Implementing the legal provisions for HIA in Slovakia: An exploration of practitioner perspectives

•Respondents were uncertain as to how HIA would be implemented in practice.•Technical and institutional barriers to HIA implementation were expressed.•The negative influence of the private sector on HIAs was identified.•Integration of HIA includes further education and national HIA resource centres.

BackgroundHealth Impact Assessment (HIA) is an instrument used in many countries across the world to assess and report on negative and positive health impacts of projects, programmes and policies. It was included in the Protection, Support and Development of Public Health Act (355/2007) of the Slovak Republic in 2007, thus legislating for HIA. Due to this novel move to legislate for HIA, exploratory research was conducted in order to inquire into the perceptions of key informants and practitioners of the upcoming enforcement of the HIA part of legislation (to take place from January 2011). This paper presents results from the survey of practitioners in the Slovak Regional Public Health Authorities.MethodsA postal questionnaire was administered to the Heads of Environmental Health Departments of the 37 Regional Public Health Authorities. Open-ended questions were contained in the survey. The response rate was 38%.ResultsResults show that a number of respondents are uncertain as to how HIA would be implemented in practice, with varying views on the technical and institutional barriers to comprehensive implementation of HIA.ConclusionAlthough the public hygiene and sanitation networks in the public health system in Slovakia operate smoothly, the readiness of the public health infrastructure for HIA, which is based broadly on the social model of health, is dubious. Although HIA is contained within legislation, time will tell whether its implementation in practice will be as comprehensive as is hoped. Recommendations for further integration of HIA into the public health system include further training and education, national HIA resource centres and cross-country support.