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Apichai Wattanapisit,1,2 Waluka Amaek,3 Sanhapan Wattanapisit,4 Titiporn Tuangratananon,5 Sunton Wongsiri,6 Prasert Pengkaew7 1School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand; 2Walailak University Hospital, Nakhon Si Thammarat, Thailand; 3College of Graduate Studies, Walailak University, Nakhon Si Thammarat, Thailand; 4Thasala Hospital, Nakhon Si Thammarat, Thailand; 5International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand; 6Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand; 7School of Informatics, Walailak University, Nakhon Si Thammarat, ThailandCorrespondence: Apichai WattanapisitSchool of Medicine, Walailak University, 222, Thaiburi, Thasala, Nakhon Si Thammarat, 80161, ThailandTel +66 7567 2801Fax +66 7567 2807Email apichai.wa@wu.ac.thIntroduction: A mobile health (mHealth) technology has the potential to facilitate personalized physical activity (PA) counselling. We aimed to explore the feasibility and challenges of implementing a newly developed mHealth application (PAC app) for personalized PA counselling.Material and Methods: A qualitative design employed a descriptive phenomenology approach. Data were collected through focus group discussions (FGDs) with primary health care (PHC) providers and were analyzed using a deductive thematic approach.Results: A total of 16 participants participated in four FGDs. Four major themes were found: application for personalized PA counselling, barriers to the use of the application by providers, patient involvement, and impact on PHC services.Discussion: The results showed that the new mHealth application can potentially facilitate PA counselling. However, its use in PHC settings requires an understanding of the context of service delivery; the challenges faced by providers and patients and effects on services must be considered.Conclusion: Future research should focus on the long-term use of PAC app and its impact on behavioral and health outcomes.Keywords: counselling, mHealth, personalization, physical activity, primary health care

The coronavirus disease 2019 (COVID-19) outbreak emerged in Thailand in January 2020 with the situation worsening during March-April 2020. The government decided to lockdown most public places, including schools and daycare nurseries even though the proportion of cases in under 15-year-old was small (about 2.8%). Evidence at the global level did not reach consensus on how to manage school openings properly. The Department of Health of the Ministry of Public Health has delivered school guidelines for the prevention and control of COVID-19. The modelling team of the Department of Disease Control demonstrated that the risk of an infective presenting with a long incubation period (more than seven days) was approximately 12%. This figure reduced to only 1% if a fourteen-day cutoff was applied. The infectivity risk did not depend on the incubation period alone, but greatly relied on the ability of a school to detect a case. With a timely and comprehensive detection rate (close to 100%), a seven-day closure policy yielded almost the same infectivity risk as a fourteen-day closure policy. Policy makers should bring the issues of health, education, and the social impact of children to the table and identify the most appropriate measures to control COVID-19 while ensuring the best quality of life of a child.

The COVID-19 pandemic will not be the last of its kind. As the world charts a way towards an equitable and resilient recovery, Public Health and Social Measures (PHSMs) that were implemented since the beginning of the pandemic need to be made a permanent feature of health systems that can be activated and readily deployed to tackle sudden surges in infections going forward. Although PHSMs aim to blunt the spread of the virus, and in turn protect lives and preserve health system capacity, there are also unintended consequences attributed to them. Importantly, the interactions between PHSMs and their accompanying key indicators that influence the strength and duration of PHSMs are elements that require in-depth exploration. This research employs case studies from six Asian countries, namely Indonesia, Singapore, South Korea, Thailand, the Philippines and Vietnam, to paint a comprehensive picture of PHSMs that protect the lives and livelihoods of populations. Nine typologies of PHSMs that emerged are as follows: (1) physical distancing, (2) border controls, (3) personal protective equipment requirements, (4) transmission monitoring, (5) surge health infrastructure capacity, (6) surge medical supplies, (7) surge human resources, (8) vaccine availability and roll-out and (9) social and economic support measures. The key indicators that influence the strength and duration of PHSMs are as follows: (1) size of community transmission, (2) number of severe cases and mortality, (3) health system capacity, (4) vaccine coverage, (5) fiscal space and (6) technology. Interactions between PHSMs can be synergistic or inhibiting, depending on various contextual factors. Fundamentally, PHSMs do not operate in silos, and a suite of PHSMs that are complementary is required to ensure that lives and livelihoods are safeguarded with an equity lens. For that to be achieved, strong governance structures and community engagement are also required at all levels of the health system.

