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
Contents
• Country description
• Environmental health status
• What we have done so far in the
context of HIA
• The way forward
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%
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
Lao Government Policy
Economic Growth
Harmonious
“triangular”
approach to
development of
Government
Social/
cultural development
Conservation of
natural resources
The Sixth National Socio-Economic Development Plan
(NSEDP 2006-2010) identifies health as one of the
four priority sectors for development.
Agriculture and Forestry
Education
4 main sectors
in National
Growth and
Poverty Eradication
Strategy (NGPES)
Infrastructure (Rural Road)
Health
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
Source: Census
2005
1995
2000
2005
2005 (LRHS 2005)
MMR
656
530
405
IMR
104
82
70
56
U5MR
170
106
98
68
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
Mining
Dam project
Road construction
Water supply
Irrigation,
Fisheries
Livestock
Environment
Development
Industrial
production
Tourism
Health
Source: Lao PDR Development Report
2010, Natural Resource Management
for Sustainable Development
Source: Lao PDR Development Report
2010, Natural Resource Management
for Sustainable Development
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
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
Degree of Prime Minister,
No: 54/MP, 23/03/2006 on
the Declaration of use and
Implementation of National
Policy on HIA
31 mining
projects
41 dam
projects
7 power
line
extension
3 agricultural
projects
1 Bank Erosion
Protection projects
97 IEE and EIA reports
4 industry
projects
9 road
projects
1 sustainable
Tourism
Development
project
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
Constraints
Awareness of HIA still limited
Lack capacity to do HIA of many
development projects
Limited HIA funding support
Policy/Program/project
Poverty
Environment
Social
Screening
Institutional
Economy
Assessment
HIA
Scoping
2005
Life expectancy (y): 61
CDR/1000: 9.8
MMR/100 000: 405
IMR/1000: 56
U5MR/1000: 68
Stunting (%): 40.7
Wasting (%): 6.4
Underweight (%): 37.1
Individual
M/E
Commu Dis
Non Comm Dis
Injury/acc
Malnutrition
Mental dis
Reporting/
Dissemination
2020
Life expectancy (y): 72
CDR/1000: 5.3
MMR/100 000: 200
IMR/1000: 32
U5MR/1000: 40
Stunting (%): 28
Wasting (%): 2
Underweight (%): 15
The Way Forward
• Short 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
Conclusion
Human health is not only
the responsibility
of the health sector !
We need a cross-sectoral
responsibility for health