Participatory Health Impact Assessment for Health and Well-Being Policy at Local Level in Thailand

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.