Duong, David2015-05-202015-052015-05-132015Duong, David B. 2015. Understanding the Service Availability for Non-Communicable Disease Prevention and Control at Public Primary Care Centers in Northern Vietnam. Doctoral dissertation, Harvard Medical School.http://nrs.harvard.edu/urn-3:HUL.InstRepos:15821581Background: Non-Communicable diseases (NCDs) are currently responsible for over 60% of global deaths, 80% of which are in low-and-middle-income countries. In Vietnam, a low-middle income country, between 1986 and 2008, the proportion of all hospital admissions attributable to NCDs increased from 39% to 69%, and mortality attributed to NCDs rose from 42% to 63%. Methodology: This mixed methods study involved a critical review of published and unpublished literature, and government documents to understand the current situation of NCDs service delivery. Additionally, from December 2013 until April 2014, 89 CHCs were surveyed in three provinces in northern Vietnam on NCD service availability using the World Health Organization Service Availability and Readiness Assessment (SARA) tool, adapted for the Vietnam context. Results: There is strong government support for NCD prevention and control at the highest levels, however, implementation of NCD programs have not resulted in substantial population health gains. In the current situation, Vietnam’s network of CHCs do not have adequate NCD service availability for either prevention or control, which can be explained by a vertical, disease specific program implementation model, a lack of medications, non-standard payment mechanisms, and low patient volume visiting the CHCs.application/pdfenThesis or Dissertation2015-05-20