Republic of the Philippines

Department of Health
OFFICE OF THE SECRETARY
DEC 16 2071

ADMINISTRATIVE ORDER
No. 2021 - _O0GY

SUBJECT: Guidelines on the Implementation of the Health Impact

Assessment (HIA) for Policies and Programs pursuant to Republic
Act No. 11223

I. RATIONALE

To achieve Republic Act No. 11223 of the Universal Health Care (UHC) Act’s vision of
health for all, there is a need for (a) an integrated and comprehensive approach to ensure that
all Filipinos are health literate, provided with healthy living conditions, and protected from
hazards and risks that could affect their health; and (b) a framework that fosters a
whole-of-system, whole-of-government, and whole-of-society approach in the development,
implementation, monitoring, and evaluation of health policies, programs and plans. As such,
the UHC Act mandated the conduct of Health Impact Assessment (HIA) for policies,
programs, and projects that are crucial in attaining better health outcomes or those that may
have an impact on the health sector.

HIA is a systematic process of identifying and addressing the potential impacts of policies,
programs, and projects. It is a globally recognized mechanism to support the creation and
implementation of public policies and programs towards improving the health and well-being
of their target individuals and communities through evidence-based, systematic, and
participatory methods. It is a decision-informing mechanism in understanding the equity and
public health impacts of policy decisions especially those made outside the health sector and
whose development objective is not primarily targeting health. It provides practical and
alternative recommendations to increase positive health effects and minimize negative health
effects.

Given the critical role of HIA as a mechanism to support UHC especially in facilitating
supportive, health-enhancing policy environments that enable people to lead healthy lives,
there is a need to articulate the enforcement scope and implementation of HIA that shall be
conducted in aid of healthy public policies and programs.

II. OBJECTIVES

This Order aims to provide the framework and implementing guidelines in the conduct of
HIA for policies and programs that are crucial in attaining better health outcomes or those
that may have an impact on the health sector pursuant to the UHC Act and its implementing
rules and regulations. Specifically, it aims to:
1. Delineate the scope and eligibility of policies and programs that shall undergo Health
Impact Assessment;
2. Describe the process of HIA for policies and programs; and

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)
 3. Outline the implementation mechanisms in the submission and application of
requesting parties to conduct HIA for their policies and program plans.

IIL SCOPE OF APPLICATION

This Order shall apply to all DOH bureaus and services, Centers for Health Development,
and attached agencies, the Bangsamoro Autonomous Region in Muslim Mindanao
(BARMM) subject to the applicable provisions of RA No. 11054 or the “Bangsamoro
Organic Act” and subsequent rules and policies issued by the Bangsamoro government, other
national government agencies, local government units, and all others concerned in the
formulation and implementation of development policies and programs.

Iv. DEFINITION OF TERMS

A. Health Impact Assessment refers to a means of assessing the health impacts of

policies, programs, and projects in diverse economic sectors before, during, and after
implementation.

B. HIA Process refers to the steps in conducting Health Impact Assessment, which
include at the minimum: screening, scoping, appraisal, review and recommendations,
and monitoring and evaluation.

C. Policy Owner refers to the national government agency, organization, or juridical

entity, whether public or private, that drafted the proposed or existing policy or program
plan, and are considered as the principal author/s.

D. Concerned Agency refers to the national government agency with jurisdiction on

affected by the implementation of the proposed or existing policy or program plan.
or
is
E. Requesting Party refers to any individual, agency, or organization submitting an
application to conduct an HIA on a proposed or existing policy or program plan.

F. Policy refers to any public policy - such as legislation, orders, ordinances, and
proclamations, that is issued by governing bodies, co-developed with and instituted on
to
behalf of the public, that are oriented towards providing solutions a particular issue or
problem.

G. Program refers to any organized government-initiated actions for public health or

social support systems such as direct services, social projects, community mobilization,
and other policy determining activities.

H. Secial Determinants of Health refers to those factors that have a significant influence,
whether positive or negative, on an individual or population’s health, which can include
biological, political, and social factors, among others.

