Primary healthcare system capacities for responding to storm and flood-related health problems: a case study from a rural district in central Vietnam

Abstract

BackgroundAs a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area.ObjectiveThis research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues.DesignThis was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions) were used to broaden understanding of the quantitative material and to get additional information on actions taken.Results1) Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2) Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3) Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4) Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5) Information and research: Data that can be used for planning and management (including population and epidemiological data) were largely lacking. The district lacked a disease early-warning system. 6) Medical products and technology: Emergency treatment protocols were not available in every studied health facility.ConclusionsThe primary care system capacity in rural Vietnam is inadequate for responding to storm and flood-related health problems in terms of preventive and treatment healthcare. Developing clear facility preparedness plans, which detail standard operating procedures during floods and identify specific job descriptions, would strengthen responses to future floods. Health facilities should have contingency funds available for emergency response in the event of storms and floods. Health facilities should ensure that standard protocols exist in order to improve responses in the event of floods. Introduction of a computerized health information system would accelerate information and data processing. National and local policies need to be strengthened and developed in a way that transfers into action in local rural communities.

Climate Change–Related Water Disasters’ Impact on Population Health

“…Local communities will face the greatest burden of initial response until national or international organizations arrive-local responses to Hurricane Sandy in Brooklyn mobilized volunteers to provide hot meals and deliver medicine and ice to homebound people, and distribute information and resources to community members for 3 weeks before government officials arrived (Schmeltz et al, 2013). Suggestions to improve the resilience of health systems include establishing standard operating procedures (Van Minh et al, 2014), ensuring a functional workforce (Ryan et al, 2016), establishing policy and land use mechanisms, setting mandatory disaster plans for hospitals, assessing current flood and environmental disaster strategies, and being aware of the social inequities that enhance vulnerability to flood-related health problems (Burton et al, 2016).…”

Prevalence, Awareness, Treatment, and Control of Hypertension and Its Risk Factors in (Central) Vietnam

“…Among the ethnic minority groups, there was high prevalence of hypertension, but the control and treatment were largely insufficient. Most of the ethnic minorities are living in the mountainous and remote rural areas, facing difficulties such as low income, poor health education, insufficient health facilities, difficult access to medical services, and lack of health resources [24, 27, 28]. There was no association between the level of education and prevalence, awareness, treatment, and control of hypertension in this study.…”

A Relação Saúde E Meio Ambiente Na Atenção Primária E Na Estratégia Saúde Da Família: Uma Revisão Narrativa

“…Entretanto, a atuação profissional, nesse tipo de evento, tende a acontecer de forma passiva, pois, por vezes, os sistemas de informação são ineficientes, resultando na dificuldade de atuação profissional (A11). 31 Aliado a isso tem-se a insuficiência de recursos governamentais para esse tipo de evento e a ausência de definição de protocolos de atuação dependendo do tipo de evento (A11). 31 Diante do exposto, percebe-se a importância do reconhecimento do território de atuação da ESF, para que se possa intervir nos problemas relacionados ao mesmo.…”

“…31 Aliado a isso tem-se a insuficiência de recursos governamentais para esse tipo de evento e a ausência de definição de protocolos de atuação dependendo do tipo de evento (A11). 31 Diante do exposto, percebe-se a importância do reconhecimento do território de atuação da ESF, para que se possa intervir nos problemas relacionados ao mesmo.…”