Exploring the policy space for public health in large-scale mining in Burkina Faso: A Q-methodology study

Large-scale resource extraction may lead to significant negative externalities on the environment, social wellbeing and public health. Negative environmental impacts of extractive projects are regularly considered through mandatory environmental impact assessments; however, public health impacts frequently remain unaddressed due to a lack of legal requirements, particularly in Africa where many resource extraction projects are being implemented. While policy instruments are available to mitigate negative externalities on public health the most eminent being the Health Impact Assessment (HIA) such instruments have not been widely established. We use Q-methodology to explore the policy space available to advance public health in large-scale mining projects in Burkina Faso. A Q-methodology study is purposeful as it allows to reveal common ground between government, private sector and civil society stakeholders on whose support successful policy initiatives depend. We identify two broader stakeholder perspectives that reveal an overarching consensus on the need to regulate health impacts of mining projects. Both perspectives reject industry self-regulation and broadly agree on introducing HIA as a regulatory instrument, but also point to different priorities and focal points among stakeholders. We develop a conceptual framework to map stakeholders' shared and divergent policy preferences. The findings can help to initiate a policy dialogue on safeguarding public health in large-scale mining projects and may guide policymakers to implement public health policy reform.