Questions/Answers

The main objective of this initiative is to encourage and develop a healthcare system for local people run by local government organisations. Such organisations have both people and resource capacities and have established a close connection with the locals, enabling the healthcare system to operate effectively to meet local demands. The specific objective of this initiative is to enhance the strength of local communities, improving their ability to manage local problems. This affects the management of social and other determinants of health and the development of an environment conducive to the promotion of healthy behaviours, leading to a culture of promoting health within the community. Focusing specifically on improving the skills of those who are involved in the management of well-being within the local community during a pandemic, we provide them with knowledge and understanding regarding the surveillance of communicable diseases within the local community, ensuring that they can perform their duties in managing the local community’s well-being during a pandemic. This process, then, leads to the development of innovation and the improvement of competency amongst staff and the individual teams who are in charge of controlling communicable diseases. Additionally, it serves as a mechanism in the local community that promotes the efficiency of the controlling system for communicable diseases. The challenge group for this initiative are these “transformative communities”, communities that are capable of adapting to and preparing for both general and crisis situations, leading to a “new way for local communities”.

Co-Creating Transformative Communities is aligned with institutional preparedness and crisis response. It focuses on strategic administration and the application of technology, integrating various sectors which share common missions via agreements, declarations, and a collaborative approach in developing communities. This is to build strength in communities, improve the quality of life for people of all ages, promote equality and reduce the gap in accessing public health services. Eventually, these aspects integrate into regular work, a “system”, through the use of big data management and an information system for administration.

Co-Creating Transformative Communities aligns with the SDGs, specifically the third goal - to have good health and well-being. By joining Co-Creating Transformative Communities, the initiative’s operators and participants in the initiative’s activities will improve their well-being physically, mentally and intellectually. The followings are some examples: access to public health services which are more thorough, comprehensive, precise and efficient; lower pain severeness; better mental health and an increased sense of value in society among the elderly; an increased sense of pride in and satisfaction from helping others amongst local volunteers in public health; a sense of pride amongst the initiative’s leaders and team for becoming role models and being recognised for having better health after quitting drinking and smoking.

Socially, Co-Creating Transformative Communities develops integrity and ethics among local people, eventually leading to a “way” of developing talent and education across all ages and improving the well-being of families. Economically, greater self-dependency and self-management allows locals to reduce their expenses while increasing their income, while also developing activities that build the local economy and improve well-being. There is an income increase for an individual member of around 9,657 Baht per year on average. Environmentally, the initiative has increased green space, conserved and rejuvenated natural resources, built food stability, dealt with global warming issues, and controlled chemical substances in agriculture.

Co-Creating Transformative Communities deploys social capital and the local area’s potential in managing various issues by the community itself. We operate with the firm belief that everybody has the potential, capacity, skills and expertise in self-management to contribute immensely by having social welfare run by local communities. Such beneficial contributions include financial and labour support and donations from important figures, social groups, and established local organisations that serve as social capital. These entities, for instance, are funds, financial institutions, savings groups, community banks, voluntary groups, vocational groups, housewives’ groups, the Children and Youth Council, disaster management groups, forest and water conservation groups, the prosthesis and orthosis centre, green market, organic agriculture learning centres and Sufficiency Economy learning centres. They also include new social capital specifically established to help those who are affected by each crisis such as a sharing-happiness cabinet, disaster management voluntary groups, cooks or canteen groups (for disaster management), the disaster coordination centre or centre for communicable disease management and control, networks of heavy machinery in transferring and rescuing ships in disastrous cases, fruit market, and various learning centres, etc.

Co-Creating Transformative Communities has led to the establishment of social collateral for local communities and integrating with government services. This, then, results in social empowerment with an emphasis on sharing and inclusion amongst groups of women, children, disabled people and elderly. Such collateral includes career promotion, providing healthy food, promoting exercise, savings for oneself, one’s family and for helping others, taking leadership roles in various voluntary groups, reducing accidents, club improvement, and consistent care, etc.

