Abstract
The purpose of this study is to study the operating model of health impact
assessment in selective local administrative organizations (LAO). The qualitative research
method was purposively applied 12 local administrative organizations. The Health Impact
Assessment (HIA) had been implemented in those selected study sites. The data were
collected by documentary reviews, participatory observations and in-depth interviews with
156 Key Informants who actively involved in HIA process. These included the personnel of
the local administrative organizations, the academia and public organizations being
supportive mechanisms and people joining the HIA process. The findings were as follows.
Firstly, Wide-ranged challenge issues were selected by 12 LAOs for HIA application
e.g., waste management, water, elderly, occupational health, community tourism. The
conditions for selecting issues include development policy direction, prioritized health
problems, and citizen requests or complaints regarding problematic issues in the area.
Secondly, the operating model of health impact assessment in selective LAOs are
three phases as follows. The 1st phase was the preparation by discussing with local
administrators, assigning the key actor or main workers, appointing the HIA board, providing
information and knowledge about the HIA for capacity buildings, setting mutual goals and
making operational plans. The 2nd phase was the operations of HIA process consisted of five
steps : 1) screening, 2) Scoping, 3) Assessing or appraisal (this process comprised of subprocesses that were data collections and analyses, policy recommendations development
and report preparations), 4) reviewing HIA report by the relevant agency and the public to
discuss the health impacts and policy recommendations to provide suggestions and
additional information for the completeness of the HIA report, and 5) Influencing. The 3rd
phase was concentrated on driving, monitoring and evaluation. The entire HIA processes
was also focused on creating the collaborative learning process among related operating
mechanisms, working together to gather information and develop the policy
recommendations or solutions that will jointly drive action towards development or solving
problems in the area. Most participants mentioned that the meaningful and inclusive
participation through the HIA process was crucial to make sense of belonging and comply with their agreement. The ‘HIA influencing’ was significant for policy commitment and
continuing support from local administrative organizations and key actors. Participants also
mentioned about feeling motivated, active citizen, community empower and strengthened
the networks to create collective leadership as well as developed mutual ownerships for
the policies driving toward sustainable future.
Thirdly, the mode of HIA performance improvements and benefits for the local
administrative organizations and communities could be classified into three types. Type 1,
learning for continually improving performances focused on certain target group’s
performances through workshops that were designed for identified target group. These
included HIA concepts and practices by learning from case studies with the HIA mentoring
academic center. Type 2, active learning how to operate and integrate from concepts into
practice and action in respective local contexts. Type 3, learning how mutual and collective
empowerment was formed by practice experience as a ‘learning platform’ by presenting
and disseminating findings from each process. Node and network was also formed providing
supports or suggestions to each other, as well as, mentoring from the academic center.
Importantly, there was the regional HIA academic center or hub to supervise and technical
support for those local implementation and network.
Fourthly, the success factors for health impact assessment by local administrative
organizations include: (1) Having common goal among team members and a strong network,
(2) Supporting from local administrators and potential key practitioners, (3) Having strong
academic mentors and access to quality data and evidence, (4) Integrating budgets from
funding sources, (5) Policy implementing through appropriate driving mechanisms.
Fifthly, key challenges include: (1) Encouraging relevant mechanisms to recognize
the importance, (2) Being sustainable of HIA process from local political changes, (3) Building
a network of strong and capable supporting mechanisms, (4) Developing concrete
recommendations from HIA, (5) Working on common policy of neighboring local
administrative organizations.
The knowledge obtained from this study will be beneficial for the local
administrative organizations across the country as the guidelines for HIA application
as well as the learning model for academic institutes/scholars/researchers’ role to support
HIA activities at local level and work with multi-sectoral networks for HIA and other
public activities. Moreover, it is also evidence for the National Health Commission Office to develop more proper supporting mechanism for HIA application in local administrative
organizations and other networks in the future.
