Continuing medical education programs for primary care physicians from remote locations of Vietnam: a needs assessment

Abstract

Background Inadequate attention has been given to ensuring ongoing training to improve knowledge, skills and capacity of primary health care providers in low- and middle-income countries. The Hanoi Medical University, Vietnam is providing training sessions for physicians working in commune health stations (CHSs) in three mountainous, remote northern provinces in 2019. This article aims to assess these physicians’ knowledge of correct medical responses to emergencies in order to assess their training needs. Methods We conducted a cross-sectional study amongst doctors posted to CHSs located in 3 mountainous remote provinces of northern Vietnam. We used a self-administered questionnaire that comprised questions on common medical emergencies, maternal and child care, and non-communicable disease management. We performed Chi-square tests to assess the statistical significance of differences in the mean proportions of correct answers for each health care question category, and for differences in mean proportions of correct answers by doctor characteristics. Results In total 302 doctors were recruited to the study. More than half of the sample answered 30–50% of the questions correctly, followed by around a third who answered 50–70% correctly. Less than 2% of doctors answered more than 70% correct responses to the entire question set. There were statistically significant differences between question categories, with cardiovascular care questions answered correctly significantly less often than any of the categories (p < 0.00001). Conclusion The findings reported here show that the doctors who participated in the study have relatively low knowledge on common emergencies, particularly to answer cardiovascular care questions. The results also support the need for continuing medical education to improve doctors’ knowledge, who are mostly practicing in resource limited remote settings.

Positive Impact on Public Perception toward Commune Health Stations (CHSs) in Rural Areas of Tyuen Quang Province, Vietnam, Following the Application of the Development Program for the Capacity-Building of CHSs

“…Previous studies have reported that in many low-and middle-income countries, such as Vietnam, primary healthcare centers provide a wide range of services to people. The services provided include the identification and control of existing health-related problems, maternal and child healthcare, family planning measures, immunization facilities, emergency health services, treatment of common diseases, and the provision of essential drugs [3][4][5][6]. The primary healthcare centers additionally provide diagnostic and referral services to specialized hospitals.…”

“…Despite the important activities of primary healthcare centers, there has been less focus on staff training. The implementation of such processes is needed to improve and update medical personnel's knowledge, skills, and building of their capacity, especially in rural and remote settings, such as those in Vietnam [6].…”

“…This variation remains a matter of concern for the CHSs. The difference in experience might be a result of several reasons such as (i) the quality of health services provided by less qualified CHS staff, as a result of inadequate professional knowledge, evaluative ability, and clinical skills; (ii) the limitations in the availability of drugs, equipment, infrastructure, and other clinical resources; and (iii) the geographical area, such as remote and mountainous regions, limiting access to and the quality of healthcare facilities [6,10].…”

“…This plan aimed to specifically increase the number of healthcare workers and improve the quality of care through training and education programs [15]. Other studies have, however, demonstrated that existing training and approaches for human resource development in CHSs are insufficient and further highlight the need for additional targeted training and developmental programs [6,11,16,17]. The "Rural Area Development Pro-gram in Tuyen Quang Province," funded by the Korea International Cooperation Agency (KOICA), is to be implemented in Vietnam from 2019 to 2023, in partnership with the Tuyen Quang Department of Health.…”