Addressing Health in SEA for Healthy Public Policy

1. Addressing Health in SEAfor Healthy Public Policy An initial contribution from SEA development in Thailand Suphakij Nuntavorakarn, Nuntana Sabrum, Decharut Sukkumnoed The HPP-HIA Program, Health Systems Research Institute

2. The ground of SEA development • The National Health System Reform, since 2000 • Health: physical, mental, social, and spiritual well-being of the people • Healthy Public Policy (HPP) become the goal and means of the reform

3. The ground of SEA development • Develop Health Impact Assessment for Healthy Public Policy, since 2001 • HPP: Healthy public policy process to achieve the ‘well-being’ in all four aspects of health; physical, mental, social, and spiritual

4. Necessities of SEA • Centralized policy and planning process • Strategic decisions with no public participation • Many conflicts at project level • EIA has limited role to play • Power inequalities in the society: Info., Knowledge, Institution, Political

5. Necessities of SEA • Health Impact Assessment: success (or progress) in some aspects, but inadequately deal with strategic issues and alternatives • Applying SEA for Healthy Public Policy

6. The evolution of SEA • SEA has been perceived and evolved differently in Thai society • SEA needs to evolve according to the context of Thai society • Policy process • Good Governance • Civil society

7. The four SEA approaches in Thai society • SEA EIA School • SEA Area Base • SEA Policy Options • SEA Development Directions

8. Various SEA approaches:Differences and connections • To facilitate the evolution of SEA in Thai society • Not answer ‘which one is the best?’ • But rather for better applying, linkages, and also the analysis of addressing health in SEA

9. SEA-EIA Impact analysis of dev. direction, program, (or mega-project), usually predetermined by powerful actors already SEAArea Base Analysis on different aspects of an area to provide the scope, limitations, and potentials for development SEA Policy Options Analysis of impacts and trade-off of various policy options SEA Development Directions Analysis of context, value, factors, problems, and opportunities to synthesize the best strategic direction/option Main characteristic

10. SEA-EIA What are the significant environmental impacts and what are the mitigation measures? SEAArea Base What are the factors, conditions and opportunity of an area that should be concerned for development? SEA Policy Options What are the policy options and comparison of the impacts, and the trade-off in each option? SEA Development Directions What is the best strategic direction/option, according to the context, value, factors, problems and opportunities of the issue? Core research question

11. SEA-EIA No action as determined or planned SEAArea Base No action to the area SEA Policy Options Action on the same option SEA Development Directions Action on the same direction Zero alternative

12. SEA-EIA Minimize envi. impacts with mitigation measures SEAArea Base Development, project dev. and site selection that are appropriate to the context of the area SEA Policy Options Deliberative decision-making process of the society on various policy options SEA Development Directions Development direction and policy that is appropriate to social and envi. context and factors Expected outcomes

13. SEA-EIA For approval/permit, Not changing strategic directions SEAArea Base Limitations of Area-base approach in the policy process SEA Policy Options No details of area-base context&factors No comprehensive alternative dev. SEA Development Directions Long process, long time Not for (seriously) conflicting issues Main limitations

14. The health concepts • EIA approach to health • Main focus on envi. impacts • Health as the consequences of envi. impacts • Ecosystem approach to health • Environment as an Ecosystem comprises of biophysical, social, and economic environment • Human health = Ecosystem health • Health as a main component in the Ecosystem

15. The health concepts • Healthy Public Policy approach • All aspects effect health • Any public policy: incorporate health consideration, promote healthy policy alternatives, and ‘Healthy’ policy process • Health as comprehensive impacts and integrated assessment

16. The health concepts • Health inequalities approach • Health is not only the matter of individual • Social factors that determine individual health risks and opportunities • ‘Cause of the Causes’ or Social Determinants of Health • Health as a way of living healthy together

17. HealthInequalities EcosystemApproach EIAApproach HealthyPublicPolicy Addressing health inthe four SEA approaches OutsideFactors NeedIntention SEA Policy Options SEAAreaBase SEADev.Direction ShouldImprove SEAEIASchool ShouldNot

18. Applying and Linking • Examples of ideas that we are working on • Power policy • We are working on SEA Policy Options (HPP approach) • But after this, should do SEA Area Base • Water crisis in the Eastern Region • Initiating SEA Policy Options (Tend to be HPP approach) • But actually, may need to do SEA Development Directions later

19. Applying and Linking • Salt resources management in the Northeastern Region: • Synthesizing fragmented problems and the totally new strategic issue emerged • Initiating SEA Development Directions (May be the Ecosystem approach) • But may need SEA Policy Options in the next step or near future • Initial mapping of addressing health for strategic issues, to be developed further

20. Thank you www.hpp-hia.or.th