HIA in the Lao PDR National Policy - HIA in ASEAN - home

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					  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/                          Conservation of
cultural development                    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


                      4 main sectors
                        in National
Education               Growth and               Health
                    Poverty Eradication
                     Strategy (NGPES)




            Infrastructure (Rural Road)
                                 Health situations
   Total fertility rate: 4.04%      Crude birth rates:         Crude death rates:
                                    29.9% (LRHS 2005)           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
                     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
                              Dam project
                     Mining
Road construction
                                             Water supply



                                               Industrial
 Irrigation,
  Fisheries
  Livestock
                    Development                production
                                                Tourism




Environment                                 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
   41 dam                                            31 mining
   projects                                           projects


 7 power                                               4 industry
   line                97 IEE and EIA reports           projects
extension


                                                         9 road
    3 agricultural
                                                        projects
       projects



   1 Bank Erosion                               1 sustainable
 Protection projects                               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                        Focal points in other
     Ministry of Health                                  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       Institutional   Individual        Economy

                                                             Assessment
   Screening
                                   HIA                        Reporting/
    Scoping                                     M/E          Dissemination

          2005                                               2020
 Life expectancy (y): 61          Commu Dis        Life expectancy (y): 72
  CDR/1000: 9.8                 Non Comm Dis       CDR/1000: 5.3
  MMR/100 000: 405                                 MMR/100 000: 200
                                  Injury/acc
  IMR/1000: 56                                     IMR/1000: 32
                                 Malnutrition      U5MR/1000: 40
  U5MR/1000: 68
  Stunting (%): 40.7              Mental dis       Stunting (%): 28
  Wasting (%): 6.4                                 Wasting (%): 2
  Underweight (%): 37.1                            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
    Thank You
for kind attention

				
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