Draft version. For copyediting and layouting in alignment with the Healthy Pilipinas branding.

7 Methods Guide for

8 Conducting Health Impact

9 Assessment for Policies and
10 Programs
11
12 Document version no. 1, s. 2022

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13 Acknowledgement
14
15 Editorial Board
16 Beverly Lorraine C. Ho, MD, MPH
17 Rodley Desmond Daniel Carza, RN, MPH
18
19
20 Editorial Staff
21 Frances Claire C. Onagan, MPH
22 Alyzza Vienn M. Eclavea
23 Lizelle Christine Jusayan
24 Karl Mari Clemente
25
26
27
28
29
30
31
32 Preface
33 This Methods Guide supplements DOH Administrative Order No. 2021-0064:
34 Guidelines on the Implementation of the Health Impact Assessment (HIA) for Policies
35 and Programs pursuant to Republic Act No. 11223, which operationalizes the HIA
36 Process for DOH and non-DOH policies and programs. It outlines the governance
37 structure, procedural framework, and operational guidelines in conducting an HIA
38 for policies and programs anchored on the Social Determinants of Health
39 Framework and as envisioned by the Universal Health Care Act.
40
41 Suggested citation:
42 Department of Health Philippines. 2022. Methods Guide for Conducting Health Impact
43 Assessment for Policies and Programs
44

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45 Table of Contents
46
47 Overview of the HIA Process 1

48 Health Impact Assessment 1

49 Social Determinants of Health Framework 1

50 General HIA Process 2

51 Governance Structure 3

52

53 HIA Process for Policies and Programs 6

54 Submission for HIA

55 Screening 6

56 Scoping 8

57 Appraisal 11

58 Endorsement 13

59 Dissemination 13

60

61 Annexes 15
62
63
64

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65 Overview of the Health Impact Assessment

66 Process
67
68 A. Health Impact Assessment
69
70 Pursuant to the Republic Act No. 11223 or the Universal Health Care Act of 2019
71 and its Implementing Rules and Regulations, Health Impact Assessment (HIA) is a
72 means of assessing the health impacts of policies, programs, and projects in
73 diverse economic sectors before, during, and after implementation. The World
74 Health Organization further defined HIA as “a practical approach used to judge
75 the potential health effects of a policy, programme or project on a population,
76 particularly on vulnerable or disadvantaged groups.”
77
78 HIA has been widely used internationally as a mechanism to ensure the safe and
79 equitable implementation of various initiatives and to provide practical and
80 alternative recommendations to increase positive health effects and minimize
81 negative health effects. The conduct of HIA utilizes and promotes the use of both
82 quantitative and qualitative means of data gathering and analysis and
83 methodologies to highlight the gravitas of both technical/ scientific and non-
84 technical/common knowledge as data sets.
85
86 B. Social Determinants of Health Framework
87
88 In support of the UHC’s vision of healthy living, schooling, and working
89 environments, the HIA modality operationalized by the DOH operates in
90 accordance with the Social Determinants of Health (SDH) Framework which
91 embodies the concept that 80% of a person’s well being is affected by factors
92 that are beyond the purview of the healthcare system and/or the medical field.
93
94 The Social Determinants of Health Framework promulgates that health and well-
95 being of an individual and of a community is greatly affected by non-medical
96 factors such as socioeconomic status, employment, family and culture,
97 environment, education,economy, politics, etc. These factors are categorized as
98 social determinants as they greatly impact individual health outcomes and well-
99 being.
100
101

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102 C. General Process

103
104 As promulgated by the WHO, the HIA process for policies and program shall be
105 operationalized and implemented through five (5) stages: Screening, Scoping,
106 Appraisal, Endorsement, and Dissemination. The steps and processes of HIA are
107 anchored on the standard processes of conducting an HIA and were tail-fitted to
108 adapt to the policy development process of the DOH and of other national
109 government agencies and sectors.
110
111 1. Screening
112 The screening stage shall identify the aspects of the policy or program plan
113 that may potentially impact health, and aid the DOH-HPB in deciding if the
114 potential impacts are sufficiently important to warrant the conduct of HIA.
115
116 2. Scoping
117 The scoping stage shall identify the assessment plan or the coverage of the
118 HIA to be conducted. This includes prioritizing key areas of assessment,
119 designing health impact pathways as the guiding framework for the
120 assessment, and identifying data sources and other data collection
121 methodologies in aid of the conduct of HIA.
122
123 3. Appraisal
124 The appraisal stage shall involve the implementation of the assessment plan
125 as defined in the scoping process. This stage in the HIA includes identifying
126 and characterizing critical health impacts of the policy or program plan, and
127 its distribution among disadvantaged groups.
128
129 4. Endorsement
130 The endorsement stage shall ensure that the findings and recommendations
131 of the HIA Technical Committee are effectively communicated to the
132 Requesting Party.
133
134 5. Dissemination
135 The dissemination stage shall ensure that the HIA outputs and
136 recommendations contribute to the decision-making and planning process of
137 concerned government agency/ies or sectors by engaging and informing
138 Policy Owners and Concerned Agencies.
139
140

