Environmental and Social Impact Screening Questionnaire

The questionnaire is composed of three sections inquiring about the Process of project identification and conceptualization (Part 1), Potential impacts related to IUCN’s E&S Standards and Guidelines (Part 2), Other potential environmental and social impacts (Part 3) and Potential climate change risks (Part 4).

The questionnaire serves as a key input for the screening decision on whether the project is classified as type A, B or C project1 and on whether further social or environmental impact studies are necessary. The questionnaire is completed first by the project proponent based on his/her available information and knowledge and professionally and ethically appropriate judgement. It is then reviewed by the respective IUCN’s national office to provide an impartial opinion and to add additional local insights, if applicable2. In countries where IUCN Secretariat is not represented, the questionnaire is reviewed by the regional office. Both parties (project proponent and IUCN reviewer) sign the form by indicating their name, function and date.

Guidance for completing the questionnaire: Please answer all questions. If neither “yes” or “no” applies please respond with “not applicable (N/A)”. It is highly desirable to provide further details on each question by adding a short description or specification of the subject in column 2. After completing the questionnaire the file name should be changed by adding “Project Proponent” and then “Reviewer” (e.g. “ESMS

Questionnaire_Project Proponent” and then “ESMS Questionnaire_Project Proponent & Reviewer”)

Project Title:Country:Organization proposing project:Has an E&S screening or ESIA already been completed? If yes, provide details (commissioning entity, date, results etc.)

Name Organization and function DateESMS Questionnaire completed by:IUCN reviewer:

1 A = high impact, B=medium/low impact and C= no or very low impact expected2 In order to ensure impartiality it is important that the review of projects developed by IUCN units is done by a reviewer who is independent from the team/unit preparing the proposal. It could be a member of the ESMS expert team who might then also be involved in the next step, the screening decision.

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Part 1: Process of project identification and conceptualization

1. Has a project stakeholder analysis been carried out and documented? Does the stakeholder analysis disaggregate between women and men? Indicate the key stakeholders that might be affected by the project (disaggregated by women and men, if applicable).

To be completed by project proponent

IUCN national/regional office opinion (Comments/ additional considerations)

2. Have consultations been held with relevant groups to discuss the project concept, in particular with potentially affected stakeholders? Have women of such groups been consulted about the project concept in a socio-culturally appropriate way?

To be completed by project proponent

IUCN national/regional office opinion (Comments/ additional considerations)

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Part 2: Identification of potential impacts related to IUCN’s E&S Standards and Guidelines

To be completed by project proponent IUCN office opinion1 2 3

yes no n/a

If yes, describe potential issues and risks, specify activities causing this and any foreseen mitigation measures (if applicable) Comments/ additional considerations

Standard on involuntary resettlement and access restrictions

3. Will / might the project involve relocation or resettlement of people?

4. Will / might the project restrict access to or reduce the benefits from the use of natural resources by local groups, e.g. forest resources?

a. If yes, describe the activities that might involve access restrictions; explain whether the project is seeking to put in place or enforce restrictions directly (e.g. strengthening enforcement capacities) or influencing unsustainable use of natural resources indirectly (e.g. through awareness building)

b. Which groups are affected by this? Are vulnerable groups affected? Also discriminate between men and women;

c. Have the implications on the peoples’ well-being been analysed?

d. Does the project foresee measures to mitigate or compensate for the loss of benefits?

5. Does the project intend to work within existing legal frameworks regulating land tenure and natural resource use or does it seek to change/influence them?

6. Explain whether the country’s existing laws that are applicable to the project context recognize traditional property

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rights for land and other natural resources.

Standard on indigenous peoples3

7. Is the project located in an area inhabited by indigenous peoples, tribal peoples and other traditional peoples? If yes, name the groups.

8. Is there a risk that the project might negatively affect indigenous peoples in terms of self-determination, livelihood conditions, cultural/ spiritual identity, values and practices?

9. Is the project likely to impair particular subgroups of indigenous peoples, e.g. women or children?

Standard on natural habitats

10. Is the project located near to areas legally protected or officially proposed for protection including reserves according to the IUCN Protected Area Management Categories I - VI, UNESCO Natural World Heritage Sites, UNESCO Biosphere Reserves, the Ramsar Convention on Wetlands and areas in the UN List of Protected Areas?

11. Is the project located near to areas not legally protected but recognized as critical habitat and protected as such by traditional local communities?

12. Is the project located near to areas which are not covered in existing protection systems but nevertheless provide critical habitat or other biodiversity value such as primary forest area, wetland area, mangrove area, estuarine area etc.

13. Is there a risk that the project might involve degradation, fragmentation or loss of natural habitats and associated biodiversity and ecosystems (even inadvertently)?

3The coverage of indigenous peoples includes: (i) peoples who identify themselves as "indigenous" in strict sense; (ii) tribal peoples whose social, cultural, and economic conditions distinguish them from other sections of the national community, and whose status is regulated wholly or partially by their own customs or traditions or by special laws or regulations; and (iii) traditional peoples not necessarily called indigenous or tribal but who share the same characteristics of social, cultural, and economic conditions that distinguish them from other sections of the national community, whose status is regulated wholly or partially by their own customs or traditions, and whose livelihoods are closely connected to ecosystems and their goods and services

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14. Is there a risk that the project will affect critical natural habitat?4

15. Is there a risk that the project might affect ecological functions of natural habitat and associated biodiversity, e.g. due to construction of infrastructure, water usage now or at a later stage or other activities?

