Commune Health Stations Research Articles

The healthcare support program and healthcare utilization of older adults in ethnic minority areas in Vietnam

Over the past few decades, Vietnam has experienced a substantial improvement in health outcomes, providing an example of a low-income country that has achieved a major success in public health despite the lack of resources. However, inequalities in access to healthcare services persist among the poor, ethnic minorities, and other vulnerable groups. To address this issue, the Vietnamese government implemented a healthcare support program in ethnic minority areas in 2013. We examine the effects of this program on healthcare utilization among older individuals aged 55–74. Employing a difference-in-differences approach and data from the Vietnam Household Living Standards Survey from 2008 to 2018, we find that the program has a positive effect on inpatient visits at public health facilities. However, the program has no impact on outpatient visits. Additional analysis reveals that the program increases outpatient visits at commune health stations and inpatient visits at district hospitals. There is also suggestive evidence of a switch from private to public facilities. Our results suggest that providing healthcare resources to disadvantaged areas can increase healthcare utilization of older people, which can, in turn, improve their health outcomes.

Effectiveness of an intervention to improve screening and treatment management of hypertension at the Commune Health Stations, Cao Bang province in 2021 – 2022

The study aimed to evaluate the effectiveness of interventions in screening and treatment management of hypertension at commune health stations (CHSs) in Cao Bang province in 2021- 2022. All 161 CHSs in Cao Bang province were selected for the study. The intervention package was developed based on the needs of CHSs in Cao Bang, including i) conducting advocacy workshops to support and remove barriers that affect activities on screening and treatment management of hypertension at CHSs; ii) providing capacity building for commune health workers, village health worker through hand-on training and supportive supervision; iii) providing CHSs with essential equipment; and iv) using software to support the management of data on hypertension screening and treatment management. Data were collected through self administered questionnaires filled by CHSs, and extracted from the management software. The effectiveness of the intervention was analyzed based on a comparison of pre and post-intervention outcomes. Results showed that the rate of CHSs implementing screening for hypertension increased from 27.3% to 95.0%. The rate of CHSs conducting treatment management also increased from 69.6% to 96.9%. The proportion of people screened for hypertension increased from 31.8% to 86.0%. The average number of hypertensive people who received treatment management at CHSs increased from 3.0 to 54.2 people. Additionally, the rate of patients achieving target blood pressure increased by 10.4% (64.4% compared to 54.0%). The results showed that the intervention package was effective and suitable for CHSs, and it should be replicated in other provinces.

Sustaining village malaria worker programmes with expanded roles: Perspectives of communities, healthcare workers, policymakers, and implementers in Vietnam.

In Vietnam, multiple types of community-based malaria workers are recruited to promote access to malaria testing and treatment for at-risk mobile and migrant populations. However, as the country approaches elimination, these roles are at risk from declining investment. This article characterises the different types of workers and relevant health policy in Vietnam, and explores stakeholder perspectives on sustaining and expanding the roles of these workers in the malaria elimination context. We conducted a rapid policy document review to describe the policy background of community-based health care in Vietnam and identify key informants. In-depth interviews were conducted with policymakers and implementers (n = 11) in different government sectors, international, and civil society organizations. We also conducted interviews (n = 8) and two focus group discussions with community members (n = 12), and interviews with health workers (n = 9) in 18 communities in Phu Yen and Binh Thuan provinces in the central region. Our study identified three main types of malaria workers: village health workers (VHWs), malaria post workers (MPWs) and other groups of workers supported by civil society organisations (CSO). Workers reported being willing to maintain their current roles and potentially provide additional services that respond to community needs, although they were concerned about excess workload and inadequate income. Besides working in a variety of jobs to secure their incomes, mainly in agriculture, VHWs in particular were primarily tasked with supporting the delivery of a wide range of health services from commune health stations. Faced with reduced patients, MPWs and CSO-supported workers could be tasked with the following potential roles: case notification for infectious diseases, real-time data collection and reporting, and screening for non-malaria illnesses using other rapid test kits. There was agreement that the community-based health network is crucial to health care delivery in remote communities and to ensure comprehensive access to care among vulnerable populations. However, policymakers and implementers stressed concerns about their limited skillsets, the inadequate budget to support these workers, and the regulation constraining them from performing diagnosis and treatment activities, highlighting the priority to maintain the capacity of workers and funding allocation through provincial advocacy and multi-programme collaboration. This study highlights the crucial role of community-based health workers in eliminating malaria in Vietnam. Sustained efforts are needed to maintain accessible case detection and treatment while addressing local health concerns beyond malaria. Implementing these strategies requires prioritizing the mapping of groups most in need and developing enablers to raise community awareness and maintain the capacity of these workers. Ensuring political advocacy, financial resources, and coordination between multiple groups are key to maximizing impact and integrating malaria activities into the broader health system.

