Improving prevention of cardiovascular diseases: Barriers and facilitators in primary care services in Vietnam
Tran Thi Duc Hanh, Le Bich Ngoc, Hoa Ngoc Lam, Enying Gong, Xuanchen Tao, Lijing L. Yan, Hoàng Văn Minh
Abstract
Background: The National Hypertention Prevention and Control has been set as the Vietnam national health target program, 2008 to 2020 and functions and responsibilities of commune health centers (CHCs) have been adjusted. The study aimed to identify barriers and facilitators to implementation of government policies about cardiovascular diseases (CVDs) preventions and control in primary health care(PHC) in Vietnam.Methodology: Ten CHCs in Chi Linh, Hai Duong province were selected. Data were collected through 26 in-depth interviews with heads and specified staffs at CHCs, policymakers at national, regional and local level, about strategy and implementation of the program. A thematic analysis (structural, organizational, professional, social context and attitudinal barriers and facilitators) was used.Results: The most frequently reported and important barriers were lack of practical guideline and skills on risk factors screening; conflict in referral guideline among PHC facilities; non-financial mechanism to counseling services. The facilitators identified were support from authorities and community. Assistance from Village Health Workers in CVDs preventions and control at PHC was a main finding of this study.Conclusion: Assessment barriers and facilitators is important to gain a better understanding of health care providers and organizational perspective when enforcement CVD healthcare policies in PHC settings.