Development of health impact assessment in Thailand: recent experiences and challenges.

The development of health impact assessment (HIA) in Thailand is taking place in difficult circumstances but with high hopes. For many years, the government has taken a clear direction to change Thai economy and society into a newly industrialized country. Many policies designed to fulfil this strategy, however — including investment in infrastructure and industrial development — have caused negative health effects on local people. Without a process for proper public participation,many conflicts have arisen around almost all large government projects throughout the country. The constitution established in 1997 provided an enormous opportunity for further progress in restructuring the relationship between the state and civil society. It stimulates the process of decentralization of decision-making and resource allocation, and has created new institutions and mechanisms that allow greater accountability, transparency, representation, and participation at all levels of the development process. It calls for urgent empowerment of citizens, in order to facilitate their influence on the decision-making process in all aspects of implementation of the policy by both central and local government. National health system reform, launched in 2000, has initiated the new concept of civil involvement in public policy processes. It advocates the development of healthy public policy (or putting health into non-health sectors) to pursue the principle of ‘‘all for health’’ in order to achieve the ultimate goal of health for all. The novel mechanism of HIA has to be created to mediate between all stakeholders of any public policy, so that they work together for a healthier society based on sound evidence.