According to this orientation, ward and commune health stations are no longer just passive medical examination and treatment places but are transformed into proactive coordination centers for primary health care for people.
Resolution 72-NQ/TW of the Politburo has clearly pointed out the long-standing limitations of grassroots healthcare in recent years. Ward and commune health stations have not provided adequate initial health care services; screening and early detection of diseases have not been widely implemented; people's trust in grassroots healthcare has not been strengthened. The consequence is that the situation of people going for out-of-line examinations is still common, even with common diseases, causing overload for upper-level hospitals and increasing social costs.
According to Mr. Tang Chi Thuong - Director of the Ho Chi Minh City Department of Health, the important reason for this situation is that the operating methods are still passive of many health stations. Most health stations are still waiting for people to come for examination, while not proactively approaching, managing and monitoring community health according to the assigned area. Grasping people's health situation is still heavily focused on administrative reports, lacking a mechanism for medical staff to regularly contact and monitor each household.
Professional activities at health stations today mainly focus on a number of individual services such as vaccination, routine medical examination or the implementation of targeted programs, while the core role of primary health care, chronic disease management, preventive counseling and long-term monitoring has not been fully promoted.
Screening, listing and risk group management are still limited, leading to many cases of late detection of diseases. In addition, the health station has not really become a focal point for coordinating health care in the area, and the connection with upper-level hospitals and related facilities is still fragmented.
In the past time, ward and commune health stations have been rearranged in the direction of becoming public non-business units directly under ward and commune People's Committees, in line with the two-level local government model. However, according to Mr. Tang Chi Thuong, reorganizing the new apparatus is only a necessary condition. If the operating model is not strongly innovated, the initial quality of health care can hardly be substantially transformed.
From that practice, the Ho Chi Minh City Department of Health proposed switching to a model of continuous health care teams associated with the area, actively operating, taking people as the center and disease prevention as the foundation. This model has been effectively implemented by many countries, with the common point being proactively managing people's health by household, risk group and each life cycle stage.
According to the proposal, each health care team includes doctors as team leaders, nurses as coordinators, pharmacists managing drugs, public health workers and health collaborators in residential areas. The teams manage people according to lists, care according to life cycles and risk groups, organize periodic visits to households, coordinate referrals and post-treatment monitoring, and maintain weekly meetings.
At the same time, digital transformation of grassroots healthcare is identified as an indispensable requirement to shift from administrative management to continuous health management. Because this is a new model, piloting in some typical wards and communes is necessary to assess the effectiveness before expanding. This is considered a specific and feasible step, creating a foundation for health stations to truly become the "first health touchpoint" of the people.
