Continue to strengthen, improve and enhance the quality of primary health care activities.

On October 25, Politburo member and Standing member of the Secretariat Truong Thi Mai signed and issued Directive No. 25-CT/TW on "continuing to strengthen, improve and enhance the quality of grassroots healthcare activities in the new situation".

The Directive clearly states that after 20 years of implementing Directive No. 06-CT/TW of the 9th Party Central Committee Secretariat on consolidating and perfecting the grassroots health care network and Conclusion Notice No. 126-TB/TW of the 11th Party Central Committee Secretariat on 10 years of implementing Directive No. 06-CT/TW, grassroots health care activities have achieved important results in primary health care, participation in health insurance examination and treatment, disease prevention and control, and expanded vaccination. The grassroots health care network covers the whole country and has been strengthened in terms of facilities, equipment, and human resources.

However, policies and laws on grassroots health care are not yet complete; some Party committees and authorities have not yet fully recognized and promoted the role, position and importance of grassroots health care; have not paid due attention to leadership and direction in consolidating and enhancing the capacity of the grassroots health network, especially in responding to emergency situations of epidemics. The grassroots health organization model is not yet stable; primary health care, disease prevention and early detection, disease management, management and improvement of people's health, and service quality have not met requirements, especially in remote areas and ethnic minority areas. Resources, facilities, equipment, drugs and medical supplies are still limited; policies and regimes for staff are not appropriate, and have not attracted people with good professional qualifications to work long-term in grassroots health care.

To improve the quality and efficiency of grassroots healthcare operations with the view that grassroots healthcare is the foundation, firmly develop the grassroots healthcare system, and build a widespread healthcare network close to the people, the Secretariat requires Party committees and organizations at all levels to focus on leading and directing the good implementation of a number of key tasks and solutions:

Raising awareness and responsibility of Party committees, Party organizations, authorities, and the political system about the role, position, and importance of grassroots health care with the task of primary health care; first aid, medical examination and treatment; personal health management and non-communicable diseases; disease prevention and control and improving people's health through public health programs and population work, creating conditions for all people to receive regular health care right in the community, towards universal health coverage.

Strengthening leadership, direction, inspection and supervision of the government and professional agencies in implementing their responsibilities, improving the quality of operations and facilitating people's access to and use of grassroots health services, especially those in remote areas and ethnic minority areas, in line with the goal of ensuring fairness in protecting, caring for and improving people's health. Heads of Party committees, Party organizations, authorities and the health sector must uphold their responsibilities for grassroots health activities within their scope of responsibility.

Regularly propagate, mobilize, raise awareness and responsibility for cadres, party members and people on the motto of disease prevention is better than cure, the requirements of primary health care and the role and tasks of grassroots health care. Expand and diversify communication activities, healtheducation , disseminate knowledge to raise awareness, change behavior in protecting, caring for and improving health. Promote the movement of training and improving the health of the whole population.

Improve the effectiveness of state management and the coordination responsibility of agencies and organizations in developing and implementing policies and laws on grassroots healthcare. Focus on integrating grassroots healthcare indicators and indicators related to health and medicine into national and local annual, 5-year and 10-year socio-economic development strategies and plans.

Complete policies and laws on primary health care in line with policies and laws on health insurance, medical examination and treatment, pharmaceuticals, prevention and control of infectious diseases, food safety, etc. to ensure that primary health care plays a leading role in disease prevention, medical examination and treatment, and health care for the people. Encourage private health care, organizations, and individuals to participate in providing primary health care services, preventive medicine, and connect with primary health care in personal health management.

Strengthening the organization of the grassroots health system, units assigned to perform grassroots health tasks include village and hamlet health; commune, ward and town health stations; district health centers; school health, agency health, agricultural and forestry farms, enterprises and health in industrial parks, high-tech parks and export processing zones. The activities of commune, ward and town health stations must be associated with comprehensive management of personal health; management and treatment of non-communicable diseases, chronic diseases, community nutrition; implementation of medical examination and treatment activities according to the family medicine model; combination of traditional medicine and modern medicine; combination of military and civilian medicine; associated with school health.

Unify the organizational and management model for district-level health centers in the direction of being under the comprehensive management of the People's Committee at the district level; perform the function of advising on state management of health, population, security, and food safety in the area; have the task of managing and guiding the improvement of the quality of resources and organizing professional activities of grassroots health. The organization and operation of health stations must be consistent with the scale, population structure, socio-economic conditions, and people's accessibility. Provinces and cities with high population density arrange health stations according to population size, not necessarily according to administrative boundaries. Industrial parks, high-tech parks, and export processing zones base on the scale of labor, practical conditions, and needs to establish appropriate health facilities.

Increase investment in primary health care associated with financial mechanism innovation, improve efficiency in using state budget. At the same time, mobilize domestic and foreign organizations and individuals to provide technical and financial support to invest in and upgrade facilities and equipment for primary health care.

Innovate the method of budget allocation in the direction of the State playing the leading role, increasing expenditure on primary health care based on performance results and practical conditions; apply the method of the State ordering and assigning tasks to primary health care to implement basic health service packages; make payments in the direction of encouraging the provision of primary health care services and managing population health in the community. Increase resources for preventive medicine, screening and early detection of diseases. Complete the price of medical examination and treatment services under health insurance in the direction of calculating correctly, fully, clearly defining welfare policies and social security policies in the price of medical services. Research and continue to increase the level of health insurance contributions according to a roadmap suitable to the state budget and the people's ability to pay; gradually expand the list of services within the scope of primary health care paid by the health insurance fund in accordance with the contribution level.

Improve the quality of human resources for grassroots health care with appropriate quantity and structure, ensuring the implementation of functions and tasks, with appropriate salary, allowance and treatment policies. Strive for each health station to have at least one full-time doctor by 2030; each village and hamlet to have one medical staff with specialized training. Pay attention to training and fostering the team of grassroots health workers; have specific training policies for disadvantaged areas; flexibly coordinate forms of training, fostering, and continuously updating medical knowledge. Have breakthrough policies to attract qualified human resources to work and stay long-term at grassroots health care, especially in disadvantaged, border and island areas. Synchronously and effectively implement rotation, transfer and mobilization of medical human resources to regularly support grassroots health care.

Strongly innovate the operation methods of grassroots health care towards focusing on disease prevention, health promotion, early detection and screening; promote management and treatment of non-communicable diseases, chronic diseases, long-term care at grassroots health care; implement health management of people at home and in the community. Quickly complete the goal of all people being monitored and comprehensively managed for their health. Strive for the rate of health insurance participation to reach over 95% of the population by 2030; over 95% of people using primary care services at grassroots health care are covered by health insurance; over 95% of the population is managed for health; people at high risk of disease are examined at least once a year, aiming for periodic health check-ups for the entire population.

Develop a family doctor model, establish a flexible referral system. Promote the role and effectiveness of traditional medicine in disease prevention, treatment and health promotion. Promote military-civilian medical cooperation, improve medical capacity in disadvantaged areas, border areas and islands.

Synchronously deploy information technology systems in grassroots healthcare activities; promote digital transformation, enhance connections between grassroots healthcare with higher-level healthcare and people in remote consultation, examination and treatment; compile statistics and manage data on grassroots healthcare in a unified manner with the healthcare system nationwide./.

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