Policy Recommendations for Response Management of Primary Health Care System to the COVID-19 Pandemic in Southern Thailand

Abstract

Primary health care system and health management played important roles in the Thai government’s response to the COVID-19 pandemic. This study’s research aims were to: 1) study the response management to the COVID-19 pandemic, 2) analyze the results and impacts of response management, and 3) make policy recommendations for the response to current and future pandemics. The study was conducted in sub-district (Tambon) health promotion hospitals in the 11th health region of Thailand. Using rapid ethnographic community assessment process, we selected informants involved in pandemic response management in the primary health care system. Step 1: Select 2 districts per province with different contexts, resulting in 14 districts. Step 2: Randomly select 1 Subdistrict Health Promotion Hospital per district by a random sampling. Step 3 Select specific information providers. The qualifications were those involved in managing the response to the COVID-19 outbreak. In the selected community, there were 12 people per community, totaling 14 districts (n=168). Data was collected by participatory observation, in-depth interviews, and a focus group discussion. Data were analyzed with qualitative content analysis and triangulation. Data were collected during November 2020 and April 2021, which measured to define containment zone areas.  It has been used as a tool to control the spread of COVID-19. These zones were created to map and prevent local transmission.

             Response management to the pandemic included: 1) providing knowledge about COVID-19 to health volunteers, 2) providing one-stop services in primary health care system, 3) using technology to take care of patients, and 4) utilizing surveillance measures in the community.

            The impacts of response management included: 1) As a result of using prevention measures, endemic diseases such as dengue fever, respiratory diseases, and gastrointestinal diseases decreased; 2) There were economic problems, especially in tourism areas; 3) Promotion of job creation and the sufficiency economy principles occurred in agricultural areas; 4) New technology and innovations emergeda.

           The policy recommendations to manage the response to the spread of COVID-19 included: 1) Organize a training course to develop health leaders in the area, 2) Have a policy to develop a telemedicine system, 3) Develop a collaborative information management platform, 4) Sub-district administrative organizations/administrators should consider creating a public health work group that accepts nursing or public health graduates directly.