Critical Analysis of HIAP: South Australia's Health in All Policies

This essay provides a comprehensive analysis of the 'Health in All Policies' (HIAP) initiative in South Australia, examining its evolution, strategic priorities, and impact on equity, particularly for vulnerable groups like Aboriginals. Utilizing Carol Bacchi's 'What's the Problem Represented to be?' approach, the essay critiques the policy's effectiveness in addressing inequalities, highlighting institutional obstacles and the supremacy of neo-liberalism. It further explores the relationship between HIAP and other policies, such as the Aboriginal Health Policy, assessing South Australia's commitment to enhancing indigenous healthcare through culturally responsive systems. The analysis concludes by emphasizing the importance of inclusive policies and diligent healthcare for all, while acknowledging the crucial role of policies in achieving desired societal outcomes and sectoral growth.

Running Head: HIAP POLICY ANALYSIS
HEALTH IN ALL POLICIES IN SOUTH AUSTRALIA
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Institutional Affiliation

HIAP POLICY ANALYSIS
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

HIAP POLICY ANALYSIS
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).
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).

HIAP POLICY ANALYSIS
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.

HIAP POLICY ANALYSIS
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

HIAP POLICY ANALYSIS
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.
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

HIAP POLICY ANALYSIS
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

HIAP POLICY ANALYSIS
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HIAP POLICY ANALYSIS
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