Abstract
Background: The COVID-19 pandemic crisis emphasizes the crucial role of community
empowerment in enabling communities to participate in the Integrated Health System (IHS) and
prepare for dealing with present and future health crises. Thus, it's essential to understand the
context of urban communities, health needs, social capital, and the appropriate processes to
develop the community-led primary care system so communities can encounter local health
crises.
Methodology: This unique Research and Development project, employing Participatory
Action Research over 18 months (March 2023-August 2024), is set in 17 urban communities in
Bangkok and other provinces. It involves 10 organizations, all dedicated to acting as "facilitator
nodes" for communities in their work area.
Result: In the post-COVID-19 era, communities are enthusiastic about dealing with specific
health needs, aka "health crises," which are wide-ranging problems affecting the communities'
well-being. Three groups of social capital enable communities to develop primary care
innovation: internal capital, including leader and trust, community awareness, and community
resources; external capital, including social network and external resources; and the enabling
factors, including the close-knit relationship between the community and the community's
culture and beliefs. Three key factors enhance the community's ability to develop social
innovation: community strength, facilitator node, and collaboration with local primary care units.
The facilitator nodes have three crucial roles: advocacy, facilitation, and technical assistance.
Discussion: A new ecosystem is needed to enhance the communities' capacity to
participate in IHS and engage in present and future health crises. It focuses on providing primary
care service by the community and for the community with the collaboration of the community,
facilitator node, the local primary care units, and the local government. It surrounded by the five
supporting systems provided by the national and local organizations: (1) a system of interoperable
data and information, (2) a system of public policy process for participatory encountering with
health crises, (3) a system of primary care that enhance communities' participation, (4) a system
of human resource development of the communities and facilitator nodes that responsive to
specific needs, and (5) a system of financial and resources support that fit with need and context
of each community.
