Upload
annabelle-bridges
View
215
Download
0
Tags:
Embed Size (px)
Citation preview
PEDIATRIC HEALTH CARE SYSTEM PEDIATRIC HEALTH CARE SYSTEM
IN VIETNAM:IN VIETNAM:
REALITY AND CHALLENGES REALITY AND CHALLENGES
TABLE OF CONTENTSTABLE OF CONTENTS
Pediatric heath care system in Vietnam
Developmental orientation
Proposals
Vietnamese health care system in general and
Vietnamese pediatric care system in particular are in
the process of reforming and developing. It focuses
on:
Effectiveness
Equity
Quality
INTRODUCTIONINTRODUCTION
VIETNAM’S HEALTH CARE VIETNAM’S HEALTH CARE SYSTEMSYSTEM
CURRENT RESOURCES IN THE CURRENT RESOURCES IN THE MEDICAL FIELDMEDICAL FIELD
Medical care providers per 10,000 citizens
Number of hospital/clinic beds
Physicians Nurses and Midwives
PEDIATRIC HOSPITAL PEDIATRIC HOSPITAL NETWORKNETWORK
PUBLIC National level
Provincial, District,Township & CountyLevels
Town & Commune level
PRIVATE
Pediatric department in
private hospitals
Private clinics
3Nationa
l hospit
als
12 pediatric hospitals11 obstetric and pediatric
hospital 84,2% general hospitals at
provincial level offer pediatric care
General doctors provides pediatric care.645 county hospitals
and 48 general hospitals
No pediatricians10,748 local health centers.
TRENDS OF POPULATION PROPORTIONTRENDS OF POPULATION PROPORTION(1989-2050)(1989-2050)
Red line: Proportion of children under the age of 15 Blue line: Proportion of adults over the age of 65 Nguồn: Tổng cục thống kê (GSO), UN
CONNECTION BETWEEN CONNECTION BETWEEN POPULATION AND PEDIATRIC POPULATION AND PEDIATRIC
CARE CARE
(Nguồn: Dân số và cơ cấu dân số Việt Nam vào năm 2014 - 2019, Tổng cục dân số và kế hoạch hóa gia đình VÀ Báo cáo tổng quan ngành Y tế năm 2013, Bộ Y tế)
HUMAN RESOURCES IN HUMAN RESOURCES IN PEDIATRIC BRANCHPEDIATRIC BRANCH
Huge shortage of medical staff
- 0.6 pediatrician/10,000 children under the age of 16( ≈ 1.800 peditricians)
- Pediatrician/Medical doctors: 3% Doctors/Patient beds: 0,2%
- Discontinuation of pediatric training since 1998
Uneven distribution of human resources
Quality of training program
CURRENT PEDIATRIC SYSTEM CURRENT PEDIATRIC SYSTEM MODELMODEL
DISEASE TRENDSDISEASE TRENDS
Source: WHO 2010
Communicable diseases
Non-Communicable diseases
Accident, poisoning & other injuries
• Possibility of
disease outbreak
during the process
of differential
diagnosis or
treatment: measles
• Possibility of
new disease
outbreak: MERS
CoV
DISEASE TRENDS DISEASE TRENDS (CONT.)(CONT.)
ENVIRONMENTAL EFFECTS ON ENVIRONMENTAL EFFECTS ON CHILDREN’S HEALTHCHILDREN’S HEALTH
Air pollutionWater pollutionFood safetySmoke Unknown factors Other factors Industrial pollutionWeather and climateWaste managementArthritis and respiratory diseases Environment safetySchool
INFLUENCING FACTORS TO INFLUENCING FACTORS TO THE THE PEDIATRICPEDIATRIC CARE SYSTEM CARE SYSTEM
Administration from Vietnamese government
and the Ministry of Health
Administration from Vietnamese government
and the Ministry of Health
PEDIATRIC FIELD PEDIATRIC FIELD PEDIATRIC FIELD PEDIATRIC FIELD
Human resources: - Doctors - Nurses…
Human resources: - Doctors - Nurses…
-Available training program for staff-- Research
-Available training program for staff-- Research
- Social insurance-Medical budget allotted from the government
- Social insurance-Medical budget allotted from the government
People’s knowledge and awareness of medical
prevention and treatment for children
People’s knowledge and awareness of medical
prevention and treatment for children
- Medical equipments- Medications and other pharmacological products
- Medical equipments- Medications and other pharmacological products
Support from charity and humanity organizations. Support from charity and humanity organizations.