Socialist Retrenchment

Both China and Vietnam went through retrenchment in their rural healthcare systems during the 1980s and 1990s. However, there is a difference between the two in the depth of retrenchment. While China allowed the Cooperative Medical System (CMS) to collapse, Vietnam nationalized the Commune Health Stations (CHS) and established national health programs. Why did the retrenchment paths of these two countries diverge? This article finds that political, economic, and social factors can explain variation across China and Vietnam. Whereas in the 1980s and early 1990s, politics was the dominant factor determining variation, the combination of political and economic factors shaped different outcomes during the mid- and late 1990s. In contrast, social factors were a contributing condition with a limited impact. In both countries, political factors such as succession struggles and institutions played a dominant role in determining the direction of change for rural healthcare policies, whereas economic factors either facilitated or delayed their execution.

An Effective Health System Approach to End TB: Implementing the Double X Strategy in Vietnam.

Countries that are high burden for TB must reverse the COVID-19 pandemic's devastating effects to accelerate progress toward ending TB. Vietnam's Double X (2X) strategy uses chest radiography (CXR) and GeneXpert (Xpert) rapid diagnostic testing to improve early detection of TB disease. Household contacts and vulnerable populations (e.g., individuals aged 60 years and older, smokers, diabetics, those with alcohol use disorders, and those previously treated for TB) with and without TB symptoms were screened in community campaigns using CXRs, followed by Xpert for those with a positive screen. In public non-TB district facilities, diabetics, respiratory outpatients, inpatients with lung disease, and other vulnerable populations underwent 2X evaluation. During COVID-19 restrictions in Vietnam, the 2X strategy improved access to TB services by decentralization to commune health stations, the lowest level of the health system, and enabling self-screening using a quick response mobile application. The number needed to screen (NNS) with CXRs to diagnose 1 person with TB disease was calculated for all 2X models and showed the highest yield among self-screeners (11 NNS with CXR), high yield for vulnerable populations in communities (60 NNS) and facilities (19 NNS), and moderately high yield for household contacts in community campaigns (154 NNS). Computer-aided diagnosis for CXRs was incorporated into community and facility implementation and improved physicians' CXR interpretations and Xpert referral decisions. Integration of TB infection and TB disease evaluation increased eligibility for TB preventive treatment among household contacts, a major challenge during implementation. The 2X strategy increased the rational use of Xpert, employing a health system-wide approach that reached vulnerable populations with and without TB symptoms in communities and facilities for early detection of TB disease. This strategy was effectively adapted to different levels of the health system during COVID-19 restrictions and contributed to post-pandemic TB recovery in Vietnam.

