Abstract
Analysis of Health Impact Assessment System from Large Investment Projects and Public PolicyDecharut SukkumnoedSince, health is redefined in Thailand as a complete state of well – being, which is well balanced of a body of intertwined elements of the physical, mental, social and spiritual dimension. Therefore, health is dynamically linked to all factors related to the way of living. Any environmental changes in terms of physical, economic and social conditions occurred in form of development process have a potential impact on the people’s health. Health Impact Assessment (HIA) is the combination of procedures, methods, and tools, which enable a judgement to be made on the positive and negative effects of policies, programs, projects, or other development actions. The overall objective of HIA is to maintain and improve the health of entire community/population by reducing health hazards as well as providing determinants for better health. HIA has been promoted by WHO since the 1980s, before developed and implemented in many developed countries during the 1990s. In general, HIA systems apply the common concept and steps of impact assessment, with the specific focus on human health, which are not adequately covered by existing EIA and SIA systems. Like other impact assessment process, the main steps of HIA process include screening, scoping, analyzing, review, mitigation, decision-making, and monitoring and evaluation.Since, according to Thailand’s experience, the people’s health has been seriously threatened by a series of developmental policy and projects themselves. The study found that HIA should become an essential mechanism to prevent and recover negative health impacts as well as to promote positive health impacts derived from development policies and activities in this country.HIA process and system, which will be developed in Thailand, should be (a) effective enough in health protection and promotion, (b) equally participated by all stakeholders, (c) relevant to contexts and conditions within the operational organizations and Thai society, and (d) emphasizing on participatory learning process and capacity strengthening within Thai society.During an initial stage, HIA system in Thailand should based their ground on being participatory learning process, aiming to provide better information and influence for better decision-making according to health aspects, rather than being approval mechanism. This positioning will provide more times and opportunities to build up information, knowledge, understanding, and recognition within society, which is very important for trust building within HIA system. Therefore, in drafting National Health Act, it should be mentioned clearly that the government should support the development of HIA system by establishing an independent organization under the supervision of the supreme organization of Thailand’s health system. It is also very important to search for more details on appropriated HIA models, especially in analytical and institutional frameworks, as well as, to look for strategic partners in order to develop HIA system in Thailand.
