Abstract ENI E&P works in complex operating environment constantly interacting with host communities sharing and facing their health and social problems. Strategic Health Management introduces a systematic approach in each phase of the project lifecycle to favour the health status of the workforce, their families and to promote/sustain lasting improvements to host communities’ health status. Dedicated projects for developing social and health services in favour of host communities are designed through standardised project management methodology with due attention to conciliate communities custom, local policies and international well established guidelines. The approach has been utilised in various country (Congo, Angola, Pakistan, Nigeria etc.) through initiatives aiming at development of local Primary Health Care systems and/or control of specific endemic diseases. Relevance, effectiveness, efficiency, impact and sustainability are the guiding and challenging criteria for any organisation dealing with cooperation activities in developing countries. This paper briefly describes ENI E&P methodology and achievements in Community Health so far. This paper intends to explain how to introduce systematic, co-operative planning in each phase of the lifecycle of a project to ensure the health of the workforce and promote lasting improvements in the health of the host community. Is important from the beginning sets out the process which upstream approved projects should follow in formulating a strategy and developing a plan for pro-active and cooperative health management. The key messages are: – industry co-operation on health is beneficial; – industry can help host governments fulfill responsibilities for community health; – primary health care focus can have the greatest impact; – early stakeholder involvement and consultation can achieve lasting improvements in community health; – strategic planning for health should be risk-based and subject to ongoing performance evaluation. Through the Strategic Health Management process intend to establish early and ongoing dialogue with the host government and other stakeholders. Eni E&P Division and/or its subsidiaries may elect to complement the host government's role by providing health care for the project workforce and their dependents. As an example, this could take the form of investment in health planning and provision of health support for the project workforce and their dependents. Such costs should be considered in the budgeting process and the design of health benefits plans.