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Health Human Resources Development Project (RRP VIE 40354) Second Health Human Resources Development Project (RRP VIE 40354) HEALTH HUMAN RESOURCES DEVELOPMENT: POLICY AND STRATEGY CONTEXT 1. National Socio-Economic Development Plans. The Government of Viet Nam recognizes the intricate relationship between inclusive growth and population health and views the health sector as central to the country’s socioeconomic development. The Socio-Economic Development Strategy 2011–2020 prioritizes developing the system of healthcare and improving the quality of health services, including (i) upgrading of health infrastructure at all levels, (ii) improvement of health human resources (HHR), and (iii) strengthening health financing, including universal health insurance.1 The Socio-Economic Development Plan 2016– 2020 reiterates these priorities, and sets national targets to 2020 for hospital beds per population, health insurance coverage, and health staff per population.2 2. The Sixth Plenary Session of the 12th Party Central Committee (October 2017) placed renewed emphasis on the health sector, highlighting amongst the sector’s priorities a need to ensure the adequate supply of qualified health workforce that is responsive to the population’s evolving health needs. The Party Committee’s Resolution on the Protection, Care, and Improvement of People’s Health set updated targets for health workforce coverage to 2030.3 The estimated number of new health staff for key professions required by 2030 in order to meet the targets include (i) 43,250 doctors, (ii) 22,199 pharmacists, and (iii) 249,416 nurses.4 3. The Resolution gave further priority to completing reform of the national health professional education system and framework, establishing a national medical council and national licensing examination, strengthening health practitioner certification and registration, and enhancing the qualifications and continuing professional training of health professionals. 4. Universal Health Coverage. Health workforce development forms a central pillar of the government’s efforts to reach universal health coverage (UHC), as articulated in the National Action Plan for the Implementation of the 2030 Sustainable Development Agenda.5 Ensuring quality human resources for the health sector, in order to meet medical diagnosis and treatment needs of all citizens, is identified as a key area of focus for achieving UHC.6 5. In parallel with the focus on health workforce quality, the government maintains its commitment to redress the imbalance in HHR distribution. The Master Plan on Building and Developing of the Local Health Care (LHC) Network in the New Situation7 recognizes the need to rapidly expand HHR coverage in LHC facilities, particularly in remote and disadvantaged areas. Various Ministry of Finance (MOH) programs, including those for the deployment of graduate doctors to difficult areas and granting preferential access to health education and professional training institutions (HEPTI) for students from disadvantaged regions, have 1 Government of Viet Nam. Viet Nam’s Socio-economic Development Strategy for the period 2011-2020. Hanoi. 2 Government of Viet Nam. National Assembly Resolution No. 142/2016/QH13 (12 April 2016) on the Five-Year Socio-Economic Development Plan, 2016–2020. Hanoi. 3 Government of Viet Nam. 12th Party Central Committee. Resolution No. 20-NQ/TW (25 October 2017) of the on the Protection, care and improvement of people’s health in the new situation. Hanoi. 4 Sector Assessment (Summary): Health (accessible from the list of linked documents in Appendix 2). 5 Government of Viet Nam, Office of the Prime Minister. 2017. National Action Plan for the Implementation of the 2030 Sustainable Development Agenda. Hanoi. 6 Aligned with SDG target 3c. 7 Government of Viet Nam. Prime Minister. Decision No. 2348/QD-TTg (5 December 2016) on the master plan on building and developing of the LHC network in the new situation. Hanoi. Second Health Human Resources Development Project (RRP VIE 40354) contributed to increasing health workforce coverage in LHC facilities.8 In 2017 the proportion of commune health station (CHS) nationwide served by a medical doctor reached 88.0% from 72% in 2011.9 6. Health Human Resource Development Master Plan. Consistent with the directions of the Soco-Economic Plan 2011-2020 and later resolutions, the MOH issued its human resource development master plan 2011-2020. The master plan includes amongst its four key objectives (i) to develop human resources in terms of quantity, quality, structure and rational distribution; and (ii) to improve the quality of health workforce training to meet the development needs of the society and international integration. Strengthening Viet Nam’s HEPTI is recognized as central to achieving these objectives. 