Abstract
This study analyzes the status, potential and operational gaps of Social Participation
within the Thai health system. Utilizing the World Health Organization (WHO) framework and
WHA Resolution 77.2, the research examines the mechanisms of five key organizations: (1)
the National Health Commission Office (NHCO) (2) National Health Security Office (NHSO) (3)
Thai Health Promotion Foundation (ThaiHealth) (4) Community Organizations Development
Institute (CODI) and (5) Ministry of Public Health (MOPH).
The findings indicate that while Thailand possesses strong legal foundations
implementation often falls short. When applying Arnstein’s Ladder of Citizen Participation,
most operations remain at the Consultation level. Although public input is solicited, it
frequently lacks concrete implementation, reflecting Tokenism rather than genuine Citizen
Power or partnership.
A critical challenge identified is terminological ambiguity. The terms Participation and
Engagement are often used interchangeably without clear operational definitions regarding
the extent of power-sharing, creating a significant expectation gap between the state and the
public. Furthermore, the system lacks effective feedback loops, causing proposals to
disappear without response. The process also suffers from elite capture, where established
civil society leaders dominate, excluding vulnerable groups and those with direct lived
experiences.
To address these issues, the study proposes four policy recommendations:
1) Standardize definitions and participation levels to align with international standards
2) Establish co-decision mechanisms to concretely devolve policy and budgetary power
3) Implement transparent feedback loops to rebuild social trust and 4) Invest in equity by
empowering real problem owners to ensure sustainable health fairness.
