Developing a community-based communicable disease surveillance model using participatory mechanisms in collaboration with primary healthcare facilities in Thepha District, Songkhla Province

-

Abstract

This research and development (R&D) study aimed to 1. develop a community-based communicable disease surveillance model using civic mechanisms in collaboration with primary health care units appropriate for the Thepha District context, Songkhla Province, and 2. evaluate the effectiveness of the model in the surveillance and control of key communicable diseases, including dengue fever, hand-foot-and-mouth disease, and acute respiratory tract infections. The study was conducted in three phases: Phase 1, situation analysis and needs assessment; Phase 2, model drafting and expert validation; and Phase 3, pilot implementation and evaluation in three pilot villages.

Sixty informants were purposively selected, comprising 34 village health volunteers (VHVs), 12 community leaders, 8 primary health care personnel, and 6 community members. Research instruments consisted of 1. a 30-item questionnaire on surveillance problems and needs with a 5-point Likert scale, 2. a focus group discussion guide, and 3. a 5-indicator model effectiveness evaluation form for pre – post comparison. Content validity was verified by 5 experts (IOC = 0.80 – 1.00) and the questionnaire reliability (Cronbach's α) was 0.87. Quantitative data were analyzed using descriptive statistics and the Wilcoxon Signed-Rank Test for pre–post comparison. Qualitative data were analyzed using content analysis, triangulation, and member checking.

The findings revealed that the developed model comprised four key components: 1. community participation mechanisms, 2. proactive household-level surveillance, 3. two-way data linkage with primary health care units, and 4. systematic response and risk communication. After six months of pilot implementation in three villages, the average case reporting time decreased from 3.6 ± 1.1 days to 1.5 ± 0.6 days (P-value < .001). The proportion of cases reported via VHVs and community members increased from 38.30 % to 72.10%. The frequency of community-level situational analysis meetings increased from an average of 0.8 to 2.4 meetings per month, and the model's appropriateness score rated by users was 4.36 ± 0.42 (high level).

In conclusion, the developed surveillance model showed improvement trends in early detection and reporting, strengthened civic participation, and systematically linked community mechanisms with primary health care services, appropriate for the Thepha District context with potential for adaptation to similar settings. Long-term follow-up and comparison with control areas are recommended to further confirm the model's effectiveness.