An Innovative Public-Private Mix Model for Improving Tuberculosis Care in Vietnam: How Well are We Doing?

To improve tuberculosis (TB) care among individuals attending a private tertiary care hospital in Vietnam, an innovative private sector engagement model was implemented from June to December 2018. This included: (i) Active facility-based screening of all adults for TB symptoms (and chest x-ray (CXR) for those with symptoms) by trained and incentivized providers, with on-site diagnostic testing or transport of sputum samples, (ii) a mobile application to reduce dropout in the care cascade and (iii) enhanced follow-up care by community health workers. We conducted a cohort study using project and routine surveillance data for evaluation. Among 52,078 attendees, 368 (0.7%) had symptoms suggestive of TB and abnormalities on CXR. Among them, 299 (81%) were tested and 103 (34.4%) were diagnosed with TB. In addition, 195 individuals with normal CXR were indicated for TB testing by attending clinicians, of whom, seven were diagnosed with TB. Of the 110 TB patients diagnosed, 104 (95%) were initiated on treatment and 97 (93%) had a successful treatment outcome. Given the success of this model, the National TB Programme is considering to scale it up nationwide after undertaking a detailed cost-effectiveness analysis.

Mother's management for children under five years who suffered from the disease

A study on mothers with children under five years who suffered the disease in 2 villages of Viªn and §«ng at Cæ NhuÕ commune, Hµ Néi has shown that rate of children under five years suffered from the disease was 12.80%. Rate of bronchitis, pneumonia among children under 5 years were highest, followed by pharyngitis (25.6%), amygdalitis (9.6%). The rate of mother who transferred their children to the communal health station was 61.60%, to the private clinics (24.40%) and to hospital (6.4%).

The bursar for the consultation and treatment in the hosehold in the publicity

A cross sectional survey and dirrect interview of 3,883 households in Co Nhue commune, Tu Liem district in which rich households: 1,359 (35%); poor househould: 39 (1.004%), avarage income/month: 250,000 VND/ capital/month were implemented during 1-4/1998. The results have shown that the average bursar/capita/round in the hospital was 195,700 VND; The highest bursar/ child with ages of 5/ round was 69,800 VND and lowest bursar capita with ages of 15-60/round was 37,172. The level of this expenditure was higher 15 times than this in the publicity. Therefore, 75/138 people who think that the bursar of consultation and treatment in hospital was excessive expensive.

Needs of home health care of people in suburb of Hµ Néi

A Sociological survey of 1500 households in 30 communes in Hanoi' s suburbs shows that 1337/1500 households (89.13%) want to be provided with home health care service 25.42% consider this as a measure to improve health - care quality in the community

study on the needs of health care and use of health services

1000 households with 6,125 persons were randomly selected from 2,773 households with 16,731 persons in Co Nhue commune, Tu Liem district, Hanoi participated to a study on the determination of needs of healthcare and use of health service. In which the direct subjects were householders and mothers with children under 6 years. The results have found that there was no difference of morbididy rate between men and women. Children under 5 years accounted for highest morbidity rate (22.6%). There was high needs of healthcare for children in the community, especially the respiratory tract infection. The children came to the communal health station and convenient health care facilities accounted for 35.06% because of the good profession and attitude.

Primary investigation of drug use in community

1,000 households (25.75%) were selected randomly from 3,883 households, included 6,125 persons in Co Nhue Commune, Tu Liem district, Ha Noi City from January to March, 1998. It is found that the medications were mainly required for common cold, fever, cough and fatigue. The drug consumers were involved in every age groups, in which the drug consumption was higher in under-5-year children due to the rate of illness was higher in this age group. The drugs have been used unsafe and inappropriately. Antibiotic overuse was 68.04%. 10.28% of illness persons have used corticoids, while a few persons used traditional medication, pain killers and antipyretics for illness.