The continuing struggle - NCDs project: 2014, Duy Xuyen, Quang Nam.  

Non Communicable Diseases (NCDs) in Vietnam has become major problem throughout the entire country. VNHIP doctors have spent 9 years working in 32 local clinics to determine the current model of care and identify obstacles to care delivery. Based on this experience (which includes seeing more than 2,000 patients) they developed a treatment protocol with a comprehensive health booklet for the management of CVD risk factors and the management of hypertension and diabetes, using international guidelines.

Vietnamese people do not have good eating habits like eating fruit and vegetables regularly. Alcohol is also a problem, men usually drink a lot of beer and rice wine. Exercise is not a priority here as people have very busy lives. All of these lifestyle factors lead to high risk of non-communicable disease. Encouraging patients to change their lifestyle is paramount, however, the workload of the district doctor is too high and they do not have time to do this. Doctors at a local community level lack training in treating NCD’s and therefore send patients to the district hospital, this leads to overcrowding and means that doctors who are trained and understand NCD’s do not have time to spend educating patients.

As these diseases are chronic, patients have to take medication for life. Another problem is that doctors always prescribe the most expensive medication.

In response to identifying a need for improved management of Non Communicable Diseases(NCDs) in Viet Nam, Dr Josh Solomon of VNHIP, working closely with the  World Health Organization(WHO), has developed a protocol to enable doctors in rural provinces to effectively and cheaply treat NCDs.

Over time, we have changed our focus from treating patients to upskilling the local health staff, in order to contribute to sustainable change in systems of care, one of the primary objectives of VNHIP. A particular aim is to improve the confidence of health staff in health counseling and patient care. This reduces the need for patients to attend district hospitals, which not only eases overcrowding, but enables them to access     quality care closer to home.

In 2011, the WHO and Ministry of Health, Viet Nam, provided VNHIP with a grant to run a pilot project in Phu Tho to assess the effectiveness of the training mentioned above. This project received such positive results, WHO has been working with the Ministry of Health to assess the feasibility of applying it across the country.

During this time, VNHIP has been continuing to implement the model for the management of non-communicable diseases, and are currently with local community doctors in Duy Xuyen, Quang Nam.