CHECK

The CHECK stage concerns monitoring the health and safety status of the potentially affected stakeholders to ensure the management actions and mitigation hierarchy adopted are effective in managing identified impacts and that management controls are effective.

Task 7 – Monitor and evaluate

Sites should monitor whether controls are being implemented according to plan and whether the controls are effective at preventing, mitigating, or managing identified CHS impacts and risks. CHS monitoring data can also inform further investigations to identify the root causes of emerging CHS issues.

Sites should develop appropriate and relevant monitoring indicators for control implementation, control effectiveness, and overall health conditions of the affected communities, as relevant and appropriate. An example is provided in Table 3C.3 in Section 3C.

Where CHS impacts and risks, management interventions and associated indicators require extensive monitoring and/or monitoring data collection by a range of internal and external parties, sites should consider developing a Community Health Monitoring Plan (ideally as part of the CHSMP) to outline the process and roles and responsibilities for collecting, tracking and analysing monitoring data. The plan should consider opportunities for participatory monitoring.

Long-term objectives identified as part of Review and Planning (see Section 2) may also relate to CHS , in which case a monitoring and evaluation (M&E) framework should also be developed to track progress against the long-term objectives (see Section 2).

Monitoring of CHS impacts and risks and controls can be complex and require the ongoing methodological collection of data to provide an indication of progress towards achieving a desired goal(s). Evaluation is focused on measuring the short, medium- and long-term results obtained from the monitoring data, to determine the overall effectiveness of interventions/actions, ideally linked to key performance indicators (KPIs).

Box 4C.10 Attributes of an effective health monitoring plan

• Define a clear M&E framework before commencing the project/intervention
• Define key performance indicators (KPIs) that:
  • capture leading and lagging data sets.
  • use units that are measurable and can support an evaluation of change (quantitative and/or qualitative).
  • can be clearly linked to the site and identified impacts (and are different from indicators that may be collected for SED indicators which may be unrelated to the site).
  • are able to distinguish between input, output and outcome indicators.
  • are simple to measure.
  • are reasonable and practical to implement and track.
  • are time-based.

• GIS-enabled
• Ability to analyse trends over time, visually and spatially
• Ensures privacy and protection
• Has linkage with worker-health surveillance data (where the denoted workforce are part of the community under evaluation).
• Is expandable and updatable as new indicators emerge
• Informs ongoing risk/impact assessments
• Informs update of major actions
• Required during major phase changes and at regular intervals during high-risk period (construction phase).

Different sources of data may be considered to support the M&E framework, with examples discussed in Tools (4C. 7 Tools).

Table 4C.3 Example KPIs

Potential impact	Controls	Target	Control owner	Timeline	Inputs	Implementation check	Outputs	Outcomes	Effectiveness or Impact
Describe the potential impact	List the controls	What are we trying to achieve?	List function responsible for the control	Date the control should start and be completed	Human and financial resources needed to implement the control	How do we know that the controls are being implemented?	Outputs produced	Changes that have occurred as a result of control ‒  include sources of verification	Value and success in managing the impact ‒ include sources of verification
Example: Increase in the incidence of vector-borne disease associated with construction activity disturbing ground and creating suitable breeding sites for mosquitoes in man-made receptacles	Management of malaria and arbo-viral breeding sites on site Awareness campaigns for workers and communities Distribution of repellents Larval source management of places of mosquito breeding sites Control of adult mosquitoes through chemical control programmes	Prevention of transmission of malaria and arbo-viral disease by mosquitoes	Site social team Site environmental team Site health team	4 months before construction Ongoing into operations	Site social team time Specialist infectious disease specialist input Specialist entomology input Capital and operational expenses for vector-control equipment and commodities Data generated by public local-health surveillance authority	MoU in place with health authority to support disease and vector-control interventions and provide monitoring data Launch of awareness campaign % of workers and households that have received repellents % completion of disease and vector-control action plan	Larval source management controls within Anglo American property Workers and community members aware of prevention measures Larval source management controls in the community % coverage of vector control activities % coverage of diagnostic and treatment Establishment of entomology and disease surveillance system	Workers and community taking prevention measures- behaviour change measure Reduction in mosquito breeding rates on entomology surveillance Reported cases of arboviral disease Reported cases of malaria Effective treatment of malaria Vector-control activities vs target	Reducing incidence rate of dengue/ malaria in target population (trends) Verification: Health survey results provided by health authority Malaria and arboviral point prevalence rates Verification: Seroprevalence studies Entomological inoculation rates Verification: Entomological studies

Participatory monitoring

Participatory monitoring is not a requirement in relation to CHS, but it is recommended where the site is contributing to, or likely to contribute to, significant CHS impacts. The Community Engagement Forum and other relevant stakeholders can conduct or be involved in participatory monitoring. This is especially valuable given the collaborative approach required to address many CHS-related issues and challenges. More information about participatory monitoring is included in Governance (see Section 1).

Participatory monitoring of CHS impacts and risks particularly helps adherence to management actions that depend on external stakeholders, such as adherence of communities and individuals to health and safety good practices; e.g. safe driving, use of mosquito bed nets and insect repellents, proper domestic-waste disposal. Because health is a sensitive issue, early stakeholder engagement is the basis for the success of participatory CHS monitoring. It helps define who can, wants and needs to participate at the monitoring stage; identifies ethical considerations and uncertainties; and allows discussions to take place about how information will be used before data is collected or stored.