Describing the primary care system capacity for the prevention and management of non-communicable diseases in rural Vietnam
Describing the primary care system capacity for the prevention and management of non-communicable diseases in rural Vietnam
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DOI：
10.1002/hpm.2179
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发表时间：
2014-04-01
影响因子：
2.7
通讯作者：
Tran Tuan Anh
中科院分区：
文献类型：
--
作者：
Hoang Van Minh;Do, Young Kyung;Tran Tuan Anh
越南的初级保健系统已被证明在疾病预防和健康促进方面发挥着至关重要的作用。本研究描述了越南一个选定农村地区的初级保健系统在预防和控制非传染性疾病（NCD）方面的能力。方法本研究于2011年在越南北方阮泰省Dong Hy区进行。混合的方法，包括定量和定性和文献综述的方法，收集数据的现状，在东海区的初级保健系统的六个组成部分。选定的卫生工作者和利益相关者在选定的医疗机构进行了调查。结果报告了东海区NCD预防和控制的初级保健能力的描述。(i)提供服务：目前非传染性疾病的预防和治疗主要基于单一风险因素，而不是心血管疾病风险的组合。(ii)治理：在初级保健一级，多部门合作有限，非传染性疾病预防活动的整合不足。(iii)资金筹措：缺乏用于预防和控制非传染性疾病的国家预算。治疗和药品的费用很高，而健康保险计划限制了可用药品的清单和报销上限。尽管卫生工作者在预防非传染性疾病方面发挥着重要作用，但他们的报酬很低。(iv)人力资源：在初级保健一级工作的保健人员，特别是预防医学人员的数量和质量都不足。(v)信息和研究：该地区的卫生信息系统薄弱，没有专门的信息系统收集基于人口的非传染性疾病数据。(vi)医疗产品和技术：社区保健中心并非总能提供世界卫生组织推荐的所有基本设备和药品。结论越南初级保健系统的能力仍然不足以满足人口的非传染性疾病相关的健康需求。越南迫切需要提高非传染性疾病预防和管理的初级保健能力。版权所有（c）2013约翰威利父子有限公司
BackgroundThe primary care system in Vietnam has been shown to play a crucial role in disease prevention and health promotion. This study described the primary care system in a selected rural area in Vietnam in terms of its capacity for prevention and control of non-communicable diseases (NCDs). MethodsThe study was conducted in 2011 in Dong Hy district, Thai Nguyen provincea rural community located in northern Vietnam. Mixed methods were used, including quantitative and qualitative and literature review approaches, to collect data on the current status of the six building blocks of the primary care system in Dong Hy district. Selected health workers and stakeholders in the selected healthcare facilities were surveyed. ResultsA description of Dong Hy district's primary care capacity for NCD prevention and control is reported. (i) Service delivery: The current practice in NCD prevention and treatment is mainly based on a single risk factor rather than a combination of cardiovascular disease risks. (ii) Governance: At the primary care level, multi-sectoral collaborations are limited, and there is insufficient integration of NCD preventive activities. (iii) Financing: A national budget for NCD prevention and control is lacking. The cost of treatment and medicines is high, whereas the health insurance scheme limits the list of available medicines and the reimbursement ceiling level. Health workers have low remuneration despite their important roles in NCD prevention. (iv) Human resources: The quantity and quality of health staff working at the primary care level, especially those in preventive medicine, are insufficient. (v) Information and research: The health information system in the district is weak, and there is no specific information system for collecting population-based NCD data. (vi) Medical products and technology: Not all essential equipment and medicines recommended by the WHO are always available at the commune health centre. ConclusionThe capacity of the primary care system in Vietnam is still inadequate to serve the NCD-related health needs of the population. There is an urgent need to improve the primary care capacity for NCD prevention and management in Vietnam. Copyright (c) 2013 John Wiley & Sons, Ltd.