Conducting an HIA of the effect of accession to the European Union on national agriculture and food policy in Slovenia

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Abstract

A health impact assessment (HIA) to consider the potential effects of European Union accession on agriculture and food policies in Slovenia has been undertaken as a joint project between the Slovenian Ministry of Health and the WHO European Region. The HIA project in Slovenia was conducted as a pilot project to develop the methods of HIA in this policy sector. The implications of the European Union Agricultural Policy to health are discussed. HIA methods have been used to assess some of the potential effects in Slovenia of accession to the European Union. This paper outlines some of the early findings and lessons to be learnt from the Slovenian HIA experience in order that other countries may adopt the approach to improve health considerations in agriculture and other intersectoral policymaking.

Section snippets

Slovenia and its accession to the European Union

The Republic of Slovenia is a small country of approximately 2 million inhabitants, and is bordered by Austria, Hungary, Italy, and Croatia. Formerly a constituent part of Yugoslavia, Slovenia declared its independence in 1991. The country is divided into 9 health and 12 statistical administrative regions. Agriculture contributes only 3.2% of gross domestic product (GDP), and is dominated by dairy farming, animal stock, and cereals with the main crops being corn, barley, and wheat (Albrecht et

The European Union Common Agricultural Policy

The EU Common Agricultural Policy (CAP) is the single biggest policy area in the EU and was allocated approximately 45% of the total budget in 2002. The CAP comprises a complex series of laws and policy instruments which regulate the production, trade and processing of agricultural products, which has recently included more emphasis on rural development. About 90% of the budget is used for subsidies to farmers. The memory of post-war food shortages and the need to improve food security in

The HIA methods used in Slovenia

HIA was proposed as an appropriate approach that could be used to investigate and clarify the expected implications for population health in the development of agriculture, food, and nutrition policy in Slovenia. This was particularly important in the agricultural sector, where public health was not on the agenda because it is not a directly negotiated factor within the CAP. The HIA in Slovenia set out to consider how adopting some of the specific aspects of how the CAP is funded and organised

Defining the policy to be assessed

The major problem in the initial stages of the HIA was clarifying the specific policy options to be assessed in the project. The HIA had to take into account the effect of adopting the CAP into Slovenian law. This could not be done with any degree of accuracy or certainty, mainly because there were ongoing negotiations with the EU about the nature and amount of common agricultural policy subsidies that Slovenia would be allocated on accession, and the date of accession had still not been

Stakeholder workshops

The most important part of an HIA is identifying and collecting information for health impacts that a policy might create. The HIA approach taken in Slovenia involved national and regional stakeholders. The first HIA workshops were held in March 2002 in the northeast region of Promurje. A total of 66 people participated, including representatives of local farmers, food processors, consumer organisations, schools, public health, non-governmental organisations, national and regional development

Review of research evidence and collection of indictors

To plan the evidence review, an expert meeting was held to assess the strength of the evidence for the links between the policy issues identified in the workshops, and health determinants and health outcomes. Unsurprisingly, for several key areas, the evidence was found to be patchy or not available in an up-to-date, easily synthesizable form. For the HIA to proceed in any depth, the next stage had to be mapping out a more detailed evidence base for how agriculture and food polices affect

Lessons learnt

As far as the authors are aware, this was the first project to attempt to estimate specific national health impacts of incorporating the CAP, and the first prospective HIA undertaken of national agricultural and food policy. As this was a new application of HIA, this work was conducted as a pilot project. This acknowledges that there would be a need for methodological development and that the final analysis would not be fully comprehensive. An important part of the work will be evaluating and

Feeding HIA into policy making

In terms of achieving more specific outcomes, many problems still exist with the HIA process in such complex policy environments as agriculture. These include the often discussed issues of the timing of an HIA, the evidence base for HIA, and how to embed HIA in organisational culture. It is still not clear when is the best time to conduct an HIA of any policy. In the HIA of agricultural policy in Slovenia, as has been the experience of national HIA in the Netherlands and Wales Breeze and Hall,

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