Project-related activities may directly, indirectly, and
even cumulatively change community exposures
to environment-based health risks, such as
communicable diseases, equipment accidents, and
exposure to hazardous materials or conditions.
Projects have the potential to affect a broad range of
environmental and social determinants of health either
positively or negatively.
Factors that may contribute to health impacts include:
A sudden influx of job seekers or extended family
that increases demands on existing health and
sanitation infrastructure
Introduction of infectious diseases (both vector-
borne and other communicable diseases)
These types of direct or indirect impacts may cause
project delays, damage to relationships with
communities or government organizations, legal
liabilities, and additional costs. However, when
properly managed, community health impacts may
reduce unnecessary cost (down time,
indemnifications), and help create positive
perceptions, such as a social license to operate.
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Section 1: Overview of HIA
A key consideration for the project is the ability to
effectively involve key stakeholders in a realistic
and positive participatory process. (Refer to Section
6 for a summary of the relevant approaches to
stakeholder engagement in the overall HIA
process, and to Appendix A for a list of IFC and
World Bank publications on the subject.)
Many health issues can be resolved with the
application of well-established, simple, and cost-
effective public health interventions, such as
treated bed nets, immunizations, and information,
education, and communication programs. A
significant portion of the underlying community
burden of disease (for example, respiratory,
diarrheal-related, or vector-borne) is often
effectively addressed by engineering strategies
such as housing design, water access and supply,
The capacity of the health system, particularly at
the local project level, is critical. This capacity
should be carefully evaluated to determine whether
and how a project might affect local health systems
and service delivery capacities. Particular attention
should also be given to the health information
systems (HIS) that record and summarize clinical
medical data.
The influx of workers and job seekers can impact local sanitation
and waste-management systems.
Consider potential impact on roadway accidents due to increased traffic.
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INTRODUCTION TO HEALTH IMPACT ASSESSMENT 7
and surface-water drainage management. (See
Appendix B for detailed sample mitigation
measures.)