GENERAL GUIDELINES

A. Requesting parties shall ensure complete submission of documentary requirements and

other pertinent documents relevant to the conduct of an HIA, and abide by the
procedures and processes stipulated in this Order.
 B. Policies and program plans submitted for an HIA shall be reviewed vis-a-vis a priority
criteria in order to determine if these shall qualify for an HIA. Prioritization shall
ascertain a policy or program plan’s contributions to development priorities,
international commitments, and effects on the Social Determinants of Health.

C. The standard HIA methodology, anchored on the Social Determinants of Health

Framework, shall be adopted to ensure a systematized and evidence-based conduct of
HIA
in accordance with global practice.

V1. SPECIFIC GUIDELINES

A. Submission and Application Process. Requesting parties with eligible policies or

programs shall submit the necessary documents and adhere to the following steps and
procedures for application:
1. Requesting Party shall submit an official correspondence addressed to the
Director of the Health Promotion Bureau, duly signed by the designated
authority. The draft policy or program plan shall be attached in the
aforementioned correspondence.
The DOH shall ensure completeness of submission prior to the evaluation and
prioritization of the draft policy or program plan for an HIA.
. The DOH may require the submission of additional documents that may be
supplemental to the conduct of the HIA.

B. Prioritization. The conduct of HIA for policy and program plans shall be prioritized
based on:
1. Alignment and contribution to the country’s socio-economic development
priorities and global commitments;
2. Demonstrated interface with and potential impacts on the Social Determinants
of Health, such as but not limited to:
a. Biophysical environment - housing and working conditions, noise, food
supply
b. Social and economic environment - employment, household cohesion,
social/ cultural norms and practices, social network and cohesion,
vulnerable population/s, violence and crimes
c. Health-related Behaviors and Lifestyles - diet, physical activity,
substance abuse, sexual behavior, oral health practices
d. Local Services - access to health services, education, childcare,
housing services, transportation
Likelihood of inequitable distribution of potential health impacts for
disadvantaged groups; and
Availability of pertinent information or detailed implementing mechanisms in
the policy or program plan to be able to assess potential health impacts.

C. HIA Process for Policies and Programs. The DOH, through the Health Promotion
Bureau, shall manage the HIA Process for policies and programs and lead the conduct
of HIA based on the standard HIA methodology as follows:

1. Screening
a. Guided by the provisions stipulated in the preceding section (Section
VLA), the screening stage shall facilitate in identifying aspects of the
policy or program plan that may potentially impact health, and aid the
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 DOH-HPB in deciding if the potential impacts are sufficiently
important to warrant the conduct of HIA.

2. Scoping
a. For policy or program plans that have qualified, the scoping stage shall
identify the assessment plan or the coverage of the HIA to be
conducted. This includes prioritizing key areas of assessment,
designing health impact pathways as the guiding framework for the
assessment, and identifying data sources and other data collection
methodologies in aid of the conduct of HIA.

3. Appraisal
a. The appraisal stage shall involve the implementation of the assessment
plan that was previously defined in the scoping process. This stage in
the HIA is tasked in identifying and characterizing critical health
impacts, and most importantly its distribution among disadvantaged
groups.
b. A Technical Committee (TC) shall be convened to appraise the
findings from the assessment and recommendations prior to the formal
endorsement of the HIA Report to the originating office, requesting
entity, and/or concerned agency. The TC shall be composed of
designated focal persons from relevant DOH Offices with mandate on
health impact assessment, health policy development, disease
prevention and control, and local health systems as permanent
representatives. Resource persons may be invited as subject-matter
experts in the TC relative to the scope and technical expertise needed
to conduct the HIA.
¢. The DOH shall convene a rapid appraisal workshop with the TC,
external stakeholders, and other subject-matter experts to synthesize
the findings and identify recommendations and mitigating measures.
Particularly, the appraisal phase of the HIA is expected to:
i. Triangulate evidence reviews and other outputs from the
scoping phase;
ii. Provide a contextual checks or validation of the identified
potential impacts on health determinants and health outcomes;
and,
iti. Identify and propose recommendations to the policy and
program design

4. Endorsement
a. The endorsement stage shall ensure that the findings and
recommendations of the TC are effectively communicated to the
Requesting Party.
b. The DOH shall issue an official communication to the requesting party
endorsing and verifying that the proposal has undergone an HIA and
enumerating the findings of the assessment and recommended
mitigating measures, if
any.
¢. Findings and recommendations formally endorsed by the Technical
Committee are recommendatory and shall not serve as the final
endorsement of the DOH in the issuance of appropriate authorizations.
The DOH, in the exercise of its power to review the findings, shall

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 analyze and inspect the findings in connection with the implementation
of this Administrative Order.

