The future of leprosy surveillance and control : A scenario - based study for Thailand
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Abstract
Thailand has achieved the World Health Organization (WHO) target for leprosy elimination as a public health concern. However, the post-elimination context presents systemic challenges, particularly declining policy prioritization and reduced resource allocation, which may affect the efficacy of surveillance and control systems. This study aimed to analyze key factors and emerging trends influencing Thailand’s leprosy surveillance and control system, develop future scenarios, and develop synthesize an appropriate system aligned with the national context. The study employed the Ethnographic Delphi Futures Research (EDFR) methodology, conducting three Delphi rounds with 21 experts. Consensus was analyzed using median and interquartile range statistics, followed by an expert validation meeting to refine and confirm the proposed system model. As a result, a total of 89 key factors and trends were identified. The legal, political, and policy dimensions demonstrated the highest level of consensus. “Strength of policy governance” and “level of information technology integration” emerged as the primary driving forces shaping four future scenarios. Based on these findings, an integrated leprosy surveillance and control model was developed, comprising four core components : Rapid detection & response, Policy-driven governance, Sustainable stigma reduction strategy and Integrated information system appropriate to the Thai context. The findings underscore the necessity of sustaining strategic policy commitment and strengthening digital data integration within primary healthcare networks.
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