Mechai’s innovative program, which included the non-physician, community-based distribution of oral contraceptives and condoms, as well as a clinic referral service, contributed significantly to the decrease of Thailand’s annual population growth rate. Mechai utilized humor and a common sense approach, which resonated in local communities. Mechai also partnered with local government agencies to reach out to rural communities beyond the local governments’ ability to serve. Through the recruitment of volunteers, including over 320,000 rural school teachers, Mechai's NGO, the Population and Community Development Association or PDA, was able to leverage its work and expand the program into most of rural Thailand.

Mechai was one of the first to sound the alarm about the possible rapid spread of HIV and AIDS in Thailand. He responded with a program that fought the epidemic with a combination of prevention, information dissemination, and care projects. AIDS prevention efforts responded to broad societal needs for accurate information and frank discussion as well as the needs of different communities. Through vocational training and education projects, Mechai has helped to give villagers economic alternatives to the commercial sex industry, especially for young northern women who are often targeted by recruiters.

PDI was established in 1983 by Mechai as a United States based 501(c)(3) with the mission of "To provide the opportunities for the poor to help themselves get out of poverty". It has implemented projects in Thailand, Cambodia, Lao PDR, Indonesia, Philippines, and East Timor. PDI works with local NGOs to facilitate projects such as the Village Development Partnership, NGO sustainability training, community health improvement, and micro-finance. The Positive Partnership Program, which partners a HIV-positive and HIV-negative individual to promote economic livelihood and de-stigmatization of HIV/AIDS, has been heralded as a best practice by the United Nations.

Mechai began the Village Development Partnership (VDP) as a serious endeavor to empower rural communities to eradicate poverty and improve their quality of life. It is a genuine partnership between the villagers and a sponsoring company or organization, which helps to advance the public interest. The current model has had 22 years of trial and error. It has clearly demonstrated to be a successful and sustainable formula of empowerment and self-help that has to do with shared responsibilities and shared opportunities. The VDP addresses issues in five key areas of: community empowerment, economic development, environment, health, and education. The process begins with villagers establishing a Village Development Committee to hold hearings to articulate the needs and aspirations of the community, and then to establish the Village Development Plan. The committee comprises youth, middle-aged, and the elderly, of whom 50% must be women.

Following the success of the Lamplaimat Pattana Primary School, the Mechai Pattana School opened in 2009. This revolutionary educational model offers free, private education to rural children in Buriram province in Northeastern Thailand. The objectives of the school are to create strong leaders and responsible community members by utilizing teaching methods that foster the students' creative process as opposed to rote memorization usually taught in Thai education. The Secondary School is constructed of environmentally-friendly bamboo. The school has received both international and national accolades, and teachers from throughout Southeast Asia travel there to learn from its innovative educational techniques.

Mechai launched the Green Village Toy Library in 2009 to foster a new generation of community-minded and philanthropic children. The Green Village Toy Library emphasizes four youth-centered concepts: philanthropy, leadership, community service and participation, and environmental stewardship. With the help and encouragement of parents and grandparents, young urban children have the opportunity to extend their hands in friendship and generosity by donating toys to rural children. In turn, by performing environmentally–focused community service in lieu of monetary payment, rural children are able to borrow and enjoy toys. The guiding principle of the Green Village Toy Library is that access to toys is a human right for children.

To help fund the operational costs of the Mechai Pattana School, BREAD was launched as a social enterprise in 2009. The company's signature product is School Rice, which is sold commercially in Thailand. It is jasmine rice grown by the parents of the students at the Mechai Pattana School. BREAD has since expanded to other profitable ventures such as corporate gifts, wedding gifts, and a CSR Advisory service.

Mechai opened the Birds & Bees Resort in Pattaya to help fund the costs of the Mechai Pattana School. It has a Cabbages & Condoms restaurant, a children's pool, an infinity pool, an agriculture demonstration area, and excellent-quality rooms. The resort also features conference rooms, and will soon house the Grade 9 students from the Mechai Pattana School.

Mechai intends on focusing on programs that will lead to poverty eradication through education and philanthropy. This involves utilizing the resources of a school to assist the local community in achieving skills training with a focus on long-term sustainability. The Foundation also takes an approach to educational scholarships that empower youth through business.