Hospital’s infrastructureHospital’s infrastructure
HOSPITALS WITH EXCEEDING HOSPITALS WITH EXCEEDING CAPACITYCAPACITY
A congested pediatric systemA congested pediatric system
National level:
-Filled to capacity, not enough staff
-Shortage of hospital beds (requires 110-130%)
-Great pressure on physicians, nurses and other staff
-Challenge in staff management and overall operation
National level:
-Filled to capacity, not enough staff
-Shortage of hospital beds (requires 110-130%)
-Great pressure on physicians, nurses and other staff
-Challenge in staff management and overall operation
Local level :
-Preference in transferring complicated cases to national levels
-Limitation in specialty training results in distrust and noncompliance in care
-Outdated infrastructure and medical supplies
-Abandonment of advanced medical equipments
-Low wage fails to motivate medical staffs at work
Local level :
-Preference in transferring complicated cases to national levels
-Limitation in specialty training results in distrust and noncompliance in care
-Outdated infrastructure and medical supplies
-Abandonment of advanced medical equipments
-Low wage fails to motivate medical staffs at work
Private care:
-Private hospitals: target people with higher income
-Private clinics: quality of care and patient safety are not yet regulated by any authority
Private care:
-Private hospitals: target people with higher income
-Private clinics: quality of care and patient safety are not yet regulated by any authority
SUMMARY OF THE CURRENT SUMMARY OF THE CURRENT STATE OF VIETNAMESE HEALTH STATE OF VIETNAMESE HEALTH
CARE SYSTEM CARE SYSTEM
Sparse network of pediatric care is unable to fully support local health providers or provide
adequate care for children nationwide
Overloading and Uneven distribution of resources between lower levels and regions
(geographic and/or socio-economic)
Infrastructure update fails to match up with the socio-economic development
Missing latest evaluation and statistics on child health’s need
Healthcare policies, systematical management, and investment still face many challenges
Ineffective campaign for communication and public health.
Modest wage and employment benefit package for workers in public hospitals
Lack of strategies and policies to retain highly skilled employees
Under pressure from the community because of many limitations in the field
DEVELOPMENTAL ORIENTATION
Effectiveness
Equity
Quality
Community oriented
Development
DIAGRAM FOR QUALITY IMPROVEMENT
Improvement scale for Vietnamese hospital quality
Long-termed goals
AcceptableStandard
Warning!Need to concentrate resources to improve
hospital quality(Prioritization)
Level 1: -No attempt to improve quality-Regulation violation
Level 2: -Follow quality assurance guideline-Implement some activities to improve quality-Deliver some input factors
Level 3: -Sufficient performing regulations-Establish and complete structure organization-Activities deployment
Level 4: -Strictly abide to rules and regulations-Output assessment- Achieve some positive results
Level 5: -Excellent outcome-“Gold en” quality -Reach international standard
SOLUTIONS???SOLUTIONS???
SUGGESTED FRAMEWORK SUGGESTED FRAMEWORK BY WHOBY WHO
PEDIATRIC STAFF TRAININGPEDIATRIC STAFF TRAINING
Pediatric Branch provide training for pediatric system
Providing adequate pediatric health workers supply for pediatric hospitals
according to population size, geographical and economic features
(pediatrician/doctor: 30%, nurse/doctor: 2)
Training programs:
– Formal training programs: First-degree and second-degree specialist program, resident doctors training, and post-graduates training program.
– Continuous training: specialty training program, module training session, and technology transfer training program,
– Training program via workshop, seminar, conference
– Cooperative training programs with other medical centers and universities national and international
EXPANDING PEDIATRIC CARE NET WORK
Narrowing the disparity in health among regions
Broadening pediatric health network in remote areas and for minority groups....
Appointing doctors to work in underserved areas
Targeted ratio of 1 doctor per 1000 children for primary care
Reducing mortality rate in children under 5 years old
Reproductive care program and obstetric hospitals
Pediatric emergency, safety in patient transferring
Enhancing and improving neonatal and pediatric departments at provincial and district levels
Redeveloping/accelerating the development of community pediatric program
IMCI, GOBIFFF, APLS, Newborn care, nutrion...
TECHNOLOGICAL TECHNOLOGICAL APPLICATION TO PEDIATRIC APPLICATION TO PEDIATRIC
CARECARE
Efficient medical practice
Effective hospital management
Enhancing professional knowledge
High-tech diagnostic and treatment equipments
M-Health, telemedicine
CONCLUSIONCONCLUSION
Current state: DIFFICULT
Challenges: IMMENSE
Demand: numerous, high, expandable, affordable
SUGGESTIONS FOR URGENT ACTION SUGGESTIONS FOR URGENT ACTION
Reopening pediatric specialist training program, opening pediatric nursing program: Pediatric Association, universities/colleges…
Ensuring consistency for all training programs (CME) within different organizations, national hospitals as well as medical school
Bring back pediatric care programs for the communities with the collaboration from all hospitals
Formalize all clinical guidelines and other medical training materials for all organizations, hospitals (including private entities), schools, etc.
An excellent system requires: connection, two-way communication
Private Health
care
Public Health
careNational security