| Stage 1 |
Activities in the HIA |
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| Screening |
To verify the need to carry out HIA based on potential impacts on the health of populations.
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* To consider the expanded concept of health, its determinants and conditions.
* To build indicators for diagnosis jointly, public power, private initiative and social representations.
* To carry out an assessment before the project is approved. Health is a variable dependent on social factors.
* To analyze studies and similar experiences in order to identify possible health problems.
* To identify the disruption of biomes that allows “silent” dissemination of health risks.
* To gather scientific evidence and survey with specialists.
* To analyze the project of the enterprise of environmental studies.
* To pay attention to the identification of issues related to mental health.
* To consider potential positive impacts. |
| Stage 2 |
Activities in the HIA |
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| Scope/Coverage |
To define the appropriate level of depth of the HIA and its area of coverage, elaboration of a specific Term of Reference (TR).
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* To assign to official bodies of the health area and the Public Ministry the supervision of the Term of Reference (TR).
* To list the entire area covered by the enterprise, from upstream to downstream.
* To problematize who is “affected”, covering the region beyond the reservoir installation.
* To create qualitative and quantitative environmental health thematic indicators, according to health determinants and conditions.
* To consider the circulating population, in addition to that living in the region.
* To cover area directly and indirectly affected and special attention to psychosomatic diseases, environmental and socioeconomic characteristics.
* To listen to the public opinion of those affected regarding the acceptability and life expectancy after the installation of the works.
* To consider the positive and negative impacts on socio-environmental determinants and the population’s quality of life.
* To pay attention to social justice in order to minimize impacts on the most vulnerable.
* To set up multiprofessional and interdisciplinary teams. |
| Stage 3 |
Activities in the HIA |
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| Identification/Data Collection |
To determine the profile of the community to be affected and carry out information gathering to identify potential health impacts.
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* Diagnosing the profile of the enrolled population should be the first step, with multidisciplinary teams. Determining the coverage area is the most difficult part of HIA.
* Also using a qualitative approach that allows reaching information that escapes official data.
* To build together with the community what data should be collected.
* To raise indicators from questionnaires, interviews, focus groups with the affected population.
* To consider culture, livelihoods, social ties and kinship, normally disregarded in environmental studies.
* To consider the typology of the enterprise, mainly operations, technology, products and raw materials with potential health risk.
* To identify income level and future perspectives of the population considering the conditions of reproduction of social life in other spaces. |
| Stage 4 |
Activities in the HIA |
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| Impact Assessment / Situational Analysis |
Critically analyze the information collected in order to define the main health impacts, in the different sources, establishing priorities.
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* To assemble a multidisciplinary team and the Public Ministry for situational analysis.
* To articulate the issues that emerged from the analysis, together with specialist and academics. Prioritize multiprofessional and interdisciplinary approaches.
* Based on historical data and knowledge produced in other regions already affected.
* To create software for qualitative and quantitative calculations, according to indicator weights.
* To perform the triangulation of data found in order to include in the scope of the project, including qualitative data.
* To pay attention to vulnerable groups, social, economic, cultural and environmental aspects.
* To conduct scientific studies to more accurately determine possible impacts.
* To create a data validation and analysis committee.
* To develop temporal baseline analysis of the epidemiological profile. |
| Stage 5 |
Activities in the HIA |
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| Making Decisions and Recommendations |
To develop an Action Plan with a set of actions to achieve goals in compliance with the proposed recommendations and strategies for implementing the actions.
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* To provide for community participation in the construction and development of the Action Plan.
* To build the Plan along the lines of health conferences, forums.
* To involve public bodies, previously affected communities, communities to be affected, and companies interested in the enterprise, as partners and not antagonists.
* To involve affected enterprises and municipalities in participatory spaces composed of affected communities.
* To consider the initial conditions of the community comparing them with the changes made.
* Appointing health professionals to be part of the assessment and planning team.
* To present the Plan to the community and directly impacted entities (city halls, health secretariats, organizations, community associations, etc.).
* Make it clear who will manage and supervise the implementation of the Plan.
* To determine that the execution and inspection are constant |
| Stage 6 |
Activities in the HIA |
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| Follow-up/Monitoring |
To evaluate the processes involved in monitoring health impacts based on pre-established indicators, monitoring criteria and impact management plan.
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* To relate the indicators to previous processes/stages organized by electronic means, software creation
* To check, periodically, how the health of the population is evolving/behaving, if new diseases appear, and how prepared or not the communities are to face these risks.
* Participation and social control in this process, in an equal way.
* To contemplate strategies of attention to the physical, mental and emotional health problems of the affected people.
* To establish a working committee made up of the affected communities, the project, social movements, researchers and professionals who work in public policy in the affected areas.
* To monitor and follow up, in detail, the impacts foreseen and not foreseen in the evaluation phase.
* To monitor for at least 5 years, comparing whether the impacts predicted in the assessment are compatible. If necessary, carry out new methodological approaches.
* To monitor continuously by means of the indicators
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