Improving the Health Care System One Community at a Time

The primary health care system in many Viet Nam provinces began to deteriorate rapidly in the mid-’80s as agricultural co-operatives were dismantled under a new Government policy. This deterioration had a particularly severe impact on commune health centres (CHCs), which serve millions of the country’s disadvantaged and vulnerable people – including rural residents, the poor, women, children, ethnic minorities and people who are physically or mentally disabled.

Attempts to restore and support the CHCs have addressed only isolated problems, and the financial resources the Government has been able to contribute have been important but limited. A more integrated, holistic approach was needed to strengthen the health care system at the rural level and enable the CHCs to meet the health care needs of disadvantaged and vulnerable populations.

Purpose and Impact of the Grant

The Khanh Hoa Provincial Health Department oversees nearly 140 commune health centres (CHCs) in Khanh Hoa province, which has a population of more than 1 million. The vast majority of these facilities are in need of renovation or complete reconstruction.

In 2003, the Department committed itself to transforming Khanh Hoa province into a national model for health care system reform, following the development of a strategic, seven-year master plan. One of the key components of this plan involves the restoration of the capabilities and effectiveness of the CHCs.

In 2004, we made an exploratory grant of $400,000 to enable the Department to begin upgrading some of the CHCs. The Department used these funds effectively to reconstruct and equip seven CHCs – an effort which was nationally recognised and praised by the Ministry of Health. An independent survey by the Population Council, which we commissioned around the same time, confirmed that physically improved health care facilities can have a catalytic effect on the reformation of a region’s health care system.

The Department obtained more than $2 million in funding from Government sources to reconstruct another 24 CHCs and upgrade 38 CHCs. The Government of Viet Nam also committed more than $15 million over a five-year period to help the Department improve the health facility infrastructure at the provincial and district level.

In 2005, we issued a new grant to enable the Department to reconstruct and equip the remaining 62 CHCs and complete the physical transformation of the province’s commune health system, which should be completed by 2009.