7. Viet Nam has 36 universities offering bachelor and postgraduate health professional training programs, eighteen of which offer medical programs. 10 Of these Hanoi Medical University (HMU) and University of Medicine and Pharmacy at Ho Chi Minh City (UMP) are recognised as the country’s leading HEPTI. Under the master plan, HMU and UMP are assigned to be developed as National Health Sciences Universities, capable of increasing graduate numbers and diversifying degree and specialty programs in response to the country’s evolving health needs and disease burden. The development of HMU and UMP is listed in the Health Human Resources Development Master Plan as a priority project for Prime Minster approval.11 8. The master plan further emphasizes reform of the system of health professional education, including training program curricula, teaching methods, and systems for quality assurance and accreditation. MOH, through the Administration of Science, Technology and Training (ASTT), oversees the reforms in consultation with the Ministry of Education and Training (MOET). A draft roadmap prepared by ASTT identifies four priority reform areas (i) developing a competency-based curriculum to produce practice-oriented graduates, suited to the changing health needs of Viet Nam; (ii) developing faculty to increase the quantity and quality of trained medical educators in universities and hospitals, to deliver profession-oriented medical education; (iii) developing a national quality framework for medical education to support standardization, quality assurance, and program accreditation; and (iv) regulating health professionals through certification and licensing. 9. In addition to ASTT, various departments within MOH assume a role for HHR development and management. The Department of Manpower oversees HHR recruitment policy, salaries and incentives. The Medical Services Administration is in charge of licensing for health professionals and health facilities. The Council of Rectors of medical and pharmaceutical universities and colleges serves as an advisory body to the Minister on policy, training plans and scientific research in HEPTI. MOH has established a taskforce group on Human Resources for Health composed of MOH staff and representatives of other ministries. The taskforce provides 8 The local health care system encompasses the network of (i) commune health stations, (ii) district health centers providing public health and preventive services, and (iii) district hospitals providing inpatient and outpatient curative services. 9 Government of Viet Nam, Ministry of Health (MOH). Report 1499/BC-BYT (29 December 2017) on review of performance in 2017 and the key directions, tasks, and solutions in 2018. Hanoi; and Government of Viet Nam, MOH. 2017. Joint Annual Health Review 2016: Towards Healthy Aging in Vietnam. Hanoi. 10 World Health Organization. 2016. Human Resources for Health Country Profiles: Viet Nam. Manila. 11 Section V. 5.1 specifies a project for establishing two universities of Health Sciences: one in the North based on the present Hanoi Medical University and another in the South based on the University of Medicine and Pharmacy Ho Chi Minh City. Second Health Human Resources Development Project (RRP VIE 40354) policy and strategy advice to the Health Minister and facilitates coordination between MOH, related ministries, and partner organizations. 10. Development Coordination. The government’s reform agenda is supported by a core group of development partners, including the Asian Development Bank. 12 ADB’s strategic engagement in HHR development commenced with the Health Human Resources Sector Development Program (HHRSDP), which marked a shift from project-based HHR trainings to investment for HHR institutions, systems, and policy. Co-financed by the Government of Australia, the HHRSDP delivered key reforms to policy and regulatory frameworks governing HHR training, planning, and management. Complementing the reforms, HHRSDP supported investments for infrastructure and strengthening teaching capacity and management in 17 HEPTI, including HMU and UMP. The proposed Second Health Human Resources Development Project consolidates and extends the achievements of HHRSDP through focused support to develop HMU and UMP as health sciences universities and replicable models of best practice in health professional education. 11. Complementing ADB’s support, the World Bank financed Health Professionals’ Education and Training for Health System Reforms Project, co-financed by the European Union, focuses investment in the areas of HEPTI quality assurance, accreditation, and curriculum reform. The Partnership for Health Advancement in Viet Nam’s (HAIVN) IMPACT MED Alliance provides technical assistance to five HEPTI, including UMP, on the development of
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