RTCCD has confirmed that the preceding issues are present within hospitals by conducting surveys in seven hospitals throughout the country. The data collected by RTCCD has led to the recommendation that an emphasis must be placed on adequate research in hospitals. It is necessary that a protocol should be implemented nationwide on the management of hospitals, allowing the practices prescribed in this protocol to be followed by all staff in all hospitals in Vietnam. In addition, a standard training course for all hospital staff in research methodology should be made mandatory, asthe ability of appropriate research work to be carried out by staff will enable management problems within the hospital to be solved. This will involve the development of a research protocol for data collection, and training for staff on how to control biases present within the research, data management and data analysis, writing reports and publishing research results.
Listed below are several of the studies and projects that the RTCCD has been involved with in the past several years that reflect its vision to improve the health system in Vietnam.
Feasibility Study of the Vietnam Draft Law on Examination and Treatment version 15: 2009
The Ministry of Health drafted this law and it is currently being reviewed by the National Assembly. RTCCD greatly contributed to this process by conducting two studies. The first involved a literature review to compare the drafted law with the health law and medical codes of conduct in other countries such as Singapore, China, Thailand, South Korea, Great Britain, Australia and America. Download report in English and Vietnamese.
The second project involved a feasibility study on the application of “Version 15” from the perspectives of health managers, health workers, patients and their families. The findings were presented in short reports and submitted to the Vietnam Union of Science and Technology (who is leading the review committee) and the National Assembly. Download report in English and Vietnamese.
Mid-term evaluation on non-communicable diseases (NCD) control model in Thai Nguyen: 2009
The Integrated Model for NCD Prevention and Control (IMP model) has been implemented in Linh Son commune of Dong Hy district, Thai Nguyen province, with financial support from the World Health Organization (WHO). Taking the recommendations from the 2008 NCD program review, MOH and WHO requested RTCCD to conduct a mid-term project evaluation. Using the intervention-comparison study design, the RTCCD evaluation team has conducted 1,047 household interviews on adult people aged18 years and over, investigating their knowledge, attitudes, and practice of NCD prevention and their access and use of health care services when suffering from NCDs. In addition, 33 commune health staff were interviewed (30 village health workers, 3 commune health staff) on their activities related to NCD prevention and control. In general, the project activities have been implemented rather well and fit to the model’s guidelines, and the evaluation team have given constructive recommendations for the project teams to improve the impact and implementation of the project. Download report summary in English and Vietnamese.
Mid-Term Review of the Vietnam Public Health Program: 2009
In April 2009, RTCCD signed a consultancy agreement with Queensland University of Technology, Australia. This involved a Mid-Term Review (MTR) of the Vietnam Public Health Program called “Improving the capacity of public health faculties in Vietnam: a national collaboration (2007-2010).” The project was designed via collaboration between Queensland University of Technology and the Faculties of Public Health in Hue, HCMC and Can Tho and the Hanoi School of Public Health. It aims to enhance the skills of public health graduates in Vietnam so they can improve the health of the Vietnamese population. The grant allowed for a total budget of $4,144,353.80 AUD from Atlantic Philanthropies. The MTR assessed the program implementation process and provided recommendations for the remaining period of the program. Recommendations proposed by the review team were acted upon by the project management unit. Download report summary in English.
Mid-Term Review of the comprehensive training project at the Cardiovascular Center (CVC) of Hue Central Hospital: 2009
Scheduled over a five year period, the project aims to train 111 hospital personnel (78 trained in Vietnam and 33 trained overseas). Personnel will receive training in cardiovascular procedures, clinical management and administration. Under the authorisation of the Royal Children’s Hospital International Australia, the RTCCD MTR conducted a review and identified that poor inter-partner communication, an overload of work for the CVC team, and a new medical practice policy of the Australian Government were pertinent issues. This made it difficult for the project to be properly implemented. The review team suggested that the project should focus more on language training, comprehensive program training for the CVC team, protocol and guideline development for medical performance and improvements in some areas of management. This is the 7th Atlantic Philanthropies-funded project in Vietnam that has been evaluated by the RTCCD team. Download report summary in English.
A Study of the Public Health Care System in Quang Dien District, Thua Thien Hue: 2007
Funded by a grant from the Luxembourg Government, this particular study focused on strengthening local governance capacity in a variety of sectors. These included a focus on health, as well as implementing a range of smaller-scale infrastructure and facility improvements. The RTCCD health consultant team worked within the Quang Dien district and eleven communes to identify common health problems and the capacity of the local health system to provide sufficient care. The possibility for project integration into the local health system and further recommendations for potential intervention strategies was also analysed. Download report summary in English and Vietnamese.
Strengthening In-Service Training Systems in Vietnam: The Potential Contributions of Professional Health Associations: 2007
In collaboration with People and Organisation UK, RTCCD conducted an organisational assessment of eight medical associations for Pathfinder International. The overall objective of this venture was to achieve a common understanding of the current and potential roles and functions of the professional medical and pharmaceutical associations in Vietnam, and to use these results to develop plans for association capacity building. By doing so, delivery of in-service training for health workers in Vietnam will improve. Download report summary in English.
