[A strategy for institutionalisation of health impact assessment in Andalusia (Spain)]

Health impact assessment (HIA) aims to incorporate people's health and wellbeing as a key feature in policy-making. Many authors believe that HIA might be systematically integrated into all decision-making processes as a way to achieve that goal. To that end, there is need to overcome a number of challenges, including the fact that Andalusia (Spain) has made HIA compulsory by law, the need for awareness of all public sectors whose decisions might have substantial impacts on health and for a methodology that would enable a comprehensive approach to health determinants and inequalities, and the training of both the public health staff and professional sectors responsible for its application. In Andalusia, a law provides mandatory and binding health impact reports for most authorisation procedures in different areas: from sectoral plans to urban planning schemes, and especially projects subject to environmental assessment. Implementation of this law has required its integration into authorisation procedures, the training of interdisciplinary working groups in public health, the preparation of technical guidelines, and the organisation of dissemination and training seminars for developers.