Knowledge of tuberculosis among physicians working at community health stations in Vietnam

Tuberculosis (TB) remains a significant health problem worldwide, including in Vietnam, where around 174,000 newly diagnosed cases and 13,200 patients died in 2018. There are challenges in the diagnostic process, treatment, and follow-up. The physicians with knowledge of TB working at commune health stations play an essential role in this struggle. The primary purpose of this study was to evaluate knowledge of TB and related factors among physicians working at community health stations in the Northern provinces of Vietnam. A cross-sectional survey was implemented on 335 physicians working at community health stations in 5 Northern provinces in Vietnam from September 2019 to October 2020. The result showed that the TB knowledge of physicians was not good. There were some severe knowledge gaps concerning at-risk groups, the main symptoms of TB, sputum tests for both diagnosis and follow-up and management of attack therapy. The TB training participants had better TB knowledge than others (aOR=1.68; 95%CI: 1.047-2.712). This study underlines the importance of clinical experience and TB training to TB knowledge. We suggest that a TB training plan is required for physicians. Our survey results could inform the process of defining the physicians who work at community health stations' role in TB management in the future.

Knowledge, attitudes and self-confidence with skills required for providing dementia care in physicians at primary healthcare settings in Vietnam

BackgroundDementia is a global public health priority. The World Health Organization adopted a Global Action Plan on Dementia, with dementia awareness a priority. This study examined the knowledge, attitudes, and self-confidence with skills required for providing dementia care among primary health care providers in Vietnam.MethodsA cross-sectional study was conducted with 405 primary health care providers who worked at commune health stations and district health centers in eight provinces across Vietnam.ResultsThe results showed that primary health care providers had poor knowledge and little confidence but more positive attitudes toward dementia care and management.ConclusionsThe results suggest the training needs for building capacity amongst primary health care providers, which will be critical as Vietnam’s population ages.

THE STATUS AND SOME FACTORS RELATED TO SAFE IMMUNIZATION PRACTICE AT COMMUNAL-WARD ADMINISTRATIVE UNITS IN PHU YEN PROVINCE IN 2022

Vaccines are preparations containing antigens that are introduced into the body to create an immune response. Therefore, the review of safe vaccination practice (TCAT) in immunization sessions at commune and ward health stations and some related factors is a very necessary and urgent issue to improve the quality of vaccination. Cross-sectional descriptive study design at 20 health stations of Phu Yen province. Results: 100% of health stations meet TCAT requirements during vaccination sessions ; 85.1% of children were trained in the satisfactory injection procedure, the reception and screening procedures and the post-injection follow-up met the requirements of 82.9% and 83.4%, respectively. There are 73.1% of children who have successfully practiced the pre-vaccination counseling process. The analysis results show that a number of factors are related to TCAT implementation, such as staff in charge of the expanded immunization program, medical qualifications, and doctors' qualifications . Besides, injection team with satisfactory general knowledge performed TCAT better than injection team with unsatisfactory general knowledge. Therefore, strengthen supervision and professional training related to vaccination practices of health workers.

Assessment of availability, readiness, and challenges for scaling-up hypertension management services at primary healthcare facilities, Central Highland region, Vietnam, 2020

IntroductionVietnam aims for 95% of commune health stations (CHSs) to have functional hypertension management programs by 2025. However, limited resources may impede the Central Highland region health system from achieving this goal. We assessed the availability and readiness of hypertension management services at CHSs in the Central Highland region and identified challenges to facilitate evidence-based planning.MethodsWe used a mixed-methods cross-sectional design to assess hypertension management services using WHO’s service availability and readiness assessment (SARA) tools in all 579 CHSs in the region, combined with twenty in-depth interviews of hypertension program focal points at communal, district, and provincial levels in all four provinces. We descriptively analyzed quantitative data and thematically analyzed qualitative data.ResultsHypertension management services were available at 65% of CHSs, and the readiness of the services was 62%. The urban areas had higher availability and readiness indices in most domains (basic amenities, basic equipment, and essential medicines) compared to rural areas, except for staff and training. The qualitative results showed a lack of trained staff and ambiguity in national hypertension treatment guidelines, insufficient essential medicines supply mechanism, and low priority and funding limitations for the hypertension program.ConclusionThe overall availability and readiness for hypertension diagnosis and management service at CHSs in the Central Highland region were low, reflecting inadequate capacity of the primary healthcare facilities. Some measures to strengthen hypertension programs in the region might include increased financial support, ensuring a sufficient supply of basic medicines, and providing more specific treatment guidelines.