5. Dissemination
a. As a decision-informing mechanism, the DOH shall exert best effort to
ensure that the HIA outputs and recommendations shall contribute in
the decision-making process by ensuring that all other Policy Owners
and Concerned Agencies are part of the dissemination networks that
the DOH shall be leveraging for this stage.
b. All potential dissemination platforms available shall be leveraged to
communicate the findings and recommendations of the HIA conducted
for a policy and program. Dissemination initiatives may be applicable
through the following modalities:
i. Findings and policy recommendations whose scope addresses
multiple determinants of health and require multisectoral,
interagency cooperation, shall be routinely presented to
relevant inter-agency Technical Board meetings convened by
NEDA.
ii. Findings and policy recommendations whose scope is more
specific to a particular sector, and can be addressed by a
sector-specific policy action, shall be endorsed to the
appropriate National Government Agency or concerned agency.
iii. Findings and policy recommendations which require policy
action at the local level shall be communicated directly to the
LGU concerned, or circulated through the DILG if applicable
to other local government contexts.

D. Management of Conflict of Interest. To ensure transparency, objectivity, and integrity

of HIA process, all members, representatives, and subject-matter experts of the
Technical Committee and other entities participating in the conduct of HIA shall declare
all possible sources of conflict of interest (COI) and abide by existing DOH regulation
on disclosing and managing Conflicts of Interests, without prejudice to future policy
issuances on this subject matter.

E. Monitoring and Evaluation. A monitoring and evaluation plan shall be developed and
implemented to examine the influence of the HIA Process in the policy development
process, in terms of adopting HIA findings and recommendations endorsed by the
Technical Committee to the Originating Office.

VII. ROLES AND RESPONSIBILITIES

A. The Health Promotion Bureau shall:

1. Provide overall management and technical oversight in the process of
conducting HIA on policies and programs;
2. Lead the conduct of HIA for policies and programs in coordination with the
Technical Committee;
3. Develop and regularly update the standard operating procedure for the conduct
of HIA for policies and programs;
Lead the coordination with relevant national government agencies related to
the conduct of the HIA Process for policies and programs;

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 5. Endorse HIA findings and recommendations to Originating Offices,
Requesting Entities, and Concerned Agencies, on behalf of the HIA Technical
Committee;
6. Implement dissemination initiatives to relevant inter-agency bodies, national
government agencies, and LGUs; and
7. Monitor the impacts of the HIA Process in the policy development process.

B. Health Policy Development and Planning Bureau, Bureau of Local Health

Systems and Development, Disease Prevention and Control Bureau, and other
concerned DOH Offices and Bureaus shall:
1. Ensure that potential health impacts of DOH policies and programs have been
identified, assessed, and properly mitigated; and
2. Provide complete details on the proposed policy or program in aid of
conducting HIA; and
3. Provide technical assistance to the Health Promotion Bureau during the
conduct of HIA, when necessary.

C. Centers for Health Development shall:

1. Lead, manage and conduct HIA for regional and local policies and programs

of
within their jurisdiction upon attainment system maturity;
2. Provide technical inputs to the Health Promotion Bureau during the conduct of
HIA especially for regional policies and programs, when necessary.

D. Other National Government Agencies, and oversight and governing bodies are
strongly enjoined to:
1. Collaborate and coordinate with DOH on the conduct of HIA for their
proposed socio-economic and social development initiatives; and
2. Abide by the guidelines set forth in this Order.

VIII. SEPARABILITY CLAUSE

If any provision of this Order declared invalid, unenforceable or unconstitutional, the

is
validity or enforceability of the remaining provisions shall not be affected, and this
Order shall be interpreted as if it did not contain the particular invalid, unenforceable, or
unconstitutional provision.

IX. EFFECTIVITY

This Order shall take effect fifteen (15) days after its publication in the Official Gazette
or in a newspaper of general circulation, with three (3) certified copies to be filed with
the Office of the National Administrative Register (ONAR) of the UP Law Center.

fest UQUE 111,

Secretary of Health
MD, MSe¢