Incorporating community perspectives in health impact assessment: A toolbox

Large infrastructure projects, such as mining and renewable energy projects, can affect the health of surrounding communities by changing the natural, physical and social environment. While there is limited understanding of potential health impacts of such projects on local populations in general, there is a particular need for community-driven and equity-oriented approaches to predict and manage such impacts. To assess health impacts as perceived by vulnerable communities affected by large infrastructure projects in sub-Saharan Africa, we present here a suite of qualitative data collection tools, which are complementary to the existing health impact assessment (HIA) tools. At the core of the toolbox are guides to conduct (i) transect walks to qualitatively map and systematically select study communities and (ii) participatory focus group discussions to explore perceived impacts on the wider determinant of health and related health implications from the perspective of the affected communities. This methodology was developed as part of a qualitative study evaluating perceived health impacts in local communities in industrial mining settings in East and West Africa. These flexible and intuitive tools produced reliable and comparable findings across different countries and contexts, suggesting that the tools can be applied in a broad range of large infrastructure project settings. The methodology, with its particular potential for translating qualitative research rapidly into visual outputs, is a promising addition to the existing, mainly quantitative HIA toolbox. Strengthening HIA driven by local communities can ultimately contribute to achieving the health-related targets of the Sustainable Development Goals (SDGs).