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Health impact assessment and health equity in sub-Saharan Africa : A scoping review

Leuenberger, Andrea ; Farnham, Andrea ; Azevedo, Sophie ; Cossa, Herminio ; Dietler, Dominik LU orcid ; Nimako, Belinda ; Adongo, Philip B. ; Merten, Sonja ; Utzinger, Jürg and Winkler, Mirko S. (2019) In Environmental Impact Assessment Review 79.
Abstract

Background: Natural resource extraction projects can have positive but also negative effects on the health of affected communities, governed by demographic, economic, environmental, physical and social changes. Negative effects often prevail and these might widen existing health inequities. Health impact assessment (HIA) is a decision-support tool that aims at maximizing benefits and minimizing negative impacts on people's health. A core value of HIA is equity; yet, little is known about health equity in the frame of HIA, particularly in sub-Saharan Africa. Methodology: We conducted a scoping review to determine whether and to what extent HIA in sub-Saharan Africa addresses health equity. We included peer-reviewed publications and... (More)

Background: Natural resource extraction projects can have positive but also negative effects on the health of affected communities, governed by demographic, economic, environmental, physical and social changes. Negative effects often prevail and these might widen existing health inequities. Health impact assessment (HIA) is a decision-support tool that aims at maximizing benefits and minimizing negative impacts on people's health. A core value of HIA is equity; yet, little is known about health equity in the frame of HIA, particularly in sub-Saharan Africa. Methodology: We conducted a scoping review to determine whether and to what extent HIA in sub-Saharan Africa addresses health equity. We included peer-reviewed publications and guidelines pertaining to HIA, environmental impact assessment (EIA) and social impact assessment (SIA). Health equity was investigated by identifying (i) how health considerations were addressed and (ii) whether health was stratified by subgroups of the community. Results: Out of 1′640 raw hits, we identified 62 articles (16 HIA, 36 EIA, one SIA and nine integrated assessments), 32 of which specifically addressed health. While 20 articles focused on a specific health topic, 12 articles used a more comprehensive approach to address health. In 15 articles there were specific subgroup analyses (e.g. mothers, children or marginalized groups) as a measure of health equity. Another 12 papers referred to the community in a more general way (e.g. affected). Without exception, health was an integral part of the nine included guidelines. HIA guidelines addressed health systematically through environmental health areas, risk assessment matrix or key performance indicators. Conclusions: We found evidence that previously conducted HIA in sub-Saharan Africa and current guidelines address health equity. However, there is a need to stratify community subgroups more systematically in order to determine health differentials better. Future HIA should consider community heterogeneity in an effort to reduce health inequities by “leaving no one behind”, as suggested by the Sustainable Development Goals.

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publishing date
type
Contribution to journal
publication status
published
subject
keywords
Extractive industry, Health equity, Health impact assessment, Scoping review, Sub-Saharan Africa
in
Environmental Impact Assessment Review
volume
79
article number
106288
publisher
Elsevier
external identifiers
  • scopus:85070250229
ISSN
0195-9255
DOI
10.1016/j.eiar.2019.106288
language
English
LU publication?
no
additional info
Funding Information: We thank Dr. Thomas Fürst from the Swiss Tropical and Public Health Institute (Basel, Switzerland) for generously sharing time and insights into his treasure trove of experience with systematic reviews. We acknowledge the inputs of the Medical Library of the University of Basel for assistance with the search strategy and inputs from the entire research group. This work was supported by the Swiss Programme for Research on Global Issues for Development (r4d Programme), which is a joint funding initiative by the Swiss Agency for Development and Cooperation (SDC) and the Swiss National Science Foundation (SNSF) [grant number 169461]. The authors declare that they have no conflict of interest. Funding Information: This work was supported by the Swiss Programme for Research on Global Issues for Development (r4d Programme), which is a joint funding initiative by the Swiss Agency for Development and Cooperation (SDC) and the Swiss National Science Foundation (SNSF) [grant number 169461 ]. Publisher Copyright: © 2019 The Authors
id
0776e48e-bfe1-470b-9900-cf9b4ee36379
date added to LUP
2023-10-12 12:15:16
date last changed
2023-10-12 14:34:26
@article{0776e48e-bfe1-470b-9900-cf9b4ee36379,
  abstract     = {{<p>Background: Natural resource extraction projects can have positive but also negative effects on the health of affected communities, governed by demographic, economic, environmental, physical and social changes. Negative effects often prevail and these might widen existing health inequities. Health impact assessment (HIA) is a decision-support tool that aims at maximizing benefits and minimizing negative impacts on people's health. A core value of HIA is equity; yet, little is known about health equity in the frame of HIA, particularly in sub-Saharan Africa. Methodology: We conducted a scoping review to determine whether and to what extent HIA in sub-Saharan Africa addresses health equity. We included peer-reviewed publications and guidelines pertaining to HIA, environmental impact assessment (EIA) and social impact assessment (SIA). Health equity was investigated by identifying (i) how health considerations were addressed and (ii) whether health was stratified by subgroups of the community. Results: Out of 1′640 raw hits, we identified 62 articles (16 HIA, 36 EIA, one SIA and nine integrated assessments), 32 of which specifically addressed health. While 20 articles focused on a specific health topic, 12 articles used a more comprehensive approach to address health. In 15 articles there were specific subgroup analyses (e.g. mothers, children or marginalized groups) as a measure of health equity. Another 12 papers referred to the community in a more general way (e.g. affected). Without exception, health was an integral part of the nine included guidelines. HIA guidelines addressed health systematically through environmental health areas, risk assessment matrix or key performance indicators. Conclusions: We found evidence that previously conducted HIA in sub-Saharan Africa and current guidelines address health equity. However, there is a need to stratify community subgroups more systematically in order to determine health differentials better. Future HIA should consider community heterogeneity in an effort to reduce health inequities by “leaving no one behind”, as suggested by the Sustainable Development Goals.</p>}},
  author       = {{Leuenberger, Andrea and Farnham, Andrea and Azevedo, Sophie and Cossa, Herminio and Dietler, Dominik and Nimako, Belinda and Adongo, Philip B. and Merten, Sonja and Utzinger, Jürg and Winkler, Mirko S.}},
  issn         = {{0195-9255}},
  keywords     = {{Extractive industry; Health equity; Health impact assessment; Scoping review; Sub-Saharan Africa}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Environmental Impact Assessment Review}},
  title        = {{Health impact assessment and health equity in sub-Saharan Africa : A scoping review}},
  url          = {{http://dx.doi.org/10.1016/j.eiar.2019.106288}},
  doi          = {{10.1016/j.eiar.2019.106288}},
  volume       = {{79}},
  year         = {{2019}},
}