Thailand, along with many other countries, was hit by coronavirus disease 2019 (COVID-19). The COVID-19 vaccines were known to be effective in mitigating the spread and preventing deaths. However, Thailand faced a crisis in mid-2021 before the vaccines could disseminated to the population. Thus, the Government introduced a lockdown policy to control the outbreak. However, many questioned the effectiveness of the policy as it did not immediately result in favorable outcomes. Therefore, this study aimed to unravel results of the lockdown using deterministic system dynamics and compartmental models. We found that there was a misperception surrounding the idea that the lockdown policy could reduce the number of newly reported cases within few days. In addition, the epidemic would always continue as long as there were susceptible people remaining in the system. Therefore, the Government needs to consider other supporting policies alongside the lockdown and communicate with the wider public about its objectives.

In mid-2021, Thailand faced a fourth wave of Coronavirus Disease 2019 (COVID-19) predominantly fueled by the Delta and Alpha variants. The number of cases and deaths rose exponentially, alongside a sharp increase in hospitalizations and intubated patients. The Thai Government then implemented a lockdown to mitigate the outbreak magnitude and prevent cases from overwhelming the healthcare system. This study aimed to model the severity of the outbreak over the following months by different levels of lockdown effectiveness. Secondary analysis was performed on data primarily obtained from the Ministry of Health; the data were analyzed using both the deterministic compartmental model and the system dynamics model. The model was calibrated against the number of daily cases in Greater Bangkok during June–July 2021. We then assessed the outcomes (daily cases, daily deaths, and intubated patients) according to hypothetical lockdowns of varying effectiveness and duration. The findings revealed that lockdown measures could reduce and delay the peak of COVID-19 cases and deaths. A two-month lockdown with 60% effectiveness in the reduction in reproduction number caused the lowest number of cases, deaths, and intubated patients, with a peak about one-fifth of the size of a no-lockdown peak. The two-month lockdown policy also delayed the peak until after December, while in the context of a one-month lockdown, cases peaked during the end of September to early December (depending on the varying degrees of lockdown effectiveness in the reduction in reproduction number). In other words, the implementation of a lockdown policy did not mean the end of the outbreak, but it helped delay the peak. In this sense, implementing a lockdown helped to buy time for the healthcare system to recover and better prepare for any future outbreaks. We recommend further studies that explore the impact of lockdown measures at a sub-provincial level, and examine the impact of lockdowns on parameters not directly related to the spread of disease, such as quality of life and economic implications for individuals and society.

Background In response to an increased health burden from non-communicable diseases (NCDs), primary health care (PHC) is effective platform to support NCDs prevention and control. This study aims to assess Thailand’s PHC capacity in providing NCDs services, identify enabling factors and challenges and provide policy recommendations for improvement. Methods This cross-sectional mixed-method study was conducted between October 2019 and May 2020. Two provinces, one rich and one poor, were randomly selected and then a city and rural district from each province were randomly selected. From these 4 sites in the 2 provinces, all 56 PHC centres responded to a self-administrative questionnaire survey on their capacities and practices related to NCDs. A total of 79 participants from Provincial and District Health Offices, provincial and district hospitals, and PHC centres who are involved with NCDs participated in focus group discussions or in-depth interviews. Results Strong health infrastructure, competent staff (however not with increased workload), essential medicines and secured budget boost PHC capacity to address NCDs prevention, control, case management, referral and rehabilitation. Community engagement through village health volunteers improves NCDs awareness, supports enrolment in screening and raises adherence to interventions. Village health volunteers, the crucial link between the health system and the community, are key in supporting health promotion and NCDs prevention and control. Collaboration between provincial and district hospitals in providing resources and technical support enhance the capacity of PHC centres to provide NCDs services. However, inconsistent national policy directions and uncertainty related to key performance indicators hamper progress in NCDs management at the operational level. The dynamic of urbanization and socialization, especially living in obesogenic environments, is one of the greatest challenges for dealing with NCDs. Conclusion PHC centres play a vital role in NCDs prevention and control. Adequate human and financial resources and policy guidance are required to improve PHC performance in managing NCDs. Implementing best buy measures at national level provides synergies for NCDS control at PHC level.

