Abstract
Background: Infrastructure spending, especially in the transport sector, is expected to increase rapidly in Vietnam. This boost in transportation investment impacts health. Environmental impact assessments (EIAs) are essential tools for decision-making to reduce and mitigate anticipated impacts of development projects, and integration of health assessment as an essential part of the EIA process has been regulated in many high-income countries. There is, however, limited knowledge about how health is evaluated in these environmental assessments in low- and middle-income countries (LMICs) such as Vietnam. Methods: We did an analysis of EIAs of four major transport projects in Vietnam, applying a six-step coding framework previously used to investigate EIAs in the Australian context. Results: We found that health was inadequately considered in all four EIAs. There was no direct health assessment within the four EIAs due to the lack of formal requirements from either Government or the financing agency, the Asian Development Bank (ADB). Health issues were often identified as risks posed by the projects within the assessment of impacts on environmental conditions. A broader consideration of health was limited. When social outcomes of the projects were present in EIAs, they were often mentioned once without any detailed assessment or linking to health. There was no evidence linking health benefits and shifts towards active travel with the construction of two metro rail projects. Mitigation measures offered in all four EIAs were found to be generic and insubstantial. Conclusion: The health assessments in the EIAs of four transport projects in Vietnam were significantly less detailed than those in Australia, mainly due to the lack of legislative requirements. The lack of health content indicates the need for involvement of health experts in the environmental assessment process, as well as requirements for the health assessment to be integrated in EIA. Our findings suggest there is the need to build capacity both within and outside of government to fully consider the health impacts of infrastructure in EIA practice.
Highlights
Infrastructure investments in Vietnam have substantial benefits for the country’s economy and the community
Financing agencies and international bodies should develop a comprehensive framework for assessing impacts of transport infrastructure on health, for low- and middle-income country (LMIC) settings and require the assessment to be included as part of the project approvals process
In relation to the known evidence linking public health and transport policy decisions,[31] as well as international calls for the inclusion of health in Environmental impact assessments (EIAs),[27,32] we find that these considerations are ‘insufficient’ due to several reasons: potential health risks were identified but direct health assessment was absent; social aspects were under-considered in terms of detail; the community health baseline was not available except for information of health facilities, which is insufficient for informing health predictions; and a lack of causal pathways considered changes to the environmental or social conditions and health outcomes
Summary
Infrastructure investments in Vietnam have substantial benefits for the country’s economy and the community. The recent launch of China’s One Belt, One Road (OBOR) Initiative, which proposes to go through many Southeast Asian countries including Cambodia, Laos, Vietnam, Myanmar, Thailand, Malaysia, and Singapore, is expected to have major impacts on the region.[2,3] It will potentially result in a boost in infrastructure development with a growing focus on transport. These developments are accompanied by a range of ensuing impacts on environmental and human health. The findings will be used to test the replicability of the framework on LMICs as well as its usefulness in a global context
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