UTILIZING INFORMATION TECHNOLOGY TO ENHANCE THE CAPACITY AND EFFICIENCY OF CONTROL SYSTEM FOR TRANSMISSIBLE DISEASES IN HO CHI MINH CITY

A research and development study was conducted from September 2020 to April 2023 involving 9 hospitals, 24 district health centers and 319 commune health stations. The main objective of the study was to establish,refine, and update a system for controlling directly transmitted diseases in Ho Chi Minh City, as well as assess its practical implementation. Before the system update, the study identified limitations in disease surveillance, particularly in monitoring cases that were not examined or treated at hospitals. The existing reportingmechanisms also resulted in incomplete disease data, with subpar data quality due to delays and inadequate processing of reported cases. Considering the prevailing circumstances, management requirements and usage needs, the system underwent enhancements and integrated GIS capabilities. This allowed healthcare personnel to swiftly and accurately identify disease cases, determine contacts, establish epidemiological zones, tracetransmission chains, and monitor the implementation of control measures. The improved control system has been successfully implemented, ensuring effective management of community-based hand, foot, and mouth disease. Additionally, the system demonstrates the potential for broader applicability in managing other directly transmitted diseases.

Assessing the Operational Feasibility of Integrating Point-of-Care G6PD Testing into Plasmodium vivax Malaria Management in Vietnam.

Plasmodium vivax cases represent more than 50% of a diminishing malaria case load in Vietnam. Safe and effective radical cure strategies could support malaria elimination by 2030. This study investigated the operational feasibility of introducing point-of-care quantitative glucose-6-phosphate dehydrogenase (G6PD) testing into malaria case management practices. A prospective interventional study was conducted at nine district hospitals and commune health stations in Binh Phuoc and Gia Lai provinces in Vietnam over the period of October 2020 to October 2021. The STANDARD™ G6PD Test (SD Biosensor, Seoul, Republic of Korea) was incorporated to inform P. vivax case management. Case management data and patient and health care provider (HCP) perspectives, as well as detailed cost data were collected. The G6PD test results were interpreted correctly by HCP and the treatment algorithm was adhered to for the majority of patients. One HCP consistently ran the test incorrectly, which was identified during the monitoring and resulted in provision of refresher training and updating of training materials and patient retesting. There was wide acceptability of the intervention among patients and HCP albeit with opportunities to improve the counseling materials. Increasing the number of facilities to which the test was deployed and decreases in the malaria cases resulted in higher per patient cost for incorporating G6PD testing into the system. Commodity costs can be reduced by using the 10-unit kits compared to the 25 unit kits, particularly when the case loads are low. These results demonstrate intervention feasibility while also highlighting specific challenges for a country approaching malaria elimination.

Assessment of medical waste generation rate in Viet Nam.

This study was conducted to estimate medical wastes generation rates in Viet Nam. Within 3 years (from 2017 to 2019), total medical wastes generated daily of 1,737 health-care facilities at different levels from 19/63 provinces in Viet Nam were surveyed. The calculation was based on the median daily generation (in kg) of 6 medical waste groups and total actual patient beds in 9 health-care facility categories. Six medical waste groups were sharps, non-sharps, high-risk infectious, pathological, non-infectious hazardous, recyclable and non-recyclable wastes. Surveyed health-care facilities were categorized in central general hospitals, central specialist hospitals, provincial general hospitals, provincial specialist hospitals, district health centers, regional clinics, commune health stations, private hospitals and private clinics. The results showed that waste generation rates varied from 0.0009 to 1.619 kg/bed/day depends on type of medical wastes or health-care facilities. For no-patient-bed facilities (commune health stations and private clinics), medical waste generation rates of these two were calculated in kg/day and varied from 0.1 to 1.75 kg/day.

