The development of health impact assessment (HIA) in
Thailand is taking place in difficult circumstances but with high
hopes. For many years, the government has taken a clear
direction to change Thai economy and society into a newly
industrialized country. Many policies designed to fulfil this
strategy, however — including investment in infrastructure
and industrial development — have caused negative health
effects on local people. Without a process for proper public
participation,manyconflictshavearisenaroundalmostalllarge
government projects throughout the country.
The constitution established in 1997 provided an
enormous opportunity for further progress in restructuring
therelationshipbetweenthestateandcivilsociety.Itstimulates
the process of decentralization of decision-making and
resource allocation, and has created new institutions and
mechanisms that allow greater accountability, transparency,
representation, and participation at all levels of the develop-
ment process. It calls for urgent empowerment of citizens, in
order to facilitate their influence on the decision-making
process in all aspects of implementation of the policy by both
central and local government.
National health system reform, launched in 2000, has
initiated the new concept of civil involvement in public policy
processes. It advocates the development of healthy public
policy (or putting health into non-healthsectors) to pursue the
principleof‘‘allforhealth’’inordertoachievetheultimategoal
of health for all. The novel mechanism of HIA has to be
created to mediate between all stakeholders of any public
policy, so that they work together for a healthier society based
on sound evidence.