PDF(Pubmed)
Abstract：
Since 2020, Thailand has experienced four waves of COVID-19. By 31 January 2022, there were 2.4 million cumulative cases and 22,176 deaths nationwide. This study assessed the governance and policy responses adapted to different sizes of the pandemic outbreaks and other challenges.
A qualitative study was applied, including literature reviews and in-depth interviews with 17 multi-sectoral actors purposively identified from those who were responsible for pandemic control and vaccine rollout. We applied deductive approaches using health systems building blocks, and inductive approaches using analysis of in-depth interview content, where key content formed sub-themes, and different sub-themes formed the themes of the study.
Three themes emerged from this study. First, the large scale of COVID-19 infections, especially the Delta strain in 2021, challenged the functioning of the health system\'s capacity to respond to cases and maintain essential health services. The Bangkok local government insufficiently performed due to its limited capacity, ineffective multi-sectoral collaboration, and high levels of vulnerability in the population. However, adequate financing, universal health coverage, and health workforce professionalism and commitment were key enabling factors that supported the health system. Second, the population\'s vulnerability exacerbated infection spread, and protracted political conflicts and political interference resulted in the politicization of pandemic control measures and vaccine roll-out; all were key barriers to effective pandemic control. Third, various innovations and adaptive capacities minimized the supply-side gaps, while social capital and civil society engagement boosted community resilience.
This study identifies key governance gaps including in public communication, managing infodemics, and inadequate coordination with Bangkok local government, and between public and private sectors on pandemic control and health service provisions. The Bangkok government had limited capacity in light of high levels of population vulnerability. These gaps were widened by political conflicts and interference. Key strengths are universal health coverage with full funding support, and health workforce commitment, innovations, and capacity to adapt interventions to the unfolding emergency. Existing social capital and civil society action increases community resilience and minimizes negative impacts on the population.
A qualitative study was applied, including literature reviews and in-depth interviews with 17 multi-sectoral actors purposively identified from those who were responsible for pandemic control and vaccine rollout. We applied deductive approaches using health systems building blocks, and inductive approaches using analysis of in-depth interview content, where key content formed sub-themes, and different sub-themes formed the themes of the study.
Three themes emerged from this study. First, the large scale of COVID-19 infections, especially the Delta strain in 2021, challenged the functioning of the health system\'s capacity to respond to cases and maintain essential health services. The Bangkok local government insufficiently performed due to its limited capacity, ineffective multi-sectoral collaboration, and high levels of vulnerability in the population. However, adequate financing, universal health coverage, and health workforce professionalism and commitment were key enabling factors that supported the health system. Second, the population\'s vulnerability exacerbated infection spread, and protracted political conflicts and political interference resulted in the politicization of pandemic control measures and vaccine roll-out; all were key barriers to effective pandemic control. Third, various innovations and adaptive capacities minimized the supply-side gaps, while social capital and civil society engagement boosted community resilience.
This study identifies key governance gaps including in public communication, managing infodemics, and inadequate coordination with Bangkok local government, and between public and private sectors on pandemic control and health service provisions. The Bangkok government had limited capacity in light of high levels of population vulnerability. These gaps were widened by political conflicts and interference. Key strengths are universal health coverage with full funding support, and health workforce commitment, innovations, and capacity to adapt interventions to the unfolding emergency. Existing social capital and civil society action increases community resilience and minimizes negative impacts on the population.
摘要：
■自2020年以来，泰国经历了四次COVID-19浪潮。到2022年1月31日，全国累计发生240万例病例和22176例死亡。这项研究评估了适应不同规模的大流行爆发和其他挑战的治理和政策应对措施。
■进行了定性研究，包括文献综述和对17个多部门参与者的深入访谈,这些参与者有目的地从负责大流行控制和疫苗推广的人员中确定.我们使用卫生系统构建模块应用演绎方法，采用深度访谈内容分析的归纳法，关键内容形成子主题，不同的子主题构成了研究的主题。
■这项研究提出了三个主题。首先,COVID-19的大规模感染，尤其是2021年的三角洲毒株，对卫生系统应对病例和维持基本卫生服务的能力的运作提出了挑战。曼谷地方政府由于能力有限，表现不够，无效的多部门合作，以及人口中的高度脆弱性。然而,充足的资金，全民健康覆盖,卫生工作人员的专业精神和承诺是支持卫生系统的关键有利因素。第二,人口的脆弱性加剧了感染的传播，旷日持久的政治冲突和政治干预导致大流行控制措施和疫苗推广的政治化；所有这些都是有效控制大流行的关键障碍。第三，各种创新和适应能力最大限度地减少了供应方的差距，而社会资本和民间社会的参与提高了社区的复原力。
■这项研究确定了关键的治理差距，包括公共沟通，管理信息流行病，与曼谷地方政府协调不足，以及公共和私营部门之间关于大流行控制和卫生服务规定的信息。鉴于人口脆弱性很高，曼谷政府的能力有限。政治冲突和干涉扩大了这些差距。主要优势是全民健康覆盖和全额资金支持，和卫生劳动力承诺，创新,以及调整干预措施以适应不断发展的紧急情况的能力。现有的社会资本和民间社会行动提高了社区的复原力，并最大限度地减少了对人口的负面影响。
■进行了定性研究，包括文献综述和对17个多部门参与者的深入访谈,这些参与者有目的地从负责大流行控制和疫苗推广的人员中确定.我们使用卫生系统构建模块应用演绎方法，采用深度访谈内容分析的归纳法，关键内容形成子主题，不同的子主题构成了研究的主题。
■这项研究提出了三个主题。首先,COVID-19的大规模感染，尤其是2021年的三角洲毒株，对卫生系统应对病例和维持基本卫生服务的能力的运作提出了挑战。曼谷地方政府由于能力有限，表现不够，无效的多部门合作，以及人口中的高度脆弱性。然而,充足的资金，全民健康覆盖,卫生工作人员的专业精神和承诺是支持卫生系统的关键有利因素。第二,人口的脆弱性加剧了感染的传播，旷日持久的政治冲突和政治干预导致大流行控制措施和疫苗推广的政治化；所有这些都是有效控制大流行的关键障碍。第三，各种创新和适应能力最大限度地减少了供应方的差距，而社会资本和民间社会的参与提高了社区的复原力。
■这项研究确定了关键的治理差距，包括公共沟通，管理信息流行病，与曼谷地方政府协调不足，以及公共和私营部门之间关于大流行控制和卫生服务规定的信息。鉴于人口脆弱性很高，曼谷政府的能力有限。政治冲突和干涉扩大了这些差距。主要优势是全民健康覆盖和全额资金支持，和卫生劳动力承诺，创新,以及调整干预措施以适应不断发展的紧急情况的能力。现有的社会资本和民间社会行动提高了社区的复原力，并最大限度地减少了对人口的负面影响。
