Solutions for building a grassroots healthcare system are constantly evolving.
On the morning of February 26th, at the Presidential Palace, President Luong Cuong met with a delegation of outstanding medical professionals and awarded the title of "People's Physician" for 2024. During the meeting, People's Physician Duong Dinh Chinh – Secretary of the Nghi Loc District Party Committee (Nghe An province) – had the honor of being the only one among the 46 People's Physicians to present a paper on the development of the grassroots healthcare system. Nghe An Newspaper has excerpted and published this paper.
Laying the foundation for the national healthcare system.
MedicalHealthcare facilities are the foundation of the national healthcare system, the closest to the people, and directly perform primary healthcare tasks.
Prior to the issuance of Directive No. 25CT/TW dated October 25, 2023, by the Party Central Committee on continuing to consolidate, improve, and enhance the quality of grassroots healthcare in the new situation, the grassroots healthcare system had gone through a period of considerable difficulties. Throughout its development, grassroots healthcare, while always playing a key role and receiving attention from the Party and the State, has not yet met the requirements and expectations of the people.
These challenges became more apparent during the COVID-19 pandemic. While the primary healthcare system made a significant contribution to disease prevention, it also revealed many limitations: inadequate facilities; uneven quality and quantity of human resources; and insufficient incentive policies to retain healthcare workers. Many commune health stations operated only minimally, lacking the capacity to provide comprehensive healthcare services to the population. In the context of the increasing prevalence of non-communicable diseases and the changing patterns of disease, these issues became even more urgent.
In developed countries, primary healthcare systems are always given special attention because they are the foundation for ensuring public health, helping to reduce the burden on higher-level healthcare facilities and improving the effectiveness of primary healthcare.
Governments in countries like Japan, South Korea, and European nations have strong investment strategies in primary healthcare, not only in infrastructure but also in policies to incentivize human resources and apply modern technology.
Universal healthcare programs, electronic health records, and family doctor systems are examples of these countries' success in developing primary healthcare. These are valuable experiences that we can learn from and adapt to the specific situation in Vietnam.
Recognizing these shortcomings, the Party Central Committee issued Directive No. 25, demonstrating the highest political determination to consolidate, improve, and enhance the quality of grassroots healthcare. This is a groundbreaking policy, not only aimed at addressing long-standing problems but also at building a modern grassroots healthcare system capable of meeting the challenges of the new situation.
Immediately after the Directive was issued, the Ministry of Health took the lead in concretizing the Party's guidelines. The Ministry developed and issued many important documents, such as the plan for implementing the Directive, detailed guidelines on improving the quality of medical examination and treatment at commune health stations, developing the family doctor model, and applying digital transformation in health management.
Furthermore, the Ministry of Health has closely coordinated with relevant ministries, sectors, and local authorities to mobilize all resources, from the state budget to social contributions, to improve infrastructure, strengthen human resource training, and enhance management capacity at the grassroots level. These efforts have yielded positive initial results.
Nationwide, the grassroots healthcare system has undergone significant changes. The percentage of communes with health stations meeting national standards is increasingly widespread. Chronic disease management programs such as those for hypertension and diabetes have been implemented in many health stations, enabling people to access healthcare services right in their communities, instead of having to go to higher-level facilities. The electronic health record system is gradually being perfected, creating a foundation for effective and scientific management of public health.
Nghe AnPositive steps have also been taken to implement Directive 25. The province has prioritized investment in building and upgrading health stations, especially in remote areas and border districts. Many health stations have been equipped with basic diagnostic equipment such as ultrasound machines and blood glucose testing machines, thereby improving primary healthcare capabilities. Training and professional development programs for commune-level health workers have also been implemented synchronously, helping the grassroots health workforce to better meet the demands of their duties.
More mechanisms and policies are needed to promote the development of primary healthcare.
However, looking back at the implementation process, primary healthcare is facing numerous challenges. The biggest challenge is the issue of human resources. Many skilled healthcare workers are not enthusiastic about working at commune health stations because the remuneration is not commensurate, and especially the limited working conditions will affect their future professional and technical development. This leads to an imbalance between regions, especially in remote and rural areas.
In addition, objective factors such as changing disease patterns due to population aging, climate change, urbanization, industrialization, globalization, unhealthy lifestyles, and the increasing and diverse healthcare needs of the population also pose challenges that the healthcare sector, especially primary healthcare, must address.
Furthermore, while financial resources for primary healthcare have improved, they still do not fully meet the needs. Many localities still face difficulties in allocating budgets, especially for health stations in disadvantaged areas, which require significant investment but have low capacity to mobilize social resources.
To address these difficulties and challenges, the Party, the State, and the National Assembly need to consider continuing to issue separate resolutions on the development of grassroots healthcare, with specific mechanisms regarding finance, human resources, and incentive policies; they need to increase the proportion of the budget allocated to grassroots healthcare in the total healthcare budget expenditure, while encouraging localities to mobilize social resources to invest in the development of this sector.
From the perspective of the Ministry of Health, it is necessary to focus on reforming the organizational structure, operational mechanisms, and financial mechanisms; and to continue promoting training programs to improve the capacity of grassroots healthcare workers. At the same time, flexible policies are needed to attract doctors to work at commune health stations, especially in remote and disadvantaged areas.
Expanding targeted training programs and ensuring that doctors have stable, long-term employment in their localities after training is a necessary solution. Implementing a comprehensive information technology system in primary healthcare, promoting digital transformation, and strengthening the connection between primary and higher-level healthcare are also crucial.
For local areas, more attention should be paid to building infrastructure, ensuring that commune health stations have adequate working conditions. At the same time, communication efforts should be strengthened to raise public awareness of the role of primary healthcare, encouraging people to utilize healthcare services at the commune level instead of unnecessarily seeking services at higher-level facilities.
Directive 25 of the Party Central Committee has opened a new, promising phase for the stronger development of the grassroots healthcare system. To successfully implement this directive, it requires the consensus and strong determination of the entire political system, the tireless efforts of the healthcare sector, and the active participation of the whole society.
We are confident that, with the wise leadership of the Party, the decisive direction of the State, and the unity of the people, grassroots healthcare will become a solid foundation for the sustainable development of the national healthcare system, better meeting the expectations of the people in the new situation.
