Primary health care: The basis for a healthy country

On 17 December, the Health Partnership Group Meeting, Quarter IV 2018 with the theme on "Strengthening Primary Health Care (PHC) towards Universal health coverage (UHC) and health related Sustainable Development Goals (SDGs)" was held in Ha Noi. The meeting was chaired by Assoc. Prof. Dr. Nguyen Truong Son, Vice Minister of Health and co-chaired by Dr. Kidong Park, WHO Representative to Viet Nam.

The meeting discussed the main contents of the Global Conference on Primary Health Care in Astana, Kazakhstan in October 2018 and implications for Viet Nam. Update the progress of PHC reform in Viet Nam and discuss the priorities and specific actions to strengthen PHC towards UHC and health reltaed SDGs, as well as discuss future support from development partners for PHC reform in Viet Nam.

Primary Health Care: the basis for people health

IIn his opening remarks, Deputy Minister of Health Nguyen Truong Son said the WHO has set a strategic priority in 2019-2023, an additional billion people to benefit from universal health coverage, an additional billion people are better protected from emergency medical situations, an additional billion people have better physical and mental health. To accomplish these goals, PHC plays a core and fundamental role. The human-oriented and population-based health care system will support maternal and child health care, preventive care, provide vaccines, respond to emergencies and implement Universal health coverage in a manner which ensures fairness and efficiency. PHC in the health system will contribute to the implementation of 16 other Sustainable Development Goals such as eliminating poverty, improving nutrition, health education, lifelong learning, reducing inequality, and further access to clean water and sanitation, building a healthy and sustainable living environment...

Dr. Kidong Park, WHO Representative, said the overarching theme of HPG this year is universal health coverage (UHC). This is also the prominent theme of global health in 2018. This year's World Health Day theme is also covering the health of the entire population. On December 12, the world celebrated the first ever people's health day. The World Health Assembly approved the WHO program within the next 5 years to move towards universal health coverage. Also in October this year, celebrating 40 years of Alma Ata Declaration on PHC and affirming the commitment to PHC and UHC.

Last October, health leaders from 149 countries including Vietnam at the PHC Global Conference in Astana, Kazakhstan pledged to declare the PHC and basic rights of people to achieve high standards of health.

Developing the solid base for "Primary Healthcare" 

Deputy Minister Nguyen Truong Son said: in Vietnam, the role of PHC has been affirmed and received guidance on strategy and political commitment. PHC can be considered as an essential and urgent task of the health sector. Resolution 20-NQ / TW has set out the goal of implementing universal health care and health insurance coverage; all people are managed and taken care of; be assured of equal rights and obligations in participating in health insurance and benefiting from health services. Project 2384 on the construction and development of the grassroots health network, and the pilot project to build 26 commune health stations in 8 cities and provinces has yielded some results, but the challenge is still remained.

During the past year, the HPG forum in Vietnam has discussed the financial mechanism for PHC to reach universal health coverage in May, draft law on alcohol harm prevention in July, and management and control of non-communicable diseases through health reform in October.

According to Dr. Kidong Park, Vietnam is on the right track in the process of covering the entire population. However, we cannot do this without a solid PHC foundation. In the coming time, we need to cover health insurance for the middle class, including near-poor and immigrants, improve the health service system in line with the changing needs of the people. Guiding people and communities how to control health and use drugs and appropriate technology. Establish a sustainable financial mechanism to support PHC. Building trust in district and commune health systems, ensuring quality and health services for all people.

According to Assoc. Phan Le Thu Hang, Deputy Director of the Department of Planning and Finance, Ministry of Health, grassroots health has achieved some remarkable achievements such as achieving the millennium goals, controlling malaria, tuberculosis, and payment of polio, elimination of neonatal tetanus, maintaining full immunization for children under 1 year of age 95%, and producing most vaccines in the EPI program. In the coming time, the goal is to reduce the incidence of hepatitis b in children under 5 years old to 1% and eliminate measles in 2020, .... Life expectancy also increased significantly. However, the proportion of out-of-pocket spending is still high at 41%. According to WHO recommendations, this rate should be below 30%.

Development partners commit to support Viet Nam Health sectoc to achieve a better primary healthcare system

At the meeting, WHO and development partners (EU, World Bank, Wallonie Bruxelles, Denmark, JICA, NGOs, etc.) are committed to accompany the Ministry of Health of Vietnam. In implementing Resolution 20 and Scheme 2348, there are many donors for primary care and basic public health functions. Activities related to non-communicable diseases, education and training projects for health workers, quality of drugs and health care, vaccines, civil status registration, payment methods for medical service providers  ... There are more than 100 projects and more than 100 partners join

The European Union (EU), World Bank and WHO are committed to support the Ministry of Health in the field of health insurance and strengthen grassroots health care and human resource training. Health insurance has achieved a breakthrough: compulsory insurance and household insurance. The 2nd Generation Health Insurance Law will continue to receive technical support from the international community. Orientation to revise health insurance law is effective to concretize PHC, effective management, payment methods based on practical capacity of health care. Access to health services is more reasonable, there is a reasonable shift and use of resources, especially at the grassroots level.

Development partners, including JICA, will also focus on supporting Vietnam's health sector in health financing, health insurance, strengthening the health sector, promoting capacity building in provinces, intensive training and clinical training, non-communicable diseases as well as global networks, dealing with population aging, improving the quality of the health system, ...