The current situation of community-based rehabilitation in commune health station of a district in Nghe An province

Community-based rehabilitation (CBR) has been proven effective for people with disabilities (PWDs) and their families, saving medical resources, and is particularly suitable for developing countries1,2. However, in Vietnam, due to the lack of facilities and CBR human resources, the rehabilitation needs of PWDs were not met. Thanh Chuong is a district that has implemented CBR activities at commune health stations for PWDs, in conjunction with the project on victims of the toxic chemical Dioxin. Several duties have been assigned to commune health workers as stated in the CBR program, yet commune health workers were not assigned specifically to do rehabilitation tasks. This study aims to describe the current status of CBR activities at commune health stations, in Thanh Chuong district, Nghe An Province in 2022. The study used a cross-sectional design, mixed methods were employed. The study was conducted from December 2021 to August 2022. Qualitative data are analyzed thematically. Participants were mainly female, about half of them aged 30-49 years old, most of them are nursing, and general medical staff and no staff had a rehabilitation background. The level of performance and confidence in performing the tasks were similar. Among the 8 tasks assigned to the commune health stations, 3 tasks have been performed in 38 communes at different levels including making management records, classifying PWDs, and reporting on transferring PWDs to higher levels. However, these activities are not carried out properly and sufficiently and there was no list of people with disabilities. It is necessary to review the list of CBR activities and have policies to support these activities at the grassroots level, especially to have a health worker in charge of CBR available to fully implement the program's activities, thus helping PWDs integrate into the community, and reducing caring burden or caregivers for PWDs.

Characteristics of traditional medicine human resources in some commune health facilities at Tra Cu District, Tra Vinh province

Objective: To survey characteristics of human resources for traditional medicine at commune medical facilities, Tra Cu district, Tra Vinh province in 2022.Research object and method: A cross-sectional descriptive study combining qualitative and quantitative research. Collecting data by retrospective method of secondary data from management software and statistical reports of 16 commune health stations and 01 health centers in Tra Cu district, Tra Vinh province. In-depth interviews with 22 medical professionals or in charge of traditional medicine, leaders of health stations. Research variables include: age characteristics, gender, ethnicity, professional qualifications, working time of traditional medicine doctors.Results: The total number of traditional medicine personnel of the commune health facilities in Tra Cu district is 330 people, the number of traditional medicine health workers only accounts for 6.6% (22 people). Male proportion accounted for 59.1%, naccounted for 40.9%. Traditional medicine human resources are mainly Kinh people (63.64%), of which 72.73% of health workers can use Khmer to communicate in medical examination and treatment. 63.63% of employees are between the ages of 30 and 50, 74.82% of employees have worked for more than 5 years and have university degrees, accounting for 54.54%. All medical staff are in charge of the main task of medical examination and treatment, including management staff, pharmaceutical activities and scientific research.Recommendation: Continue to train in traditional medicine human resources, increase the rate of undergraduate and graduate school, strive to have medical doctors at health stations. Constantly training to constantly update and improve knowledge in accordance with the local disease model.

Kết quả cung cấp dịch vụ y tế và một số yếu tố ảnh hưởng tại các Trạm Y tế xã, thị trấn của huyện Sông Lô, tỉnh Vĩnh Phúc giai đoạn 2019-2021

