At first, many researchers and local communities in Thailand tended to focus on the first platform, since it provides the authority for accepting or rejecting a project proposal. However, the practical weaknesses of this approach in Thai contexts have been pointed out. To implement HIA with a broader scope of participation, the existing EIA process would need to be changed, which is not easy to achieve politically: such a proposal might encounter strong political opposition against the whole movement of health system reform. With inadequate knowledge, experience, and human resources, HIA is highly exposed to political abuses of its process if it becomes a formal project approval mechanism.