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Open Access Highly Accessed Research article

Health impact assessment and short-term medical missions: A methods study to evaluate quality of care

Jesse Maki*, Munirih Qualls, Benjamin White, Sharon Kleefield and Robert Crone

BMC Health Services Research 2008, 8:121  doi:10.1186/1472-6963-8-121

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Health impact assessment (HIA) is a structured procedure for ex-ante assessment, not evaluation

Ben Harris-Roxas   (2008-06-11 10:42)  UNSW Research Centre for Primary Health Care and Equity, University of New South Wales email

The authors are to be congratulated for undertaking research into what is by all accounts a neglected area - the development of self-evaluation tools for use in relation to short-term medical missions.

Unfortunately health impact assessment (HIA), as referred to in the title, is not a generic term. It refers to a specific structured procedure for ex-ante assessment of potential health impacts, i.e. assessing policies, programs or projects for their potential health effects prior to implementation [1-7]. By including HIA in the title the authors give the misleading impression that this article will refer to this ex-ante assessment procedure. The only HIA citation in the article [8] is to a paper that doesn’t look at the HIA process itself but at the evidence base that may be required to undertake or support HIAs and as such may be somewhat off-topic.

Nomenclature may seem like a semantic issue but in this case it serves to draw an audience to the article that may not actually be directly interested in the research that has been conducted. The failure of the reviewers and the editors to pick this up prior to publication is somewhat disappointing, even if somewhat understandable given that HIA may seem like a self-explanatory term.

This issue about HIA terminology in no way relates to the quality of the research itself, nor does it detract from the importance of the study’s findings.

Ben Harris-Roxas

Research Fellow

UNSW Research Centre for Primary Health Care and Equity

University of New South Wales


1. Harris P, Harris-Roxas B, Harris E, Kemp L: Health Impact Assessment: A practical guide. Sydney: UNSW Research Centre for Primary Health Care and Equity and NSW Health; 2007.

2. enHealth: Health Impact Assessment Guidelines. Canberra: National Public Health Partnership, Commonwealth Department of Health and Aged Care; 2001.$FILE/env_impact.pdf

3. ECHP: Gothenburg Consensus Paper on Health Impact Assessment: Main concepts and suggested approach. Brussels: European Centre for Health Policy, WHO Regional Office for Europe; 1999.

4. Abrahams D, Pennington A, Scott-Samuel A, Doyle C, Metcalfe O, den Broeder L, Haigh F, Mekel O, Fehr R: European Policy Health Impact Assessment. Brussels: European Commission; 2004.

5. Scott-Samuel A, Birley M, Ardern K: The Merseyside Guidelines for Health Impact Assessment. 2nd edition. Liverpool: International Health Impact Assessment Consortium (IMPACT); 2001.

6. PHAC: A Guide to Health Impact Assessment: A policy tool for New Zealand. 2nd edition. Wellington: Public Health Advisory Committee; 2005.$File/guidetohia.pdf

7. Kemm J, Parry J, Palmer S (Eds.): Health Impact Assessment. Oxford: Oxford University Press; 2004.

8. Joffe M, Mindell J: A Framework for the Evidence Base to Support Health Impact Assessment. JECH 2002, 56:132-138.

Competing interests

No competing interests.


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