Objectives: Describe the results of the healthcare services expanded program on immunization (EPI), reproductive health, and influencing factors at 17 commune health stations (CHS) in Song Lo District, Vinh Phuc Province from 2019-2021. Methods: This is a cross-sectional study design applying mixed methods. Quantitative data was collected by reports of 17 CHS. Qualitative data were collected from 6 in-depth interviews (IDIs) with the Hospital manager and head doctors and 3 focus group discussions (FGDs) with the CHS manager and healthcare workers. Quantitative data were analyzed using descriptive statistics. Qualitative data were recorded, transcribed, and analyzed by thematic coding. Results: 17/17 CHS had well-performed EPI and reproductive health. The vaccination rate for the first and second Covid-19 was over 95%. In 2019-2021, The full immunization coverage for children under 1-year-old was over 95%; The percentage of women giving birth was managing pregnancy, tetanus vaccination, and medical staff support high (>99%). Healthcare provided by CHS was not sufficient. 3/17 CHS had not performed 8 basic healthcare services. 17 CHS performed 80,9-87,1% of the medicines from the model lists of essential medicines. 5/17 CHS performed under 70% of the registered technical procedures. Qualitative data showed that factors positively influenced the results of healthcare services were: effective supervision and monitoring. Whereas, factors negatively affected the results of healthcare services were: the lack of human resources; staff training; the lack of finance, the lack of money for healthcare workers; The lack of human resources, medicines, and medical equipment; The lack of policy of attracting high-quality human resources. The covid-19 pandemic still sees complicated developments. It affected to health worker and the quality of healthcare provided. Recommendations: Song Lo medical center should continue to monitor, and assess CHS. The need for building technical capacity for the healthcare worker. It is essential to enhance financial resources for CHS and healthcare worker. Providing more human resources, especially specialists, pharmacists medicines. Providing more medicines, and medical equipment such as cardiovascular, tuberculosis drugs, echograph, and electrocardiogram,…especially for CHS. Providing midwives for those stations such as Tan Lap, Bach Luu, Phuong Khoan Nhu Thuy, Nhao Son, Tu Yen CHS. Keywords: Commune health station, healthcare, healthcare worker

Putting non-communicable disease data to work in Vietnam: an investigation of community health surveillance capacity

IntroductionDespite the public health system’s critical role in non-communicable disease (NCD) surveillance in Vietnam, limited evidence exists on the implementation of NCD surveillance activities within these systems and the need for capacity building across different system levels to meet expected NCD surveillance goals. This study aimed to evaluate the status of and describe factors affecting the implementation of NCD surveillance activities and to identify the NCD surveillance capacity building needs of the public health system in Vietnam.MethodsWe used a mixed-methods approach in four provinces, conducting self-completed surveys of staff from six Preventive Medicine Institutes (PHI), 53 Centres for Disease Control (CDC) and 148 commune health stations (CHS), as well as 14 in-depth interviews and 22 focus group discussions at four PHI, four CDC, and eight district health centres and CHS.ResultsStudy findings highlighted that although Vietnam has a well-functioning NCD surveillance system, a number of quality issues related to NCD surveillance data were salient. Multifactorial reasons were identified for incomplete, unconfirmed, and inaccurate mortality data and current disease surveillance data. Data on NCD management and treatment were reported to be of better quality than data for screening, targeted treatment, and counselling communication. Main factors affected the effective implementation of NCD surveillance, namely lack of complete and specific guidelines for NCD surveillance, limitations in human resource capacity within NCD departments, and shortage of funding for NCD surveillance activities.ConclusionStudy findings provide practical strategies for strengthening health system capacity for NCD surveillance through developing policies, guidelines, and standardised tools to guide NCD surveillance and a road map for integrated NCD surveillance, developing training packages and manuals for all levels of the health system, and conducting utilisation-focused surveillance training programs.

Positive Impact on Public Perception toward Commune Health Stations (CHSs) in Rural Areas of Tyuen Quang Province, Vietnam, Following the Application of the Development Program for the Capacity-Building of CHSs.

This study aims to discover whether or not the capacity-building intervention through implementing the "Rural Area Development Program" in Tuyen Quang province, in partnership with the Korea International Cooperation Agency (KOICA) and the Vietnamese Department of Health", would positively affect the perception of the public toward the communal health stations (CHSs). To address this, three specific indicator-related satisfaction levels were examined regarding the infrastructure, the professional skills, and the service attitude of the medical personnel of the three CHSs toward outpatients. This cross-sectional study was conducted with 100 participants from three rural CHSs (Binh Yen, Vinh Loi, and Thang Long Communes). As a researcher-directed survey, a structured questionnaire was adopted to gauge the outpatient satisfaction levels in relation to the three indicators from the CHS medical milieu toward the patients and the medical services received. Descriptive and inferential analyses were performed to determine the perceptions of outpatient satisfaction relating to the three indicators. A higher satisfaction rate was found (overall 89-100% descriptive data with three indicators, as well as significant satisfaction differences in inferential data based on F-ratio and p-value) between the three regions with the three indicators, and two major data showed that the commune with a higher or more significant satisfaction rate or difference was Binh Yan > Vinh Loi > Thang Long. Collectively, this study clearly indicates the positive impact of CHSs capacity-building by implementing the Development Program in Tuyen Quang province with KOICA in relation to the public perception toward CHSs through significantly increased satisfaction levels-specifically, the infrastructure, the professional skills, and the service attitude of the medical milieu from the three CHSs toward outpatients.

