Approach to Health Impact Assessment in Iran (Health Annex) and challenges facing it

Health impact Assessment (HIA) helps decision makers to predict the Health Impact of proposed projects, programs, and policies. The Fifth Development Plan of Islamic Republic of Iran obligated implementing HIA of Developmental Plans’ as ‘Health Annex’. The questions asked are, what is the Iranian approach to HIA and what are challenges facing it?
To carry out this study, we used the data emerged from a qualitative study performed through semistructured interviews with key informants. The data from the interviews were analyzed manually using the thematic content analysis method.
Codes extracted from data analysis were placed respectively under 2 principle themes of ‘approach to HIA’ and ‘Challenges of this approach’. There were some notable subthemes such as assignation of developing the ‘National Standards of Health Annex’to Environment and Occupational Health Center, emphasis on environmental factors, opposition to direct community participation, and opposition to integration with Environmental Impact Assessment.
The current approach of health authorities of the HIA system to HIA is an environmental healthapproach. Considering its challenges and other countries’ experiences, this approach could be a barrier in progressing HIA for programs and policies and could limit the role of this tool to achieve healthy public policy and to control the social determinants of health.