Background School health plays a vital role in lifelong health outcomes. Migrant children are a vulnerable population that seem to have inadequate health promotion interventions, and limited studies have assessed their health status and personal hygiene at schools. This study aimed to evaluate school health promotion and health outcomes of migrant children in Thai public schools (TPSs) and migrant learning centers (MLCs). Methods A cross-sectional study was applied. Data were collected from questionnaires focusing on health care access, nutritional status, and personal hygiene of migrant children in two MLCs and four TPSs, along with Thai children in the same TPSs. Descriptive analysis and logistic regression model were used to compare access to health promotion and the health status of migrant children with the Thai counterparts. Results Blended school health services were generally found in TPSs, which led to indifferent vaccination rates between Thai and migrant children in TPSs (odds ratio [OR] 0.457 (0.186-1.120)). However, vaccination rates of migrant children in MLCs are noticeably around fourfold lower. Overall, migrant children received fewer dental health services than Thai children, both in TPSs (OR 0.198 (0.076,0.517)) and MLCs (OR 0.156 (0.004,0.055)). Other personal hygiene behaviors and nutritional statuses saw no significant difference between Thai children and migrant children in either TPSs or MLCs. The uninsured status among migrant children posed another challenge to health care access, as 81.7% of the migrant children in MLCs and 56.6% in TPSs were uninsured. Conclusion Migrant children in MLCs received a lower rate of essential vaccinations compared to those in TPSs. Dental services appeared to be the most neglected area of care in migrant children. The findings indicate the necessity of supportive policy for MLCs, while regulating quality and standards concurrently. Multisectoral collaboration is critically needed for sustainably improving the quality of life of migrant children.

Thailand’s first wave of COVID-19 in March 2020 was triggered from boxing events and nightclubs in Bangkok, which spread to 68 provinces. The nation responded rapidly with strong public health and social measures on 26 March 2020. Contact tracing was performed by over 1000 surveillance and rapid response teams with support from 1.1 million village health volunteers to identify, isolate and quarantine cases.Thailand implemented social measures in April 2020 including a full-scale national lockdown, curfews and 14-day mandatory quarantine for international travellers. With a strong health system infrastructure, people’s adherence to social measures and a whole-of-government approach, the first wave recorded only 3042 cases and 57 deaths with 1.46% case fatality rate. Economic activities were resumed on 1 May 2020 until the end of the year. On 17 December 2020, a second wave was carried by undocumented migrants who were not captured by the quarantine system. As the total lockdown earlier led to serious negative economic impact, the government employed a targeted strategy, locking down specific areas and employing active case finding. Essential resources including case finding teams, clinicians and medicine were mobilised.With synergistic multisectoral efforts involving health, non-health and private sector, the outbreak was contained in February 2021. Total cases were seven times higher than the first wave, however, early admission and treatment resulted in 0.11% case fatality rate. In conclusion, experiences of responding to the first wave informed the second wave response with targeted locking down of affected localities and active case findings in affected sites.

