Eni E&P works in complex operating environments, interacting with host communities and sharing their health and social problems. Strategic health management (SHM) introduces a systematic approach in each phase of the project life cycle to improve the health status of the workforce and their families and to promote/sustain lasting improvements to the health status of host communities.The approach has been used in various countries through initiatives aiming at development of local primary-health-care systems and/ or control of specific endemic diseases.