Abstract
This study, which employs a mixed methods approach, aims to: 1) examine the situations, lessons learned, problems, barriers, and contributing factors in the lead-up to, prevention of, and emergency response to the coronavirus disease in 2019; 2) examine the requirements and preparedness of the health system in the event of a national epidemic; and 3) examine the factors that impact health system governance in the event of a national epidemic in the southern border provinces. This research was split into two stages: Phase I: record investigation and analysis of the circumstances, lessons discovered, barriers, and contributing elements studying the health service system's requirements and preparedness for handling public health emergencies in the case of a nationwide epidemic. In Phase II of this qualitative study, 115 key informants were interviewed to examine the variables influencing health system governance in the event of a national epidemic. It is a qualitative research study that combines quantitative research with five experts and the Delphi technique. 633 individuals made up the sample. In-depth interviews, topics for discussions in small groups, and self-answer questionnaires made up the research instruments. Content analysis techniques were applied to the analysis of qualitative data. Descriptive statistics (frequency, percentage, mean, standard deviation) and inferential statistics (factor analysis) were employed for the analysis of quantitative data. The findings demonstrated that the primary, secondary, and tertiary health care systems in the five southern border provinces were still not operating efficiently when it came to emergency management of the coronavirus disease during waves 1-3 in 2019. Operations were hampered by a number of factors, such as a lack of PPE kits and disease prevention materials, a shortage of staff, a lack of knowledge and practical skills, an inadequate management budget, handling COVID patient corpses without adhering to disease prevention principles, a lack of awareness of disease prevention, people not wearing masks, and way of life or religious beliefs. Regarding the health service system's preparedness, it comprises knowledgeable and experienced staff. There is a group of personnel with various specialties. Local administrative organizations support the needs of the health system, including worker compensation and morale, with people, money, and goods, encouraging the acquisition of new skills and knowledge, providing a sufficient supply of emergency medical supplies, protective gear, vaccines, and medication, and well-defined protocols for disease investigation, treatment, and surveillance. Every year, incident response plans are rehearsed and an emergency budget is set aside for operations. The involvement of network partners, prospective development, and the health workforce are the next most crucial components and supporting factors, after those from special agencies. Development of Subdistrict Health Promotion Hospitals to have full potential at the primary care level, development of communicators at the community level, sub-districts, development of disease control and prevention models at the community level, practice of contingency plans, potential development of village health volunteers as an expert in epidemics, and building morale for employees of local agencies were all important policy proposals. They needed to improve the health service system's capacity for disease surveillance and investigation, strengthen collaboration with local special agencies and spiritual leaders (babo), and develop the CDCU team's and Dawah leaders' potential in health literacy.