Additional file 2. Summary of the included studies

Additional file 1. Summary of methodological assessment

Background School health plays a vital role in lifelong health outcomes. Migrant children are a vulnerable population that seem to have inadequate health promotion interventions, and limited studies have assessed their health status and personal hygiene at schools. This study aimed to evaluate school health promotion and health outcomes of migrant children in Thai public schools (TPSs) and migrant learning centers (MLCs). Methods A cross-sectional study was applied. Data were collected from questionnaires focusing on health care access, nutritional status, and personal hygiene of migrant children in two MLCs and four TPSs, along with Thai children in the same TPSs. Descriptive analysis and logistic regression model were used to compare access to health promotion and the health status of migrant children with the Thai counterparts. Results Blended school health services were generally found in TPSs, which led to indifferent vaccination rates between Thai and migrant children in TPSs (odds ratio [OR] 0.457 (0.186–1.120)). However, vaccination rates of migrant children in MLCs are noticeably around fourfold lower. Overall, migrant children received fewer dental health services than Thai children, both in TPSs (OR 0.198 (0.076,0.517)) and MLCs (OR 0.156 (0.004,0.055)). Other personal hygiene behaviors and nutritional statuses saw no significant difference between Thai children and migrant children in either TPSs or MLCs. The uninsured status among migrant children posed another challenge to health care access, as 81.7% of the migrant children in MLCs and 56.6% in TPSs were uninsured. Conclusion Migrant children in MLCs received a lower rate of essential vaccinations compared to those in TPSs. Dental services appeared to be the most neglected area of care in migrant children. The findings indicate the necessity of supportive policy for MLCs, while regulating quality and standards concurrently. Multisectoral collaboration is critically needed for sustainably improving the quality of life of migrant children.

