Public governance is a subject of growing interest due to shaking public trust in the state worldwide. This presentation addresses this issue using case studies in Thailand. It focuses on participatory approach for public governance in the development of healthy public policies.

1. I shall start my talk by highlighting an implicit meaning of the lack of consensus on the
definition of good governance among international public agencies. This may indicate
differing ideology and principles underpinning power struggle in politics, globally and
locally.
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2. • Putting good governance into Thai context, it was argue that today public governance
has been mainly influenced by the WB good governance concept.
• According to Pasuk Pongpaichit, a well‐known political scientist in Thailand, good
governance under the WB framework was considered a better legal framework to
ensure transparency and accountability in public administration. The adoption of the
framework was a top‐down exercise. This author inserted that Thailand’s recent
experiences about good governance deal with political reform and social movements.
To my understanding these were initiated mainly by political elites including the
bureaucrats.
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3. In order to share selected Thai stories of good governance and the development of healthy
public policy through participatory approach, I will use the lens of innovative public
governance proposed by Anttiroiko. In broad sense, the meaning of good governance
under the lens encompasses transparency, participation, accountability etc.
The performance of good governance was considered under the influence of globalization,
democratization, localization and marketization. This analytical framework fits well with
the followings:
‐ The influence of the WB/IMF on member countries could be a good example in terms of
how globalization affects public governance.
‐ Researches in political epidemiology recently provide evidence on the linkages between
democracy, public governance and health outcomes.
‐ In the UK, Lawton and Macaulay reported changes in local governance as a result of the
Localism Act 2011.
‐ Finally, contracting out to private operator under a public private mix model was shown
to ensure efficient use of shockwave lithotripsy in Thailand by Tangchareonsatien et al.
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4. Now let me share with you my personal account of tobacco control in Thailand. It has been
globally recognized as a success story and been used to inform relevant policy decisions in
a number of developing countries. To a large extent, the success was a result of well‐
informed social mobilization at national scale with episodic linkages to global community
started 30 years ago. One of the historical landmark records for this social mobilization is
the collection of 6 million signatures to support the value of smoke free society. The
signatures were gathered by several 10,000 of runners from all walks of live organized
across all geographical regions of the country. When global trade forced Thailand to open
its monopolized tobacco market, this threat was turned into opportunity by health
professional leaders formed alliance with global anti‐tobacco experts. The opportunity was
exploited to further strengthen national alliance especially politically influential public
agencies i.e., the Ministries of: finance, commerce and foreign affair. Another landmark
success was the enactment of one of the most comprehensive legislation on tobacco
control in the world. This was, in fact, achieved within a shorter time frame as compared
to those of developed countries through making use of accumulated momentum of the
social mobilization enabling successful exploitation of windows of opportunity emerged
during coup d'état governments. Nonetheless, a new challenge arises as indicated by the
downward trends of tobacco use hitting the floor shown in this slide plus sustained urban‐
rural difference in smoking rates.
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A key challenge under the current paradigm of tobacco control in Thailand may be the lack
of knowledge in social mobilization and in engagement with public authorities at local level
as indicated by the urban‐rural gap.
Another challenge might be the lack of knowledge to deal with social determinants of health
depriving the under privileged capacity to cope with daily life stress without tobacco use.
These challenges call for innovative research to further move the society into a new frontier
of politico‐economic‐social development on equity ground.

6. The next story deals with recent initiative in social mobilization. This slide summarizes
findings from a participatory‐based evaluation of a publicly financed program on promoting
healthy public policies using national health assembly mechanism (NHA in short) and
health statue approach after the first 4 years of implementation. NHA was designed to be
multi‐level policy platforms organized thru participatory approach from local to national
level covering issues classified as national relevant, agenda specific, area specific and issues
related to health and environmental impact assessment. H statue could be considered a
participatory process organized initially at national level then expanded to cover local level
aiming at a framework to guide policy formulation and implementation of all sectors.
The evaluation explored changes across major program areas i.e., h statue at national,
organization, and local level; nha of all the categories. The findings were graded into a
spectrum of no progress to clear progress using color codes of red to dark green,
respectively and grey for no evidence. Based on a set of indicators agreed among the
evaluator team and the program implementer, it was found that
clear progression was observed in policy content formulation at the most. The least
progress was found in information sharing process and deliberation among equally well‐
informed participants. There was no evidence to assess policy impacts in most program
areas except h statue which was found no progress in all dimensions.
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7. One would say NHA is a copy cat of the world health assembly with highly systematized
formal procedures of participation at all levels. This raises a concern for more customized
processes of social mobilization especially at local level with relevant and sufficient
understanding of local context. Although the participation includes voice, choice and
representation; more inclusive processes of engagement with politically influential actors
and stakeholders in broader scope are needed for better consensus building. Participants
should be better informed to engage in voice and choice making using more evidence
gained from participatory approach and stronger scientific methods.
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