Brief Report: Study on the current situation of services delivery of commune health centres in some regions and associated factors

MINISTRY OF HEALTH THE HEALTH SYSTEMS STRENGTHENING PROJECT IN SOME SELECTED PROVINCES BRIEF REPORT STUDY ON THE CURRENT SITUATION OF SERVICES DELIVERY OF COMMUNE HEALTH CENTRES IN SOME REGIONS AND ASSOCIATED FACTORS 1 Hanoi, December 2014 CONTENTS CONTENTS.................................................................................................................................................2 ABBREVIATIONS.......................................................................................................................................4 SUMMARY..................................................................................................................................................5 1. BACKGROUND.......................................................................................................................................7 2. SUBJECTS AND RESEARCH METHODS.............................................................................................8 2.1. STUDY DESIGN: ACROSS-SECTIONAL STUDY THAT COMBINED QUALITATIVE AND QUANTITATIVE TECHNIQUES.......8 2.2. SUBJECTS: LOCAL RESIDENTS, MEDICAL STAFFS, AUTHORITIES, LEADERS OF COMMUNAL ORGANIZATION, LEADERS OF DISTRICT HOSPITAL, HEALTH PROVISIONS AND DISTRICT HEALTH PREVENTION CENTRE, AVAILABLE SECONDARY DATA........................................................................................................................................8 2.3. TIME: 2014.........................................................................................................................................8 2.4. LOCATION:EIGHT PROVINCES REPRESENTING EIGHT ECOLOGICAL REGIONS, INCLUDING: HA GIANG, HOA BINH, THAI BINH, HA TINH, QUANG NAM, BINH DUONG, KIEN GIANG, KONTUM. IN EACH PROVINCE, CHCS WERE SELECTED ACCORDING TO THREE CLUSTERS: URBAN, RURAL AND DIFFICULT AREAS...............................................8 2.5. SAMPLE SIZE AND SAMPLING TECHNIQUE:.................................................................................................8 2.6. DATA ANALYSIS: AFTER COLLECTING, QUANTITATIVE DATA WAS CHECKED, CLEANED, CODED AND ENTERED INTO EPIDATA 3.1, MICROSOFT EXCEL. STATA SOFTWARE WAS USED TO ANALYZE DATA: DESCRIPTIVE STATISTIC (MEAN, PERCENTAGE %), ANALYTIC STATISTIC (T-TEST, WALLIS TEST, Χ2 TEST,…). QUALITATIVE DATA WAS ANALYZED REGARDING TO THE THEMES INFORMED BY EACH OBJECTIVE..............................................................................9 2.7. ETHICAL APPROVAL: THIS STUDY HAD THE APPROVAL OF COMMUNITIES, THE AGREEMENT OF LOCAL GOVERNMENT AND THE LEADERS OF HEALTH AUTHORITIES IN THE SETTINGS. PEOPLE WERE VOLUNTARILY ENROLLED INTO THE STUDY, THE INDIVIDUAL INFORMATION WAS CONFIDENTIAL AND THEIR NAMES WERE NOT RECORDED...........9 3. RESULTS................................................................................................................................................9 3.1. THE CURRENT SITUATION OF THE CHC SERVICE NEEDS AND USE OF POPULATION IN SOME VIETNAMESE REGIONS IN 2014........................................................................................................................................9 3.2. THE CAPACITY TO DELIVER HEALTH CARE SERVICES OF CHC IN SOME VIETNAMESE REGIONS IN 2014:.........10 3.3. FACTORS ASSOCIATED WITH THE CAPACITY TO DELIVER HEALTH CARE SERVICES OF CHCS IN SOME VIETNAMESE REGIONS IN 2014...................................................................................................................12 4. DISCUSSION.........................................................................................................................................13 5. CONCLUSIONS....................................................................................................................................17 5.1. THE CURRENT SITUATION OF PEOPLE’S NEEDS FOR AND USE OF CHC SERVICES IN SOME VIETNAMESE REGIONS IN 2014......................................................................................................................................17 5.2. THE CAPACITY TO DELIVER HEALTH CARE SERVICES OF CHCS IN SOME VIETNAMESE REGIONS IN 2014.........17 RECOMMENDATIONS.............................................................................................................................18 2 RESEARCH TEAM REPRENTATIVE.......................................................................................................19 NGUYEN HOANG LONG, PHD................................................................................................................19 REFERENCES..........................................................................................................................................20 ANNEX – LIST OF RESEARCH TEAM....................................................................................................21 3 ABBREVIATIONS CHC Commune Health Centre MoH Ministry of Health 4 SUMMARY A cross­sectional study, combining both qualitative and quantitative approach, was conducted to describe the current situation of services delivery of commune health centres (CHCs) in some Vietnamese regions and its associated factors. The quantitative study was conducted on 600 households (equivalent to 2023 individual residents), while the qualitative studies comprised in­depth interviews with 9 leaders at district health levels; focus group discussion with 53 medical staffs of CHCs and 63 leaders of government and local organizations at commune level. Facilities of ninety CHCs were observed and secondary data of 240 CHCs was collected in eight provinces which represented Vietnamese ecological regions in 2014. The findings showed that the proportion of residents suffering acute diseases was 8.5%, of which the percentage was the highest in urban areas with 10.2%. When having those illness, 44.0% people went to CHCs based on some reasons: having health insurance (50%), convenience/near house (20.8%); habit (12%); meanwhile, 25.7% people went to the hospital because of: health insurance (61.5%), modern/adequate equipments (7.7%). The proportion of residents suffering chronic diseases was 15.2%, of which the percentage was the highest in urban areas with 19.3%.When having those illness, 48.7% people went to the hospital because of: health insurance (69.4%), transfer from lower levels of health system (13.9%); meanwhile, 37.1% people went to CHCs based on some reasons: having health insurance (44.1%), convenience/near house (20.6%) and having been treated before (13.7%). The reason why residents did not use health care services in CHCs included inadequate equipments (26.1%), inadequate drug (19.7%), and inconvenience of health insurance mechanism (18.5%). The findings also showed the concerned capacity of CHCs to deliver services: About human resources: 64.4% CHCs did not reach the National standards for human resources (insufficiency in both quantity and components of medical staffs): 40.4% CHCs did not have a medical doctor, 37.8% did not have obstetrical assistant doctors. Facilites and equipments: the proportion of CHCs having laboratory and sterilization room was low, of which the lowest proportion was in mountainous areas. CHCs had the average of 45/69 equipments as requirement of Ministry of Health (MoH); only a third of CHCs reached the National standard of equipments for traditional medicine, ear­nose­throat, dental and testing. Drugs: > 70% CHCs had adequate drug categories according to the list of MoH, but the quantity of each category was insufficient. Performing medical techniques at CHCs: 95% 5 ... - tailieumienphi.vn