Co-Creating Transformative Communities established patterns for promoting strength in surveillance, prevention and controlling systems for communicable diseases. These patterns were adapted by local communities for local government organisations to improve the well-being of all populations in their local area, which covered risk groups who travelled from foreign countries and provinces in Thailand that had wide infection of the virus, high and low risk contact groups, and patient groups. This process led to a New Normal within the community in terms of surveilling, preventing, and controlling the spread of coronavirus 2019 (COVID-19) at the level of individual, social group, sector, organisation, and for places that provided social services. This can be summarised in terms of a situation report in the community, which is comprised of (1) information on local context; (2) situations such as the spreading situation, risk groups that travelled in and out of the area; (3) information on a lack of protective equipment; (4) demands in receiving health services; (5) early child development centre management; (6) local educational institutions management; (7) risk areas commonly used by local people; and (8) economic impact.

Co-Creating Transformative Communities designed its developments via six activities which were comprised of (1) development of local management; (2) research and study about the community; (3) learning management; (4) development of innovation; (5) drive in public policy; (6) development in communication and campaign systems. Through these activities, each district developed preparedness for adjusting and dealing with general and crisis situations occurred in their area. This can be confirmed by the following key procedures implemented: (1) decoding lessons from surveillance, prevention, and controlling the communicable disease of coronavirus 2019 (COVID-19) in 39 districts, which are parts of the networks of the ThaiHealth Promotion Foundation—referred to as “Healthy Community Network”. This leads to a pattern in promoting strength in communicable diseases surveillance, prevention, and controlling systems by local communities; (2) developing training courses essential for developing the potential of local communities so that they are capable of dealing with adversity from the pandemic; (3) encouraging members of the networks from 101 districts to participate in the process in order to manage the disaster situations resulting from the pandemic, which affected social capitals and their communities’ potentials; and (4) developing assessable tools and approaches for self-evaluation in order to do a knowledge-check related to prevention and controlling of dangerous communicable disease (the communicable disease of coronavirus 2019).

The obstacles encountered during the process were the change in staff and the main mechanism in operation. The received data came from various sources—some were collected by us and others from other sectors. Additionally, various legal issues, regulations, and restrictions contributed to the obstacles in our development. The solution to overcome these issues lay in exchanging knowledge both internal and external of the areas and our networks to manage success and failures that happened. By involving staff, mechanisms and various sectors, we developed partnership and ownership, which led to the achievement as planned in our mission.

Co-Creating Transformative Communities helped developing health crisis management systems for the areas to support the management of the virus, particularly during the spread of COVID-19. In these areas, we created innovation in three key aspects, which are (1) pattern in promoting strength in surveillance, prevention, and controlling communicable diseases by local communities; (2) training courses in developing a well-being management system for local communities in the case of a pandemic disaster; (3) tools in evaluating comprehensive knowledge related to prevention and controlling dangerous communicable diseases.

Co-Creating Transformative Communities was further developed from the operation of “healthy district (pleasing district)”, which has been operated consistently for ten years by ThaiHealth Promotion Foundation. This initiative has capacity in managing situations which affect local communities by adjusting and preparing for general and crisis situations in a timely manner. This is done through processes of establishing learning, participation, and changes.

Co-Creating Transformative Communities deployed technology in managing a large amount of and diverse information of local communities. The information was used to assess whether or not local people could access basic social services provided by the government, particularly health services and social welfare. The key obstacles that prevented local people from accessing such services were physical or personal obstacles. The technology utilised in this initiative was also beneficial to social capitals, allowing them to manage disastrous situations resulting from pandemic during the spread of COVID-19 in accordance with the community’s context.

Co-Creating Transformative Communities shares knowledge and ability to adapt between ThaiHealth Promotion Foundation, local government organisations and health promotion associates who share the goal of strengthening local communities. Through our ten years of continuous operations, we have been able to expand and adapt to cover up to 3,190 local districts (forty percent of local government organisations). This led to our finding that, in each area, there can be up to 110 social capitals per district and at least 200 local community leaders per district. Eventually, this created a large network of social protection which contains 350,000 social capitals and at least 638,000 local leaders. We are able to achieve such results from promoting and supporting social capitals and local leaders consistently. Some instances include increasing leaders’ competencies, learning about new knowledge, developing innovations that create an impact in various aspects, efficient management and administration, and establishing cooperation with other social capitals in dealing with the spread of COVID-19.

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1. In terms of financial resources, ThaiHealth has a budget of 15 million Baht per initiative for 3 years of operation (16 local government organisations). 2. In terms of human resources, ThaiHealth provided training for the initiative’s operators to drive the initiative and adapt it in accordance with each local area. These trainings were courses conducted on competency development in community research, district information systems, communication, leadership for transformation, skills and approaches in network management. 3. In terms of areas, ThaiHealth provided and managed a total of 3,190 local government organisations with 346 model areas and 2,844 network areas.

