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Applying Participatory Health Impact Assessment for Advocating Development of

Applying Participatory Health Impact Assessment for Advocating Development of Healthy Public Policy in Thai Local Government Planning Processes. Uraiwan Inmuong Lertchai Charerntanyarak Faculty of Public Health, Khon Kaen University, Thailand Peter Furu

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Applying Participatory Health Impact Assessment for Advocating Development of

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  1. Applying Participatory Health Impact Assessment for Advocating Development of Healthy Public Policy in Thai Local Government Planning Processes Uraiwan Inmuong Lertchai Charerntanyarak Faculty of Public Health, Khon Kaen University, Thailand Peter Furu DBL- Centre for Health Research and Development Faculty of Life Sciences, University of Copenhagen, Denmark

  2. Overview of presentation 1 Background Objectives of the study Methods Study results Discussion and conclusion 2 3 4 5

  3. Background • Thailand decentralization countrywide 1999. • The local governments (LG) have legitimate role in city/town/village policy development and planning • Question: HOW can HIA be capable of advocating HPP within the LG policy& planning framework?

  4. Background Thailand LG structure • 75 Provincial Administrative Organizations • 1,129 Municipalities • 6,744 Sub-district Administrative Organizations (SAOs) • The lowest and closer to people is the ‘SAO’

  5. Study site A small LG at Khon Kaen Province Northeast Thailand (400 km from Bangkok) Bueng Nium LG with 12 Villages and 8,000 Population

  6. 24-LG Council Members (elected 2 members per village) 1-President with 2-Vice Presidents (elected) Bueng Nium SAO governing structure

  7. Background Bueng Nium SAO planning framework National Guideline by Ministry of Interior 5-year Strategic Plan (approved by LG Council) SAO Planning Committees 3-year Rolling Plan (approved by LG Council) • Annual Action Plan • (approved by LG Council) • Sectoral oriented SAO Implementing Divisions/ Sections Village/Community

  8. Procedure Stakeholders Background 5-year strategic plan 2005-2009 procedure (done in 2004) • 1. Local development committee, • community leaders and villagers 1. Collections of problems and needs of community 2. Formulating draft strategic plan • 2. Local development supporting committee 3. Approval of draft strategic plan 3. Local development committee 4. Adoption strategic plan to SAO Council 4. SAO council members (Decision-makers)

  9. Procedure Stakeholders Background 3-year rolling plan 2007-2009 procedure(done in 2006) • 1. Local development committee, • community leaders and villagers 1. Collections of problems and needs of community 2. Formulating draft 3-year plan • 2. Local development supporting committee 3. Approval of draft 3-year plan 3. Local development committee 4. Adoption 3-year plan to SAO Council 4. SAO council members (Decision-makers)

  10. 7 plans: 1.Poverty reduction plan 2. City and healthy community development plan 3. Human resources and quality society development plan 4. Grass root economy, trade and investment development plan 5. Tourism development plan 6. Natural resources and environmental management plan 7.Good governance development plan 1-6 were later selected to be assessed health impact Background Components of the 3-year Bueng Nium rolling plan (2007-2009)

  11. Objectives • To apply participatory HIA tool for • assessing an existing 3-year SAO • rolling development plan • To create participatory recommendations • for building healthy public policy and • planning frameworks for future SAO • development plan

  12. Methods (1) Applying HIA procedure in planning processes 1. Screening SAO 3-year development plan (2007-2009) (done in 2006) 2. Scoping 3. Full scale HIA 4. Appraisal of draft HIA report SAO 3-year development plan (2008-2010) (being done in May-July 2007) 5. Decision-making 6. Evaluation of HIA outcome

  13. Methods (2) Research activities:(June 2006 – September 2007)

  14. Methods (3) Research activities:(June 2006 – September 2007)

  15. Methods (4) Research activities:(June 2006 – September 2007)

  16. Study results (1) Population health statusfrom health authority records • Indicators (2006) • Birth rate : 10.05/1000 • Mortality rate : 0.75/1000 • Population increasing rate : 9.30/1000 • Key health problems (2006) • Diarrhoea • Diabetes mellitus /Hypertension • Vulnerable groups (2007) • 117 Elderly • 28 Handicaps • 5 AIDs patients

  17. Study results (2) Number of communicable disease cases (Jan-Dec 06) PUO = Pyrexia of unknown origin Source: Khon Kaen hospital, Bueng Nium health center, 2007

  18. Study results (3) Number of chronic non-communicable disease cases(April 2007) Number • Diabetes mellitus (DM) 134 • Hypertension (Ht) 27 • DM and Ht 18 • Toxic goiter 1 Total 180 Source: Bueng Nium health center, 2007

  19. Health hazards Intestinal pathogen Influenza virus Dengue virus Pesticide poisons Particulate matters from rice mill factory Traffic Study results (5) Health hazards perceived by local villagers

  20. Individual & family determinants age/gender/genetic/education/eating behavior/alcohol consumption/exercise/occupation/family structure Environmental determinants Physical & Chemical environment flooding/food hygiene/water quantity and quality/air quality/soil quality/recreation area/housing/community sanitation/infrastructure/industrial pollution Biological environment - plant insects attack/plant disease/ disease vector breeding place Study results (6) Health determinants viewed by local villagers 1 2

  21. Study results (7) Health determinants viewed by local villagers Social environment • religion/believe/local cultures/ traditions/community development activities/local regulations/community agreements/social cohesion/lottery buying / individual/family and community security/burglary/crime/drug abuse Economical environment • income/debt/agricultural production price Institutional determinants • Sub-district health center services/health volunteer services/community development volunteer service/police service • SAO services: • solid waste collection • emergency response • community security services 3

  22. Study results (8) Assessing health impacts from development plans

  23. Study results (9) Assessing health impacts from development plans

  24. Benefits of HIA found: Stakeholders responded of gaining knowledge and experiences on policy & planning development process HIA well supported and fixed community participation problem in the planning development process HIA fostered social cohesion between decision-makers, community leaders, local officers and villagers HIA made the local stakeholders know more about health hazard/risk/safeguard as well as how to do HPP Discussion and conclusion

  25. HIA report was submitted to the SAO, some changes were recently observed: Some recommendations were used for improvement of the SAO action plan 2007 A set of recommendations based on HIA report were brought at stake and used for planning development process of the LG 3-year plan (2008-2010), currently done by the Bueng Nium SAO during April-July 2007 Discussion and conclusion

  26. Acknowledgements • Higher Education Commission, Ministry of Education, Thailand • The Graduate School, Khon Kaen University, Thailand • DBL- Centre for Health Research and Development Faculty of Life Sciences, University of Copenhagen, Denmark • IAIA and Swedish International Development Cooperation Agency • Bueng Nium SAO administrators, SAO council members, community leaders, SAO officers, health volunteers, community development volunteers, sub-district health center officers, and local people

  27. Thank You for Your Attention

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