16. Is there a risk that the project might affect protected or threatened species by impacts other than habitat destruction / degradation?

17. Is there a risk that the project might affect local ecosystems by giving rise to invasive species (directly or indirectly)?

18. Is there a risk that the project might affect local ecosystems by negatively impacting the water cycle (e.g. water infiltration and aquifer recharge) or the quality of waterways?

Standard on physical cultural resources

19. Is the project located in or close to a site, buildings, structures or archaeological remains officially designated or proposed as cultural heritage sites (e.g. UNESCO World Cultural or Mixed Heritage Sites, or Cultural Landscapes) or nationally designated sites for cultural heritage protection?

20. Does the project area harbour physical cultural resources such as tangible cultural property, site, building or group of buildings with paleontological, archaeological, historical, cultural, artistic, spiritual or symbolic value for a nation, people or community?

21. Does the project area harbour natural features with cultural, spiritual or symbolic significance for communities associated with that feature such as sacred natural sites, ceremonial areas or sacred species?

4 Critical natural habitat is defined as areas already designated or in the process of being designated (see question 10), recognized by local communities (question 11), or areas identified by authoritative sources for their high conservation value or significant biodiversity (see Standard on Natural Habitats for definition).

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22. Will the project involve physical interventions (movement of earth, flooding etc.) that might affect areas or sites that have known physical or natural cultural significance to indigenous peoples or other local communities?

23. Is there a risk that such physical interventions might affect unknown (e.g. buried) cultural resources?

24. Is there a risk that the project might restrict access by local users to known physical or natural cultural resources?

25. Does the project plans to promote the use or development of economic or social benefits from physical cultural resources?

Guidelines on pest management planning

26. Does the project intend to use pesticides, herbicides or other agrochemicals?

Guidelines to avoid impacts on dams and other water infrastructure

27. Will / might the project have impacts on the safety of dams or other built water infrastructure (reservoirs, irrigation systems, canals) e.g. by impacting peak and flood flows down- or upstream of dam operations?

Part 3: Identification of other potential environmental and social impacts

To be completed by project proponent IUCN regional office opinion1 2 3

Yes,no n/a

If yes, describe potential issues and risks, specify activities causing this and any foreseen mitigation measures (if applicable)

Comments/ additional considerations

Other social impacts

28. Is there a risk that the project might infringe on human rights of social groups other than indigenous peoples (e.g. self-determination, access to education, right to health, property rights, cultural rights)? Differentiate between women and men.

29. Is the project likely to create, aggravate or perpetuate inequalities between women and men?

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30. Is the project likely to benefit women and men in unequal terms that cannot be justified as affirmative action?

31. Is the project likely to negatively affect vulnerable groups (e.g. landless, the elderly, persons with disabilities, children, ethnic minorities, displaced persons) in terms of livelihood conditions, and development opportunities that have not been considered under Part 2?

32. Is there a risk that the project affects human health and safety?

33. Is there a risk that the project be directly or indirectly involved in forced labour and/or child labour?

34. Is the project likely to induce immigration and significant increases in population density which might trigger environmental or social problems (with special consideration to women) or possible overloading of social infrastructure?

35. Please specify other potential negative social impacts; also consider indirect, cumulative (due to interaction with other projects or activities, current or planned) or transboundary impacts.

Other environmental impacts

36. Will the project lead to increased waste production, in particular hazardous waste?

37. Is the project likely to cause pollution or degradation of soil, soil erosion or siltation?

38. Will / might the project cause pollution to air or create other nuisances such as dust, traffic, noise or odour?

39. Will the project lead to significant increases of greenhouse gas emissions?

40. Please specify other potential negative environmental impacts; also consider indirect, cumulative (due to interaction with other projects or activities, current or planned) or

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transboundary impacts.

Part 4: Identification of potential climate change risks

To be completed by project proponent IUCN office opinion1 2 3

Yes,no n/a

If yes, describe potential issues and risks, specify activities causing this and any foreseen mitigation measures (if applicable)

Comments/ additional considerations

Climate change risks

41. Have historical, current, and future trends in climate variability and climate change in the project area been taken into consideration (including climate sensitivity of region 5)?

42. Is the project area prone to specific climate hazards (e.g. floods, droughts, wildfires, landslides, cyclones, storm surges etc.)?

43. During the life span of the project, could the current or projected climate variability and changes affect the implementation of activities, project costs or effectiveness and sustainability of the project?

44. Could the planned activities of the project potentially increase the vulnerability of the local communities, ecosystems, and biodiversity to current or future climate variability and changes?

45. Could the project activities lead to climate maladaptation6 through yielding short-term benefits while increasing longer-term climate risks?

46. Do the project activities enhance the adaptive capacity of communities to climate change? Or do they hinder the development of adaptive capacity?

47. Are there any specific barriers or opportunities for managing climate risks and adaptation in the project area?

5 Sensitivity is the degree to which a system can be affected, negatively or positively, by climate-related stimuli. IPCC, 20016 Maladaptation is a business-as-usual development, which by overlooking climate change impacts, inadvertently increases exposure and/or vulnerability to climate change. OECD, 2008

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