Co-Creating Transformative Communities are essentially strong local communities that are capable of self-management by relying on shared goals and agreements. Such goals and agreements were achieved through the following methods. Firstly, the ThaiHealth Promotion Foundation operated with legal authority from local government organisations. This operation proceeded with the main focus on people’s collaboration. Secondly, we put various plans into practice, establishing leaders in areas such as administration leaders, career leaders and information leaders. Finally, we have competent teams of staff who are accepted by the local people.

Yes

1. The initiative was evaluated using the Knowledge Spiral or SECI Model approach in 4 aspects, which are: 1) enhancing the potentials of leaders for transformation in terms of knowledge management; 2) a productive public policy process; 3) increasing the body of knowledge within communities (geared towards building new knowledge and innovation); and 4) networks of happy local community management evaluated by Solve Company Ltd. 2. We analysed the social return on investment (SROI) by converting results from changes brought about in society to values which share the same unit measure with the money currency, evaluated by Khonkhaen University.

1. Analysis of the knowledge from the first to the fourth spiral of each district to assess the communities’ situations resulting from improving the potential of leaders of transformation. We also carried out insight interviews with educators within the community along with evaluating their life quality and well-being by randomly selecting 1 village and not more than 10 people per district. 2. Determining social return on investment (SROI) by dividing benefits from stakeholders at present value with the budget the initiative received from ThaiHealth Promotion Foundation.

1. The satisfaction evaluation of the local operators of the initiative supported by ThaiHealth Promotion Foundation: overall score 8 out of 10. This is divided into life quality, score 8.1, citizenship, score 7.8, and well-being, score 8.2 2. The initiative supported by ThaiHealth Promotion Foundation has social return on investment of every 1 Baht equal to 1.74 to 7.53 Baht of social benefits.

Academic cooperation: developing tools, patterns, approaches, training courses, and evaluation tools. The academic institutions in cooperation consist of: Research and Development Centre for Community Health System, Faculty of Nursing at Khonkhaen University, Department of Disease Control, Ministry of Public Health, centres for promoting academic for local management and academic institutions. Human resource cooperation: functions as the main mechanism for local operation and driving, consists of: local government organisations, committee of district development, hospitals that promote well-being in the district and school level. Policy cooperation: institutions that support the initiative’s operations according to the agreements are: Department of Local Administration, Department of Community Development, Local Community Development Institution, Department of Elderly Affairs, Department of Disaster Prevention and Mitigation.

Key actors in driving the initiative are local government organisations, health promotion hospitals, local districts, various social groups, district and village chiefs, etc. Key actors in supporting budget and communication, and laying a foundation for health promotion system are ThaiHealth Promotion Foundation in collaboration with Research and Development of Community Health System Centre and Faculty of Nursing at Khonkhaen University, which designed the initiative by revising and reviewing the approach for well-being development system by local communities in the case of the pandemic disaster. The design has been approved by expert judges and can be summarised into 8 knowledge bodies, which are (1) development of potential of the communicable disease controlling team; (2) monitoring and surveilling risk groups, contact groups, and associated people; (3) establishing rules and agreements within families, villages, and districts; (4) adjusting individual and family behaviours; (5) preventing and controlling the spread in communities and public spaces; (6) creating engagement from social capitals in preventing and controlling the spread of communicable diseases; (7) affected rejuvenation; (8) summary of lessons and knowledge management.

The key lessons for developing the initiative further are the following: 1. Enhance the potentials of 20 Transformative Communities, preparing them to be coordination centres for the development of well-being management in local communities in the case of a pandemic disaster. These 20 communities succeeded in organising lessons, leading to learning networks shared with 4-5 nearby areas and within their own area. 2. Join the networks of 600 Transformative Communities that are ready to develop well-being management systems in local communities in the case a pandemic disaster and expand the impact for interested local government organisations. 3. Enhance potential by training associated individuals until they can perform their role as a “developer of surveillance system for communicable diseases by local communities”. Each district has at least 3 developers and there are 600 districts that are parts of the initiative. We also expanded the impact to interested local government organisations. 4. Utilise evaluation tools and survey comprehensive knowledge related to the prevention and controlling dangerous communicable diseases in 600 districts and expand the impact to interested local government organisations. 5. We further develop, expand, and improve the initiative in collaboration with associated organisations.