1. National Policy on Health Impact Assessment, Lao PDR
1st HIA for ASEAN Workshop
“Understanding Health Impact Assessment (HIA):
A Foundation for the Well-being of the ASEAN Community”
13-14 February 2012, Thailand by
Dr Tayphasavanh Fengthong
Dr Soutsakhone Chanthaphone
Dr Bountang Duangtaphak
Mr Sisavath Kongmy

2. Contents Country description Environmental health status
What we have done so far in the context of HIA
The way forward

3. Country description Lao PDR is a land-linked country,
and shares border with China, Vietnam,
Cambodia, Thailand and Myanmar.
Total area : 236,800 km2
Population: 5.62 mill
Density : 24 p/sqkm
17 provinces
Capital: Vientiane
Climate: Rainy and Dry seasons
Religion: Buddhism
Population in rural areas: 72.8%

4. Country description Adult literacy rate: (F: 50%; M:74%)
Population growth rate: 2.5% per year
Life expectancy: 61 years (F: 63; M: 59)
Country description
47 ethnic groups, covering
120 ethnic sub-groups and languages
11,000+ small villages and mostly
with poor road access
Agriculture = 80% of jobs, mostly
subsistence farming in remote areas

5. Lao Government Policy Economic Growth Social/ cultural development
Harmonious
“triangular”
approach to
development of
Government
Social/
cultural development
Conservation of
natural resources

6. Agriculture and Forestry Infrastructure (Rural Road)
The Sixth National Socio-Economic Development Plan (NSEDP ) identifies health as one of the four priority sectors for development.
Agriculture and Forestry
4 main sectors
in National
Growth and
Poverty Eradication
Strategy (NGPES)
Education
Health
Infrastructure (Rural Road)

7. Total fertility rate: 4.04%
Health situations
Total fertility rate: 4.04%
Crude birth rates:
29.9% (LRHS 2005)
Crude death rates:
5.4% (LRHS 2005)
Considerable progress has been achieved over the past ten years in improving
the health system in the Lao PDR which are Maternal, infant and under five
infant mortality rates (MMR, IMR and U5MR, respectively) have dropped significantly
1995
2000
2005
2005 (LRHS 2005)
MMR
656
530
405
IMR
104 82 70 56
U5MR
170
106 98 68
Source: Census 2005

8. Child and maternal malnutrition
The malnutrition rate in children under five in Lao PDR is very high compared to other countries in South East Asia and Asia in general.
Almost two in every five children under age five in Lao PDR are moderately and severely underweight (37.9%)
Stunting: 41.2%
Wasting: 7.4%
Northern part
34%
Middle part
33%
Southern part
50%
Source: MICs3 2006

9. Development Environment Health
Dam project
Mining
Road construction
Water supply
Development
Industrial
production
Tourism
Irrigation,
Fisheries
Livestock
Environment
Health

10. Source: Lao PDR Development Report 2010, Natural Resource Management for Sustainable Development

11. Source: Lao PDR Development Report 2010, Natural Resource Management for Sustainable Development

12. Implementation progress on HIA
Developed HIA policy and approved by Prime Minister on March 2006
Shared experiences and learning with other countries about HIA
Established HIA Team and focal point
Developed a Practical Guideline for HIA
Appraised IEE or EIA of many development projects

13. Implementation progress on HIA
Increased HIA capacity for MoH staffs and different sectors
Good HIA model of Namtheun2
Harmonization of HIA with the existing EIA
Carried out case studies:
Health impacts of traditional artisanal mining activities
Health impacts of indoor air pollution
Health Vulnerable Assessment of climate change
Field monitoring with others sectors

14. Degree of Prime Minister, No: 54/MP, 23/03/2006 on the Declaration of use and Implementation of National Policy on HIA

15. 3 agricultural projects
31 mining projects
41 dam projects
7 power line extension
4 industry projects
97 IEE and EIA reports
9 road projects
3 agricultural projects
1 sustainable Tourism Development project
1 Bank Erosion Protection projects

16. Environmental & Occupational Health and Safety Division
Organization Structure on HIA
Ministry of Health
Department of Hygiene and Prevention
Environmental & Occupational Health and Safety Division
Health Impact Assessment Unit
Technical back up team within
Ministry of Health
Focal points in other ministries

17. Awareness of HIA still limited Limited HIA funding support
Constraints
Awareness of HIA still limited
Lack capacity to do HIA of many development projects
Limited HIA funding support

18. Policy/Program/project Reporting/ Dissemination
Poverty
Environment
Social
Institutional
Individual
Economy
Assessment
Screening
HIA
Reporting/ Dissemination
Scoping
M/E
2005
2020
Life expectancy (y): 72
CDR/1000: 5.3
MMR/ : 200
IMR/1000: 32
U5MR/1000: 40
Stunting (%): 28
Wasting (%): 2
Underweight (%): 15
Life expectancy (y): 61
CDR/1000: 9.8
MMR/ : 405
IMR/1000: 56
U5MR/1000: 68
Stunting (%): 40.7
Wasting (%): 6.4
Underweight (%): 37.1
Commu Dis
Non Comm Dis
Injury/acc
Malnutrition
Mental dis

19. The Way Forward Short term: Long term:
Review the community health impacts from the existing development projects in terms of public health action plan including M/E
Strengthening HIA capacity for HIA Team and provincial staffs
Conduct HIA advocacy meeting with high levels from different ministries
Sharing knowledge and experiences on HIA with other countries
Considering HIA of small projects (SME, Land fill sites etc,.)
Long term:
Develop a HIA long term action plan to get funding support

20. Human health is not only the responsibility of the health sector !
Conclusion
Human health is not only
the responsibility
of the health sector !
We need a cross-sectoral
responsibility for health

21. Thank You
for kind attention