The Development of Communicable Disease and Emerging Disease Surveillance, Prevention and Control System along Thai-Myanmar and Thai-Lao PDR Border Areas, Chiang Rai Province, 2017-2018

Abstract

Background: Chiang Rai provincial health office has implemented a project for the development of communicable disease and emerging disease surveillance, prevention and control system along Thai-Myanmar and Thai-Lao PDR border areas since 2015. Monitoring and evaluation of its progress as well as taking lessons learned from the project implementationare therefore needed in order to further improve the project and to present lessons learned to the network of organizations in the border areas. Objective: To investigate and analyze the results of the Chiang Rai’s project for communicable and emerging disease surveillance, prevention and control along the border areas of Thai, Myanmar and Lao PDR. Methods: The descriptive evaluative study design was implemented. Data were collected using questionnaires for basic demographic characteristics along with qualitative components by performing focus group discussion and in-depth interview using the CIPP model. The 1,481 participants purposely selected for the study were composed of administrators, public health staff, public health volunteers, migrant health volunteers and villagers residing in the border areas along Chiang Rai province, Laos and Myanmar. Descriptive statistics and content analysis were used to analyze quantitative and qualitative data, respectively. Results: For Thai-Lao border, it was found that most of the participants were female (56.9%). Almost all of the participants were Buddhists (83.2%). There were wide varieties of ethnicity and nationality. About 39.2% of them were farmers. For Thai- Myanmar border, most of the participants were also female (53.7%) and Buddhists (65.3%). About half of participants were Tai-yai ethnic group (50.1%), followed by Myanmar (38.6%). The most common occupation was casual laborer, which accounts for 51.0%. The outcomes of the project evaluation based on CIPP model indicated that in the context in terms of information about policy, program and project in areas bordering these two neighboring countries it was found to have been thoroughly fulfilled.  For the input, it showed that readiness concerning the budget, materials and potential of human resources in supporting implementation of activities in the areas was at a good level. The process evaluation showed that the process of implementing projects and method of solving the gap of local problems were at an appropriate level. As for the product, the project delivered the successful and distinct method of implementation. Conclusion: The project demonstrated positive and concrete outcome results in policy and local dimensions, both formal and informal implementations in a top-down fashion at the Thai-Lao border. In Thai – Myanmar border, however, the project implementation at the local level could only utilize an informal type of collaboration and resulted in its limited success. The policy recommendation based on the evaluation is that the central government policy should be implemented to advance the collaboration to adequately address communicable diseases and health threats focusing on the local area, and implementation of the twin-city and twin-village health collaboration model along Thai –Myanmar and Thai - Lao PDR border areas.