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Health Impact Assessment “Key Tool”

West Africa Network for Capacity Building in Integrated Water Resources Management. Health Impact Assessment “Key Tool”. Regional Training of Trainers Workshop National Water Resources Institute, Kaduna, Nigeria 6 – 10 December 2004. Emmanuel Ofoezie.

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Health Impact Assessment “Key Tool”

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  1. West Africa Network for Capacity Building in Integrated Water Resources Management Health Impact Assessment “Key Tool” Regional Training of Trainers Workshop National Water Resources Institute, Kaduna, Nigeria 6 – 10 December 2004 Emmanuel Ofoezie Obafemi Awolowo University, Ile-Ife, Nigeria

  2. Sanitation Health Impact Assessment • What? • Why ? • When ? • How ? • By whom ? • Capacity building needs S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  3. WHAT ? • Sanitation and health impact assessment • Health impacts • Conditions stimulating negative impacts S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  4. WHAT ? • Sanitation and health impact assessment • A tool for identifying unexpected negative effects of development projects and formulating safeguards against the impacts • Health impacts • Conditions stimulating negative impacts S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  5. WHAT ? • Sanitation and health impact assessment • Health impacts • Communicable diseases • Non communicable diseases • Injuries • Social disorders • Conditions stimulating negative impacts S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  6. WHAT ? • Health impacts • Communicable diseases • Water borne e.g. Diarrhoea • Water washed e.g. Ascariasis • Water based e.g. Schistosomiasis, guinea worm • Water related e.g. Malaria, Onchocerciasis • Non communicable disease • Injury • Social disorders S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  7. WHAT ? • Health impacts • Communicable diseases • Non communicable diseases • Poisoning by mineral pollutants, toxins, pesticides residues, industrial effluents, etc. • Injuries • Social disorders S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  8. WHAT ? • Health impacts • Communicable diseases • Non communicable disease. • Injury • Drowning • Construction injuries • Communal violence • Social disorders S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  9. WHAT ? • Health impacts • Communicable diseases • Non communicable disease • Injury • Social disorders • Social disruption due to religious, tribal, economic reasons • Stress S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  10. WHAT ? • Sanitation and health impact assessment • Health impacts • Conditions stimulating negative impacts • Migration • Ecological changes • Water supply • Sanitation • Health support systems • Socio-economic status S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  11. WHAT ? • Conditions stimulating negative impacts • Migration • Movement of workforce, support staff, family members etc. • Movement of opportunists e.g. fishermen, farmers, traders, prostitutes, etc. S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  12. WHAT ? • Conditions stimulating negative impacts • Ecological changes • Water current • Surface area • Volume S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  13. WHAT ? • Conditions stimulating negative impacts • Water supply • Alternative water supply • Frequency and duration of supply • Quality and quantity of supply • Distance to source S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  14. WHAT ? • Conditions stimulating negative impacts • Sanitation • Nature, type and quantity of wastes • Availability and types of latrines • KAB to latrines and waste disposal S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  15. WHAT ? • Conditions stimulating negative impacts • Health support systems • Nature of health care facility • Distance of health care facility • Availability of expertise and essential drugs • Cost of health care provision S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  16. WHAT ? • Conditions stimulating negative impacts • Socio-economic status • Educational background • Economic status • Occupation • Religion • Others S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  17. WHY ? • HIA is sound economics • HIA helps identify and protect vulnerable groups • HIA is about risks and opportunities • HIA fits in a larger frame of best planning practice S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  18. WHY ? • HIA is sound economics • no transfer of hidden cost to the health sector • early design and operational interventions often more cost-effective than health sector interventions later • healthy communities are essential for successful and sustainable projects • HIA helps identify and protect vulnerable groups • HIA is about risks and opportunities • HIA fits in a larger frame of best planning practice S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  19. WHY ? • HIA is sound economics • HIA helps identify and protect vulnerable groups • development aims at bringing benefits to society at large, but it may overlook adverse impacts on vulnerable groups • no trade-off’s between the health status of different groups ! • HIA is about risks and opportunities • HIA fits in a larger frame of best planning practice S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  20. WHY ? • HIA is sound economics • HIA helps identify and protect vulnerable groups • HIA is about risks and opportunities • impact assessment considers positive and negative impacts • seizing opportunities adds value and make economic sense • HIA fits in a larger frame of best planning practice S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  21. WHY ? • HIA is sound economics • HIA helps identify and protect vulnerable groups • HIA is about risks and opportunities • HIA fits in a larger frame of best planning practice • HIA links with Environmental Impact Assessment • EIA & HIA help determine best options • EIA & HIA help focus on involuntary risk exposure and the need for compensation S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  22. WHEN ? Identification Operation & Maintenance Design Pre-feasibility & TOR Evaluation Feasibility Hand-over Appraisal Construction Negotiation THE PROJECT CYCLE: Critical stages for HIA