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141 D. Governance Structure

142
143 1. HPB as the Process Owner and Manager
144
145 As mandated by the DOH Administrative Order (AO) No. 2021-0064 or Guidelines
146 on the Implementation of the Health Impact Assessment for Policies and
147 Programs pursuant to Republic Act No. 11223, it is the responsibility of the
148 Health Promotion Bureau (HPB) with authority under the DOH to manage the
149 HIA Process for policies and programs and organize the structure and
150 composition of the HIA Technical Committee. Further, the HIA Unit shall be
151 lodged directly under the Policy, Planning, Standards, and Research Division
152 (PPRSD) tasked to provide technical and administrative support for the operation
153 of the HIA Process.
154
155 Upon attainment of system maturity, authority to manage and operationalize the
156 HIA Process shall be delegated to Centers for Health Development to conduct
157 HIA on local ordinances and programs within their administrative jurisdiction.
158
159 Roles and Responsibilities
160
161 The Health Promotion Bureau, through the PPRSD - HIA Unit, shall have
162 oversight on the operation of the HIA Process for policies and programs, and
163 assume technical and administrative functions in carrying out its day-to-day
164 activities and deliverables.
165
166 As such, the following are the specific roles and responsibilities of the HIA Unit:
167 1. Provide overall management and technical oversight in the
168 process of conducting HIA on policies and programs;
169 2. Lead the conduct of HIA for policies and programs in coordination
170 with the HIA Technical Committee;
171 3. Ensure the provision of honoraria of consultants and technical
172 experts of the Technical Committee, based on existing accounting
173 and auditing rules;
174 4. Provide administrative and secretariat support to the Technical
175 Committee in conducting appraisal workshops and meetings;
176 5. Provide routine capacity building activities to the HIA Unit,
177 Technical Committee, and other experts and consultants on HIA;
178 6. Develop and regularly update the standard operating procedure
179 on the conduct of HIA for policies and program in coordination
180 with the HIA Technical Committee;

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181 7. Lead the coordination with relevant national government agencies

182 related to the conduct of the HIA Process for policies and
183 programs;
184 8. Endorse HIA findings and recommendations to Policy Owner,
185 Requesting Party, and Concerned Agencies, on behalf of the HIA
186 Technical Committee;
187 9. Implement dissemination initiatives to relevant inter-agency
188 bodies, national government agencies, and LGUs; and
189 10. Monitor the impacts of the HIA Process in the policy development
190 process
191
192 2. HIA Technical Committee
193
194 The HIA Technical Committee is a multidisciplinary team tasked to conduct the
195 HIA of submitted policies and programs plans in compliance with the provision
196 under §33 of the Universal Health Care Act and its Implementing Rules and
197 Regulations, and the DOH AO No. 2021-0064.
198
199 The HIA Technical Committee shall be composed of Core Members with a fixed-
200 term position of at least three years, and Rotating Members who will be
201 onboarded depending on the agreed scope of assessment and needed technical
202 expertise to conduct the HIA.
203
204 Pursuant to AO No. 2021-0064, core members of the HIA Technical Committee
205 shall be designated focal person/s from relevant DOH offices with mandate on
206 the following:
207 1. Health Impact Assessment
208 2. Health Policy Development
209 3. Disease Prevention and Control
210 4. Local Health Systems
211
212 Rotating members and/or resource persons may be invited as subject-matter
213 experts in the TC relative to the scope and technical expertise needed to conduct
214 the HIA.
215
216 Roles and Responsibilities
217
218 The Technical Committee is primarily tasked to appraise the findings of the
219 assessment and provide technical inputs and recommendations to the HIA

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220 conducted in relation to their respective technical expertise. As such, the

221 following are their specific roles and responsibilities:
222 1. Serve as subject-matter experts and provide technical inputs to the
223 HIA
224 2. Attend committee meetings and participate in the review and
225 assessment of the HIA Report
226 3. Triangulate evidence reviews and other outputs from the scoping
227 phase;
228 4. Provide contextual checks or validation of the identified potential
229 impacts on health determinants and health outcomes; and,
230 5. Identify and propose recommendations to the policy and program
231 design
232

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233 Health Impact Assessment Process for Policies

