WHO's Service Availability and Readiness Assessment of primary health care services of commune health centers in a rural district of Northern Vietnam.

The objective of this study was to assess the availability and readiness of the primary health care (PHC) services of commune health centers (CHCs) in Quoc Oai, a rural district of Northern Vietnam based on the World Health Organization's Service Availability and Readiness Assessment (SARA) tool. The study was done in 2 steps. First, the heads of the 21 CHCs of Quoc Oai district were interviewed using SARA, a quantitative survey, and the responses were then validated by direct observations of each facility. The results showed that although the average number of health staffs in each CHC met the national standards (at least 5 staffs per CHC), its allocation within each CHC was not properly met because some CHCs had only 2 health staffs. Several health equipment and facilities were not fully available in many CHCs, and although the majority of the PHC services were available at the CHCs, their readiness remained limited. Several significant correlates between the availability of health care workers and the availability of the facilities and the PHC services were observed, suggesting that they depend upon and affect one another in the health system. Using the SARA-based inventory, the study helps health managers and policy makers to prioritize efforts and allocate resources more appropriately. To be effective, attention should be given to how to make facilities, services, and human resources for health ready for PHC activities-more investment and support from the system (from higher to lower level) and the government.

Van Huy N ，Nam YS ，Van Thanh N ，Tuan NT ，Ha NTT ，Hoat LN ，Hoang NM ，Hoa DM ... -  《-》

Readiness, Availability and Utilization of Rural Vietnamese Health Facilities for Community Based Primary Care of Non-communicable Diseases: A CrossSectional Survey of 3 Provinces in Northern Vietnam.

Vietnam's network of commune health centers (CHCs) have historically managed acute infectious diseases and implemented national disease-specific vertical programs. Vietnam has undergone an epidemiological transition towards non-communicable diseases (NCDs). Limited data exist on Vietnamese CHC capacity to prevent, diagnose, and treat NCDs. In this paper, we assess NCD service readiness, availability, and utilization at rural CHCs in 3 provinces in northern Vietnam. Between January 2014 and April 2014, we conducted a cross-sectional survey of a representative sample of 89 rural CHCs from 3 provinces. Our study outcomes included service readiness, availability of equipment and medications, and utilization for five NCD conditions: hypertension, diabetes, chronic pulmonary diseases, cancer, and mental illnesses. NCD service availability was limited, except for mental health. Only 25% of CHCs indicated that they conducted activities focused on NCD prevention. Patient utilization of CHCs was approximately 223 visits per month or 8 visits per day. We found a statistically significant difference (P<.05) for NCD service availability, medication availability and CHC utilization among the 3 provinces studied. This is the first multi-site study on NCD service availability in Vietnam and the first study in a mountainous region consisting predominately of ethnic minorities. Despite strong government support for NCD prevention and control, Vietnam's current network of CHCs has limited NCD service capacity.

Duong DB ，Minh HV ，Ngo LH ，Ellner AL ... -  《International Journal of Health Policy and Management》

The effect of a poverty reduction policy and service quality standards on commune-level primary health care utilization in Thai Nguyen Province, Vietnam.

Nguyen P ，Bich Hanh D ，Lavergne MR ，Mai T ，Nguyen Q ，Phillips JF ，Hughes J ，Van Thuc H ... -  《-》

Free and universal access to primary healthcare in Mongolia: the service availability and readiness assessment.

Jigjidsuren A ，Byambaa T ，Altangerel E ，Batbaatar S ，Saw YM ，Kariya T ，Yamamoto E ，Hamajima N ... -  《BMC HEALTH SERVICES RESEARCH》

Preparedness of primary and secondary health facilities in India to address major noncommunicable diseases: results of a National Noncommunicable Disease Monitoring Survey (NNMS).

The monitoring framework for evaluating health system response to noncommunicable diseases (NCDs) include indicators to assess availability of affordable basic technologies and essential medicines to treat them in both public and private primary care facilities. The Government of India launched the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular diseases and Stroke (NPCDCS) in 2010 to strengthen health systems. We assessed availability of trained human resources, essential medicines and technologies for diabetes, cardiovascular and chronic respiratory diseases as one of the components of the National Noncommunicable Disease Monitoring Survey (NNMS - 2017-18). NNMS was a cross-sectional survey. Health facility survey component covered three public [Primary health centre (PHC), Community health centre (CHC) and District hospital (DH)] and one private primary in each of the 600 primary sampling units (PSUs) selected by stratified multistage random sampling to be nationally representative. Survey teams interviewed medical officers, laboratory technicians, and pharmacists using an adapted World Health Organization (WHO) - Service Availability and Readiness Assessment (SARA) tool on handhelds with Open Data Kit (ODK) technology. List of essential medicines and technology was according to WHO - Package of Essential Medicines and Technologies for NCDs (PEN) and NPCDCS guidelines for primary and secondary facilities, respectively. Availability was defined as reported to be generally available within facility premises. Total of 537 public and 512 private primary facilities, 386 CHCs and 334 DHs across India were covered. NPCDCS was being implemented in 72.8% of CHCs and 86.8% of DHs. All essential technologies and medicines available to manage three NCDs in primary care varied between 1.1% (95% CI; 0.3-3.3) in rural public to 9.0% (95% CI; 6.2-13.0) in urban private facilities. In NPCDCS implementing districts, 0.4% of CHCs and 14.5% of the DHs were fully equipped. DHs were well staffed, CHCs had deficits in physiotherapist and specialist positions, whereas PHCs reported shortage of nurse-midwives and health assistants. Training under NPCDCS was uniformly poor across all facilities. Both private and public primary care facilities and public secondary facilities are currently not adequately prepared to comprehensively address the burden of NCDs in India.

Krishnan A ，Mathur P ，Kulothungan V ，Salve HR ，Leburu S ，Amarchand R ，Nongkynrih B ，Chaturvedi HK ，Ganeshkumar P ，K S VU ，Laxmaiah A ，Boruah M ，Kumar S ，Patro BK ，Raghav PR ，Rajkumar P ，Sarma PS ，Sharma R ，Tambe M ，Arlappa N ，Mahanta TG ，Bhuyan PJ ，Joshi RP ，Pakhare AP ，Galhotra A ，Kumar D ，Behera BK ，Topno RK ，Gupta MK ，Rustagi N ，Trivedi AV ，Thankappan KR ，Gupta S ，Garg S ，Shelke SC ，ICMR-NNMS investigator group ，Co-investigators ，Collaborators ... -  《BMC HEALTH SERVICES RESEARCH》