An evaluation of provincial management of surveillance, prevention and control of occupational and environmental diseases, Thailand, 2022

Abstract

This study aimed to assess the operational management of the provinces in surveillance, prevention, and control of occupational and environmental diseases (EnvOcc) in Thailand and examine problems, obstacles, and suggestions for improvement. A cross-sectional study was conducted using online survey via Google Form between April and August 2022. The target population included the representative staff from 76 provincial health offices and Bangkok Metropolitan Administration (BMA)’s Health Department. Data were analyzed using descriptive statistics which include frequency and percentage. The overall operational performance of each province was categorized into five levels - “beginner”, “basic”, “good”, “very good”, and “excellent”. Furthermore, problems, obstacles, and recommendations related to regional and provincial operations were also summarized. Of 77 provinces, 43 (55.8%) obtained performance score of 80% or higher, which was categorized as “excellent”; while only three provinces earned score of less than 50%, classified as “beginner.” The competencies under which less than 50% of the provinces could achieve are as follows: (1) situation analysis of seven diseases under the Control of Occupational and Environmental Diseases Act B.E. 2562 (2019), including risk analysis or their respective area of jurisdiction, and (2) preparation of a report on the situation of such seven diseases under the Act. Most of the provinces reportedly faced various operational problems, including COVID-19 outbreaks, limited budget, and unclear reporting mechanism. Thus, measures on surveillance, prevention and control of occupational and environmental diseases should be promoted to be a key focus at the ministerial level. To ensure efficient operations among staff responsible for EnvOcc disease control efforts at the provincial level, effective reporting and information system should be developed and implemented, and capacity building program should be continuously provided.