Statement of Dr Kidong Park on the occasion of the Workshop on hypertension and diabetes management applying basic Family Medicine Principles at Commune Health Station for Lecturers of National Training Centres
Dr Kidong Park 07 May 2018
I welcome you to the training workshop on hypertension and diabetes management applying basic Family Medicine Principles at Commune Health Station for Lecturers of National Training Centres.
I appreciated Vice Minister Tuan for his leadership in tackling NCD issues in Viet Nam and strengthening primary health care system in Viet Nam.
NCD and primay health care are two different sides of same coin.
A side of coin is NCD. Disease burden of NCD in Viet Nam is increasing. We are facing many challenges and NCD management in Viet Nam.
NCDs kill 380,000 Vietnamese people each year. This is equivalent to 73% of all deaths.
An indicator of NCD management performance is premature death by NCD – the probability of dying from any major NCDs (cardiovascular diseases, cancer, diabetes and chronic respiratory diseases between age 30 and 70). The WHO Western Pacific Regional Office released UHC country profiles last World Health Day on 7 April 2018. Premature death by NCD of Vietnamese people was 17.3% while the regional aveage was 17.1%. The figure of 17.3% means that about 1 in 6 Vietnamese people at the age of 30 as of now may die of NCDs before he or she reaches the age of 70. We must save the lives of Vietnamese young adult. The health sector of Viet Nam should do more.
Another side of coin is primary health care. We have to admit the situation that primary health care system in Viet Nam, grass-root health care facilities in Viet Nam should be re-vitalized. The problem statement will be overcrowding of hospitals at higher levels and bypassing of grass root level health care facilities.
What are the reasons for bypassing? People believe that they may receive health service of better quality at higher level. A study reported that the quality of services at grass-root level is low. Less than 60% of commune health station doctors demonstrated their capacity of correct diagnosis and correct treatment of level 1 hypertension.
Colleagues and friends
NCD and primary health care are two different sides of same coin. Better management of NCDs is possible only when we have strengthened primary health care facilities on the ground.
NCD and primary health care are two different sides of same coin. We can strengthen primary health care facilities at grass root level by improving capacities of NCD management of health care workers at commune health stations.
One stone hit two birds.
I appreciated Vice Minister Tuan for his leadership in tackling NCD issues in Viet Nam and strengthening primary health care system in Viet Nam. I believe this approach, once delivered as planned, will help a lot in tacking NCD issues in Viet Nam and strengthening primary health care system in Viet Nam.
Key components of this approaches are:
First, using hypertension and diabetes as an entry point in improving capacities of NCD management of health care workers at commune health stations. Hypertension and diabetes are two most important risk factors of CVDs and also the most prevalent NCDs both in Viet Nam and globally. Hypertension and diabetes could be diagnosed and managed easily at primary care level. As a result, we could prevent severe complication and premature deaths from CVDs.
Second, using existing resource maximally and taking a short-cut for nation-wide scale up. MOH and WHO agreed to designate existing Medical University with Family Medicine Faculty and Public Health Institutes as national training centres to support provinces in building capacity for CHSs. We acknowledge the important role of your universities/institutes in promoting implementation of NCD management at CHS. Most of you here are experts in family medicine and chronic management. Therefore, in this training workshop we mainly introduce the standardized training materials and tools for training HCWs of CHSs and we will discuss with you on how to deliver the course in active learning method. You will also be asked to give comment for revising the documents.
Colleagues and friends
I would remind you that the party resolution 20 set the goal that by 2025, 95% of commune, ward and township health stations perform preventive measures, management and treatment of some NCDs; and by 2030, 100%. I am confident that the launching of this training initiative will contribute a lot in achieving the goal set by the Party Resolution 20.
After training workshop, WHO together with MOH will support you in the process of supporting provinces in implementing hypertension and diabetes management at CHSs. It will include training of local trainers and mentors, supervision HCWs to perform their work as well as working with stakeholders for supportive environment for NCD management at commune health stations. We already have a detailed plan to support more than 10 provinces in implementing the MOH’s Plan. We will also try to mobilize resource to support other provinces with this task.
I strongly believe that with our effort in the right direction, we will achieve the goals of the communist party resolution No20 and reduce burden of NCD for Vietnamese people in the coming years.