Abstract Background Natural resource extraction projects can have positive but also negative effects on the health of affected communities, governed by demographic, economic, environmental, physical and social changes. Negative effects often prevail and these might widen existing health inequities. Health impact assessment (HIA) is a decision-support tool that aims at maximizing benefits and minimizing negative impacts on people's health. A core value of HIA is equity; yet, little is known about health equity in the frame of HIA, particularly in sub-Saharan Africa. Methodology We conducted a scoping review to determine whether and to what extent HIA in sub-Saharan Africa addresses health equity. We included peer-reviewed publications and guidelines pertaining to HIA, environmental impact assessment (EIA) and social impact assessment (SIA). Health equity was investigated by identifying (i) how health considerations were addressed and (ii) whether health was stratified by subgroups of the community. Results Out of 1′640 raw hits, we identified 62 articles (16 HIA, 36 EIA, one SIA and nine integrated assessments), 32 of which specifically addressed health. While 20 articles focused on a specific health topic, 12 articles used a more comprehensive approach to address health. In 15 articles there were specific subgroup analyses (e.g. mothers, children or marginalized groups) as a measure of health equity. Another 12 papers referred to the community in a more general way (e.g. affected). Without exception, health was an integral part of the nine included guidelines. HIA guidelines addressed health systematically through environmental health areas, risk assessment matrix or key performance indicators. Conclusions We found evidence that previously conducted HIA in sub-Saharan Africa and current guidelines address health equity. However, there is a need to stratify community subgroups more systematically in order to determine health differentials better. Future HIA should consider community heterogeneity in an effort to reduce health inequities by “leaving no one behind”, as suggested by the Sustainable Development Goals.

中文翻译：

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撒哈拉以南非洲的健康影响评估和健康公平：范围界定审查

摘要 背景 自然资源开采项目可以对受影响社区的健康产生积极但也有消极影响，受人口、经济、环境、自然和社会变化的影响。负面影响往往盛行，这可能会扩大现有的健康不平等。健康影响评估 (HIA) 是一种决策支持工具，旨在最大限度地提高对人们的健康的益处并最大限度地减少负面影响。HIA 的核心价值是公平；然而，人们对 HIA 框架内的健康公平知之甚少，尤其是在撒哈拉以南非洲。方法论 我们进行了范围界定审查，以确定撒哈拉以南非洲地区的 HIA 是否以及在多大程度上解决了健康公平问题。我们收录了与 HIA、环境影响评估 (EIA) 和社会影响评估 (SIA) 有关的同行评审出版物和指南。通过确定 (i) 如何解决健康问题以及 (ii) 是否按社区亚组对健康进行分层，对健康公平进行了调查。结果 在 1,640 篇原始点击中，我们确定了 62 篇文章（16 篇 HIA、36 篇 EIA、1 篇 SIA 和 9 项综合评估），其中 32 篇专门针对健康。虽然 20 篇文章专注于特定的健康主题，但 12 篇文章使用了更全面的方法来解决健康问题。在 15 篇文章中，有特定的亚组分析（例如母亲、儿童或边缘化群体）作为健康公平的衡量标准。另有 12 篇论文以更一般的方式（例如受影响）提及社区。无一例外，健康是九项包含的指南的组成部分。HIA 指南通过环境健康领域系统地解决了健康问题，风险评估矩阵或关键绩效指标。结论 我们发现了先前在撒哈拉以南非洲地区进行 HIA 的证据，目前的指南解决了健康公平问题。然而，需要更系统地对社区亚群进行分层，以便更好地确定健康差异。正如可持续发展目标所建议的那样，未来的 HIA 应考虑社区异质性，以通过“不让任何人掉队”来减少健康不平等。