234 and Programs
235
236 Scope of Implementation
237
238 The HIA Process to be implemented pursuant to DOH Administrative Order No. 2021-
239 0064 shall cover all development public policies such as legislation, orders, ordinances, and
240 proclamations, that are issued by governing bodies, co-developed with and instituted on
241 behalf of the public, that are oriented towards providing solutions to a particular issue or
242 problem. Likewise, it shall cover all development programs which are organized
243 government-initiated actions for public health or social support systems such as direct
244 services, social projects, community mobilization, and other policy-determining activities.
245
246 This methods guide does not cover the implementation of the HIA Review Process for
247 Development Projects, whose governance and implementation mechanism, is provided
248 for under the DOH-DILG Joint Administrative Order No. 2021-0001 and its other auxiliary
249 documents.
250
251 HIA Process for Policies and Programs
252
253 I. Submission for HIA
254
255 To request the conduct of HIA for policies and programs, the Requesting Party
256 must submit an official correspondence (Annex A. Templates for Internal or
257 External Requests) to the HIA Unit addressed to the Director of the Health
258 Promotion Bureau duly signed by the designated authority. At the minimum,
259 the Requesting Party should submit the following:
260 1. Official correspondence signed by the designated authority (Annex A.1.
261 or A.2.)
262 2. A copy of the policy or program plan that has been cleared or endorsed
263 by the designated authority (i.e., Director-level at the minimum)
264 3. Other supplementary documents in relation to consultations conducted
265 in the policy development, if any
266
267 Upon submission, the HIA Unit shall assess whether the policy or program plan
268 warrants the conduct of an HIA. The HIA Unit shall ensure completeness of
269 submission prior to the evaluation of eligibility of the draft policy or program
270 plan for an HIA. If deemed necessary, additional documents that may be
271 supplemental to the conduct of the HIA may be requested from the Requesting
272 Party. All incomplete submissions shall be reverted to the Requesting Party for
273 compliance.
274
275 For DOH-originating and/or co-authored policies that will undergo the policy
276 review and clearance process of the DOH, the endorsement documents

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277 emanating from the HIA Unit shall constitute proof of complete staff work
278 that will be submitted to the Health Policy Development and Planning
279 Bureau. The Requesting Party and/or Policy Owner shall not self-exempt
280 their policy or program plan from the HIA Process on the basis of their
281 understanding of the evaluation criteria.
282
283 All Requesting Parties requiring the endorsement documents on HIA must
284 abide by the submission procedures promulgated in this Methods Guide.
285
286 II. Screening
287
288 Screening of Policies and Programs
289
290 The screening stage shall assess the eligibility of policies and program plans to
291 warrant the conduct of an HIA, and identify preliminary impacts of the policy or
292 program plan to the social determinants of health. The HIA Unit shall ensure that
293 applications satisfy all the initial screening criteria provided in Annex B.
294 Screening Form.
295
296 Identifying Changes in the Social Determinants of Health
297
298 A scoring mechanism shall be utilized to identify the potential impacts of the policy
299 or program to various Social Determinants of Health and its projected level of risk
300 to the general public and/or disadvantaged groups.
301
302 Based on the provided implementing provisions of the policy or program and on
303 best available evidence and literature, the HIA Unit shall identify the social
304 determinants of health that may be positively and/or negatively affected by the
305 policy or program by checking the appropriate box. Further, the HIA Unit shall rate
306 the level of risk/ likely magnitude of the negative effect to the SDH from one (1)
307 being the lowest to three (3) being the highest.
308
309 III. Scoping
310
311 The scoping stage shall develop the assessment plan (i.e., HIA Terms of Reference)
312 and determine key areas of assessment for the conduct of the HIA for the policy
313 or program plan.
314
315 A. Methodology
316
317 The scoping stage employs a two-part process namely the community scoping and
318 technical scoping, which aims to extract both community-based and technical
319 information on the policy or program.
320

