Governance, policy, and health systems responses to the COVID-19 pandemic in Thailand: a qualitative study

Health systems resilience is key to learning lessons from country responses to crises such as coronavirus disease 2019 (COVID-19). In this perspective, we review COVID-19 responses in 28 countries using a new health systems resilience framework. Through a combination of literature review, national government submissions and interviews with experts, we conducted a comparative analysis of national responses. We report on domains addressing governance and financing, health workforce, medical products and technologies, public health functions, health service delivery and community engagement to prevent and mitigate the spread of COVID-19. We then synthesize four salient elements that underlie highly effective national responses and offer recommendations toward strengthening health systems resilience globally.

Abstract Governments are being put to the test as they struggle with the fast and wide spread of COVID‐19. This article discusses the compelling challenges posed by the COVID‐19 pandemic by examining how this wicked problem has been managed by the South Korean government with agile‐adaptive, transparent actions to mitigate the surge of COVID‐19. Unlike many Western countries, South Korea has been able to contain the spread of COVID‐19 without a harsh forced lockdown of the epicenter of the virus. This essay argues that an agile‐adaptive approach, a policy of transparency in communicating risk, and citizens’ voluntary cooperation are critical factors. It also suggests that the South Korean government learned costly lessons from the MERS failure of 2015. This essay suggests ways that Western countries can manage future wicked problems such as COVID‐19 without paying too much cost and maintaining quality of life in open and free societies.

Highlights • Adaptive governance requires oscillation between decentral and central decision-making structures. • Agility can hinder adaptability. • Bureaucracy and adaptability can go hand in hand. • Agile and adaptive governance are not the same. • Technology might hinder adaptiveness.