HIA capacity in Slovakia: barriers and training needs among public health trainees

Background

Health Impact Assessment (HIA) is a key tool for integrating health considerations into policies and projects. Despite its recognised importance, its use in Slovakia remains limited. Strengthening HIA capacity among future public health professionals is essential for improving evidence-based decision-making.

Methods

A cross-sectional study was conducted among postgraduate trainees in public health professions in Slovakia between 2023 and 2026 (n = 181). Data were collected using a structured questionnaire assessing awareness, knowledge, training participation, practical experience, and perceived barriers. Descriptive analyses and chi-square tests were performed.

Results

Awareness of HIA was reported by 60.5% of respondents; however, the majority demonstrated limited expertise, with approximately 60–65% reporting low or very low levels of knowledge. Practical experience was minimal, and participation in formal training was moderate. Despite these gaps, attitudes were highly positive, with over 94% supporting integration into policies and decision-making. No statistically significant differences in awareness were observed across student cohorts, gender, age, place of residence (all p > 0.05). Key barriers included insufficient education and training, lack of institutional support, limited integration into decision-making processes, and low awareness among policymakers. Over time, modest improvements in awareness were observed, although gaps in skills and application persist.

Conclusions

HIA capacity among public health trainees in Slovakia is improving, but remains insufficient for routine application. The strong support for HIA implementation highlights an opportunity to strengthen postgraduate training, integrate this approach into curricula, and enhance institutional support. Addressing these barriers is essential for strengthening the public health workforce and supporting the systematic integration of HIA into policy and practice.

Key messages

• Public health trainees recognise the importance of HIA but lack practical experience in applying it.

• Strengthening training and institutional support is essential for the effective implementation of Health Impact Assessment in Slovakia.