By 2016, Member States of the World Health Organization (WHO) had developed and implemented national action plans on noncommunicable diseases in line with theEn 2016, les États membres de l'Organisation mondiale de la Santé (OMS) avaient élaboré et mis en œuvre des plans d'action nationaux sur les maladies non transmissibles conformément au Plan d'action mondial pour la lutte contre les maladies non transmissibles (2013–2020). En 2018, nous avons évalué l'état de l'application des interventions les plus avantageuses recommandées en matière de maladies non transmissibles dans sept pays asiatiques: le Bhoutan, le Cambodge, l'Indonésie, les Philippines, le Sri Lanka, la Thaïlande et le Viet Nam. Nous avons recueilli des données à partir de toute une série de rapports publiés et directement auprès des ministères de la Santé. Nous avons inclus les interventions qui concernaient la consommation de tabac et d'alcool, une activité physique inadéquate et une consommation de sel élevée, ainsi que les réponses des systèmes de santé, et nous avons identifié les lacunes et proposé des solutions. En 2018, les progrès étaient variables selon les pays. Les lacunes étaient largement dues à un financement inadéquat; des capacités institutionnelles limitées (malgré des unités dédiées aux maladies non transmissibles); une action inadéquate dans les différents secteurs au sein et en dehors du système de santé; et l'absence de mécanismes de suivi et d'évaluation standardisés pour orienter les politiques. Afin de combler ces lacunes, les gouvernements doivent investir davantage dans des interventions efficaces telles que les interventions les plus avantageuses recommandées par l'OMS, améliorer l'action dans les différents secteurs, et renforcer les capacités en matière de suivi et d'évaluation, mais aussi de recherche. En s'inspirant de la Convention-cadre pour la lutte antitabac, l'OMS et ses partenaires internationaux devraient élaborer un outil de suivi complet et standardisé sur la consommation d'alcool, de sel et d'aliments malsains, l'activité physique et la réponse des systèmes de santé.Para 2016, los Estados miembros de la Organización Mundial de la Salud (OMS) habían elaborado y aplicado planes de acción nacionales sobre las enfermedades no contagiosas de acuerdo con el Plan de acción mundial para la prevención y el control de las enfermedades no transmisibles (2013-2020). En 2018, se evaluó el estado de implementación de las intervenciones recomendadas en siete países asiáticos en materia de enfermedades no contagiosas: Bhután, Camboya, Filipinas, Indonesia, Sri Lanka, Tailandia y Vietnam. Se recopilaron datos de una serie de informes publicados y directamente de los ministerios de salud. Se incluyeron intervenciones que abordaron el uso del tabaco y el alcohol, la actividad física inadecuada y la ingesta elevada de sal, así como las respuestas de los sistemas de salud, se identificaron las deficiencias y se propusieron soluciones. En 2018, el progreso fue desigual entre los países. Las deficiencias en la aplicación se debieron en gran medida a la falta de financiación, a la limitada capacidad institucional (a pesar de las dependencias designadas para las enfermedades no contagiosas), a la inadecuación de las medidas adoptadas en los diferentes sectores dentro y fuera del sistema de salud y a la falta de mecanismos normalizados de supervisión y evaluación que sirvieran de base a las políticas. Para subsanar las deficiencias en materia de aplicación, los gobiernos deben invertir más en intervenciones eficaces, como las recomendadas por la OMS, mejorar las medidas adoptadas en los distintos sectores y aumentar la capacidad de seguimiento y evaluación y de investigación. A partir de las enseñanzas del Convenio Marco para el Control del Tabaco, la OMS y los asociados internacionales deberían elaborar un instrumento de seguimiento normalizado y completo para el consumo de alcohol, sal y alimentos no saludables, la actividad física y la respuesta de los sistemas de salud.قامت الدول الأعضاء في منظمة الصحة العالمية (WHO) في عام 2016 بتطوير وتنفيذ خطط عمل وطنية بشأن الأمراض غير المعدية بما يتماشى مع خطة العمل العالمية للوقاية من الأمراض غير المعدية ومكافحتها (2013-2020). في عام 2018، قمنا بتقييم حالة تنفيذ أفضل التدخلات الموصى في الأمراض غير المعدية في سبعة بلدان آسيوية: إندونيسيا والفلبين وبوتان وتايلند وسري لانكا وفييت نام وكمبوديا. قمنا بجمع بيانات من مجموعة من التقارير المنشورة، كما جمعنا البيانات مباشرة من وزارات الصحة. وقمنا بتضمين التدخلات التي تناولت استخدام التبغ والكحول، والنشاط البدني غير الكافي والاستهلاك المرتفع من الملح، وكذلك استجابات الأنظمة الصحية، وحددنا الفجوات والحلول المقترحة. وفي عام 2018، كان التقدم متفاوتا بين البلدان. وكانت الفجوات في مستوى التنفيذ ترجع إلى حد كبير إلى عدم كفاية التمويل؛ والقدرات المؤسسية المحدودة (على الرغم من الوحدات المخصصة للأمراض غير السارية)؛ وعدم كفاية العمل عبر القطاعات المختلفة داخل وخارج النظام الصحي؛ وعدم وجود آليات موحدة للرصد والتقييم لتوجيه السياسات. ولمعالجة الفجوات على مستوى التنفيذ، تحتاج الحكومات إلى أن تستثمر أكثر في التدخلات الفعالة مثل أفضل التدخلات التي توصى بها منظمة الصحة العالمية، وتحسين العمل عبر مختلف القطاعات، وتعزيز القدرة على الرصد والتقييم في الأبحاث. بناء على الاستفادة المحققة من الاتفاقية الإطارية لمكافحة التبغ، فإنه يجب على كل من منظمة الصحة العالمية والشركاء الدوليين تطوير أداة رصد قياسية وشاملة لكل من الكحول والملح والاستهلاك الغذائي غير الصحي والنشاط البدني واستجابة النظم الصحية.截至 2016 年，世界卫生组织 (WHO) 成员国均已根据《预防和控制非传染性疾病全球行动计划 (2013-2020)》开展并实施了非传染性疾病国家行动计划。2018 年，我们评估了亚洲七国预防和控制非传染性疾病的“最合算措施”以及其它推荐干预措施的实施情况。这七个国家分别是：不丹、菲律宾、柬埔寨、斯里兰卡、泰国、印度尼西亚、和越南。我们从一系列已发表的报告和卫生部门直接收集数据。调查涵盖了减少烟草使用、减少有害使用酒精、减少身体不足活动、减少高盐摄入等干预措施，同时还有卫生系统反应，我们由此确定实施的差距，并提出解决方案。2018 年，各国在此方面的进展并不均衡。干预措施的实施存在差距的主要原因包括资金不足；机构能力有限（尽管指派了非传染性疾病部门）；卫生系统内外不同部门的行动不足；以及缺乏制定政策的标准化监测和评估机制。为了解决实施差距，政府应更多地采取有效的干预措施，例如世界卫生组织预防和控制非传染性疾病的“最合算措施”以及其它推荐干预措施，从而改善不同部门的行动力，提高监测、评估和研究的能力。根据《烟草控制框架公约》，世卫组织及其国际合作伙伴应制定关于酒精、盐和不健康饮食、身体活动不足和卫生系统反应的标准化综合监测工具。.К 2016 году страны-члены Всемирной организации здравоохранения (ВОЗ) разработали и осуществили национальные планы действий в отношении неинфекционных заболеваний в соответствии с Мировым планом действий по предотвращению и контролю распространения неинфекционных заболеваний (2013–2020 гг.). В 2018 году была проведена оценка состояния рекомендуемых и наиболее популярных мер борьбы с неинфекционными заболеваниями в семи странах Азии: в Бутане, Вьетнаме, Индонезии, Камбодже, Таиланде, на Филиппинах и в Шри-Ланке. Были собраны данные ряда опубликованных отчетов, а также получены сведения непосредственно из министерств здравоохранения. Авторы включили в обзор действия в отношении употребления табака и алкоголя, борьбы с недостаточной физической активностью и высоким потреблением соли, а также оценили реакцию систем здравоохранения, выявили недостатки системы действий и предложили способы их устранения. По состоянию на 2018 год страны демонстрировали неравномерный прогресс. Основные недостатки предпринятых действий были связаны с недостаточным финансированием, ограниченными институциональными возможностями (несмотря на наличие специально созданных отделов по борьбе с неинфекционными заболеваниями), недостаточностью действий в разных секторах внутри системы здравоохранения и вне ее, а также с нехваткой стандартизированных механизмов мониторинга и оценки для информирования лиц, принимающих стратегические решения. Для ликвидации отставания правительства должны больше инвестировать в эффективные меры борьбы, которые рекомендованы ВОЗ как наиболее популярные, улучшать взаимодействие секторов и расширять возможности исследований, мониторинга и оценки. Опираясь на опыт Рамочной конвенции по борьбе против табака, ВОЗ и ее международные партнеры должны разработать стандартизированный всеобъемлющий метод мониторинга потребления алкоголя, соли и вредных продуктов питания, а также оценки физической активности и реакции системы здравоохранения.

