"Three Nooses on Our Head": The influence of district health reforms on maternal health service delivery in Vietnam
Nguyen, Thi Hoai Thu
MetadataShow full item record
Nguyen, T. H. T., McDonald, F., Witter, S. & Wilson, A. (2017) "Three Nooses on Our Head": The influence of district health reforms on maternal health service delivery in Vietnam. International Journal of Health Policy and Management, 7 (7), pp. 593-602.
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.
Showing items related by title, author, creator and subject.
O'Brien, Oonagh; White, Alan (2003)There is growing national and international recognition that gender is an important indicator of health differences. The United Kingdom is in danger of falling behind many other countries that are beginning to recognise ...
COPING WITH COMMUNITY HEALTH FINANCING: Illness costs and their implications for poor households' abilities to pay for health care and children's access to health services. A Study for Save the Children UK. Bate, Angela; Witter, Sophie (University of YorkQueen Margaret University, 2003)
Advancing the science behind human resources for health: highlights from the Health Policy and Systems Research Reader on Human Resources for Health George, A. S.; Campbell, J.; Ghaffar, A.; HPSR HRH reader collaborators (BioMed Central, 2018-08-14)Health workers are central to people-centred health systems, resilient economies and sustainable development. Given the rising importance of the health workforce, changing human resource for health (HRH) policy and practice ...