The 3rd session of Health Assembly for social participation in Health Policy

Nanoot expressed her concern about the effectiveness and goals of mutual learning in the vastly different contexts of Thailand and Tamil Nadu. For example, in the Health Assemblies (HAs) in Tamil Nadu, the government’s agenda is prioritized, and the voices of NGOs and the people’s sector are not considered. In the previous two sessions, the Thai team shared their insights on the HAs from a government perspective, while the Tamil Nadu team viewed the HAs from an NGO perspective. She inquired to clarify our goal and roadmap of this mutual learning process.

AHI responded that, according to the report “Health Assembly – Tamil Nadu Health System Reform Program, Program for Results supported by the World Bank,” the Health Assembly (HA) in Tamil Nadu was established to be “a platform in which representatives of citizens directly or indirectly related to health (users, the public) and key stakeholders (both public and private service providers, policymakers and other government officials, academics, civil society, CBOs, NGOs, etc.) come together to have a dialogue on health issues, brainstorm solutions, and come up with resolutions to further the health of the people in a jurisdiction and make health a major part of political discourse.” 

AHI believes that we can learn from each other to make the HAs a venue for multisectoral collaboration, especially to explore strategies to make the attitudes and mindsets of government personnel more open to and collaborative with the people’s sector.

Nanoot proposed inviting both NGO and government representatives from Tamil Nadu to Thailand to observe the Provincial HA and interact with the involved stakeholders. This would help them learn how the people’s sector and government sector developed mutual respect and a collaborative relationship over the years to create a co-working platform on equal footing. To make it an organizational initiative of NHCO, it needs to follow the official decision-making process.

Chhaya advised considering the following points to develop effective strategies to improve the HAs in Tamil Nadu:
Top-down decision-making processes are prevalent among policymakers and government agencies in India.

• Health and development policies and schemes are excellent on paper, but there are many challenges and limitations in implementation.
• NGOs face difficulties in pointing out the gaps between policy and implementation to the government.
• If the expanded Tamil Nadu team observes Thailand’s Provincial HA, efforts to foster a relationship between the people’s sector and the government sector will be crucial. This collaboration is essential to cultivate the HAs as a co-working platform for strengthening the health system.

Nanoot suggested involving the World Bank, which has funded research and planning for health system reform in Tamil Nadu, to ensure follow-up on the collaborative relationship after the exposure visit.

Participants reached the following conclusions:

• We need to identify and approach government officers who are influential and responsible for implementing the HAs in Tamil Nadu.
• To do this, we need to involve an NGO workers with a connection with these government officers.
• We need to learn the detailed process of developing the idea and structure of the HAs in Tamil Nadu.
• Therefore, we will invite Mr. Ameer from the People’s Health Movement (PHM) Tamil Nadu Chapter to present his insight on the HAs in Tamil Nadu at the next meeting.