Catastrophic Health Care Expenditure and Household Impoverishment in Vietnam – A Study Conducted within the Context of the Project ‘Development of Health Sector in Vietnam: 2006 - 2008
Implemented by the Central Commission for Science and Education and RTCCD, with support from the World Health Organisation, this particular study is the first part of a two year research project on health system development. Specifically, its aim is to provide sufficient evidence in order to improve health financing policy in Vietnam by identifying the share of households that suffered from catastrophic health expenditure in 2002. Download report summary in English.
Effects of Swedish Development Co-operation on the Democracy & Human Rights situation in Viet Nam: 2006
The country strategy for the Swedish-Vietnamese development cooperation 2004-08 called for a special assessment of the effects of Swedish Development Co-operation on the Democracy and Human Rights situation in Vietnam. One of the areas identified for assessment is health. With profound experience in health system and health policy research, RTCCD was invited to conduct a component of the field study and to synthesize the findings into a final report, whose sub reports were being written by institutes and departments dependant of the Ministry of Health. The final report addressed the issue of identifying the evidence to show that SIDA support has contributed to improvement of democracy and the right to health in Vietnam? By analysing the evidence, the lessons for improving democracy and human rights in Vietnam were outlined. Download report summary in English.
Perspectives and Solutions to Support the Poor in Healthcare Service Use: 2005-2006
Funded by the Ministry of Science and Technology and conducted in response to a request from the National Commission of Science and Technology, this study was designed by RTCCD in order to help reduce the financial burden placed upon the poor during healthcare service use. The aim of this study was to measure the expenditure of the poor who were eligible for Program Number 139 during their in-patient treatment at national hospitals. Further objectives included:
· to investigate coping strategies of the poor during in-patient treatment;
· to explore differences in living standards during the treatment period;
· to measure contributions to support patients; and
· to make recommendations to policy makers and the Ministry of Health to improve Program 139.
Download report summary in Vietnamese.
Assessment of accessibility to the “Health Care fund for the Poor”: 2005-2006
This study directly investigated the National Program No. 139, implemented nation-wide since 2003 under the formal title “Health Care Fund for the Poor”. RTCCD, in collaboration with the Communist Commission for Science and Education (CCSE) and the Anti-Poverty Policy Study group of VUSTA, carried out the study in which RTCCD held the role of technical designer. The study aimed to seek answers to two questions: is the HCFP helpful in reducing the financial burden of healthcare for the poor, and what are the systematic barriers to the program implementation? The study was conducted in 2006. The data collection team includes staff from member organisations of the Anti-Poverty Policy Study Group, and was launched in three provinces: Yen Bai, Ninh Thuan and Dong Thap. Download report summary in Vietnamese.
Training Need Assessment for Improvement of Medical Services in the Central Region Hospitals: 2005-2006
The assessment was conducted at the request of JICA. It had three objectives: to provide information for designing a training program for upgrading medical services in 14 hospitals; to survey hospitals’ experiences in training organization and evaluate its impact on the hospitals; and to identify specific training needs in the project targeted medical areas. The study was organized using the “participatory approach in research” between RTCCD and the Hue Central Hospital who managed the implementation of the study within the project context. Data collection was carried out in seven hospitals in central regions. Download report summary in English and Vietnamese.
Baseline survey of the health system in Hung Yen: 2001
This was a preparatory assistance phase to support the Hung Yen People’s Committee, with the provincial health department as a key counterpart. The objective was to assess the sustainable development of the provincial health system in order to propose interventions, with support from the Government of Luxembourg for the period 2002-2006. From June 2001, with technical involvement from RTCCD, assessment of the health system, including the communal health system and users’ health needs and behaviours was launched. The survey aimed to identify some of the main problems related to utilization, quality of care, referral systems, accessibility, management and technical skills, patient satisfaction and community attitude towards various services at commune and district level. In addition, it aimed to determine the role of private health care providers in healthcare delivery in the province, as well as the future development potential of this sector.
Baseline Study for the Health System Development Program in Thai Binh, An Giang and Binh Thuan provinces: 2000
The baseline survey for the health system development program (HSDP) in the three provinces, a joint venture between Ministry of Health Vietnam and the Commission of the European Community (EU), aims to identify some of the main problems related to utilization, quality of care, referral systems, accessibility, management skills, technical skills, satisfaction and attitudes towards various health services for each health system level: commune, district and province. The baseline survey consisted of four components which were implemented according to RTCCD’s design and management in early 2000: a health service user survey, an exit-patient survey, a health service provider survey and a commune characteristics survey. The report provided recommendations for strategic adjustment and for program actions, and led to a 30-million dollar program being granted by the EU to the government of Vietnam to upgrade the health system in these three provinces and some neighbouring provinces.