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Health and education are interrelated, and it is for this reason that we studied the education of migrant children. The Thai Government has ratified ‘rights’ to education for all children in Thailand since 2005. However, there are gaps in knowledge concerning the implementation of education policy for migrants, such as whether and to what extent migrant children receive education services according to policy intentions. The objective of this study is to explore the implementation of education policy for migrants and the factors that determine education choices among them. A cross-sectional qualitative design was applied. The main data collection technique was in-depth interviews with 34 key informants. Thematic analysis with an intersectionality approach was used. Ranong province was selected as the main study site. Results found that Migrant Learning Centers (MLCs) were the preferable choice for most migrant children instead of Thai Public Schools (TPSs), even though MLCs were not recognized as formal education sites. The main reason for choosing MLCs was because MLCs provided a more culturally sensitive service. Teaching in MLCs was done in Myanmar’s language and the MLCs offer a better chance to pursue higher education in Myanmar if migrants migrate back to their homeland. However, MLCs still face budget and human resources inadequacies. School health promotion was underserviced in MLCs compared to TPSs. Dental service was underserviced in most MLCs and TPSs. Implicit discrimination against migrant children was noted. The Thai Government should view MLCs as allies in expanding education coverage to all children in the Thai territory. A participatory public policy process that engages all stakeholders, including education officials, health care providers, Non-Governmental Organizations (NGOs), MLCs’ representatives, and migrants themselves is needed to improve the education standards of MLCs, keeping their culturally-sensitive strengths.