Difficulties in building a model of medical stations in Nghe An
(Baonghean) - The project to deploy a pilot model to enhance the capacity of grassroots health care at 6 commune health stations in the province aims to improve the capacity of preventive health care, medical examination and treatment, and people's health management, and then expand it to the whole province. However, the implementation of the project is currently facing many difficulties.
Slow to establish health records...
The project "Implementing a pilot model to strengthen grassroots health capacity at 6 commune health stations in Nam Dan district, period 2018 - 2020" sets the goal that by 2018, staff working at 6 commune health stations will be trained and professionally trained according to the principles of family medicine; 100% of health stations within the scope of the project will deploy health management software, in which 90% of people will have their health records created.
At the same time, by the end of 2019, 6 health stations will be trained to improve their capacity in preventive medicine, population and food safety, and to prevent, manage and treat a number of non-communicable diseases. By 2020, over 90% of people in the above 6 communes will have their health managed and all 6 communes will maintain national health standards.
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| Health Department leaders inspect the progress of building a pilot model at Khanh Son Commune Health Station. Photo: Thanh Chung |
Khanh Son is one of 6 communes of Nam Dan district (along with Kim Lien, Nam Loc, Nam Thai, Van Dien and Nam Cat communes) selected to implement the project according to Decision No. 26/QD-UBND dated June 12, 2018 of Nghe An Provincial People's Committee.
After nearly 1 year of implementation, the commune has done a number of tasks such as: Propagating to people about the family doctor principle and the benefits of implementing the principle; sending health station staff to participate in family doctor training classes, and hamlet health workers to participate in family medicine training; conducting surveys to establish personal health records; surveying non-communicable diseases in the entire population; upgrading and repairing some construction items at the health station, building a green, clean, and beautiful environment...
However, according to Dr. Thao, up to now, like other communes in the project, Khanh Son is currently "stuck" in the content of "creating personal health records". Dr. Thao said: "The Ministry of Health has not yet provided or trained software for people's health management; the district and commune do not have the funds to conduct general health check-ups for 12,560 people in Khanh Son in particular and more than 53,000 people in 6 communes, so the creation of personal health records is still "stuck in place".
With 53,000 people, the estimated cost of testing and imaging is about 200,000 VND/person, while the total cost of implementing the project in Nam Dan is 4.2 billion VND, it is clear that creating records in 6 communes cannot be done like in Dien Van commune (Dien Chau).
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| Entering personal health records at Dien Van commune (Dien Chau). Photo: Thanh Chung. |
Before implementing the project in Nam Dan, Nghe An Health Department had piloted the establishment of personal health records in Dien Van commune (Dien Chau). However, the software that this commune imported was not a national "standard" software and had not been connected to the national electronic health records management system. Currently, the Ministry of Health has not issued "standard" software and has not built a national management system. This means that when there is standard software, all parameters of Dien Van people will have to be re-entered for synchronization.
Nghe An Health Department has directed that the creation of records at the commune level will be carried out in a gradually updated manner based on the results of investigations, declarations of people and the results of medical examination and treatment of people at medical facilities. However, the creation of records in this manner is also stagnant as the Ministry of Health has just deployed the software and the Nghe An Health Department has just deployed the instructions; in addition, the district does not have the budget (according to the project, it is nearly 1.98 billion VND). If this situation continues, the project will certainly be behind schedule.
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| Up to now, Nghe An has conducted 2/16 classes to popularize Electronic Health Records of Nghe An Health sector. Photo: Thanh Chung |
...and the issue of funding and human resources
Ms. Pham Thi Hai - Head of Nam Dan District Health Department said: With the support of the province and the health sector, Nam Dan has made a lot of efforts to implement the project. In the context of not having enough funding for implementation, the district has tried to advance resources to repair equipment, carry out communications; connect with sponsors to receive technology transfer... However, if based on the project's objectives, the district is at risk of being behind schedule due to lack of funding for implementation.
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| Nam Thai Commune Health Station, Nam Dan District receives technology transferred from the Department of Information Technology of the Ministry of Health. Photo: Thanh Chung |
According to Ms. Hai, in addition to the financial issue, the current difficulties affecting the implementation of the project in Nam Dan are also the human resource issue. Specifically, at the three medical stations of Kim Lien, Nam Thai and Nam Loc, although 3 doctors have been trained, they have not been granted a practice certificate (because the training unit did not have a professional code); 8 doctors who have just been trained in the family doctor class are waiting for a certificate and it is not clear whether there is any priority mechanism to be granted a practice certificate early (according to regulations, they must ensure 18 months of practice at a medical examination and treatment facility). Without a certificate, health insurance examination and treatment will not be implemented at the medical station.
Another difficulty in human resources is that from 2016 to now, the commune-level medical staff in Nam Dan has had 15 retirees but has not been allowed to recruit more. In the report of Nam Dan District Medical Center sent to Nghe An Department of Health on April 26, 2019, it requested the Department of Health to supplement human resources for the commune health station, creating favorable conditions for professional activities as approved in the project (6 staff/commune health station); recommended the Provincial People's Committee to allocate funds according to the project implementation roadmap...
Regarding human resources, recently, the Board of Directors of the Department of Health had a meeting to agree on the recruitment policy for Nam Dan district, focusing on recruiting doctors.
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| Examination and treatment for children at Kim Lien Commune Health Station. Photo: Thanh Chung |
Doctor Chinh also affirmed: "The project "Implementing a pilot model to strengthen grassroots health capacity at 6 commune health stations in Nam Dan district, period 2018-2020" is of special importance in the work of protecting and taking care of people's health.
Nam Dan district also needs to expand this project to the entire district on the basis of integrating resources according to Decision No. 17/QD-TTg dated January 4, 2019 of the Prime Minister approving the pilot project "Building Nam Dan district, Nghe An province to become a model new rural district in the direction of cultural development associated with tourism in the period 2018-2025".