Improving hypertension awareness and management in Vietnam through a community-based model

Hypertension prevalence in Vietnam is high, but few people are aware of their disease status. Detection, diagnosis, and treatment are limited, so new approaches are needed to improve awareness and manage the condition, especially at the primary health care level. The Communities for Healthy Hearts programme operated in four districts of Ho Chi Minh City, with the aim of increasing awareness and ensuring linkage to care. Interventions focused on extending services beyond health facilities to convenient community locations; training cadres of community volunteers to screen, refer, and follow up with clients; training health workers in facilities to diagnose, educate, and manage patients referred from the community; and supporting the process with digital case tracking. Community-based blood pressure screenings took place in client homes, commune health stations, and non-traditional sites such as coffee shops, dentists’ offices, marketplaces, neighbourhood watch/security posts, and tailor shops. In total, 121,273 adults aged 40 and older were screened. Of these, 25.1% had elevated blood pressure or a previous hypertension diagnosis and were referred to health facilities. Of those referred, 56.2% were confirmed to have hypertension, and of those confirmed, 75.2% were treated. Of those treated, 51.0% achieved blood pressure control, a favourable outcome over past programmes.

The management of diabetes patients and some related factors at commune health stations in Can Tho city in 2021

Background: As diabetes is increasing rapidly in Vietnam, the management of diabetes patients at commune health stations should be focused on effective investment. Objectives: Identify the percentage of commune health stations implementing diabetes patient management by the Ministry of Health requirements and some related factors in Can Tho city in 2021. Materials and methods: A cross-sectional descriptive study at all 80 commune health stations in Can Tho city in 2021. Results: The percentage of commune health stations implementing diabetes patients management meeting the Ministry of Health requirement is 43.8%. Factors related to satisfactory management of diabetic patients include: promulgating guidelines for transferring diabetic patients (p=0.003), gaining support from higher-level health agencies (p=0.042), training on diabetes management (p=0.04), using diabetes management software (p<0.001), updating complete health records of diabetic patients (p <0.001), being fully invested in equipment (p=0.026). Conclusion: The study shows that the percentage of diabetes patient management at commune health stations meeting the requirements of the Ministry of Health is at an average level, so it is necessary to have investment and support policies for the commune health stations to manage diabetes in the community effectively.

Community health care workers knowledge on hypertension and diabetes in a mountainous province in Vietnam

Objective: This study aims to describe the knowledge of health care workers at commune health stations about hypertension and diabetes in Ha Giang province in 2019; Methods: We conducted an analyze data from the suvey of pre-training course evaluation data. Results: The proportion of health care workers who had good knowledge about the diagnosis and treatment target of hypertension was 60.8% and 55.9%, respectively. The proportion of health care workers who had correct answers on the diagnosis criteria of diabetes was 29.4%, and the target of HbA1C diabetes was 25.5%, and detecting kidney complications accounted for only 14.7%. Age and seniority were closely related to the level of knowledge among these health care workers. Younger health care workers (<35yrs) are likely have better knowledge on diagnostic criteria, treatment goals and medication treatment of hypertension. Health care workers who has less working time (<10 years) are likely to have better knowledge on dianostic criteria for hypertension. Conclusions: The result indicated that the knowledge among health care workers at commune health stations on hypertension and diabetes were not high. Therefore, organizing continuous training courses to regularly update knowledge for old and senior health care workers at commune level is a critical intervention in improving the quality of diagnosis, treatment and management of hypertension and diabetes at the facility.