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321 To conduct community and technical scoping, the HIA Unit may employ
322 participatory methodologies such as but not limited to key informant interviews,
323 conversation, inter-agency meetings, and/or workshops with the appropriate
324 stakeholders. In conducting the scoping activities, the HIA Unit must ensure that
325 lay knowledge perspectives are gathered from affected group/s of interest as well
326 as technical knowledge from content and subject-matter experts.
327
328 Data gathering techniques and data management employed during the scoping
329 activity/ies shall be conducted based on standard ethical conduct of data
330 gathering and the Data Privacy Act of 2012. The HIA Unit shall exert all means to
331 generate, at the minimum, the following data and information on the group/s of
332 interest:
333
334 1. Special population/s present (e.g. minors or children under 18 years
335 old, elderly, differently-abled persons, refugees or displaced persons,
336 indigenous peoples and ethnic minority groups, etc.
337 2. Demographic characteristics (e.g. population estimate of the group of
338 interest, gender identifications and expressions present,
339 socioeconomic status and distribution, employment and/or sources of
340 income, educational status, etc.)
341 3. Baseline health condition (e.g. disease prevalence and incidence)
342 4. Available and/or accessible health and social services and safety nets
343 (e.g. livelihood programs, access to medicine and health care, social
344 amelioration programs, cash grants, etc.)
345 5. Social risks and issues present among the members of the group of
346 interest (e.g., poverty and homelessness, unemployment,
347 discrimination such as gender, race, religion, culture, age, etc., gender-
348 based violence, violence against children, social disorganization,
349 illiteracy, etc.
350
351 B. Community Scoping
352
353 The HIA Unit shall conduct a stakeholder analysis to identify group/s of interest to
354 be invited in order to gain insight on their perceived impacts of the policy or
355 program plan once implemented.
356
357 C. Technical Scoping
358
359 The HIA Unit shall elicit additional technical information from content or
360 subject-matter experts to determine aspects of the proposed policy or
361 program plan that need to be further investigated during the Appraisal
362 phase of the HIA. Invited technical experts shall be contingent on the
363 identified potential impact as determined in the screening stage.
364
365
366 D. Developing the Health Impact Pathway Diagram

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367
368 The Health Impact Pathway Diagram shall be informed by the insights on
369 potential impact areas that were raised during the community and technical
370 scoping. This exercise shall guide the HIA Unit in prioritizing and
371 systematically identifying the key areas of assessment that will be the focus
372 in the Appraisal stage of the HIA Process.
373
374 The HIA Unit shall provide information on the corresponding categories:
375 1. Policy or Program Component - identify specific implementing
376 measures or components of the policy or program that will be integral
377 in the attainment of the policy/ program goals and objectives
378 2. Proximal Impacts - per policy/program component, enumerate
379 immediate positive and/or negative impacts of the policy or program
380 to the affected population
381 3. Health Determinants - specify the determinant of health that will be
382 affected by the proximal impacts
383 4. Health Indicators - based on best available evidence and initial data
384 collected, identify the health effect caused by the changes in the SDH
385 identified in the previous item
386

Project Proximal Health Health

Impacts Determinant Indicators
What is the What are the What are the Based on the
specific project immediate by- health evidence base,
being products of the determinants what are the
387
388 Figure 1. Health Impact Pathway Diagram
389
390 E. Prioritizing Key Areas of Assessment
391
392 Upon completion of the Health Impact Pathway Diagram, the HIA Unit shall
393 conduct a prioritization exercise with the group/s of interest to identify major
394 areas of concern and determine key areas of assessment of the proposed policy
395 or program deemed critical by the group/s of interest.
396
397 Identifying key areas of assessment may be done by majority votation, thematic
398 analysis, scoring mechanism, or other means deemed appropriate to arrive at a
399 definitive decision.
400
401 F. Developing the HIA Terms of Reference
402
403 Guided by evidence collected during the scoping stage and the key areas of
404 assessment that were prioritized, the HIA Terms of Reference (Annex C) shall be
405 developed by the HIA Unit to serve as the assessment plan in data gathering and

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406 analysis in the course of conducting HIA for the policy or program plan under
407 evaluation.
408
409 At the minimum, the HIA TOR shall discuss in detail the following sections:
410 1. Overview of the Policy or Program Plan
411 2. Suggested Methodology
412 a. Data Gathering Methodologies
413 b. Data Analysis Plan
414 c. Timelines
415 3. List of HIA Preparer/s
416
417 Once finalized, the draft HIA Terms of Reference shall be endorsed to the HIA
418 Technical Committee for ad referendum review and approval prior to the
419 commencement of the HIA.
420
421 IV. Appraisal
422
423 The appraisal stage shall gather and synthesize relevant data on impacts using
424 best available data sources, and systematically cull out recommendations for
425 mitigating measures to address the identified health impacts of a policy or
426 program plan if implemented. The conduct of the appraisal stage shall be done
427 based on ethical and scientific conduct of research and data gathering.
428
429 A. Suggested Methodology
430
431 a. Literature Review
432
433 A review of published evidence relevant to the HIA being done will be
434 conducted to supplement the data acquired from the community and
435 technical scoping. The HIA Unit shall collect quantitative and qualitative data
436 from all relevant and available data sources, as well as evidence bases
437 comprising primary and secondary data. The stages and procedures outlined
438 in the London Health Observatory's "A Guide to Reviewing Evidence for Use in
439 Health Impact Assessment" will be used to guide the literature review.
440
441 In conducting literature review, the HIA Unit must ensure that:
442 1. The question/s or key areas of assessment to be analyzed is/are
443 clear and focused, and as identified with the group/s of interest;
444 2. Data and information on group/s of interest and other
445 demographic factors, including vulnerable groups and others with
446 different exposure or susceptibility, are comprehensively collected
447 and collated;
448 3. The purpose of the review is stated clearly;
449 4. Inclusion and exclusion criteria are clearly defined and
450 distinguished;
451 5. Search strategies are explicit and outlined; and,

