Health Impact Assessment Capacity Building Activities in the Mekong Region: Progress and Future Perspectives

1. Health Impact Assessment Capacity Building Activities in the Mekong Region 2003 - 2007: Progress and Future Perspectives Peter Furu DBL – Centre for Health Research and Development, Charlottenlund, Denmark WHO Collaborating Centre for Health and Environment in Sustainable Development WHO Collaborating Centre for Integrated Control of Helminth Infections

2. DBL-Centre for Health Research and Development Overview Policy framework for HIA and institutional arrangements for managing the HIA process Achievements in Lao PDR, Cambodia and Vietnam Challenges and future perspectives

3. DBL-Centre for Health Research and Development Achievements Lao PDR HIA capacity building (CB) 2007 - 2010 2003 2003 2004 2005 2006 2005

4. DBL-Centre for Health Research and Development Achievements Lao PDR March 2006: Following approval of a new HIA Policy by the Lao Government – a decree on HIA has been issued by the Prime Minister’s Office Foundation for the establishment of institutional arrangements for managing the HIA process

5. DBL-Centre for Health Research and Development Achievements Lao PDR Division of Environmental Health, Dept of Hygiene and Prevention,MOH HIA Unit Essential functions in HIA Process Screening of proposed projects; Scoping an formulating TOR; Critical appraisal of HIA report; Completing Public Health Action Plan; Negotiating intra- and intersectoral institutional arrangement and resource allocations; Monitoring health

6. DBL-Centre for Health Research and Development Achievements Lao PDR Process Line Ministry (project proponent) CPI STEA Identifies and designs proposal; submits to Committee for Planning and Investment (CPI) Checks against macro-economic policies EIA screening; forward proposal to: HIA Unit

7. DBL-Centre for Health Research and Development Achievements Lao PDR Process Screening; Scoping; Critical appraisal of HIA report; Completing Public Health Action Plan; Negotiating with proponent, CPI and Ministry of Finance Monitoring HIA Unit Carry out essential functions in consultation with STEA and relevant MOH departments

8. DBL-Centre for Health Research and Development Achievements Lao PDR Process First cases Cement factory Hydropower project

9. DBL-Centre for Health Research and Development Achievements Cambodia Good progress following another sequence of capacity building activities National Workshop (initial basic HIA training for MOH staff HIA Policy Seminar

10. DBL-Centre for Health Research and Development Achievements Cambodia April 2007: National HIA Policy Seminar – attended by high-level officials from 11 ministries Output: Situation analysis on health issues relevant to all public sectors. Outline of a National Action Plan for an HIA Policy framework linked to the ongoing process of developing National Environmental Health Action Plans (NEHAPs)

11. DBL-Centre for Health Research and Development Achievements Cambodia The National Action Plan was endorsed by ministerial Under-Secretaries-of-State and Director Generals attending the last day of the HIA Policy Seminar A “go-ahead” for HIA Policy development and the process of inclusion of the concept of HIA in a new National Strategic Health Sector Plan 2007-2010 A contribution to meeting the Cambodian Millennium Development Goals

12. DBL-Centre for Health Research and Development Achievements Vietnam Good progress with alternative approach to HIA capacity building National Workshop (initial basic HIA training for MOH staff Focus on Training-of-trainers (ToT) for HIA

13. DBL-Centre for Health Research and Development Achievements Vietnam The ToT approach may secure a cascade effect meeting some of the demands for HIA CB at provincial level (64 provinces)

14. DBL-Centre for Health Research and Development Challenges and future perspectives Although there is a political will there are challenges related to mainstreaming HIA into existing management practices Critical mass will be low even with the investment in CB so far – a planned e-learning programme for HIA may contribute to solving this problem

15. DBL-Centre for Health Research and Development Challenges and future perspectives It will be a challenge to ensure continuous interest and commitment by both health and non-health sectors There is still work to be done promoting and ensuring intersectoral collaboration Some uncertainty as to sector responsibilities at the interface of health and environment A constraint for progress may be limitations in funding

16. DBL-Centre for Health Research and Development Challenges and future perspectives Good reasons for optimism ! Future work will benefit from the very high level of commitment, diligence and continued interest by the Mekong governments to pursue the goal of widely use of HIA for safeguarding human health in development

17. DBL-Centre for Health Research and Development Acknowledgements Based on joint activities by: Ministry of Health, Lao PDR Ministry of Health, Cambodia Ministry of Health, Vietnam Vietnam Environment Protection Agency Mahasarakham University, Thailand InWEnt (Capacity Building International), Germany World Health Organization, Switzerland DBL – Centre for Health Research and Development, Denmark Main sponsors: DBL, Denmark and InWEnt (Capacity Building International), Germany