การวิเคราะห์นโยบายน้ำดื่มประชารัฐผ่านกรอบแนวคิดทุกนโยบายใส่ใจสุขภาพ: กรณีศึกษาจังหวัดลำพูน

Abstract

Water is an essential factor for life. However, after the state launched the Pracharath drinking water policy to stimulate the foundation economy in 2016, more than half of bottled water did not meet the quality criteria. This research aimed to analyze Pracharath drinking water through a concept of "Health in All Polices (HiAP)" in order to provide feedback to policymakers for developing health- conscious public policies. This qualitative study was conducted through a documentary research and in-depth interview using the framework of 3 key HiAP components: promote health and equality in policy process, opportunity for change, and the stakeholders. The interview was conducted with 5 groups of stakeholders of Pracharath drinking water in Lamphun Province including chief executive of relevant departments, operational level personnel, Pracharath drinking water operator, village committee and villagers, a total of 39 people during March 2019 to February 2020. The results revealed incomplete HiAP components of the Pracharath drinking water policy. First, health consideration was not yet embed as part of policy processes across sectors: situation of community drinking water problems and the need for clean and safe drinking water of the people led to the village community resolution in implementing the Pracharath drinking water project. However, even though the National Village and Urban Community Fund Office knows that Pracharath drinking water was related to health and that the application for production permission and the assessment of production sites must meet the standards, but information on health problems was not required in their budget approval criteria. Second, opportunities for a policy change to HiAP were not yet clear: the government saw an opportunity to solve the drinking water problem in the community along with stimulating the grassroots economy created an opportunity for the formation of Pracharath drinking water policy. However, as health factors had not been linked to the policy's economic goals, there were no opportunity to transform it to HiAP. Finally, stakeholders were not yet comprehensive and lack of participation: the absence of health agencies in the Provincial Civil-State Policy Coordinating and Driving Committee, together with the lack of existing capital ties between health agencies and village fund offices, had resulted in the implementation of each agency separately Therefore, the involvement of health agencies was at a low level, the "inform" level. Even if this study would only be conducted in Lamphun province and may not cover the view of the private sector, this analysis of Pracharath drinking water policy in Lamphun was one example that reflected the vulnerabilities of the link between the health and economic goals of national public policy affecting the health of local people. Provincial administrators could support the provincial government's drinking water policy to be more HiAP, both by directing (e.g. providing health goals and assessing health impact as fundamental issues in policy-making, adjusting committee structure to include health agencies), promoting awareness and empowering of stakeholders' capacity (e.g. HiAP training, develop data analysis skills for evidence-based policymaking and skills for creating policy change opportunities), as well as fostering cross-sector collaboration.