Viet Nam is on the right way to fight health care associated infections

In line with global trend, Viet Nam is facing burden from health care associated infections (HAI) and antimicrobial resistant (AMR) in health care facilities. On average, one in 10 patients in Viet Nam suffers from infection while receiving health care and the rate is even higher in intensive care units at central hospitals. The recent outbreaks and rise in the number of infections serve as a warning to hospitals and health care facilities in Viet Nam and highlight the importance of infection control activities in tackling HAI and AMR. These events include: SARS outbreak in 2003; measles outbreak in 2014; surgical site infections in Ha Giang provincial general hospital in 2013; HAIs in new-borns in Bac Ninh Maternal and Child hospital in 2017; and the increasing prevalence of AMR, particularly Methicillin-Resistant Staphylococcus aureus (MRSA) and Carbapenem-resistant Enterobacteriaceae (CRE).

Viet Nam’s health sector was early to recognise the importance of Infection Prevention and Control (IPC) activities. In 2009, the first policy document, the Circular No. 18/2009/BYT, guiding comprehensive IPC activities to health care facilities, was issued and implemented within the health care system. The 2016-2020 National Action Plan (NAP) on IPC was issued and is being implemented in health care facilities; the IPC system has been established at nearly all hospitals. In addition, the Ministry of Health issued a number of national technical guidelines and training materials on IPC; and established the National Technical Advisory Groups (TAG) on IPC.

According to recommendations from the World Health Organization (WHO), implementing effective IPC measures reduces HAI by at least 30%, with the simplest and most effective activity being hand hygiene. Viet Nam’s health sector has set objectives of having more than 95% of hospitals implement annual hand hygiene campaigns, and more than 40% of central and provincial hospitals implement systematic HAI surveillance system by 2020.

Over the last years, WHO Viet Nam has been in a good collaboration with international development partners, such as United State Centre for Disease Control (USCDC), PATH, HAIVN to provide advocacy and technical support to VAMS in development of the National Action Plan on Infection Control of the Health Sector for the period 2016-2020, development of national technical guidelines on IPC, development of criteria for assessment of IPC, capacity building for IPC technical staff, and establishment of IPC model hospitals.

Aiming to accelerate the commitment towards strengthening IPC activities and reducing HAI in health care facilities, on 27 March 2018 in Hanoi, the Ministry of Health, led by Vice Minister of Health Dr. Nguyen Viet Tien, held a high-level advocacy meeting on IPC. Participants included more than 300 delegates, including leaders of relevant departments in Ministry of Health (MOH), directors of 63 Provincial Departments of Health, directors and heads of IPC departments of 63 provincial general hospitals, and about 30 provincial maternal and child Hospitals. The meeting also saw participation from many international agencies and donors, such as United States Agency for International Development (USAID), United States Centre for Disease Control and Prevention (USCDC), PATH, and WHO.

During the meeting, the Vice Minister Nguyen Viet Tien emphasized the need for health care facilities to appropriately and adequately implement IPC measures and to ensure sufficient equipment, conditions, personal protective equipment (PPE) and finance and human resources for IPC activities, enhancing hand hygiene, and HAI surveillance.

Dr Kidong Park giving speech at the conference

At the meeting, Dr. Kidong Park, WHO Representative in Viet Nam expressed appreciation for the efforts and achievements of Viet Nam’s Health sector over the last decade in IPC, and advocated for enhanced commitment, especially from hospital leaders, to IPC activities. Dr. Kidong reaffirmed “WHO in Viet Nam is committed to providing continual support for Viet Nam’s health sector in achieving the objectives of the 2016-2020 National Action Plan on IPC.”

Director of Viet Nam Administrative of Medical Service, Dr. Luong Ngoc Khue, pointed out current challenges facing health system in IPC activities; particularly emphasizing the lack of clarification on the roles of and commitment from hospital leaders on IPC.

During the meeting, representatives from the hospitals also exchanged experiences and lessons on HAI and AMR surveillance; environmental surveillance; training on IPC; financial management in IPC; and activity of network on IPC. These are key IPC activities to address HAI and AMR, as well as enhancing quality of health care.

In his concluding remarks, Vice Minister Nguyen Viet Tien asked leaders of hospitals to show greater commitment in strengthening investment for IPC activities. “We cannot have more patients die due to HAI that is our fault,” he emphasized. In response to the call of the Vice Minister, representatives from more than 200 hospitals signed the commitment on strengthening implementation of IPC activities.