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将非传染性疾病数据付诸实践:社区卫生监测能力调查。

Putting non-communicable disease data to work in Vietnam: an investigation of community health surveillance capacity.

机构信息

FHI 360 Vietnam Office, 17Th Floor, Capital Tower, 109 Tran Hung Dao Street, Hanoi, Vietnam.

Noncommunicable Disease Prevention and Control Department, National Institute of Hygiene and Epidemiology, 1 Yec Xanh Street, Hanoi, Vietnam.

出版信息

BMC Public Health. 2023 Feb 14;23(1):321. doi: 10.1186/s12889-023-14986-4.

Abstract

INTRODUCTION

Despite the public health system's critical role in non-communicable disease (NCD) surveillance in Vietnam, limited evidence exists on the implementation of NCD surveillance activities within these systems and the need for capacity building across different system levels to meet expected NCD surveillance goals. This study aimed to evaluate the status of and describe factors affecting the implementation of NCD surveillance activities and to identify the NCD surveillance capacity building needs of the public health system in Vietnam.

METHODS

We used a mixed-methods approach in four provinces, conducting self-completed surveys of staff from six Preventive Medicine Institutes (PHI), 53 Centres for Disease Control (CDC) and 148 commune health stations (CHS), as well as 14 in-depth interviews and 22 focus group discussions at four PHI, four CDC, and eight district health centres and CHS.

RESULTS

Study findings highlighted that although Vietnam has a well-functioning NCD surveillance system, a number of quality issues related to NCD surveillance data were salient. Multifactorial reasons were identified for incomplete, unconfirmed, and inaccurate mortality data and current disease surveillance data. Data on NCD management and treatment were reported to be of better quality than data for screening, targeted treatment, and counselling communication. Main factors affected the effective implementation of NCD surveillance, namely lack of complete and specific guidelines for NCD surveillance, limitations in human resource capacity within NCD departments, and shortage of funding for NCD surveillance activities.

CONCLUSION

Study findings provide practical strategies for strengthening health system capacity for NCD surveillance through developing policies, guidelines, and standardised tools to guide NCD surveillance and a road map for integrated NCD surveillance, developing training packages and manuals for all levels of the health system, and conducting utilisation-focused surveillance training programs.

摘要

简介

尽管越南公共卫生系统在非传染性疾病(NCD)监测方面发挥着至关重要的作用,但关于这些系统内 NCD 监测活动的实施情况以及为满足预期 NCD 监测目标而在不同系统层面进行能力建设的证据有限。本研究旨在评估 NCD 监测活动的实施现状并描述影响因素,并确定越南公共卫生系统的 NCD 监测能力建设需求。

方法

我们在四个省份采用混合方法,对来自六个预防医学研究所(PHI)、53 个疾病控制中心(CDC)和 148 个社区卫生站(CHS)的工作人员进行了自我完成的调查,以及在四个 PHI、四个 CDC 和八个地区卫生中心和 CHS 进行了 14 次深入访谈和 22 次焦点小组讨论。

结果

研究结果突出表明,尽管越南拥有运作良好的 NCD 监测系统,但与 NCD 监测数据相关的一些质量问题仍然存在。确定了与不完整、未经证实和不准确的死亡率数据以及当前疾病监测数据相关的多种因素。与筛查、针对性治疗和咨询沟通数据相比,NCD 管理和治疗数据的质量被报告为更好。影响 NCD 监测有效实施的主要因素包括缺乏针对 NCD 监测的完整和具体指南、NCD 部门人力资源能力的限制以及 NCD 监测活动的资金短缺。

结论

研究结果为通过制定政策、指南和标准化工具来指导 NCD 监测以及制定综合 NCD 监测路线图、为各级卫生系统制定培训包和手册以及开展以利用为重点的监测培训计划,为加强卫生系统 NCD 监测能力提供了切实可行的策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f53/9926709/bbf016593369/12889_2023_14986_Fig1_HTML.jpg

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