(JM test no intro)Family-oriented primary care underappreciated in Vietnam

Family-orientedness was perceived to be least evident among six family medicine (FM) principles in a cross-sectional survey of 196 participants from follow-up patients at four commune health centers (CHCs) in Ninh Kieu District, Can Tho City, Vietnam, last year.

Four CHCs were randomly selected for the study. At each CHC, participants were randomly selected from among patients who had been seen at the CHC at least twice. Data was collected using a questionnaire consisting of 35 items.

The investigators Thuy Thi Ngoc Thai and Hieu Chi Nguyen of the Family Medicine Department in Can Tho University identified five other FM principles: continuity, comprehensiveness, coordination, prevention and community-orientedness. At 88.3 percent, prevention was the principle perceived by the most number of patients to be practiced correctly followed by continuity at 69.4 percent. At 3.1 percent, family-orientedness was a distant last, trailing coordination that was at 31.6 percent.

The study also sought to determine the percentage of participants with a correct perception of FM. A correct perception was determined by the presence of two out of three paramaters: knowledge of FM, correct understanding of the specialty and recognition of its benefits. Overall, 66.8 percent held correct perceptions toward FM. Correct perception was particularly associated with younger age of the participant (p<0.001) and higher income (p=0.005) but was not associated with gender (p=0.946) or presence of a family physician at the CHC (p=0.448). In contrast to what was expected, absence of chronic illness was associated with correct perception (p=0.006).

The investigators discussed that while FM has proven to be a comprehensive and cost-effective approach to health in many countries, health care in Vietnam still focused on special hospitals. A training program was started in 2002 and Can Tho University has fielded 252 FM graduates, contributing to half the total number in the country.

They urged that the Ministry of Health and provincial health authorities should promote the practice of family medicine as well as their benefits among the community. They also felt that academic institutions should increase training to improve the capacities and quality of care at CHCs.