Ngo Anh D, Hill Peter S
Viet Nam Evidence for Health Policy Project, School of Population Health, University of Queensland, Health Strategy and Policy Institute, Hanoi, Viet Nam.
Reprod Health Matters. 2011 May;19(37):52-61. doi: 10.1016/S0968-8080(11)37555-6.
This paper presents a qualitative study conducted in 2009 of provider and patient perceptions of primary level reproductive health services provided by commune health stations (CHSs), and the implications for Viet Nam's 2011-2020 National Strategy for Reproductive Health Care. In the three provinces of Thai Nguyen, Thua Thien Hue, and Vinh Long, we interviewed the heads of CHSs, held focus group discussions with midwives and women patients, and observed facilities. Half the 30 CHSs visited were in poor physical condition; the rest were newly renovated. However, the model of service delivery was largely unchanged from ten years before. Many appeared to fall short in meeting patient expectations in terms of modern medical equipment and technology, range of drug supplies, and levels of staff expertise. As a result, many women were turning to private doctors and public hospitals, at least in urban areas, or seeking medication from pharmacies. To make CHS clinics sustainable, promotion of access to reproductive health services should be undertaken concurrently with quality improvement. A responsive payment scheme must also be developed to generate revenues. Efforts should be made to reduce the unnecessary use of more costly services from private clinics and higher level public facilities.
本文介绍了2009年开展的一项定性研究，该研究涉及服务提供者和患者对公社卫生站（CHS）提供的初级生殖健康服务的看法，以及对越南《2011 - 2020年国家生殖健康保健战略》的影响。在北江、承天顺化和槟椥三省，我们采访了公社卫生站站长，与助产士和女性患者进行了焦点小组讨论，并对相关设施进行了观察。所走访的30个公社卫生站中有一半的硬件条件较差；其余的是新装修的。然而，服务提供模式与十年前相比基本没有变化。在现代医疗设备和技术、药品供应种类以及工作人员专业水平方面，许多公社卫生站似乎未能达到患者的期望。因此，许多女性转而求助于私人医生和公立医院，至少在城市地区是这样，或者从药店购药。为了使公社卫生站诊所能够持续运营，在提高服务质量的同时，应促进生殖健康服务的可及性。还必须制定一个灵活的付费方案以增加收入。应努力减少对私人诊所和更高级别公共设施中成本更高的服务的不必要使用。
