Strategic Implementation of Dengue Hemorrhagic Fever Prevention and Control by Multisectoral Participation in Chiang Mai Province

Abstract

     This research aimed to develop a model for the prevention and control of dengue hemorrhagic fever in Chiang Mai province. It was conducted as an action research beginning by collecting existing data from key informants purposively sampled to include specific target groups who were heads of provincial official, district chief officers and representatives from private agencies. The study was divided into 4 phases including (1) problem analysis, (2) strategy development, (3) strategy implementation and (4) evaluation. Data were collected by using questionnaire and focus group discussion; and were analyzed by using SWOT analysis, mind mapping and the use of Deming cycle (PDCA). It was found that the provincial dengue control program faced some operational obstacles which include unclear provincial action policy, the lack of monitoring, intermittent operation and limited collaboration from non-health sectors. Based on the model development and implementation, the provincial committee was found to be quite strong, and regular problem solving meetings were regularly conducted. Budget and disease control equipment were sufficiently provided by local administration organizations. Essential data were returned to relevant sectors; and independent discussion and recommendations for program improvement were promoted among stakeholders which resulted in increasing work satisfaction and better direction of the program strategy.

The provincial governor was the major strategic influencer who worked together with heads of provincial sectors, civil society and chief district officers, with clear policy. Continued monitoring and evaluation was performed by the provincial team. As a result, the decline in disease incidence was observed, from 270.23 per hundred thousand population in 2016 to 127.73 per hundred thousand population in 2017 and 47.63 per hundred thousand population in 2018; together with the reduction of mosquito larval indices dengue risk areas.