This article is part of the Research Topic ‘Health Systems Recovery in the Context of COVID-19 and Protracted Conflict’. The third quarter of 2022 saw COVID-19 cases and deaths in Thailand reduced significantly, and high levels of COVID-19 vaccine coverage. COVID-19 was declared an “endemic” disease, and economic activities resumed. This paper reviews pre-pandemic health systems capacity and identifies pandemic response strengths, weaknesses and lessons that guided resilient and equitable health system recovery. Robust health systems and adaptive strategies drive an effective pandemic response. To support health system recovery Thailand should (1) minimize vulnerability and extend universal health coverage to include migrant workers and dependents; (2) sustain provincial primary healthcare (PHC) capacity and strengthen PHC in greater Bangkok; (3) leverage information technology for telemedicine and teleconsultation; (4) enhance and extend case and event-based surveillance of notifiable diseases, and for public health threats, including pathogens with pandemic potential in wildlife and domesticated animals. This requires policy and financial commitment across successive governments, adequate numbers of committed and competent health workforce at all levels supported by over a million village health volunteers, strong social capital and community resilience. A strengthened global health architecture and international collaboration also have critical roles in establishing local capacities to develop and manufacture pandemic response products through transfer of technology and know-how. Countries should engage in the ongoing Inter-government Negotiating Body to ensure a legally binding instrument to safeguard the world from catastrophic impacts of future pandemics.
ObjectivesThe Thai Ministry of Public Health is committed to reaching the United Nations’ goal of zero new HIV infections, zero AIDS-related deaths, and zero discrimination towards people living with HIV by 2030. While significant progress has been made towards the first two targets, stigma against women living with HIV (WLHIV), particularly in the context of their desire to have and raise children, remains an issue.MethodsWe conducted interviews with WLHIV (n=10) who expressed a desire to have a child or delivered an infant within 2 years of the study date, and key informants (KI) involved in their medical care and social support. We asked women about their HIV diagnosis, thoughts about pregnancy, desires to have children, and perceived stigma. KIs were asked about their perceptions of stigma towards WLHIV and policies or recommended actions to reduce discrimination towards this population.ResultsWhile the WLHIV reported that their healthcare providers had generally been supportive of them having children, internalised stigma and the perceived risk of or actual discrimination by community members negatively impacted fertility desire and peripartum experiences among the study participants. KIs confirmed similar sources of discrimination, emphasising more internalised and community-based stigma rather than from healthcare providers. Both groups highlighted the importance of increasing community education and awareness about HIV to reduce stigma.ConclusionsComplex issues around stigma and discrimination specific to women with HIV should be addressed at the community level in order to reach the goal of zero discrimination against all people living with HIV in Thailand.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.