Integration of Social Return on Investment with Health Impact Assessment and evaluation frameworks

BACKGROUND: To enable sustainable investment in public health to aid recovery from the COVID-19 pandemic and other global adversities, it is necessary to incorporate social, economic and environmental outcomes and value measurement into decision-making processes. Holistic frameworks, such as Social Return on Investment (SROI), look to capture this through understanding stakeholder impact and committing to valuing and monetizing their perceived outcomes. However, opportunities for conducting standalone SROI analyses may be limited due to resources. A solution is to undertake an SROI analysis alongside other analytical frameworks, impact assessments or evaluation methods. METHODS: In 2023, two innovative case studies in Wales, United Kingdom, integrated SROI into evaluations and assessments. The first is in conjunction with a Health Impact Assessment (HIA) on a sexual health self-testing service in a prison setting, while the second is in combination with an evaluation of a breastfeeding and infant nutrition programme. RESULTS: SROI offers a broad framework through which to integrate a holistic health economics lens to different types of evaluation and impact assessment. Traditional evaluations and HIA share common elements with SROI, for example developing a theory of change in evaluations and the screening and scoping stages of a HIA. Learning reflections for future integration were identified, for example ensuring quality assessment approaches align and ensuring design is scoped to enable effective integration from study outset. CONCLUSIONS: SROI is the predominant tool used to assess the wider value of policies or programmes by identifying and evaluating holistic outcomes which have traditionally been difficult to measure. However, opportunities for standalone SROI studies may be limited for several reasons. As demonstrated, integrating SROI into different methods and approaches offers the opportunity to expand thinking on understanding value in a resource efficient way. KEY MESSAGES: • Social Return on Investment (SROI) can be effectively integrated into different evaluation approaches and Health Impact Assessment. • Integration of approaches has been shown to be resource efficient and beneficial to better understanding value and impact on health and well-being.