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452 6. Scope and limitation of the review is described;

453
454 Data may be scoured from sources such as but not limited to previous HIA
455 Reports, HIA-specific literature reviews, existing systematic reviews,
456 existing literature reviews, and grey literature reviews.
457
458 b. Content Analysis of Data from the Scoping Stage
459
460 To analyze data extracted from the community and technical scoping, the
461 HIA Unit may conduct a thematic content analysis (Annex D) guided by the
462 Braun and Clarke (2016) six-phase framework as follows:
463 1. Step 1: Transcribe and encode the data
464 2. Step 2: Generate initial codes
465 3. Step 3: Search for themes
466 4. Step 4: Review pre-identified and emerging themes
467 5. Step 5: Refine themes identified
468 6. Step 6: Write-up
469
470 Summary of interviews, meeting and workshop documentation, and other
471 qualitative data collected during the scoping stage shall be transcribed in
472 full. Codes will then be assigned and encoded by the HIA Unit on words,
473 concepts, and ideas related to key areas of assessment and potential
474 health impacts of the policy or program.
475
476 Upon encoding, the HIA Unit shall collectively categorize codes to the
477 identified key areas of assessment using meta-cards and/or excel sheets.
478 Any discrepancies during the coding process will be settled through
479 consensus. Emerging key areas of assessment not included in the initially
480 prioritized key areas will also be documented.
481
482 All data will be anonymized and no identifiers will be included in the HIA
483 report.
484
485 B. Evidence Synthesis of Potential Impacts and Data Triangulation
486
487 Based on quantitative and qualitative data collated from literature, technical
488 experts, and the population group, the HIA Unit shall comprehensively discuss
489 and elaborate potential health outcomes, direct and indirect effects, pathways
490 and linkages of the policy or program to the various determinants of health.
491
492 Specifically, the HIA Unit shall describe:
493 - Potential direct effects on health such as prevalence and/or incidence of
494 pertinent diseases, change in the capacity and/or operation of the local
495 health system, access to and availability of local health services

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496 - Potential social and cultural impacts on health such as housing and
497 settlement conditions, local education system, local transport or mobility,
498 social cohesion and capital
499 - Potential economic impacts on health such as local livelihood, household
500 employment, and sources of income
501 - Potential Impacts on other health determinants
502
503 The HIA Unit shall comprehensively triangulate evidence collected from
504 technical scoping and literature review with the data gathered from the
505 community scoping to validate evidence and identify critical health impacts to
506 be prioritized for management and mitigation.
507
508 C. Characterization of Potential Impacts
509
510 To assess the level of impact of the identified potential health consequences, the
511 HIA Unit shall discuss and determine - using an assessment matrix (Annex E), the
512 following categories:
513 1. Nature of the impact - whether the identified health impact will cause
514 positive, negative, or unclear impact based on the collected data;
515 2. Likelihood and/or certainty of impact - as defined:
516 a. Definite - as established by evidence from both published literature,
517 grey literature, and scoping evidence
518 b. Probable - as identified in the community and technical scoping
519 with supporting evidence from grey literature
520 c. Speculate - as mentioned in the technical and community scoping
521 with inadequate literary evidence to establish certainty
522 3. Size and severity of possible health consequences - the scale of which the
523 potential impact will affect (i.e., the larger the population group/s, the
524 higher the severity of health consequences)
525
526 The HIA unit shall also identify specific group/s that will bear the identified
527 impact/s and the corresponding nature of the impact in terms of its effect to the
528 identified group/s of interest.
529
530 D. Developing the HIA Report
531
532 A more thorough analysis of the community and the primary areas of assessment
533 is provided in the HIA Report (Annex F. , which is created following the completion
534 of the HIA based on the agreed-upon techniques and scope outlined in the HIA
535 Terms of Reference. The HIA Report details the processes and data collection
536 procedures used, the synthesis of possible impacts and available information, and
537 the conclusions and recommendations of the HIA Preparers based on the
538 examined data.
539
540 The HIA Report shall be developed by the HIA Unit to discuss the HIA conducted
541 and provide information on data collected, summary of analysis, and comments

