Abstract
Citizen participation in policy decision making process is a key component of good governance. The
National Health Security Act (NHSA) 2002 deliberately provides legal space for civic participation in governing
the Universal Coverage Scheme (UCS). Articles 13(4) and 48(8) mandate the representation of
civil society organizations (CSO) as members in the National Health Security Board and the Quality and
Standard Board. This paper aimed to analyze the processes and outcomes of citizen indirect participation
in Thai UC Scheme through CSO representation in UCS governance. Qualitative research method was
employed. Literature review and in-depth interviews with 10 informants were conducted.
The study found that CSO representatives actively participated through three functions of the UCS
governance: 1) participating in decision making and governance through representation as committee
members, 2) supporting the decision making process through representation as sub-committee members
appointed by the two committees, and 3) interlinking between CSO representatives in the two committees
and various sub-committees and the broad-based CSO networks at grass root level, for which
problems and concerns are seamlessly transmitted from local to policy decisions (at UCS governance)
which ensure effectiveness of the UCS. The outcomes of CSO contributions included successful expansion
of services in the benefits package and building public ownership of the UCS through surveillance, protect,
promote and support the implementation of the UCS for the benefit of people. Citizen participation,
which has advanced beyond legislative provision, was the result of policy space that allowed citizens to
indirectly engage (through CSO representative) in the governing body and the active citizenship has
maximized the use of policy space provided by the Law.
