Abstract
Background and Rationale: The flood disaster which affected Bangkok and the central region of Thailand in 2011 presented a critical challenge to the resilience of Thailand’s health system in the face of sudden crisis. Objective: To explore the extent to which the Thai health system was capable of responding to a public health shock, through the lens of health system resilience, with a particular focus on the issues of ‘awareness’ and ‘adaptability’. Methodology: A cross sectional study design was applied. Data were obtained from the representative household survey in 2011. Descriptive statistics and inferential statistics using t-test, Chi-square test and rank-sum test were applied. Results: Overall, the Thai health system is quite ‘resilient’ especially in terms of ‘awareness’, as demonstrated by the good level of satisfaction that people had with the flood warning messages that they received. However, concerning ‘adaptability’, and using public health relief as an indicator, the Thai health system did not appear to perform well. Households in Bangkok had a better level of awareness than those in the central region. Households in the central region reported greater satisfaction in obtaining external public health assistance than the Bangkokian households. Conclusion: The Thai health system is somewhat resilient in coping with public health shocks, but there remains room for further improvement. An expansion of public health collaboration to all relevant sectors including local communities, non-governmental organizations, as well as media and social networks is needed. Furthermore, re-orientating the health registration system to have clearer catchment areas is recommended.
