The  purposes of this research were to: 1) study the scope and implementation of the One Tambon One Product (OTOP)1 policy at the provincial and sub-district levels. 2) study the impact of the OTOP policy on the physical, mental, social, and spiritual health of local fabric weaving groups in the Northeastern or Isaan region, Thailand and 3) provide guidelines for related policy makers to improve the implementation of the policy in order to increase positive and minimize negative health impact. The OTOP policy is aimed at promoting the production of local goods by using local wisdom and resources in order to distribute them to national and international markets, thereby raising the economic living standard in Thailand, particularly in rural areas where income levels and consumer demand are low. There were 4 groups in this study, which comprised of 1) local fabric weaving groups (126 participants) 2) government officials, members of tambon administrative organizations, village headmen/village committees (23 participants) 3) middle men (5 participants) and 4) the consumers of the local fabric (5 participants). A variety of qualitative methods  were used to gather data, namely focus groups, informal interviews, in-depth interviews, participant observation, and field notes.  The data were analyzed by using quantitative and qualitative methods.The results of the research indicated divergent levels of understanding amongst local fabric weaving groups, government officials, middle men and consumers of traditional fabric. Additionally, the OTOP policy had both positive and negative impact on the physical, mental, social and spiritual health of the four - group participants as follows: 		1. Local fabric weaving groups There were both positive and negative health impact to these groups. The positive impacts were gaining new knowledge about dye, weaving fabric, and business management. The themes also appeared in the increase of learning  about society in big cities, using local wisdom to create new pattern of fabric, and teaching the culture of fabric weaving to their children. Furthermore, the themes emerged center on the increase of the family members’ relationship, the opportunity to access health care services and the opportunity for their children to study in universities or colleges Also, the themes showed the decrease number of burglars. Regarding the negative health impact, themes emerged center on the unfair treat on local fabric weaving groups by some government officials who are responsible for OTOP. Moreover, themes appeared  the increase of physical illness. Additionally, the themes showed the deteriorate of spirituality; the feeling of losing the culture and heritage of their ancestors’ fabric pattern.  Concerning the congruence of positive and negative health impact, themes appeared the increase of   both  income and debt,  well-being and struggle in wandering to sell products, unity and conflict, and happiness and anxiety or stress. The themes also emerged center on the decrease number of immigrants but increase number of wandering merchants.  2. Middle men The positive impact was that middle  men appreciated local people had jobs and earned money from them. The negative impact was that their own business were regressive after the OTOP policy has been introduced. 3. The consumers of the local fabric Most consumers appreciated that they had better products both styles and qualities. However, they were upset about the local fabric weaving groups that these groups were unable in management marketing.  4. 	Government officials, members of tambon administrative organizations, village headmen/village committeesSome government officials, members of tambon administrative organizations, village headmen/village committees delicated themselves for work by paying their own budgets to run  this project for serving the local weaving groups. Additionally, they had the problem to deal with some government official groups who took advantages and selected their own people to sell the products. These problems affected the succeed of OTOP policy. The suggestions from this study  were 1) the government officials have to use integrative approach and  management  to reduce the repetitive jobs, work loyally and stop taking advantage from the local fabric weaving. 2) the Ministry of Public Health and Ministry of Interior have to enhance staffs’ knowledge about the health impact of OTOP policy on local fabric weaving groups in the North-Eastern, Thailand. 3) staffs who were responsible for OTOP policy at the provincial health care agencies should take responsibility for not only food standard but also  for  the negative health impact on local fabric weaving groups from OTOP policy. These findings contribute to a more nuanced understanding of the impact of OTOP on the village level, as well as provide guidelines for policy makers, for example the government should welcome the opinion of grass root people for better problem solving to improve the implementation of the policy in order to encourage the positive outcomes of the program, particularly in under-developed regions in Isaan.