Readiness, Availability and Utilization of Rural Vietnamese Health Facilities for Community Based Primary Care of Non-communicable Diseases: A Cross-Sectional Survey of 3 Provinces in Northern Vietnam

Document Type: Original Article

Authors

1 Department of Medicine, Brigham and Women’s Hospital, Center for Primary Care, Harvard Medical School, Boston, MA, USA

2 Hanoi University of Public Health, Hanoi, Vietnam

3 Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

4 Division of Global Health Equity, Brigham and Women’s Hospital, Center for Primary Care, Harvard Medical School, Boston, MA, USA

Abstract

Background
Vietnam’s network of commune health centers (CHCs) have historically managed acute infectious diseases and implemented national disease-specific vertical programs. Vietnam has undergone an epidemiological transition towards non-communicable diseases (NCDs). Limited data exist on Vietnamese CHC capacity to prevent, diagnose, and treat NCDs. In this paper, we assess NCD service readiness, availability, and utilization at rural CHCs in 3 provinces in northern Vietnam.
 
Methods
Between January 2014 and April 2014, we conducted a cross-sectional survey of a representative sample of 89 rural CHCs from 3 provinces. Our study outcomes included service readiness, availability of equipment and medications, and utilization for five NCD conditions: hypertension, diabetes, chronic pulmonary diseases, cancer, and mental illnesses.
 
Results
NCD service availability was limited, except for mental health. Only 25% of CHCs indicated that they conducted activities focused on NCD prevention. Patient utilization of CHCs was approximately 223 visits per month or 8 visits per day. We found a statistically significant difference (P < .05) for NCD service availability, medication availability and CHC utilization among the 3 provinces studied.
 
Conclusion
This is the first multi-site study on NCD service availability in Vietnam and the first study in a mountainous region consisting predominately of ethnic minorities. Despite strong government support for NCD prevention and control, Vietnam’s current network of CHCs has limited NCD service capacity.

Keywords

Main Subjects


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