decision-making Critical stages for inter-sectoral action S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  23. WHEN ? • Identification (Options for a development proposal) • Project identification • Pre-feasibility TOR • Screening of development projects • Initial HIA of each option using available information from project documents, reference materials, consultations, etc. • Scoping for significant issues S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  24. WHEN ? • Feasibility • Detailed HIA and report (often with EIA) • Relate health risks to hazards based on: • Vulnerable groups, communities, etc. • Dynamics of environmental factors • Existing protective health facilities • Detailed mitigating plans for each option S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  25. WHEN ? • Design (Technical and operational specifications) • Determine health problems of each option S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  26. WHEN ? • Appraisal • Independent quality control of recommendations of HIA • Issue appraisal report S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  27. WHEN ? • Negotiations: • Intersectoral discussions • Decision on development project • Allocation of funds • Construction • Development of physical Infrastructure S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  28. WHEN ? • Evaluation • Confirm implementation of recommended safeguards in HIA and Appraisal reports accepted by negotiations S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  29. WHEN ? • Operation and Maintenance (The outputs (energy, agricultural products etc.) that were the projects goal) • Determine efficacy of mitigating systems • Identify unexpected risks • Recommend mortifications to ineffective safeguards and new safeguards for the unexpected risks. S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  30. Policy Procedure Method HOW ? Tools S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  31. HOW ? • Policy must be right • Adequate and effective Institutional Arrangement • Legal framework must be specific and compelling • Resource allocation must be adequate and regular S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  32. The trend of dam construction in Nigeria since 1920 S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  33. WHEN ? • Dam statistics and health in Nigeria • Total number of dams 323 • No. investigated for snail hosts 47 (14.6%) • Number positive for snail hosts 20 (42.6%) • No. investigated for human infection 11(55%) • Number positive for human infection 10 (90.9) S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  34. The Authority Teacher’s Board Management Establishment Board Establishment Committee Tender’s Committee Departments Engineering Training Administration Agriculture Planning Health & Environment Organizational structure for river basin development authorities (RBDs) in Nigeria S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  35. EIA requirements in Nigeria Description of the proposed activities Description of potentially affected environment Description of practical activities Description of potential environmental impacts at local, national and global levels Identification and description of measures to mitigate the environmental impacts To control pollution in rivers, lakes and lagoons S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  36. HOW ? • Procedure is good management • saying what you will do • Screening (focusing on key disease issues) • Scoping (setting boundaries in time and space) • TOR (drawing up terms of reference for HIA) • Negotiations (ensuring resource allocations) • MoU (creating a framework for intersectoral action) S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  37. HOW ? • Procedure is good management • Getting it done • implementation (physical infrastructure for project and safeguards) • Proving that you have done it • appraisal (verify compliance with TOR) • evaluation (verify resources allocation and cost benefit analysis of project) S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  38. HOW ? • Method is technical • Ecological evaluation of • Community risk factors • Environmental risk factors • Institutional risk factors • Socio economic evaluations (evidence base is not limited to scientific information) S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  39. BY WHOM ? Actors in the procedure • Project proponent is responsible for overall procedure to be carried out correctly and in a coordinated way • Ministry of Health is responsible for HIA TOR and for the appraisal process of the HIA report • Consultants are responsible for carrying out the HIA • Ministry of Finance approves resource allocations for health safeguards S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  40. CAPACITY BUILDING NEEDS To disseminate know-how of the HIA methods: • incorporation of the topic into relevant curricula for tertiary learning • in-service training for professionals involved in development planning and management, in public and private sector institutions and in NGOs S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  41. CAPACITY BUILDING NEEDS To ensure optimal procedures: • Skills development in intersectoral decision-making and negotiation • Problem-based learning in real settings S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  42. CAPACITY BUILDING NEEDS To create an enabling environment: • strengthening the capacity in policy formulation, review and harmonisation • product-oriented workshops on incorporating health into IWRM policies S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  43. RECOMMENDATIONS • Department of Health and Environment • Identify project-specific impacts • Keep updated records of disease profile in each project • Implement and evaluate mitigating safeguards • Evolve practical and quantifiable local indicators for auditing each project S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

  44. More information The Water, Sanitation and Health Electronic Library www.who.int/water_sanitation_health The Report of the World Commission on Dams (WCD) www.dams.org The World Health Organization Water, Sanitation and Health Programme (WSH) Avenue Appia 1211 Genève 27, Switzerland Water Supply, Sanitation Collaborative Councilww.wsscc.org S13-HIA, Emmanuel Ofoezie 8 Dec. 2004

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