Environmental health indicators in policy evaluation.

In carrying out two projects involving environmental health indicators--a national environmental health programme evaluation and an international environmental health indicator system--in parallel, it became apparent that an international indicator set has limitations regarding the evaluation of a national programme such as the Swiss National Environment and Health Action Plan (NEHAP). The international indicator set proposed by WHO serves the structured description of the underlying cause-effect chains, allows an integrated monitoring of the general environment and health situation and provides valuable international comparisons. However, the relevance of an international indicator set varies in the national context. Moreover, it does not allow the evaluation of a national implementation process, which is highly important in assessing success or failure of an environmental health promotion programme. For a comprehensive evaluation of such a programme, a specific evaluation concept derived from the formulated goals and targets needs to be developed with emphasis on evaluation of the implementation process.