Abstract
For disease control such as COVID-19, limiting the spread of epidemics is an important activity. Parts of activities are the roles of primary care or health centers in the area including contact tracing and active care finding. The objective of this study is to develop the methodology to assess the workload of health personnel at primary care in the normal situation and in the COVID-19 pandemics situation in order to identify human resource capacity and gap at primary care level for defending COVID-19 at different levels of epidemics. This study assessed the workload for 6 types of health services by analyzing the related databases and estimating average time of service using previous study and discussion with 9 health centers in 3 provinces. Subtraction of total working hours for 4 types of health personnel including doctor, nurse, public health technical officer, public health officer by service workload (6 types of services) and workload for community services and others (2 hours per person per day in average) was done. The remaining working hours were used for estimating capacity of COVID-19 control activities, in this case, the highest number of contact tracing and active case finding that can be performed in one day at health center level, district level and provincial level for the whole country (except Bangkok). The result of the study showed that in case of using 50% of remaining working hours after subtraction by the existing workload (6 services workload and community workload), there are about 85% of provinces that can perform 2,000 – 8,000 cases per day of contact tracing or active case finding. At district level, there are about 75% of districts that can perform 200 – 800 cases per day. At health center level, there are about 75% of health centers that can perform 20 – 80 cases per day. These figures are based on service data between January and June 2020 which was the first round of COVID-19 epidemics. The result reflects that health centers have different capacity (flexible working hours) for defending epidemics. District level seems to be more flexible and manageable to mobilize human resources within district for not severe epidemics situation and provinces can cover higher volume of active case finding per day. Therefore, the surge capacity plan should be developed at district and provincial level for mobilizing human resources within area in the situation of epidemics.
