Bản Sao Của Abstract Vietnam Experience.pdf

University Exchange Experience: Vietnam, a country in rapid transition.
Camia P.*, Minh HV.^​, Vân Phạm T.^, Visciarelli S.*, Ciorba V.*, Sarli L.*, Pasquarella C.*, Signorelli C.*
* Università degli Studi di Parma, ^Hanoi Medical University - Institute for Preventive Medicine and Public
Health

INTRODUCTION
Vietnam has become in the last two decades a middle-income country, shifting from one of the
poorest nations to one of the fastest growing economies. It has made remarkable progress in
improving the health status of its people, achieving or even exceeding the majority of health
related UN Millennium Development Goals, eg. the under-five mortality rate was reduced
considerably from 58 per 1,000 live births in 1990 to 16 in 2011. However though, the health
care system still has to face many difficulties and challenges such as epidemiological transition,
health inequalities, universal health insurance, double burden of infection and Non
Communicable Diseases (NCDs) (from 56% in 1990 to 72% in 2010 of total deaths).
According to the protocol of international university cooperation between the University of
Parma and Hanoi Medical University (HMU), a month university exchange was planned in
November 2013 in order to understand the Vietnamese Health System, focusing on Primary
Health Care System (PHC) and NCDs prevention and control strategies.
METHODS
The data was collected by literature review, including policies and research papers, health
facilities at district and commune level site visit and consultation with HMU’s professors and
both traditional and modern physicians.
RESULTS
Vietnam Health System is a mixed public-private provider system based on 4 level of service
delivery: ​central (central/regional hospitals, research institutes) managed directly by the Ministry
of Health (MoH); ​provincial (general/specialized hospitals and preventive care centers) and
district ​(general district hospitals and district preventive care centers) managed by Provincial
Health Departments (PHD); ​commune managed by the district health centers. PHC includes
commune health stations and district health center, PHD and the MoH have programs and
offices to support primary care delivery at district and commune levels.
Five-Year Health Sector Development Plan 2011-2015 identifies as one objective PHC

strengthening through prevention and management of NCDs to assure to every people access
to quality basic health care services, continuity and comprehensiveness of care. Five national
target projects on the prevention and control of NCDs (hypertension, diabetes, cancer, COPD
and asthma, mental health) were organized and implemented. Family physician is asked to
achieve a key role in PHC in order to improve the quality of medical examination and treatment
at the primary level, following the March 2001 MOH Decree which established family medicine
as a first-degree medical specialty with the aim of staffing every commune health center with a
family physician. To date, the grassroots health network (district and commune level) has been
upgraded with medical equipment and health manpower, although primary care capacity for


NCDs prevention and management is still weak, causing overcrowding in hospitals at higher
levels and inequity in health care.
CONCLUSION
Though the Vietnamese Health System progressed significantly, more PHC-oriented strategies
development are required to reform PHC in line with WHO guideline and improve the
effectiveness and efficiency of the health system. The experience reported underlines the
importance of international exchange from a professional and human perspective. It helps to
gain a global view of Public Health issues, view future challenges differently and solve problems
from a different perspective. Such experience should be included in the Public Health specialist
curricula.