Development system preparedness of a public health emergency response In Regional Health 10

Abstract

Public health emergencies are complex threats with wide-ranging impacts, underscoring the critical need to strengthen institutional capacity in accordance with the International Health Regulations (IHR 2005). This study employed an action research approach to develop a public health emergency preparedness and response system for provincial public health agencies across five provinces in Regional Health 10, Thailand. The study was conducted between October 2022 and September 2025. The research was implemented in two phases: Phase 1; focused on system development in a pilot province, and Phase 2; involved scaling up the system to four additional provinces. The study population was divided into two groups: participants involved in system development (n = 78) and participants responsible for system implementation (n = 479). The primary assessment instrument was the EOC Assessment Tool. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed through thematic grouping and interpretation in accordance with the study objectives.

The developed preparedness and response system consisted of 11 steps: (1) strategic planning for system preparedness across three core capacities (Staff, Stuff, and System) (2) assignment of responsibilities across 10 functional domains with 74 indicators (3) self-assessment to identify gaps and formulate development plans (4) implementation of development plans (5) monitoring and evaluation (6) technical support and academic mentoring (7) post-development self-assessment (8) external assessment (9) system improvement based on assessment findings (10) appeal of assessment results and (11) synthesis of development outcomes. In the pilot province (Yasothon), the EOC capacity score reached 81.08%, exceeding the national benchmark of 80% in fiscal year 2022. After scale-up in 2025, the highest EOC capacity score was observed in Ubon Ratchathani Province (94.59%), followed by Amnat Charoen, Sisaket (86.49%) and Mukdahan Province (82.43%). These findings demonstrate that the developed system is practical, scalable, and effective in enhancing provincial preparedness for public health emergencies in alignment with the Department of Disease Control standards. Key success factors included participatory engagement, data-driven decision-making, and a strong mentoring and support system. Nevertheless, critical gaps remain across the three core capacities, including shortages of specialized personnel (Staff), insufficient supporting resources such as backup power systems (Stuff), and incomplete integration of operational plans and data systems (System). It is recommended that public health authorities prioritize data system integration, conduct regular simulation exercises, and invest in essential infrastructure to ensure sustainable emergency preparedness and response across Regional Health 10.