Capacity assessment of commune health workforce in treatment and management of hypertension and diabetes in Tuyen Quang and Thai Binh
For the last decades, non-communicable diseases (NCDs) have become the leading burden of morbidity and mortality in Vietnam, of which hypertension and diabetes are among the most common chronic NCDs. The national surveys of NCD risk factors in Vietnam found the prevalence of hypertension in the population aged 18-25 increased from 15.8% in 2010 to 20.3% in 2015. The number of the people with diabetes was 5.53 million (2.9% of the population) in 2017 and is expected to increase to 6.1 million people by 2040, according to the IDF Diabetes Atlas 2017 Report. In responding to NCDs, the Prime Minister issued the National Strategy on NCDs prevention and control 2015-2025, which prioritizes solutions to strengthen the prevention and management of common NCDs at the grassroots health level. Consequently, the Ministry of Health (MOH) has recently issued a number of critical policies and technical guidelines for the grassroots health level, targeting commune health stations (CHS), including Decision 3756/2018/QĐ-BYT (The guideline on the prevention, early detection, diagnosis, treatment and management of NCDs at CHS); Decision 2559/2018/QĐ-BYT (The plan of strengthening the implementation of treatment, management of hypertension and diabetes at CHSs following the principles of family medicine in the period of 2018 – 2020).
In order to provide evidence informing the policies on building the capacity of grassroots health workforce, and thereby improving the performance of CHSs in treatment and management hypertension and diabetes, the Health Strategy and Policy Institute (HSPI) conducts a study on assessing the capacity of health workforce and resource availability for the treatment and management of hypertension and diabetes at CHS. The study was planned to implement in Tuyen Quang, Thai Binh and Ha Tinh provinces.
In September and November, 2020, the research team led by Dr. Nguyen Thi Thang – Head of the Public Health Department conducted the field survey and worked with local stakeholders in Tuyen Quang and Thai Binh. Firstly, focused group discussions were undertaken with representatives of local stakeholders at all levels: the provincial Department of Health, district health centers (Chiem Hoa and Yen Son district in Tuyen Quang; Thai Thuy and Hung Ha district in Thai Binh province), Commune People Healthcare Committees, doctors working in CHSs, village health workers, patients with hypertension and/or diabetes. Secondly, the team conducted the capacity assessment survey among assistant doctors/doctors working in CHSs using self-administered questionnaire. Additionally, secondary data on the topics of interest were collected using self-reported data templates.
In summary, the treatment and management hypertension have been provided at CHS in Tuyen Quang; however, the treatment for diabetes are only delivered from district or higher levels. In Thai Binh, the provision of management and treatment of hypertension and diabetes at CHSs piloted in 42 CHSs. The Thai Binh Department of Health issued the local guideline on referring patients from district hospitals to CHS for follow-up treatment. During the field visits, the research team noted the challenges and gaps in the implementation of NCD treatment and management at the grassroots level and suggestions from the local stakeholders. The information and field data will be analyzed and synthesized after the filed visit in the last province.