Access to hypertension care and services in primary health-care settings in Vietnam: a systematic narrative review of existing literature

ABSTRACT

Background: Health care in Vietnam is challenged by a high burden of hypertension (HTN). Since 2000, several interventions were implemented to manage HTN; it is not clear what is the status of patient access to HTN care.

Objective: This article aims to perform a systematic narrative review of the available evidence on access to HTN care and services in primary health-care settings in Vietnam.

Methods: Search engines were used to identify relevant records of scientific and grey literature. Data from selected articles were analysed using standardised spreadsheets and MaxQDA and following a framework synthesis methodology.

Results: There has been increasing interest in research and policy concerning the burden of HTN in Vietnam, covering many aspects of access to treatment at the primary health-care level. Vietnam’s National HTN Programme is managed as a vertical programme and its services integrated into the network of primary health-care facilities across the public sector in selected provinces. The Programme financed population-wide screening campaigns for the early detection of HTN among people above 40 years of age. There was no information on the acceptability of HTN health services, especially regarding the interaction between patients and health professionals. In general, articles reported good availability of medication, but problems in accessing them included: fragmentation and lack of consistency in prescribing medication between different levels and short timespans for dispensing medication at primary health-care facilities. There was limited information related to the cost and economic impact of HTN treatment. Treatment adherence among hypertensive patients based on four studies did not exceed 70%.

Conclusions: Although the Vietnamese health-care system has taken steps to accommodate some of the needs of HTN patients, it is crucial to scale-up interventions that allow for regular, systematic, and integrated care, especially at the lowest levels of care.

KEYWORDS:

• Delivery of health care
• hypertension
• primary health-care settings
• Vietnam
• access to care

Responsible Editor Peter Byass, Umeå University, Sweden

Responsible Editor Peter Byass, Umeå University, Sweden

Acknowledgments

The authors would like to thank Hans Ket from VrijeUniversiteit Library, for his assistance and guidance in refining the search strategy and modifying it to fit the parameters of the various databases. The authors would also like to thank Onaedo Ilozumba, Esther van Adrichem and Dr Pham Dung for their comments on an earlier version. Deborah Eade provided editing assistance.

Author contributions

LM conceived, designed, undertook the review, and wrote the initial draft. TPLN supported synthesis and interpretation of results, in addition to language translation. All authors contributed to the revisions and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics and consent

Not required.

Paper context

In limited-resources settings, health systems are facing an increased burden of chronic conditions (for example, hypertension in Vietnam). Vietnam is facing a high burden of hypertension. Services to patients are integrated into primary health-care network. Despite progress, challenges arise with the system’s approachability, accommodation, and appropriateness. People need support in perceiving health needs, seeking, reaching and engaging with care. Commune levels need further support to provide regular and systematic care and follow-up to stable patients.

Supplementary Materials

Supplemental data for this article can be accessed here.

Additional information

Funding

The Erasmus Mundus Joint Doctorate Fellowship [Specific Grant Agreement 2014–0681], of which LM is a beneficiary, supported this review. The funding agency had no role in study design, analysis, or preparation of the manuscript.