Gwimbi Patrick, Lebese Palesa, Kanono Kamohelo
Department of Environmental Health, National University of Lesotho, P. O. Roma 180, Lesotho.
Heliyon. 2020 Jul 2;6(7):e04362. doi: 10.1016/j.heliyon.2020.e04362. eCollection 2020 Jul.
Health impact assessment (HIA) is internationally identified as a mechanism for ensuring that potential health impacts of project proposals are considered before project implementation. This study examined the inclusion of HIAs in environmental impact statement (EIS) and their translation into planning obligations of a dam project in Lesotho. A framework premised on the general systems theory, and integrating EIS contents, environmental management plans and monitoring obligations in post dam construction was used as the analytic lens. A review of the EIS was conducted to assess HIAs covered during the environmental impact assessment (EIA) of the dam. Data drawn from selected household questionnaire interviews and analysis of related documents was used to assess the extent of HIA mainstreaming into planning and monitoring obligations in post dam construction. Results showed inclusion of HIAs in EIS, including endemic diseases such as sexually transmitted infections (STIs) and HIV/AIDS, acute respiratory infections, pharyngitis, hypertension, influenza and diarrhea. Social, economic and environmental conditions were identified as major determinants of health; while mental and nutritional determinants of health were less discussed. The results also showed that some HIAs included in EIS influenced decision-making in relation to raising awareness of health issues in the community. Deficiencies were however reported by respondents in relation to mainstreaming of several HIA recommendations. HIAs can be useful in promoting community health and mitigating adverse impacts of decisions made by project proponents.
健康影响评估（HIA）在国际上被视为一种机制，以确保在项目实施前考虑项目提案可能产生的健康影响。本研究考察了莱索托一个大坝项目的环境影响声明（EIS）中健康影响评估的纳入情况及其转化为规划义务的情况。一个以一般系统理论为前提、整合了EIS内容、环境管理计划以及大坝建成后的监测义务的框架被用作分析视角。对EIS进行了审查，以评估大坝环境影响评估（EIA）期间涵盖的健康影响评估。从选定的家庭问卷调查访谈和相关文件分析中获取的数据，用于评估健康影响评估在大坝建成后规划和监测义务中的主流化程度。结果显示，EIS中纳入了健康影响评估，包括性传播感染（STIs）和艾滋病毒/艾滋病等地方病、急性呼吸道感染、咽炎、高血压、流感和腹泻。社会、经济和环境状况被确定为健康的主要决定因素；而健康的心理和营养决定因素讨论较少。结果还表明，EIS中纳入的一些健康影响评估影响了社区健康问题提高认识方面的决策。然而，受访者报告称，在将若干健康影响评估建议纳入主流方面存在不足。健康影响评估有助于促进社区健康，并减轻项目支持者所做决策的不利影响。
