Engaging village health workers in non-communicable disease (NCD) prevention and control in Vietnam: A qualitative study

ABSTRACT

The burden of non-communicable diseases (NCDs) continues to grow in Vietnam, and reducing the burden of NCDs is a national priority. This study explored perspective of community health workers (CHWs), known as Village Health Workers (VHWs) in Vietnam, and public health leaders towards potential of expanding VHWs’ role to deliver NCDs prevention and control services, and determined barriers and facilitators. We conducted focus group discussions (FGDs) with VHWs (n = 24) and in-depth interviews (IDIs) with public health administrators (n = 13). The findings show that VHWs in Vietnam deliver multiple public health services, including several NCDs related services. Perceived barriers include lack of policy support, shortages of trained health personnel, lack of training, imbalanced workload and inadequate remuneration. Perceived barriers include lack of policy support, shortages of trained health personnel, lack of training, imbalanced workload and inadequate remuneration. Facilitators include government commitment to NCDs prevention and control, priority on capacity building, professional recognition and provision of incentives with availability of appropriate resources. While additional quantitative studies are needed to supplement the current qualitative findings, the current results inform the policy and intervention development in engaging VHWs in the delivery of community-based NCDs prevention and control initiatives in Vietnam.

KEYWORDS:

• Village health workers (VHWs)
• community health workers (CHWs)
• non-communicable diseases (NCDs)
• Vietnam

Acknowledgements

This paper, as part of the outputs emanating from the Research Hub of Asia Pacific Observatory on Health Systems and Policies (APO) hosted by the Global Health Research Center of Duke Kunshan University. The Research Hub consists of several universities in Asia-Pacific countries. The authors of the paper appreciate technical and financial supports from the Research Hub and the secretariat of APO in the completion of the project upon which the paper was developed. The funders had no role in the design or conduct of the study; collection, management, analysis and interpretation of the data; or preparation, review, and approval of the manuscript. ASA and HL planned the study and oversaw the overall implementation of the study. HL and TTDH supervised the field work in Vietnam. HL led the data analyses with supports from ASA and TTDH. HL and ZM prepared the first draft of the manuscript, which was then distributed to all the co-authors for comments. DSM helped in the analyses and manuscript preparation. HVH, ST, TZ and LBR critically reviewed the first draft of the manuscript and provided useful insights. All authors approved the final draft of the paper.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

All relevant data are within the paper. Additional data could be available upon request to the corresponding author.

Additional information

Funding

This work was supported by World Health Organization [Purchase Order 201710952].