The methodology of this assessment consisted of a simple self-assessment questionnaire was used as a tool to gauge the progress of implementation of the Libreville Declaration. The questionnaires were shared with the 47 Member States in the WHO African region, to complete and submit within a two-week period. Countries were advised to involve relevant officers in their ministries of health and their ministries in charge of environment in responding to the questionnaires. The assessment was based on a set of open-ended questions structured around the following five areas: 1. Description of the institutional arrangements established to steer and coordinate implementation of the Libreville Declaration; 2. Description of the major joint actions that have been undertaken by the ministry of health, the ministry of environment and other relevant ministries and institutions; 3. Description of the main outputs resulting from the above actions; 4. Status of progress and achievements in relation to the 11 priority actions agreed upon in Libreville; and 5. Description of efforts made by the Government to address any of the ten priorities of the Luanda Commitment.