Promthong Nattaya, Thaweesook Suwicha, Sukmak Phen, Mongkolsomlit Sirima, Jaidee Patchana Hengboriboonpong, Putthasri Weerasak
National Health Commission Office, Nonthaburi, Thailand.
Public Policy Institute, Prince of Songkhla University, Songkhla, Thailand.
Health Promot J Austr. 2025 Jul;36(3):e70073. doi: 10.1002/hpja.70073.
Achieving the Sustainable Development Goals (SDGs) related to health and well-being requires diverse stakeholders' engagement. According to Thailand's constitution, the decentralisation of health promotion to Local Administrative Organizations (LAOs) has been increasingly implemented. The lessons learned from experiences in implementing well-being tools and engaging stakeholders in diverse local and cultural contexts offer practical benefits. This article describes the development of participatory policy using health impact assessment (HIA) in selected LAOs across Thailand, alongside bottom-up policy formulation, to support sustainable social well-being and community empowerment.
A qualitative research approach was applied to examine HIA implementation in 12 purposively selected LAOs across Thailand. Data collection included document reviews, participatory observations of HIA meetings/activities and 156 in-depth interviews with key informants (KIs) who were actively involved in the HIA process. The analysis specifically examined the roles of community and stakeholder engagement, the implementation processes and the resulting outcomes.
The 12 LAOs selected a diverse range of challenges for HIA applications, including waste management, water pollution, elderly care, occupational health and community tourism. Community consultation with government personnel, academics and community members was conducted as the preparation phase to identify priority issues. Most participants emphasised that meaningful and inclusive participation through the HIA process was crucial for creating ownership and ensuring compliance with agreements. The influencing step of HIA was significant in securing commitment and continued support from local governments. Participants also mentioned increased motivation, active citizenship, community empowerment and collective leadership development.
The findings indicate that the HIA is a social tool effectively implemented in the community. Various issues and challenges of health and well-being are manifest in deployment. SO WHAT?: Inclusive participation through the policy development process at the local level is clarity to support sustainable social well-being and community empowerment.
实现与健康和福祉相关的可持续发展目标需要不同利益相关者的参与。根据泰国宪法，促进健康的权力下放已越来越多地落实到地方行政组织（LAO）。从在不同地方和文化背景下实施福祉工具及让利益相关者参与的经验中吸取的教训具有实际益处。本文描述了泰国部分地方行政组织如何通过健康影响评估（HIA）并结合自下而上的政策制定来制定参与性政策，以支持可持续的社会福祉和社区赋权。
采用定性研究方法，对泰国12个经过有目的选择的地方行政组织中健康影响评估的实施情况进行研究。数据收集包括文件审查、对健康影响评估会议/活动的参与式观察以及对积极参与健康影响评估过程的156名关键信息提供者（KI）进行深度访谈。分析具体考察了社区和利益相关者参与的作用、实施过程及产生结果。
12个地方行政组织为健康影响评估应用选择了一系列不同的挑战，包括废物管理、水污染、老年护理、职业健康和社区旅游。作为准备阶段，与政府人员、学者和社区成员进行了社区协商，以确定优先问题。大多数参与者强调，通过健康影响评估过程进行有意义和包容性的参与对于建立主人翁意识和确保遵守协议至关重要。健康影响评估的影响步骤在获得地方政府的承诺和持续支持方面具有重要意义。参与者还提到积极性提高、积极公民意识增强、社区赋权和集体领导力发展。
研究结果表明，健康影响评估是一种在社区中有效实施的社会工具。在部署过程中体现了健康和福祉的各种问题及挑战。那么又如何呢？：在地方层面通过政策制定过程进行包容性参与显然有助于支持可持续的社会福祉和社区赋权。
