The second step in the HIA process is the scoping stage. This stage is about determining the focus of the HIA, deciding on the methods and work plan. The rest of the HIA is planned in this phase.
The main question to answer in this phase is which health outcomes or determinants of health outcomes the HIA should focus on and how the HIA will be carried out.
To define the focus of the HIA, it is important to consider which population groups are likely to be affected and which geographic areas are affected (regions, cities, villages). Much of this information will already be available from the Needs Assessment. In addition, key stakeholders should be identified. Stakeholders are those who have an interest in the intervention, those who benefit from the intervention, those who may be adversely affected by the intervention and those who may impact or influence the development or implementation of the intervention. For example, important stakeholders could be those involved in developing intervention (e.g. municipality, researchers), those involved in implementing the intervention (e.g. nurses, local businesses) and those targeted by the intervention (e.g. residents of an area, members of population subgroups). Also, those who are not directly involved or affected by the intervention but who could potentially obstruct or facilitate it should be considered. The scoping phase usually involves convening a steering group that can assist in determining the focus, methods and work plan.
Which methods are to be used are determined by the main questions that need to be answered, the complexity of the HIA, and the available resources (time, staff, expertise, budget). The methods can include literature reviews, quantitative modelling, and qualitative analysis, such as expert consultations, interviews and focus groups.
Potential equity-focused questions (Gunther, 2011) that can be asked in the scoping step are “Which determinants of health (related to health equity) will be assessed in the context of the policy or intervention?” or “What evidence (quantitative and/or qualitative) will be used that will show how the health equity impact is identified?” (Download here).
The focus and the required methods will determine what type of HIA needs to be done.