Anti-epidemic campaigns in Macao during the war and post-war reconstruction period (1937 - 1949): A procedural grounded theory analysis of news reports from Overseas Chinese News

This study explores how Macao, a semi-autonomous colonial territory under Portuguese neutrality, governed epidemic crises between 1937 and 1949 through a civic-driven, multi-actor approach. It examines how local responses to epidemics were formulated and sustained amid institutional fragility, political isolation, mass refugee inflows, and in the absence of strong centralized authority. Drawing on 1036 contemporaneous reports from Overseas Chinese News, the study employs procedural grounded theory to inductively reconstruct Macao’s epidemic governance logic. The findings reveal six interrelated strategies: real-time epidemiological monitoring and disclosure, universal compulsory vaccination, cross-institutional and transregional collaboration, grassroots hygiene education, institutionalized civil society participation, and strict quarantine and sanitation enforcement. The study proposes a “Civic-Driven Epidemic Governance Framework under Neutrality”, illustrating how decentralized collaboration, institutional improvisation, and social capital compensated for limited state control. The Macao case offers a historically grounded alternative to state-centric public health models by underscoring the role of civic engagement and cross-border cooperation Finally, it highlights the media’s dual role as a platform for public communication and a driver of social mobilization. These findings contribute to broader debates on resilient, inclusive and adaptive governance in politically fragmented or fragile contexts.