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在国家层面实施健康影响评估:伊朗的经验

Implementing Health Impact Assessment at National Level: An Experience in Iran.

作者信息

Damari Behzad, Vosoogh-Moghaddam Abbas, Riazi-Isfahani Sahand

机构信息

Dept. of Social Determinants of Health, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran.

Ministry of Health and Medical Education, Tehran, Iran.

出版信息

Iran J Public Health. 2018 Feb;47(2):246-255.

Abstract

BACKGROUND

According to the general health policies issued in 2014, Health Impact Assessment (HIA) or Health Annex should be implemented in Iran. The present study provided a model for executing HIA in the Iranian context as a developing country.

METHODS

This is a system design study with the qualitative approach. The data on the system components were gathered via reviews of the literature, in-depth interviews and focused group discussions (FGDs) with experts. The information were contently analyzed in order to draft the model and a consensus was reached on by the steering committee.

RESULTS

Fifteen in-depth interviews and six FGD meeting were conducted. The equity-based approach in assessing the health impacts of policies, programs and projects were chosen as the most practical tool. Experts believe that for the next five years, HIA should be used just for the "national projects" so that the ministries and national agencies could be empowered. Components of the model including structure, procedures, and standards, management style, mission and resources were prepared. The national regulations and protocols were sent to the SCHFS Secretariat for final revision and the council approval.

CONCLUSION

The hasty implementation of HIA will face serious resistances as the health-oriented attitude and behavior in both government and non-governmental sectors will gradually form. Also, the overlapping of the contents of HIA with other tools such as Environmental, Cultural and Social Impact Assessments, currently used by other sectors, causes difficulties in implementing the HIA by the Ministry of Health and Medical Education.

摘要

背景

根据2014年发布的总体卫生政策,伊朗应实施健康影响评估(HIA)或健康附件。本研究为在伊朗这样一个发展中国家实施HIA提供了一个模型。

方法

这是一项采用定性方法的系统设计研究。通过文献综述、深入访谈以及与专家进行焦点小组讨论(FGD)收集系统组件的数据。对这些信息进行内容分析以起草模型,并由指导委员会达成共识。

结果

进行了15次深入访谈和6次FGD会议。基于公平的方法被选为评估政策、计划和项目健康影响的最实用工具。专家们认为,在未来五年内,HIA应仅用于“国家项目”,以便增强各部委和国家机构的能力。准备了模型的组件,包括结构、程序和标准、管理方式、使命和资源。国家法规和协议已送交最高卫生服务委员会秘书处进行最终修订并经委员会批准。

结论

随着政府和非政府部门以健康为导向的态度和行为逐渐形成,仓促实施HIA将面临严重阻力。此外,HIA的内容与其他部门目前使用的其他工具(如环境、文化和社会影响评估)存在重叠,给卫生和医学教育部实施HIA带来困难。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e52d/5810388/a77365184016/IJPH-47-246-g001.jpg

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