Chris Jenkins¹*, Tran Thu Ngan², Nguyen Bao Ngoc², Tran Bich Phuong², Lynne Lohfeld¹, Michael Donnelly¹,

Hoang Van Minh² and Liam Murray¹

 

Affiliations

 

1: Centre for Public Health, Queen’s University Belfast, Royal Victoria Hospital Site, Institute of Clinical Sciences Block B, Grosvenor Road, Belfast BT12 6BJ, UK

2: Center for Population Health Sciences – Hanoi University of Public Health

 

Abstract

 

Background: Incidence of breast cancer has increased in Vietnam over the past two decades, but little data exists to inform policy and planning. This study examined the organization and delivery of breast cancer services in Vietnam in order to address the lack of data on detection, diagnosis and treatment.

Methods: We gathered quantitative and qualitative data using an adapted survey-based Service Availability and Readiness Assessment (SARA) tool and semi-structured interviews from healthcare providers in 69 healthcare facilities about the experience and challenges of delivering breast cancer services. We conducted our study across four levels of the health system in three provinces in Vietnam.

Results: The analysis of our data show that a number of areas require strengthening particularly in relation to service availability and service readiness. Firstly, healthcare providers across all levels of the health system reported that service provision was constrained by a lack of resources both in relation to health infrastructure and training for healthcare providers. Secondly, access to timely diagnosis and treatment is limited due to services only being available at the top two levels of the health system. Women living outside the immediate vicinity of such facilities tend to find access more costly and time-consuming, and there is a need to investigate the social, economic, geographic and cultural barriers that may prevent women from accessing services.

Conclusions: Our study suggests that there is a need to strengthen lower levels of the Vietnamese health system in relation to the detection of breast cancer. Provision of some services such as clinical breast examination, advice on self-examination, and conducting ultrasound tests (supported with appropriate training and capacity-building of healthcare providers) at commune and district levels of the health system may reduce the overcrowding and service-delivery burden experienced in provincial and national-level hospitals. Empowering lower levels of the health system to conduct breast cancer screening, which is currently undertaken on an ad hoc basis through higher-level facilities, is likely to improve access to services for women.

 

Keywords: Breast Cancer, Vietnam, Health systems, Cancer, NCDs

 

Full-text link: Strengthening breast cancer services in Vietnam: a mixed-methods study

                                       

Nguồn: Trung tâm Nghiên cứu Khoa học Sức khỏe - Trường Đại học Y tế công cộng