Abstract
This study aimed to: 1) develop a community-based health impact monitoring
and surveillance model for health impacts arising from industrial development projects in
selected case study areas, and 2) study approaches for developing community support
systems for health impact surveillance and remediation assistance to protect public health
rights. The study applied the CIPP Model framework (Context, Input, Process, Product) in
conjunction with Community Health Impact Assessment (CHIA) as the foundation for
developing approaches, using Participatory Action Research (PAR) methodology through
stages of document research, model development, model implementation, model
evaluation, and model approval. Mixed-method data collection (quantitative and qualitative)
was employed, with analysis using descriptive statistics and content analysis. Implementation
was conducted in two areas: the Thailand-Malaysia gas separation plant and natural gas
pipeline project in Jana District, Songkhla Province, and the limestone and shale mining
project for cement industry in Muak Lek District, Saraburi Province.
The findings revealed that 1) A health impact monitoring and surveillance model
suitable for both areas' contexts, characterized by community implementation in
collaboration with external agencies, with leaders from various community groups as main
drivers and support from academic groups, government sectors, developers, legal experts, and
other relevant parties to ensure credible and academically sound monitoring processes and
reports. 2) Key steps in community surveillance include: establishing community working
groups and building shared understanding, defining surveillance issues and impacts, data
collection and impact analysis, communicating results to the public, and using surveillance
results to drive local policy proposals. However, the two areas had different key success
factors for impact surveillance: In Jana District, Songkhla Province, the community was the
most critical success factor due to strong community networks with diverse, large, and longestablished groups that possessed both knowledge capacity and coordination skills with
external agencies. In Muak Lek District, Saraburi Province, government and academic sectors
played the primary role in initial surveillance and would support community capacity building
for future independent operation. Issues and obstacles related to health impact surveillance
mechanisms, protection, and remediation of damages and impacts from state-approved
projects include 1. Legal dimension problems regarding impact assessment and monitoring
evaluation systems, 2. Administrative mechanism problems in prevention, monitoring,
surveillance, and warning systems, 3. Local-level mechanism problems in implementing
impact remediation from policy and project implementation, 4. Limitations in supporting
public participation in monitoring, evaluation, and surveillance, and 5. Public communication
mechanisms.
Support systems and mechanisms for monitoring and surveillance comprise 1.
Capacity development support systems through HIA (Health Impact Assessment) academic
networks or health impact assessment experts in the area, 2. Information systems with
relevant and necessary reports for community surveillance from the Ministry of Public
Health, Office of Natural Resources and Environmental Policy and Planning, private project
owners, or consulting companies responsible for preparing project impact monitoring reports
to support information exchange with community monitoring and surveillance working
groups, 3. Resource and coordination aspects with local government organizations supporting
budgets for monitoring and surveillance through local or area health insurance fund
mechanisms (Sub-district Health Funds), relevant government agencies such as provinciallevel departments assisting in coordination with private sectors a nd operators, 4.
Communication and public relations systems with local communication mechanisms such as
citizen journalists and local government public relations officers playing roles in
communication and awareness creation in community surveillance processes, including early
warning communication and communication for determining corrective and preventive
measures, as well as communication with relevant local agencies.
Support mechanisms include 1. Academic mechanisms with academics from
educational institutions having knowledge, skills, and expertise in health impact assessment
to help design operations, develop leader capacity, and jointly develop tools for community
monitoring and surveillance working groups, 2. Community mechanisms consisting of
community leaders with active citizen characteristics who are interested in and continuously
conduct various community activities, 3. Local or area health insurance fund mechanisms of
local government organizations and Provincial Administrative Committee (PAC) mechanisms
that support budgets for continuous and sustainable operations, 4. Government mechanisms
such as community leaders, village heads, and sub-district chiefs under administrative
supervision, with district chiefs playing important roles in communicating community
surveillance results, creating awareness, and providing basic impact prevention.
The development of community-based health impact monitoring and surveillance
models can empower communities to play roles in determining their own future, reduce
conflicts, and create sustainability for area development. However, implementation must
receive support from government agencies and continuous community capacity
development. Relevant agencies should promote systematic integration of community
surveillance with Environmental Impact Assessment (EIA) or Environmental and Health
Impact Assessment (EHIA) processes, develop regulations or laws supporting community
participation at all stages, and provide continuous budget support for community
surveillance mechanisms while promoting networks of academics and civil society at local
levels to serve as academic mentors, thereby sustainably elevating the country's health
impact monitoring and assessment system.