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542 and recommendations on the policy or program. The report shall be developed in
543 accordance with ethical and scientific integrity standards in developing technical
544 documents.
545
546 The HIA Report for Policies and Programs shall discuss in detail the following
547 sections:
548 1. Evidence from Community and Technical Scoping
549 2. Evidence from Literature Review
550 3. Appraisal of Impacts
551 4. Recommendations
552 a. What to retain
553 b. What to enhance
554 c. What to reconsider
555 d. What to monitor
556
557 E. Convening the Technical Committee
558
559 To triangulate evidence and recommendations provided by the HIA Unit, the HIA
560 Technical Committee shall be convened by the HIA Unit to assess and validate the
561 output, policy or program recommendations, and proposed mitigating measures
562 stipulated in the HIA Report.
563
564 V. Endorsement
565
566 The endorsement stage shall ensure that comments, recommendations, and
567 proposed mitigation measures of the HIA Unit on the policy or program plan
568 under review are disseminated and forwarded to the Requesting Party for their
569 review and consideration.
570
571 The findings of the HIA and the recommendations and mitigating measures
572 provided in the HIA Report are recommendatory in nature for consideration of
573 the Policy Owner. Likewise, it does not represent the official stand of the
574 Department of Health on the policy or program plan under review and should
575 not be used to ascertain the DOH’s official position on other matters relevant to
576 the policy or program plan. Further to this, HIA endorsements emanating from
577 the HIA Unit shall not substitute the final endorsement of the DOH in the
578 issuance of appropriate authorizations.
579
580 The decision to adopt, implement, and monitor the mitigating measures
581 provided in the HIA Report shall be the responsibility of the Policy Owner.
582
583 VI. Dissemination
584
585 To contribute to the policy- and decision-making process of Policy Owners and
586 Concerned Agencies as well as ensure transparency of the HIA Process, the DOH

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587 shall extensively disseminate the HIA outputs and recommendations through
588 various modalities and platforms.

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589 Appendix A. Definition of Terms

590
591 1. Core Members refers to the permanent members with technical expertise on the
592 minimum required qualifications and competencies to constitute the HIA
593 Technical Committee and shall review all types policies and program plans as
594 mandated by the DOH AO 2021-0064
595
596 2. Concerned Agency refers to the national government agency with jurisdiction on
597 or is affected by the implementation of the proposed or existing policy or program
598 plan.
599
600 3. Group/s of interest refers to population groups, groups of individuals, sectoral
601 groups, vulnerable or marginalized groups that are not necessarily geographically
602 or administratively bound, who are affected or may potentially be affected by the
603 policy or program plan.
604
605 4. Health Impact Assessment refers to a means of assessing the health impacts of
606 policies, programs, and projects in diverse economic sectors before, during, and
607 after implementation
608
609 5. HIA Process refers to the standard steps in conducting Health Impact Assessment
610 as promulgated by the World Health Organization, which include at the minimum:
611 screening, scoping, appraisal, review and recommendations, and monitoring and
612 evaluation
613
614 6. Policy refers to any public policy - such as legislation, orders, ordinances, and
615 proclamations, that is issued by governing bodies, co-developed with and
616 instituted on behalf of the public, that are oriented towards providing solutions to
617 a particular issue or problem.
618
619 7. Policy Owner refers to the national government agency, organization, or juridical
620 entity, whether public or private, that drafted the proposed or existing policy or
621 program plan, and are considered as the principal author/s.
622
623 8. Program refers to any organized state-initiated actions for public health or social
624 support systems such as direct services, community mobilization, and other policy
625 determining activities.
626
627 9. Requesting Party refers to any individual, agency, or organization submitting an
628 application to conduct an HIA on a proposed or existing policy or program plan.
629
630 10. Rotating Member refers to the non-permanent members of the HIA Technical
631 Committee with technical expertise on specific fields of expertise and shall be
632 invited to the HIA Process as deemed necessary
633

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634 11. Social Determinants of Health refers to the non-medical factors that influence
635 health outcomes. They are the conditions in which people are born, grow, work,
636 live, and age, and the wider set of forces and systems shaping the conditions of
637 daily life. These forces and systems include economic policies and systems,
638 development agendas, social norms, social policies and political systems.

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639 Appendix B. Reference/s

640

641 Harris, P., Harris-Roxas, B., Harris, E., & Kemp, L. (2007). (tech.). Health Impact Assessment:
642 A Practical Guide. NSW Department of Health. Retrieved 2022, from
643 https://hiaconnect.edu.au/wp-content/uploads/2012/05/Health_
644 Impact_Assessment_A_Practical_Guide.pdf.

