การพัฒนารูปแบบการประเมินผลกระทบทางสุขภาพระดับยุทธศาสตร์: กรณีศึกษา การท่องเที่ยวโดยชุมชน เขตพัฒนาการท่องเที่ยวอันดามัน

Abstract

This action research aimed to develop Health Impact Assessment (HIA) Model at a strategy level in a case study of the Andaman Tourism Development Cluster. Two main steps were carried out; 1) HIA model development by reviewing the related documents and using a focus group discussion to study the area context with ten representative of entrepreneurs directly related to this community-based tourism management in (1) Ban Sam Chong Nuea, (2) Ban Hua Khuan, (3) Ban Na Tin, (4) Bo Hin Farm Stay, and (5) Ban Bo Chet Luk. Then, a focus group discussion was operated with twenty officials from the Tourism Development Committee, Andaman Tourism Cluster, and 2) the model was validated by using Modified Delphi Technique with the opinions of 17 experts. Afterward, the HIA model at a strategic level was confirmed by using a group discussion with the community-based tourism stakeholders and the organizations. The research results revealed that HIA at a strategy level included six main steps. The first main step was screening, consisting of six substeps: (1) the appointment for the Tourism Development Sub-committee, Andaman Tourism Cluster to be the HIA monitoring committee, (2) the working committee appointment, (3) the determination of their roles and duties, (4) surveys and interviews to ask about tourists’ needs, (5) interviews with officials in government and private offices, and community leaders, and (6) holding a screening meeting. The second step was scoping of the study and HIA guidelines, containing four substeps: (1) a group meeting for the Tourism Development Sub-committee, Andaman Tourism Cluster and the HIA working committee to determine the scope, (2) a group meeting or a workshop between two committees to determine the technical scope of the target and indicators, (3) a group meeting or a workshop between two committees to develop alternatives, and (4) the conclusion of strategic alternatives by two committees. In the third step, HIA, there were four substeps: (1) the collection of the primary and secondary data as scoped, (2) the data analysis for positive and negative impacts, (3) prioritizing health impacts, and (4) making the HIA report, and the results of the strategic alternatives. In the fourth step, reviews of the study report, and the health impact analysis included five substeps: (1) a meeting for brainstorming, (2) sending emails to the organizations to review together with the communities, (3) making the review conclusion and the report, (4) conducting a plan and a project based on the strategic proposal, and (5) the online data distribution. For the fifth step, the encouragement for decision-making was composed of three substeps: (1) a meeting for the study presentation to make a decision on the strategy operation, follow-up, and assessments, (2) the determination of the guidance and follow-up and assessments as well as responsible people and organizations for follow-up and assessments, and (3) the public presentation. Regarding the sixth step, the follow-up and assessments were operated based on requirements and suggestions from the assessments, positive and negative health impacts, well-beings, and equality. This strategic health impact assessment model is a practical model that can be implemented to determine the development direction from the facts and create value for communities with the capacity to participate in developing strategies.