WHO's Service Availability and Readiness Assessment of primary health care services of commune health centers in a rural district of Northern Vietnam

Abstract

The objective of this study was to assess the availability and readiness of the primary health care (PHC) services of commune health centers (CHCs) in Quoc Oai, a rural district of Northern Vietnam based on the World Health Organization's Service Availability and Readiness Assessment (SARA) tool. The study was done in 2 steps. First, the heads of the 21 CHCs of Quoc Oai district were interviewed using SARA, a quantitative survey, and the responses were then validated by direct observations of each facility. The results showed that although the average number of health staffs in each CHC met the national standards (at least 5 staffs per CHC), its allocation within each CHC was not properly met because some CHCs had only 2 health staffs. Several health equipment and facilities were not fully available in many CHCs, and although the majority of the PHC services were available at the CHCs, their readiness remained limited. Several significant correlates between the availability of health care workers and the availability of the facilities and the PHC services were observed, suggesting that they depend upon and affect one another in the health system. Using the SARA-based inventory, the study helps health managers and policy makers to prioritize efforts and allocate resources more appropriately. To be effective, attention should be given to how to make facilities, services, and human resources for health ready for PHC activities-more investment and support from the system (from higher to lower level) and the government.

Development of summary indices of antenatal care service quality in Haiti, Malawi and Tanzania

“…Studies on quality of care in LMICs largely rely on data from health facility surveys that collect data on facility readiness and provision of care. These studies often use summary indices or composite scores to provide an overall description of service quality 16–26. Summary scores are useful to LMIC governments in that they simplify complex data and enable comparison of performance within facilities, across administrative units and over time.…”

“…The number of items that were included in an index varied from a minimum of 7 to a maximum of 40, and various methods were used to combine items into indices. These methods include a simple and weighted additive approaches20 22–26 as well as principal components analysis (PCA)28 31–33. While many of these studies had some overlap in the items selected for inclusion in their ANC quality of care index, the quality of care indices varied greatly in the items selected for inclusion in the indices and in the methodology used for combining items into a summary measure.…”

What Drives Utilization of Primary Care Facilities in Vietnam?

“…Availability of basic medicines is measured as a binary variable capturing whether the CHS has at least 70 percent of the 30 basic medicines that were checked in the DSCF. 5 4. Availability of human resources is measured as to whether the CHS has a contracted/permanent medical doctor.…”

“…It can be operationalized in empirical work as the availability of the various domains of inputs, such as infrastructure, human resources, basic equipment, medicines, and medical consumables, required to provide a specific service or sets of services [4]. Previous studies in Vietnam have focused on describing CHS service readiness, encompassing infrastructure, medical equipment, pharmaceutical products, and human resources, and find that CHSs across the country still vary significantly in their service readiness [5,6]. Empirical analysis in Vietnam has not yet sought to identify which domains of service readiness are associated with higher population utilization of commune-level primary curative care services.…”

Strengthening human and physical infrastructure of primary healthcare settings to deliver hypertension care in Vietnam: a mixed-methods comparison of two provinces

“…In Vietnam, the overall prevalence of HTN was 21% and subjects with HTN had low estimates for the prevalence of HTN awareness (43%) and treatment (33%); these three estimates were significantly lower in rural areas. A few studies showed limited accommodation for HTN medications at commune health stations (CHSs), which are the entry point of care to the health system ( Van Huy et al , 2018 ; Duong et al , 2019 ; Meiqari et al , 2019b ). In 2008, the Ministry of Health established the National HTN programme, which piloted a model for HTN management at the grassroots level ( Nguyen et al , 2011 ; 2012 ; Lim et al , 2014 ; Meiqari et al , 2019b ); although this model was scaled-up gradually, activities for HTN were implemented in less than half of the CHSs by 2014 ( Meiqari et al , 2019b ).…”