Enhancing community health services through a health needs assessment approach during the COVID-19 pandemic in Eastern Thailand

Abstract

Background: The COVID-19 pandemic placed sustained pressure on primary healthcare systems and highlighted the need for context-specific evidence to guide service planning. Health Needs Assessment (HNA) provides a structured, evidence-based approach to identifying priority health problems, community needs, and healthcare system improvement requirements, particularly during public health emergencies. Methods: This study applied a sequential exploratory mixed-methods HNA in Eastern Thailand. A community-based quantitative survey was conducted among 940 residents to identify priority health problems, health needs, and barriers to accessing healthcare services. In-depth qualitative interviews were conducted with 20 primary healthcare providers to contextualize survey findings and explore system-level perspectives. Quantitative data were analyzed descriptively, and qualitative data were analyzed thematically. Results: COVID-19 was the most frequently reported primary health concern among community residents (311/940, 33.1%), followed by hypertension (124/940, 13.2%). Community health needs emphasized infectious disease prevention, chronic disease screening, physical activity promotion, and dietary improvement. Barriers to healthcare access included concerns related to infection risk, service availability, and logistical constraints. Qualitative findings highlighted the importance of service continuity, emergency preparedness, proactive community outreach, and strengthened health information systems. While community residents focused primarily on practical access-related needs, healthcare providers emphasized service organization and system capacity strengthening. Conclusions: This study integrates community and healthcare provider perspectives to identify priority health concerns and healthcare system needs. The findings generate context-specific, policy-relevant evidence to support primary care planning and health service improvement. These findings underscore the value of the HNA approach as an evidence-based framework for responsive community health planning.