Abstract
This research aimed to explore the roles of village health volunteers (VHV), implement processes of surveillance, prevention and control (IPC) of COVID-19 in communities among Village Health Volunteers (VHV) with key success factors and barriers. Moreover, policy suggestions were provided. This research captured lessons learned in 5 steps: define the project; collect data; verify and synthesize; store and disseminate. Methodological approaches were quantitative and qualitative parts. Surveys of 207 VHV took place in February-May 2021. Participants were recruited to take part in-depth interviews that they were VHV, policy makers and executive committees of Center of Disease Control (COVID-19 situation administration) at level of Province, District, and Sub-district in Health Region 7,8,9,10. The survey data were analyzed using descriptive and inferential statistics including frequency, percentage, mean, standard deviation and multiple logistic regression. Content analysis of interview transcripts identified IPC implement processes of COVID-19, key success factors and barriers. Findings showed that VHV had worked on 5 IPC components including searching and screening for COVID-19 in high-risk groups (97.6%), home visits for person who might have been exposed to COVID-19 (89.4%), collaborated with other organizations (87.9%), completed a record and reported (86.0%), reported and separate of high-risk groups (84.5%). Regarding to IPC of COVID-19 implementation, the level of implementation was top-down direction from national policy to area based practices. The factors statistically significantly related to IPC practices in communities were occupation, Public Health Region and multiple communication channels to the communities. It was found that the farmers VHV took place on 5 components of IPC 6.87 times more regularly than those who had other occupations (95% CI 2.63-17.91, p-value<0.001). VHV working for the Public Health Region 9 had 2.76 times more regularly in practice than other Northeastern Region (95% CI 1.17-6.53, p-value 0.021). The VHV who used more than 5 channels in provided information of COVID-19 to local people in communities included home visit; local audio announcement; leaflet; documents; and online media had 3.98 time more regularly in practices than VHV who used less than 5 channels to communicate in publicly (95% CI 1.61-9.84, P-Value 0.003). VHV who had the role to coordinate with local team network had more 6.55 time than VHV who did not take action on this role. (95% CI 0.88-48.59, P-Value 0.066). In the implement policy to practice, VHV were key persons working on control COVID-19 in their villages. They had kept taking steps to protect themselves avoiding exposure to the virus, Home visit by knocking the door with team network. Key success factors were VHV were local people with high intention, collaboration with team network and village people. VHV got facilities both financial and none-financial support, and monitoring. VHV had some barriers of their works such as their knowledge and skills of IPC, unclear IPC guidelines, level of corporate from other organizations, unclear information of policy implementation, Inadequate supplies of appropriate IPC devices, and unawareness from people. Therefore, the development should be composed of redesign of administration, capacity building providing for VHV, the support of facilities, the management of health information technology, and collaboration with network.
