6 June 2007 Dias 1 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 Health Impact Assessment Capacity Building Activities in the Mekong Region : Progress and Future Perspectives

6 June 2007 Dias 2 DBL-Centre for Health Research and Development Achievements in Lao PDR, Cambodia and Vietnam Overview Policy framework for HIA and institutional arrangements for managing the HIA process Challenges and future perspectives

6 June 2007 Dias 3 DBL-Centre for Health Research and Development Achievements Lao PDR HIA capacity building (CB)

6 June 2007 Dias 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 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

6 June 2007 Dias 5 DBL-Centre for Health Research and Development Achievements Lao PDR HIA Unit Essential functions in HIA Process Division of Environmental Health, Dept of Hygiene and Prevention,MOH 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 June 2007 Dias 6 DBL-Centre for Health Research and Development Identifies and designs proposal; submits to Committee for Planning and Investment (CPI) Achievements Lao PDR Line Ministry (project proponent) Process Checks against macro- economic policies CPI EIA screening; forward proposal to: STEA HIA Unit

6 June 2007 Dias 7 DBL-Centre for Health Research and Development Carry out essential functions in consultation with STEA and relevant MOH departments 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

6 June 2007 Dias 8 DBL-Centre for Health Research and Development Achievements Lao PDR First cases Process Cement factory Hydropower project

6 June 2007 Dias 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

6 June 2007 Dias 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)

6 June 2007 Dias 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 A contribution to meeting the Cambodian Millennium Development Goals

6 June 2007 Dias 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

6 June 2007 Dias 13 DBL-Centre for Health Research and Development Vietnam Achievements The ToT approach may secure a cascade effect meeting some of the demands for HIA CB at provincial level (64 provinces)

6 June 2007 Dias 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

6 June 2007 Dias 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 A constraint for progress may be limitations in funding Some uncertainty as to sector responsibilities at the interface of health and environment

6 June 2007 Dias 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

6 June 2007 Dias 17 DBL-Centre for Health Research and DevelopmentAcknowledgements Ministry of Health, Lao PDR Mahasarakham University, Thailand World Health Organization, Switzerland DBL – Centre for Health Research and Development, Denmark Based on joint activities by: Main sponsors: DBL, Denmark and InWEnt (Capacity Building International), Germany Ministry of Health, Vietnam Ministry of Health, Cambodia InWEnt (Capacity Building International), Germany Vietnam Environment Protection Agency