645 Health impact assessment (HIA) tools and methods. World Health Organization. (n.d.).
646 Retrieved 2022, from https://www.who.int/tools/health-impact-assessments

647 Ministry of Health, Department of Hygiene and Prevention. (n.d.). (tech.). A Practical
648 Guideline on Health Impact Assessment in Lao PDR. Retrieved 2022, from
649 http://www.hianetworkasiapac.com/wp-content/uploads/Laos_Health-Impact-
650 Assessment-practical-guideline-complete-.pdf.

651 Mindell J., Biddulph J.P., Boaz A., Boltong A., Curtis S., Joffe M., Lock K, Taylor L. (2006). A
652 Guide to Reviewing Evidence for use in Health Impact Assessment. London: London
653 Health Observatory. Retrieved 2022, from
654 https://discovery.ucl.ac.uk/id/eprint/122644/1/Mindell_Reviewing%20Evidence-
655 Final%20v6.4_230806.pdf

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Annex A.1. Request for the Conduct of HIA for Policy and Programs (Letter Template)

[DATE]

BEVERLY LORRAINE C. HO, MD, MPH

Director IV, Health Promotion Bureau
Department of Health

THRU: MR. RODLEY DESMOND DANIEL M. CARZA, MPH, RN

Chief, Policy, Planning, Standards, and Research Division
Health Promotion Bureau

Dear Director Ho:

Good day!

We would like to request for the conduct of a Health Impact Assessment, as operationalized by
the Department of Health (DOH) Administrative Order No. 2021-0064: Guidelines on the
Implementation of the Health Impact Assessment Process for Policies and Programs Pursuant to
Republic Act No. 11223, of the [policy or program plan] with the following details:
1. Title of the Policy or Program Plan:
2. General Objective/s:
3. Policy Owner/s or Author/s:
4. Legal or Policy Basis (if any):
5. Target Implementation Date (Month and/or Year)

Attached herewith are the copies of the draft [policy or program plan] and other reference
documents (if any), for your perusal. Soft copies of the aforementioned documents may be
accessed here: [link to documents]

For questions or clarifications, your office may contact [Name of Focal Person] at [contact
number] or via email at [email address.]

Thank you.

Very truly yours,

[Signature]
[Name of Requesting Party]
[Affiliation of Requesting Party]

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Annex A.2 Request for the Conduct of HIA for Policy and Programs (Memo Template)

Republic of the Philippines

Department of Health
OFFICE OF THE SECRETARY

[DATE]

MEMORANDUM

FOR: BEVERLY LORRAINE C. HO, MD, MPH

Director IV
Health Promotion Bureau

THRU: MR. RODLEY DESMOND DANIEL M. CARZA, MPH, RN

Chief, Policy, Planning, Standards, and Research Division
Health Promotion Bureau

FROM: [DIRECTOR OF REQUESTING PARTY]

SUBJECT: Request for Health Impact Assessment of the [Insert Title of Policy
or Program Plan]

_____________________________________________________________________________

We would like to request for the conduct of a Health Impact Assessment, as operationalized by
the Department of Health (DOH) Administrative Order No. 2021-0064: Guidelines on the
Implementation of the Health Impact Assessment Process for Policies and Programs Pursuant to
Republic Act No. 11223, of the [policy or program plan] with the following details:
1. Title of the Policy or Program Plan:
2. General Objective/s:
3. Policy Owner/s or Author/s:
4. Legal or Policy Basis (if any):
5. Target Implementation Date (Month and/or Year)

Attached herewith are the copies of the draft [policy or program plan] and other reference
documents (if any), for your perusal. Soft copies of the aforementioned documents may be
accessed here: [link to documents]

For questions or clarifications, your office may contact [Name of Focal Person] at [contact
number] or via email at [email address.]

Thank you.

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Annex B. Screening Form

FORM 1
SCREENING FORM
To be filled up by the HIA Unit

Policy or Program Title: _______________________________________________________________________________________

Requesting Party: ____________________________________
Date of Request: ______________________________________ HIA Code: ________________________________

Y/N Remarks

Is this a proposed policy or program plan?

Does this policy or program plan have clear

implementing, action-driven provisions? (i.e., content is
not limited to guiding principles, frameworks, strategies,
governance structure, etc.)

Is there sufficient information provided in the draft

policy or program plan, to be able to assess the health
impacts by the way of changes in the Social
Determinants of Health?

Supports the country’s socio-economic priorities and

global commitments?

