Suchergebnisse

AbstractClinical breast examination (CBE) screening for breast cancer in Vietnam was proved to be cost‐effective and acceptable to women. However, the outcomes of the implementation of such proposed programme are unknown. To inform the design and implementation planning of the proposed screening programme, this study investigated and analysed the contextual factors of implementing a CBE programme as part of primary care in Vietnam. Regarding methods, the Breast Health Global Initiative Framework and its seven contextual domains for breast cancer health care (including i. epidemiological, ii. policy/legal, iii. geographical/environmental, iv. service and organisational, v. financial, vi. social and economic, vii. cultural and psychosocial) guided the programme implementation analysis. Literature review, documentary analysis of polices, and key informant interviews (with representatives of health authorities at all four levels of Vietnam health system) were used to gather data for each domain. The results show that Vietnam's policy context pointed to the focus on cancer early detection through screening. According to key informants, district level was the most appropriate level for organising and delivering a CBE programme, and only doctors should perform a CBE. Knowledge about breast cancer and perceived susceptibility to receiving a breast cancer diagnosis was positively associated with CBE uptake. In conclusions, the current policy framework supports the implementation of a CBE screening programme in Vietnam. CBE should be performed by doctors, at the district level, and alongside health promotion.

Background: Over the recent decades, Vietnam has attained remarkable achievements in all areas of health care. However, shortcomings including health disparities persist particularly with a rapidly aging population. This has resulted in a shift in the disease burden from communicable to noncommunicable diseases such as dementia, cancer, and diabetes. These medical conditions require long-term care, which causes an accelerating crisis for the health sector and society. The current health care system in Vietnam is unlikely to cope with these challenges. Objective: The aim of this paper was to explore the opportunities, challenges, and necessary conditions for Vietnam in transforming toward a patient-centered care model to produce better health for people and reduce health care costs. Methods: We examine the applicability of a personalized and integrated Bespoke Health Care System (BHS) for Vietnam using a strength, weakness, opportunity, and threat analysis and examining the successes or failures of digital health care innovations in Vietnam. We then make suggestions for successful adoption of the BHS model in Vietnam. Results: The BHS model of patient-centered care empowers patients to become active participants in their own health care. Vietnam's current policy, social, technological, and economic environment favors the transition of its health care system toward the BHS model. Nevertheless, the country is in an early stage of health care digitalization. The legal and regulatory system to protect patient privacy and information security is still lacking. The readiness to implement electronic medical records, a core element of the BHS, varies across health providers and clinical practices. The scarcity of empirical evidence and evaluation regarding the effectiveness and sustainability of digital health initiatives is an obstacle to the Vietnamese government in policymaking, development, and implementation of health care digitalization. Conclusions: Implementing a personalized and integrated health care system may help Vietnam to address health care needs, reduce pressure on the health care system and society, improve health care delivery, and promote health equity. However, in order to adopt the patient-centered care system and digitalized health care, a whole-system approach in transformation and operation with a co-design in the whole span of a digital health initiative developing process are necessary

INTRODUCTION: The objectives of this study are to estimate the prevalence of multimorbidity (MM) among adults in the Central Highland Region (a poor region) of Vietnam in 2017 and to identify the sociodemographic correlates of these conditions. METHODS: We used data from a cross-sectional study conducted in 2018 on health status among people in four provinces in the Central Highlands Region (Tay Nguyen) of Vietnam. A sample of 1680 adults (aged 15 years and older) were randomly selected for this study. Respondents were asked whether they had been told by a health worker that they had cancer, heart and circulatory conditions, chronic joint problems, chronic pulmonary diseases, chronic kidney problems, chronic digestive problems, psychological illness, diabetes, and/or other chronic conditions. RESULTS: The prevalence of MM among the study participants was 16.4% (95% confidence interval (CI): 14.6%–18.2%). By looking at the 95% CIs, the differences in MM prevalence between the groups classified by gender, age, education, and occupation were not statistically significant. Only the difference in MM prevalence between farmers and government staff was statistically significant. Multivariate logistic analyses show education and occupations were shown to be significant correlates of MM. CONCLUSION: MMs were quite common among the adult populations in the study area, especially among people with lower socioeconomic status. Given the evidence, actions to reduce levels of MM in the setting are clearly urgent. The interventions should address all people in society, with focus on disadvantaged groups, like those with lower education and farmers.