The development of the desired model of the urban disease prevention and control system of Thailand

Abstract

This research aims to analyze the opinions of the general public and the executives toward Thailand’s urban disease prevention and control system and develop the desirable model of Thailand’s urban disease prevention and control system. The research utilizes a mixed methods design consisting of quantitative research with 1,639 participants of the sample group and qualitative research with 25 participants from the target group. Research tools include a public opinion questionnaire regarding the urban disease prevention and control system and an in-depth interview regarding factors affecting the success of urban disease prevention and control system. Findings are as follows. Most participants are female (60.89%), aged between 21-30 years old (35.75%), and have a Bachelor’s Degree (55.28%). 25.44% of the participants are students and 25.38% are private employees. 40.45% of the participants live in Bangkok and its vicinity and 32.28% have lived in urban areas for more than 20 years. The opinions and expectations toward the urban disease prevention and control system are that most participants think that major diseases and health threats in urban areas include occupational and environmental diseases, communicable diseases, and non-communicable diseases. An agency that is responsible for disease prevention and control in urban areas is the Ministry of Public Health. Participants (39.93%) receive news from social media, such as Facebook, Line, Twitter, IG, and mobile applications. Information received is reliable (68.52%). After receiving information, participants seek for instructions to protect themselves and their family (48.32%) and find more information from Google (25.87%). If developing symptoms (headache, eye pain, blurred vision, chest pain, abdominal pain, aches, and rashes) for more than one day, participants will go to a local clinic or hospital (49.68%). Participants (80.66%) want doctors at clinics and hospitals to support and conduct disease prevention and control in urban areas and provide more comprehensive services (30.81%) .The results of the in-depth interview reveals that most participants see that policies and laws create an opportunity to develop a prevention and control system in urban areas. These include the Regulation of the Office of the Prime Minister on the Development of the Quality of Life in Local Area Level B.E. 2561 (2018) and Communicable Diseases Act B.E. 2558 (2015). Also, there are clear laws on the decentralization to local administrative organizations. Other supporting factors include the development of economy, blended urban and rural societies, the availability of modern technology covering urban areas, easy access to services, increasing healthy behaviors of working age population, the availability of a disease prevention and control system, strong SRRT team and networks of operations. In addition, there is a public health information database system and a channel to send information between government organizations and members of the public. The advantage of the available information database from a data system (Big Data) can be used to develop the system more effectively than in rural areas. People are encouraged to have more health knowledge and health personnel to have knowledge, experience, and ability in the job for which they are responsible. However, there are weaknesses, including the lack of seriousness and continuity of law enforcement, unclear coordinating and monitoring mechanism between government organizations, local administrative organizations, private sector, and educational institutions, an increasing amount of nonregistered populations which are difficult to reach and manage their health, the unsuitable current disease prevention and control system which does not support the context of people in urban areas, the lack of linkage of database systems among public health organizations, the lack of coverage of communication between networks, the changing way of life, resulting in the difficulty to examine the accuracy of information on disease and health threat situations before being published, the lack of appropriate health risk communication channels for migrant workers, increasing of non-communicable diseases risk behaviors of people in urban areas, the lack of proper urban planning and environment, and the density of the population affecting various problems such as waste water, garbage, dust, smoke, and traffic pollution. The results of the study suggest the desirable model of the urban disease prevention and control system of Thailand. It should allow people and communities in the city to be able to prevent and control diseases and health threats in a timely manner in accordance with the economy and society of Thailand and the world with cooperation between the network of stakeholders, including government organizations, local administrative organizations, private sector, and educational institutions. Information technology is used as communication channels that are suitable for the target group. Policies and laws are used as proactive driving mechanisms. (1) The Ministry of Public Health by the Department of Disease Control as the main unit sets up goals, strategies, action plans for urban disease prevention and control. These will be used as a joint operational framework between government organizations, local administrative organizations, private sector, and educational institutions. The focus will be on building personnel capacity, identifying target problems, and proposing a set of specific measures that can be applied to the contextual target group. Local administrative organizations will be the main mechanism for management in the local area. (2) In a local area level, local administrative organizations provide a full service of urban disease prevention and control, in cooperation with the Ministry of Social Development and Human Security, Ministry of Labour, Ministry of Digital Economy and Society, Ministry of Interior, and Ministry of Public Health. (3) Measures to prevent and control diseases and health threats in urban areas are evidence-based measures, which engage personal measures, social measures, and law enforcement measures. The implementation of these measures are based on the leverage of big data and private providers for basic services. (4) Expanding the operational structure and evaluation and monitoring system of the Institute for Urban Disease Prevention and Control. The Institute has the main function to conduct study research in collaboration with educational institutions to set policies and create new knowledge that leads to operations compliance with the context of the area. There are working groups from 12 Offices of Disease Prevention and Control, coordinating with the Provincial Public Health Office, local government organizations, private sector, and educational institutions to deliver impacts adequately addressing the problem of disease and health threats in the urban areas.