TABLE 2. IDENTIFYING CHANGES IN THE SOCIAL DETERMINANTS OF HEALTH

Determinant Potential Effect Likely

(please check) magnitude of
negative
Positiv Negativ
impact?
e e
(1) low
(2) medium
(3) high

Biophysical Environment

Housing Conditions

Working Conditions

Noise

Food Supply

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List of potential effects, if any:

Social and economic environment

Employment
Job stability
Employment opportunities
Income
Cost-of-living
Access to financial services

Household Cohesion

Social/ Cultural Norms and Practices

Social Network and Cohesion

Vulnerable Population
Children under 18 years old
Pregnant Women
Senior Citizens
Ethnic Minority Group
People with disabilities
People living in isolated areas
Chronically Ill
Unemployed
Indigent Population

Violence and Crimes

List of potential effects, if any:

Health-Related Behaviors and Lifestyles

Diet

Physical Activity

Substance abuse
Tobacco use
Alcohol use
Prescription drug abuse
Illicit drug abuse

Sexual behavior

Oral health practices

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List of potential effects, if any:

Local Services

Access to health services

Education

Childcare

Housing services

Transportation

List of potential effects, if any:

TOTAL:

LEVEL OF RISK:

Y/N REMARKS

With significant projected health impacts? Yes if medium

to high risk, no if low risk

Are the health impacts more pronounced for vulnerable

populations?

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Annex C. HIA Terms of Reference

FORM 2
HIA Terms of Reference

Policy or Program Title HIA Code:

Section I. Overview of the Policy or Program Plan

Provide a short overview of the policy and information on the following:

1. Background/ Rationale
2. Goals and Objectives
3. Timeline (if any)

Section II. Proposed Methodology

Methodologies 1. List of data collection activities

2. Objective of each activity

Scope of Evidence
Key Area of Research Type of Data Data Sources
Assessment Question Needed

Specify the State the Identify the type of List down

key area of specific data needed to potential data
assessment research answer the sources of the
as identified question in identified research identified data
in the Health relation to the question needs
Impact KAA
Pathway
Diagram

Data Analysis Plan Provide information and work plan for data analysis

Timeline Provide HIA timeline and Gantt chart/s, if any

Section III. List HIA Preparer/s

Name/s Background/ Qualification/s

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Annex D. Thematic Content Analysis Framework

Data Code Key Area of Assessment Additional Key Area (if any)

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Annex E. Assessment Matrix

Policy or Affected SDH/ Source of Potential Nature of Impact1 Size of Likelihood4 Groups, Nature of Differential Impacts
Program KRA Information Impact Magnitude3 Communities, or
Component Populations
+ - Unclear +/-/Unclear Is this Is this
Bearing
Avoidable fair?
Differential
Impacts5

Component 1 Determinant 1

Determinant 2

Notes

Component 1 Determinant 1

Determinant 2

Notes

1
Impacts can be both positive and negative - provide notes on what aspects are negative, positive, unclear.
2
Long, medium or short. Note the information this assessment of timing of impacts is based on.
3
Large, medium, small, or negligible. Note the information this assessment of magnitude is based on and why that category was chosen.
4
Definite, probable, or speculate. Note the information this assessment of likelihood is based on.
5
List groups, communities, or populations who may bear differential impacts. At a minimum, consider differential impacts in terms of age, gender, ethnicity/culture,
socioeconomic position and locational disadvantage. Include the size of the population (large, medium, small, negligible, unclear), noting the information this assessment
of size is based on.
6
High, medium, low, or negligible. Note the information this assessment of achieving change is based on.

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Annex F. HIA Report

FORM 4
HIA Report

Policy or Program Title HIA Code:

(To be provided by HPB)

Section I. Evidence from Scoping

Provide information on:

1. Data collection activities conducted including data needs and sources
2. Stakeholders engaged including stakeholder analysis conducted, date and duration of engagement,
mode of engagement or communication
3. Summary of data gathered including concerns and issues raised, commitments, and agreements
4. Documentations and proof of consultation

Section II. Evidence from Literature Review

Provide information on:

1. Data collection activities conducted including data needs and sources
2. Summary of data gathered

Section III. Appraisal of Impacts

Evidence Synthesis of Present and triangulate all relevant empirical evidence on the predicted
Potential Impacts impacts of the policy or program plan to health and its determinants.
Discussion of evidence may include:

- Use of primary data from combination of methods

- Use of secondary data from systematic review of published
reports and literature
- Provide complete references where historical data is used
- Impact pathways to individual and public health
- Description of techniques used in predicting impacts (i.e. models,
etc.)

Characterization of Using the assessment matrix, describe the nature of the impact, likelihood
Potential Impacts and/or certainty of impact, severity or magnitude of potential health
consequence, and inequitable distribution of impacts (if any)

Summary of Findings Provide a summary of the evidence synthesis and characterization

conducted to arrive at the policy or program recommendations

Section VI. Recommendation

What to retain

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What to enhance

What to reconsider

What to monitor

Section VIII. Contact Information

Contact Person

Signature

Date & Time

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