A woman in Thai Nguyen has been in declining health since age 40, but due to inadequate screening and disease management, she has spent the past decade slipping into financial ruin.

Speaking at the Healthcare Innovation Forum on June 6, David Duong, MPH, from the Center for Primary Care at Harvard Medical School, emphasized that investment in primary healthcare is key to reducing the burden of disease in Vietnam.

Duong cited the case of Lan, a 54-year-old woman in Thai Nguyen City. Beginning at age 40, she frequently experienced headaches and fatigue but never sought medical attention, believing these were symptoms of overwork.

Between ages 46 and 49, she bought over-the-counter painkillers without checking her blood pressure or glucose levels. Even though she visited the local health station for a persistent cough, she was never screened for non-communicable diseases.

At age 50, Lan was diagnosed with diabetes and hypertension, but received neither proper consultation nor follow-up.

By age 53, she was rushed to the hospital with kidney failure and began dialysis treatment. Now unable to work, her condition has left the family deeply in debt.

According to Duong, three main factors led to this outcome: a lack of early screening, insufficient health education, and weak disease management at the grassroots level.

He referenced global evidence showing that investment in primary care in low- and middle-income countries yields exceptional returns. Every dollar spent can generate between 9 to 16 dollars in economic benefits by lowering treatment costs and preventing complications. Compared to specialized programs or high-end care models, primary care is more cost-effective and meets up to 90% of healthcare needs.

If implemented broadly, this model could prevent 60 million deaths and increase average life expectancy by 3.7 years by 2030, while also reducing maternal and infant mortality and deaths from infectious and chronic diseases.

In Vietnam, Duong stressed that investing in primary care is an urgent strategy to ease the overload on higher-level hospitals, where bed occupancy often exceeds 100% and accounts for over 75% of national health expenditures. It is estimated that 65% of patients treated at top-tier hospitals could be managed effectively at lower levels if the primary healthcare system were strengthened.

Non-communicable diseases currently account for more than 81% of all deaths in Vietnam. However, only 19% of people with hypertension and 6% of those with diabetes are diagnosed and treated within their communities. Rural populations (65%) and ethnic minorities (15%) are particularly disadvantaged, with life expectancies 3-4 years lower and much lower rates of diagnosis and treatment.

To improve primary healthcare outcomes, Duong proposed three solutions:

Increase funding for facilities, medical staff training, and the supply of essential medicines at the commune and district levels. Develop a data system to monitor and enhance service quality.

Promote intersectoral collaboration, integrate primary care into medical training, and conduct research on community health needs.

Partner with local healthcare providers and adopt global best practices to drive systemic innovation.

Phuong Thuy