Browsing by Person "Wilson, Andrew"

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In-service Training of Maternal Health Workers in Rural Areas in Vietnam: Is it Relevant, Timely and Effective? A Mixed-method Study
(SAGE, 2023-09-30) Thu, Nguyen Thi Hoai; McDonald, Fiona; Witter, Sophie; Anh, Bui Thi My; Wilson, Andrew
Training is widely considered to contribute to the ‘can do’ and ‘will do’ capacities of health workers. Having appropriately skilled health workers is recognised as critical to assuring quality health services. This study examined the relevance of in-service training (IST) provided to maternal health workers (MHW) in rural Vietnam. A mixed method approach was used involving a survey of 240 health workers providing maternal health services and managers and 43 in-depth interviews of health workers and managers from 5 health districts across two provinces in Vietnam. Although two thirds of participants reported accessing IST within the previous 12 months, only 53.3% attended maternal health training. Factors related to the self-reported ability to perform Essential Obstetric Care (EOC) include: Being trained on EOC; Work experience; and Qualifications of MHWs. Participants reported that the IST was irrelevant to their actual needs, while managers reported frustration that IST programs were scheduled haphazardly, dependent on budget availability. In conclusion, in-service training programs should be designed taking into account the needs of the workforce and managers in terms of content, mode of delivery, scheduling and follow-up. Poorly planned and inappropriately delivered training may contribute to a perceived inability to provide EOC.
"Three Nooses on Our Head": The influence of district health reforms on maternal health service delivery in Vietnam
(Kerman University of Medical Sciences, 2017-11-22) Nguyen, Thi Hoai Thu; McDonald, Fiona; Witter, Sophie; Wilson, Andrew
Background: The impact of reorganisation on health services delivery is a recurring issue in every healthcare system. In 2005 Vietnam reorganised the delivery of health services at the district level by splitting preventive, curative, and administrative roles. This qualitative study explored how these reforms impacted on the organisation of maternal health service delivery at district and commune levels. Methods: Forty-three semi-structured interviews were conducted with health staff and managers involved in the provision of maternal health services from the commune to the central level within five districts of two Northern provinces in Vietnam. The data were analysed thematically. Results: The results showed that 10 years after the reforms created three district-level entities, participants reported difficulties in management of health services at the district and commune levels in Vietnam. The reforms were largely perceived to negatively affect the efficient and effective use of clinical and other resources. At the commune level, the reforms are said to have affected the quality of supervision of the communes and their staff and increased the workload in community health centres. Conclusion: The findings from this study suggest that the current organisation of district health services in Vietnam may have had unintended negative consequences. It also indicates that countries which decide to reform their systems in a manner similar to Vietnam need to pay attention to coordination between a multiplicity of agencies at the district level.