Abstract
In 2001, the Health System Research Institute (HSRI) launched a research programme “Healthy Public Policy and Health Impact Assessment (HPP-HIA)” with an aim to develop an important component of the new health system in the future. Recognizing that HPP-HIA was a new experience for the Thai society, the HSRI perceived the first three years of the programme (2001-2003) as a research and social experiment to test the relevance and acceptance of HPP-HIA in the Thai society, and as a first step toward capacity and institutional building. The programme experience will help determine an appropriate approach in developing a HPP-HIA programme in Thailand. The main purpose of the programme evaluation in 2004 was to facilitate the review of the experience, success, and constraints of the programme, and to consider future options. The evaluation team’s mission was to conduct and facilitate “empowerment evaluation” to help the management and staff of the HPP-HIA programme reflect on past performance – and consider future options. This participatory exercise was designed to maximize the opportunities for exchanges among all parties concerned, to plan for better programme performance, and to discuss development alternatives. In advancing HPP-HIA, the programme has 4 strategies: (1) analytical framework, (2) institutional framework, (3) critical mass, and (4) enabling environment, which are expected to (1) facilitate social learning especially among civil society and community actors., (2) influence policy changes at national and local levels toward a healthy public policy, and (3) support the health reform movement. The four strategies were implemented through a system of networking. The thematic (policy) networks consist of industry and energy policy network, water management network, agricultural and rural development network, urban and transportation network, natural resources and international agreements network. The regional networks consist of the Northern network, the Northeastern network, and the Southern network. The programme core team was responsible for overall management. The programme also included the HPP knowledge development center and the HPP-HIA thesis programme at Chiang Mai University, both of which aimed to create and expand a HPP-HIA “critical mass”. Findings from the evaluation indicate that: The HPP-HIA programme’s strength lied in its role in pioneering the development and dissemination of HPP-HIA knowledge and practice in Thailand. The programme management, staff and networks were highly dedicated individuals who were committed to work as a team. As a result, the programme, within a span of 3-4 years, produced a large volume of works in various forms, namely research, policy papers, manual, training, workshop, newsletter, etc that covered a wide range of issues and geographical areas. The programme was successful in raising the awareness and the interest concerning HPP-HIA among academics, health personnel, and civil society groups. HPP-HIA was perceived to have a good potential to drive policy and social changes. But the programme had some limitations in networking with the public sector especially at the national policy level, and had less success in influencing policy changes at the national level.Although the programme outlined a set of strategies, it expanded at a very fast rate to the extent that it had spread itself too thin, and lacked a strategic focus. This complicated the coordination within the programme and with other groups.In recent years, the programme encountered a number of problems due to personnel and budget constraints. The situation called for a medium-term and long-term organization/business strategic plan.The followings were significant “new situations” that emerged during 2003-2004.HSRI scaled down the planned programme budget. Other “HPP-HIA” programmes were set up, partly as a result of the programme’s success in promoting HPP-HIA. This represented an opportunity for collaboration, but also called for a serious review of the programme’s positioning, mission, and core competencies, to maximize synergy and minimize overlapping with other programmes. The performance review and the situation analysis provided the background and context for the consultations and meetings between the evaluation team and the programme management and staff that took place throughout the evaluation period (January-August 2004). The followings are results or ideas that play a role in shaping the future of the programme. The programme’s first mission will be HPP-HIA knowledge development and knowledge dissemination; secondary mission will be influencing and shaping HPP, which will be implemented mainly by providing policy advocate groups with the programme’s knowledge and practical experience about HPP-HIA.The programe will develop a medium-term and long-term organization/business strategic plan that includes resource mobilization. HPP-HIA research and training will be more responsive to the needs of potential clients and the programme will explore the use of social marketing to support its overall operation.The programme will adopt a leaner and flexible structure. It is possible that the programme will have only 2 work components, namely the regional networks, and the center which features the policy group, the knowledge management group, with administrative support.The programme will outline key strategic results and restructure the programme and work process as well as develop core competencies of various parts of the programme accordingly.The new work process calls for a common strategic focus and synergy among various work groups/network, while allowing adequate room for each group/network to tailor its work in response to local situations. In the next three years, the regional networks should have the ability to drive the implementation all four strategies at the local level, with support from the center. The center will focus on strengthening the programme by leveraging on existing outputs and driving the programme’s key strategic results.In medium-term, the programme aims to be an independent institute under the HSRI.
