JMIR Publications

ABSTRACT

Background:

Natural resource extraction projects (NREPs) offer both opportunities and risks for sustainable development and health in host communities. Often, however, the health of the community suffers. Health impact assessment (HIA) can mitigate the risks and promote the benefits of development, but is not routinely done in the developing regions that could most benefit.

Objective:

Our study aims to investigate health and health determinants in regions affected by extractive industries in Burkina Faso, Ghana, Mozambique, and Tanzania. The evidence generated in our study will inform a policy dialogue on how HIA can be promoted as a regulatory approach as part of the larger research initiative called the HIA4SD project.

Methods:

The study is a mixed-methods, multi-stage, multi-focus project that specifically addresses the topics of governance and policy, social determinants of health, health economics, health systems, maternal and child health, morbidity and mortality, and environmental determinants and associated health outcomes in NREP settings across four countries. To investigate each of these health topics, the project will (1) use existing population level databases to quantify incidence of disease and other health outcomes and determinants over time using time series analysis; (2) conduct two quantitative surveys on mortality and cost of disease in NREP regions; and (3) collect primary qualitative data using focus groups and key informant interviews describing community perceptions of the impacts of NREPs on health and partnership arrangements between the NREPs and local and national governance. Differences in health outcomes and health determinants between districts with an NREP and those without an NREP will be analyzed using matched geographical analyses in quasi-Poisson regression models and binominal regression models. Costs to the health system and to the households from disease found to be associated with NREPs in each country will be estimated retrospectively.

Results:

Fieldwork for the study began in February 2019 and will continue until February 2020. At the time of submission, qualitative data collection had been completed in Burkina Faso and Tanzania and is ongoing in Mozambique and Ghana; quantitative data extraction is ongoing in all four study countries. Results are expected to be published in 2020 and 2021.

Conclusions:

Disentangling the complex interactions of NREPs with their host communities requires an integrative approach drawing on many methodologies under the HIA umbrella. By using complementary data sources to address the question of population health in project areas from several angles, bias and missing data will be reduced, generating high-quality evidence to aid countries in moving towards sustainable development. Clinical Trial: None.