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Improving the quality of health services at the grassroots level is the most
effective method of preventing overcrowding at central hospitals and improving
people’s lives in poorer areas.
 | | A doctor examines an
elderly woman in the northern province of Hoa Binh’s Social Healthcare Centre.
Improving primary healthcare services at the grassroots level could ease
overloading in central hospitals. (Photo: VNS) | This was
agreed at a recent seminar on primary health care in commune health clinics held
in Hoa Binh. Dr Jean
Marc Olive, World Health Organisation Representative in Viet Nam, said Viet Nam
had made positive changes to improve the national health sector, but problems
remained on dividing treatment between primary and secondary-care. He said this
was standing in the way of an efficient healthcare system. “The
primary health care offered at local health clinics is supposed to treat up to
85 per cent of all patients with common diseases. The clinics have the basic
equipment and general practitioners to do this. “The
higher-care level available at central hospitals are meant to treat the
remaining, most severe diseases,” he said. However,
Olive said that in Viet Nam, district-level or central hospitals were the first
places patients had in mind, no matter what ailment they had. As a result, these
hospitals had become overcrowded. Patients
also had to pay high fees and additional costs for travelling and accommodation. Dr
Anders Norman, chief technical adviser to the Viet Nam-Belgium Development
Co-operation’s project called Key Improvement in Community Health, said local
people had no trust in their local health centres. “Most
take advice from physicians from local pharmacies or self-medicate to treat
common diseases and go to hospitals for high-tech diagnosis if things get
serious,” he said. “Thus,
central hospitals are running at up to 150 per cent over their capacity while
commune health clinics may receive only one or two patients a day.”
Figures from the Ministry of Health show that Viet Nam has more
than 10,370 commune health clinics. Only 70 per cent of them have doctors and
more than 90 per cent have obstetricians, paediatricians or mid-wives. However,
these centres mostly provide preventive health care, including telling patients
how to maintain good health with exercise, preventing epidemics, and helping
pregnant women deliver babies. |
Primary care in Hoa Binh
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A US$3.3 million project to develop sustainable,
primary health care has been implemented for the past four years in six
remote communes in Tan Lac and Mai Chau districts in northern Hoa Binh
Province. It is part of health co-operation between the
Belgian and Vietnamese governments Nearly 840 health workers have been retrained in
primary health care and nearly 40 have been trained as general
practitioners. So far, they have provided treatment to 23,000 patients. The project is also co-operating with central
hospitals to provide better care for patients with chronic diseases. Another $25.8 million project is being run by
the European Commission to support health care for the poor in five other
northern upland areas and Central Highland provinces. |
According to Norman, inadequate and poor medical equipment and a shortage of
qualified health workers are to blame for the empty clinics. Health experts at
the Hoa Binh seminar also agreed that commune health workers lived near their
patients and had a better understanding about the culture and lifestyle of their
locality. Thus, it was easier for them to monitor chronic patients and move them
to central hospitals if necessary.
Vo Ngoc
Hung, a resident in Duc Phu Commune, Mo Duc District, in central Quang Ngai
Province, said he preferred to go to the district-level hospital 13km from his
house than the commune health centre. “The
centre was built many years ago and there is no equipment for blood or urine
analysis or an ultrasound. All the rooms leak on rainy days and health workers
have to use rain coats to protect medical equipment,” Hung said. He said
he and local people only went to the centre for drugs. Former
Deputy Minister of Health Pham Manh Hung said more than 70 per cent of
Vietnamese lived in rural areas where the standard of living was generally low.
The cost of medical treatment could send some low-income earners below the
poverty line. VietNamNet/Viet
Nam News | 
