Bridging the Gap: An Innovative Community-based Training Program for Respiratory Infection Triage, Post-COVID-19 Era, Thailand

Background. Respiratory infections, including COVID-19, continue to pose a major global health burden, highlighting the need for effective community-based healthcare strategies. Community health workers (CHWs), particularly Thailand’s village health volunteers, play a critical role in surveillance, prevention, and primary care delivery; however, evidence-based respiratory triage tools and continuing training programs for CHWs remain limited. Addressing these gaps may strengthen community health systems and improve preparedness for future public health emergencies.

Objective. This research aimed to evaluate Community Health Worker (CHW) readiness in respiratory infection triage and implemented an innovative, theoretically grounded training program in Khon Kaen, Thailand.

Methods. A two-phase action research was conducted. Phase 1 assessed CHW knowledge and skill gaps using Priority Needs Index analysis. Phase 2 designed, developed, and implemented an innovative training program with workshops, field training, and a 4-color triage card. Multi-stage sampling selected 215 CHWs and 111 providers for assessment; 50 CHWs and 14 providers participated in workshops and practical training. Three expert-validated instruments ensured reliability. We collected the data from October 2022 to September 2023.

Results. In Phase 1, significant gaps were identified, with 89.3% of CHWs indicating low-moderate knowledge and 70.23% triage skill. PNI (modify) discovered significant differences between CHW capabilities and provider expectations (p = 0.026). Most CHWs positively expanded the triage role. In Phase 2, researchers found that CHW knowledge significantly improved from 10.56 to 11.38 (p = 0.018), along with an increase in triage skill, which had a mean score of 4.48. Both CHWs (4.51) and providers (4.82) achieved high levels of satisfaction. Success factors were stakeholder participation, contextbased design, and simple tools.

Conclusion. The innovative training program effectively bridged critical competency gaps, significantly enhancing CHWs' knowledge and practical skills in respiratory triage while garnering high stakeholder satisfaction. By empowering the community workforce with user-friendly tools such as a 4-color triage card, this evidence-based model offers a scalable solution to reduce the disease burden. Consequently, this adaptable framework serves as a vital mechanism for strengthening global health security and community resilience in resource-limited settings post-COVID.