Abstract
Background: Infrastructure spending, especially in the transport sector, is expected to increase rapidly in Vietnam.
This boost in transportation investment impacts health. Environmental impact assessments (EIAs) are essential tools
for decision-making to reduce and mitigate anticipated impacts of development projects, and integration of health
assessment as an essential part of the EIA process has been regulated in many high-income countries. There is, however,
limited knowledge about how health is evaluated in these environmental assessments in low- and middle-income
countries (LMICs) such as Vietnam.
Methods: We did an analysis of EIAs of four major transport projects in Vietnam, applying a six-step coding framework
previously used to investigate EIAs in the Australian context.
Results: We found that health was inadequately considered in all four EIAs. There was no direct health assessment
within the four EIAs due to the lack of formal requirements from either Government or the financing agency, the Asian
Development Bank (ADB). Health issues were often identified as risks posed by the projects within the assessment of
impacts on environmental conditions. A broader consideration of health was limited. When social outcomes of the
projects were present in EIAs, they were often mentioned once without any detailed assessment or linking to health.
There was no evidence linking health benefits and shifts towards active travel with the construction of two metro rail
projects. Mitigation measures offered in all four EIAs were found to be generic and insubstantial.
Conclusion: The health assessments in the EIAs of four transport projects in Vietnam were significantly less detailed
than those in Australia, mainly due to the lack of legislative requirements. The lack of health content indicates the
need for involvement of health experts in the environmental assessment process, as well as requirements for the health
assessment to be integrated in EIA. Our findings suggest there is the need to build capacity both within and outside of
government to fully consider the health impacts of infrastructure in EIA practice.