to best attract, engage, inform, and support participants. This resource outlines such obstacles to participation as education, infrastructure, social-cultural context, location, and finances (but, don’t forget another important obstacle: time).
Other Resources to Better Understand Obstacles for Participation:
A budget resource sheet has been developed as part of the SOPHIA HIA of the Americas Stakeholder Engagement Workgroup activities. It serves to help practitioners identify the best stakeholder engagement strategies for their particular HIA, think through the range of costs and time associated with different strategies, and build meaningful stakeholder engagement into an HIA budget upfront. The Budget and Planning Resource is available here.
Ideally, consideration of stakeholder engagement doesn’t end with the conclusion of the HIA. It’s advisable that HIA practitioners critically evaluate the engagement process to identify strengths, weaknesses, and opportunities so that stakeholder participation and input utilization in future HIAs can be optimized. Lessons can always be learned from reviewing the engagement process, regardless of how many times a practitioner has conducted an HIA. A template for evaluating the stakeholder engagement process can be found here. If resources allow, this template can also be completed during the HIA to improve ongoing stakeholder engagement activities.
Other Resources for Evaluating Stakeholder Engagement:
BiodivERsA. Stakeholder Engagement Toolkit, Part 3: How to Identify Stakeholders. Consultation draft December 2013. BiodivERsA, Paris.
AccountAbility, the United Nations Environmental Programme, and Stakeholder Research Associates. From Words to Action. The Stakeholder Engagement Manual, Volume 2: The Practitioner’s Handbook on Stakeholder Engagement. 2005.
Stakeholder Participation in HIA Working Group of the 2010 HIA of the Americas Workshop (SPWG). Guidance and Best Practices for Stakeholder Participation in Health Impact Assessment, v1.0. Oakland, CA. October 2011.
International Finance Corporation. Stakeholder Engagement: A Good Practice Handbook for Companies Doing Business in Emerging Markets, Appendix 3. Washington, DC. 2007.
Jeffery, N. Stakeholder Engagement: A Road Map to Meaningful Engagement. Doughty Centre, Cranfield School of Management. 2009. Bedford, UK.
Human Impact Partners. Health, Place, and Policy- Tree Exercise. 2010. Oakland, CA.
Robert Wood Johnson Foundation. A New Way to Talk About the Social Determinants of Health. Vulnerable Populations Portfolio. 2010. Princeton, NJ.
Ceres and the Facility Reporting Project team. FRP Guide to Stakeholder Engagement. November 2007.
Kansas Health Institute. Potential Health Effects of Casino Development in Southeast Kansas. Kansas Health Impact Assessment Project. October 2012. Topeka, KS.