Health system strengthening

As of December 2016, IFFIm has disbursed US$ 277 million for Gavi's health system strengthening (HSS) support. In this example, HSS is helping the Vietnamese health service train health workers in the remote northern provinces

HSS Vietnam Dan Thomas

Vietnam's far northern province of Ha Giang is home to more than 20 ethnic minorities, each with their own traditions and language.  In this remote mountainous region, the first contact with health care often comes on foot, from village health workers like Nguyen Thi Xuan. 

This 45-year-old grandmother is one of hundreds of volunteers who go from door to door in their communities to offer basic medical treatment and information.

Life and death

For 10 years, Xuan has been conducting check-ups and providing down-to-earth advice on all kinds of health matters.  In her village, her intervention, at an early stage, can mean the difference between life and death.

Xuan spends about a quarter of her time performing health work and attends a monthly meeting at the commune clinic. She is responsible for 266 people in 55 households at her village Na Pong, about 5 km from the commune health clinic.

"Before, there was no health worker in our village. I was interested in volunteering to be a village heath worker so I could care for my community's health as well as the health of my own family," she explains.

Upgrade skills

Xuan and dozens of other village health workers have been selected to take part in a residential training course specially designed to upgrade their skills and give them a broader understanding of the services on offer in the province's commune clinics and hospitals. Her previous training in 1999 lasted only a month.

Dr Dang Van Huynh, Deputy Director of Health in Ha Giang Province, said the training programme started in 1995. In 2008, Ha Giang Province received US$ 1.6 million in funding for health system strengthening (HSS) to help pay for 14 activities over three years. The support from IFFIm through Gavi has enabled his department to extend the training from two months to nine months.

"Thanks to this support we can now focus on the quality of training," he said.

HSS activities

Thanks to this support, we can focus on the quality of training.

Dr Dang Van Huynh, Deputy Director of Health

Ha Giang's Health Department aims to strengthen and extend its health system to serve every community. The Gavi-supported HSS activities include training courses for village health workers, special bags for health workers containing basic health equipment, and computers to help gather data and information. More than 240 people were trained in 2009 and more than 2,000 bags have been distributed.

The basic training course for village health workers lasts for 36 weeks, including 21 weeks at a residential training school (food and accommodation is provided), 13 weeks of on-the-job training at the district level and two weeks at a district hospital.

With 22 different minority languages spoken in this province, it is vital to train people from each community. The trainees need to have at least a primary education and to speak Vietnamese. One or two are selected from each village and they have to commit to go back to their communities after the training.

Preventive health

When it comes to preventive health, Vietnam's immunisation programme is a good example of what can be achieved. The country eradicated polio in 2000 and eliminated neonatal tetanus in 2005.

With support from Gavi and other development partners, Vietnam started using the hepatitis B vaccine in 2002 and plans to introduce the Hib vaccine against Haemophilus influenzae type b in 2010 as part of its pentavalent introduction.

Locally-produced autodisable syringes are widely used and funding for health system strengthening will help increase management capacity and monitoring at all levels.

In communities across Vietnam, volunteers like Nguyen Thi Xuan are ensuring that mothers and children receive care in even the remotest of places.

"Before taking this course I was a birth attendant and I helped deliver dozens of babies. Having done the course, I now know more about diseases. Now people come to me with many questions about diseases and I am able to help them," Xuan says with a proud smile.

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