Policy-Oriented Development of the Dengue NS1 Rapid Test Utilization System in Sub-District Health Promotion Hospitals
1
Division of Vector-Borne Diseases, Department of Disease Control, Ministry of Public Health, Mueang District, Nonthaburi, Thailand
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Dengue has remained a major public health challenge in Thailand for over four decades, causing substantial morbidity and preventable mortality. Delayed access to diagnosis is a key contributor to severe outcomes. To address this, Department of Disease Control has implemented “3-3-1” strategy to ensure rapid reporting and control actions within one day. Strengthening early diagnostic capacity at primary healthcare level aligns with World Health Organization recommendations, particularly in resource-limited settings.1 Despite high diagnostic accuracy (>95%),2 Dengue NS1 Rapid Test remains largely hospital-based in Thailand, limiting access at sub-district health promotion hospitals and lacking a standardized utilization system. Similar challenges are observed in many low- and middle-income countries.
METHODS:
An action research design based on Kemmis and McTaggart framework3 was conducted in sub-districts of Thailand. Phase 1 assessed existing practices, barriers, and stakeholder perspectives through literature review, questionnaires, interviews, and focus group discussions. Phase 2 involved co-developing a utilization system with local and national stakeholders, incorporating workforce training. Phase 3 evaluated the system in terms of user satisfaction, appropriateness, and feasibility to inform policy decisions.
RESULTS:
Baseline findings showed limited use of Dengue NS1 Rapid Tests at sub-district health promotion hospitals, resulting in inequitable access to early diagnosis. The developed system integrated financing and procurement mechanisms, structured workforce training, streamlined operational and reporting processes, community engagement, and monitoring and evaluation. Following implementation, user satisfaction increased significantly (p < 0.01), with high perceived appropriateness and feasibility. The system and recommendations were subsequently advanced for national policy uptake.
CONCLUSIONS:
Policy-oriented development of point-of-care dengue diagnostic systems at primary healthcare level can reduce diagnostic inequities, strengthen early detection and response, and enhance the timeliness of dengue surveillance reporting. This model offers transferable lessons for dengue-endemic countries seeking scalable, equitable, and sustainable strategies to integrate rapid diagnostics into decentralized health systems.
Dengue has remained a major public health challenge in Thailand for over four decades, causing substantial morbidity and preventable mortality. Delayed access to diagnosis is a key contributor to severe outcomes. To address this, Department of Disease Control has implemented “3-3-1” strategy to ensure rapid reporting and control actions within one day. Strengthening early diagnostic capacity at primary healthcare level aligns with World Health Organization recommendations, particularly in resource-limited settings.1 Despite high diagnostic accuracy (>95%),2 Dengue NS1 Rapid Test remains largely hospital-based in Thailand, limiting access at sub-district health promotion hospitals and lacking a standardized utilization system. Similar challenges are observed in many low- and middle-income countries.
METHODS:
An action research design based on Kemmis and McTaggart framework3 was conducted in sub-districts of Thailand. Phase 1 assessed existing practices, barriers, and stakeholder perspectives through literature review, questionnaires, interviews, and focus group discussions. Phase 2 involved co-developing a utilization system with local and national stakeholders, incorporating workforce training. Phase 3 evaluated the system in terms of user satisfaction, appropriateness, and feasibility to inform policy decisions.
RESULTS:
Baseline findings showed limited use of Dengue NS1 Rapid Tests at sub-district health promotion hospitals, resulting in inequitable access to early diagnosis. The developed system integrated financing and procurement mechanisms, structured workforce training, streamlined operational and reporting processes, community engagement, and monitoring and evaluation. Following implementation, user satisfaction increased significantly (p < 0.01), with high perceived appropriateness and feasibility. The system and recommendations were subsequently advanced for national policy uptake.
CONCLUSIONS:
Policy-oriented development of point-of-care dengue diagnostic systems at primary healthcare level can reduce diagnostic inequities, strengthen early detection and response, and enhance the timeliness of dengue surveillance reporting. This model offers transferable lessons for dengue-endemic countries seeking scalable, equitable, and sustainable strategies to integrate rapid diagnostics into decentralized health systems.
| eISSN: | 2654-1459 |
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