Bringing Quality Healthcare Services Closer to Disadvantaged Communities in Vietnam

It’s a three-hour drive from the center of Vietnam’s Van Yen District to remote Lang Thip Commune – if you have a car. If you’re on a motorbike, as most are, the journey is considerably longer. It has been an uncomfortable ride for many locals seeking medical care.

Lang Thip’s commune health station was understaffed and under-resourced; able to provide vaccinations, but unable to deal with resurgent non-communicable diseases such as hyperextension, stroke, or diabetes.

No longer. The World Bank’s Vietnam Investing and Innovating for Grassroots Health Service Delivery Project has transformed the Lang Thip commune health station, and many like it, into effective community health resources.

The project is helping commune health stations in 13 provinces take on new roles in detecting and managing non-communicable diseases. It is also helping strengthen the role health stations play in disseminating health promotion programs, controlling infectious diseases, and providing essential mother and child healthcare services. As of November 2022, the project has supported the construction and renovation of 186 health stations and provided on-the job training for more than 2,900 staff.

Midway into project implementation, the project is delivering results. On a recent visit, the Lang Thip station’s new building was a full house. Walls were hung with colorful health information promoting breastfeeding and other health practices and guidelines.

One patient, Cu Thi Lien, once headed a health station in Yen Bai Province, and is now a regular visitor to Lang Thip for hypertension.

“Ten years ago, when I worked here, the Commune Health Station (CHS) was a make-shift house, operated without a doctor and focused mostly on giving immunization shots,” she said. “What we see at the CHS now is a completely different story.”

What Cu finds at Lang Thip these days is a modern facility, with doctors and a good supply of drugs. She is able to obtain insurance-covered examination and medications on the spot.

“It is so convenient,” she said.

After the facility’s renovation, patient visits increased by 1.5-fold to 500 patients per month, and more than half of them were seeking care for non-communicable diseases, said Ban Van Loi, head of the health station.

Prominent in the facility is a big white board showing key health monitoring indicators and responsibilities of each of the five staff members.  Ly Thi Mai, a nurse who received technical training from the project, manages patient records with software.

 “It makes it much easier to keep track of each patient’s conditions and treatment,” she said.

The Scorecards have been rolled out in nearly 400 commune health centers across 13 project provinces.  Health center staff have found the tool so useful that some use it more frequently than the recommended six month interval.

What users find so appealing, is that it pulls valuable health information together in one place. If managers want to assess the health system’s performance, they can log on and quickly see where strengths and weaknesses exist among individual components.  

“This data-rich system will prove extremely useful for health managers to develop investment or capacity-building plans or acquire valuable evidence for the formulation of relevant policies,” said Le Thi Hong Van, director of Yen Bai Provincial Department of Health. Van found the tool so effective that she decided to expand its use to all 173 commune health centers in the province, at the department’s expense.  

Ultimately, the health outcomes of the communities the project supports, and whether the project’s approach has broader applicability, will be the most important indicators of success. It may take some time for the project interventions to materialize into demonstrably better health outcomes.

For now however, community members are clearly valuing the improved care they are finding at commune health stations served by the project.

“The CHS is much cleaner and in a better shape,” she said. “Doctors and nurses are caring. I don’t have to go far to get medications.”

The health center has become more popular in her community as well.

“From now on, this is my go-to place whenever I am sick. Where else could I go?” she said with a smile.  

The Vietnam Investing and Innovating for Grassroots Health Service Delivery Project (GSD project – 2020 - 2024) is an IBRD project implemented by Vietnam’s Ministry of Health and 13 provinces. It is co-financed by the Global Financing Facility, Australia’s Department of Foreign Affairs and Trade, and Access Accelerate Initiative.