Part 3: Opportunity to restructure

Dong Nai’s healthcare sector

Despite achieving many positive results, frontline healthcare in Dong Nai still reveals a number of limitations. Thus, its “gatekeeper” role in public healthcare has yet to meet expectations, prompting many residents to bypass lower-level facilities and place increasing pressure on higher-level hospitals.

A doctor examines a patient at the polyclinic of Long Thanh Regional Health Center. Photo: Hanh Dung

Against this backdrop, Resolution No. 72-NQ/TW was issued by the Politburo on September 9, 2025, regarding breakthrough solutions to strengthen the protection and improvement of public health (Resolution No. 72). It is regarded as a strategic orientation of major significance, a call to action aimed at addressing longstanding “bottlenecks” in human resources, infrastructure, technology, and the quality of medical examination and treatment at the grassroots level, with the ultimate goal of bringing high-quality healthcare closer to the people.

Bottlenecks need to be removed

In the border commune of Dak O, Doctor Tran Van Nhan, in charge of the commune Health Station (HS), said that the locality now has a population of more than 19,000 people scattered across a vast and geographically fragmented area, but the commune HS has only 15 personnel, following administrative restructuring. Medical staff must shoulder an enormous workload generated by the two-tier local government system, making it impossible to fully implement all tasks required by the Ministry of Health.

Even in urban areas, M.Sc. Doctor Nguyen Minh Duc, in charge of the Dong Xoai ward HS, expressed concerns that although the station has 21 staff members, it must carry out as many as 22 categories of tasks. According to Doctor Duc, only with sufficient staffing can the station confidently propose investment in modern equipment such as ultrasound machines, electrocardiogram systems, and laboratory testing devices. Otherwise, without qualified personnel, investments in machinery and equipment may fail to deliver effectiveness and could even result in waste.

Doctor Ho Van Hoai, Director of Vinh Cuu Regional Health Center (HC), pointed out that the absence of effective mechanisms and policies to attract, retain, and maximize the expertise of doctors at the grassroots level has caused many physicians to leave the public sector for private healthcare after only a short period of service. If residents do not receive adequate medical examination and treatment at HSs, they are unlikely to return.

To improve healthcare service quality and narrow the gap between different levels of the healthcare system, digital transformation is considered an inevitable path. In Dong Nai, this process is being accelerated vigorously. To date, 100% of public healthcare facilities with inpatient beds across the city have implemented electronic medical records. According to the roadmap, Dong Nai will completely eliminate paper medical records from January 1, 2027. This represents not merely a change in form, but a fundamental transformation in healthcare management itself.  However, Le Quang Trung, Deputy Director of the Dong Nai Department of Health frankly acknowledged several major barriers to digital transformation, including time pressure, inconsistent information technology infrastructure, and especially financial constraints. Investment in servers, data storage systems, and artificial intelligence requires enormous funding, while current medical service pricing does not fully account for information technology costs. This financial challenge has made it difficult for many healthcare units to reinvest in and sustainably maintain digital systems.

To overcome these challenges, the healthcare sector has identified a “focused and targeted” roadmap, concentrating on core systems such as PACS (Picture Archiving and Communication System), LIS (Laboratory Information System), and HIS (Hospital Information System) to ensure smooth and interconnected data integration across all levels of care.

Le Quang Trung, Deputy Director of the Dong Nai Department of Health

Strategic vision and breakthrough targets

Do Xuan Tuyen, Deputy Minister of Health noted, “For many decades, resources have largely been concentrated on building large and modern hospitals to treat severe cases, while disease prevention, early and remote health management have not received adequate attention. Resolution No. 72 reaffirms the principle that “prevention is better than cure”, emphasizing the role of preventive healthcare as a “shield” and grassroots healthcare as the “foundation” of the system. Instead of placing pressure on higher-level hospitals, the healthcare system will be reorganized so that grassroots facilities are capable of helping people access healthcare services right where they live and saving both time and costs.”

To implement Resolution No. 72, Dong Nai has issued both an action plan and an implementation roadmap. The City Party Committee, City People’s Committee, and Department of Health have identified the implementation of the resolution as a key, long-term strategic mission, requiring departments, sectors, and localities to carry out tasks in a timely, synchronized, feasible, and effective manner. Responsibilities have also been assigned according to the principle of “six clarities”: clear personnel, clear tasks, clear timelines, clear responsibilities, clear outputs, and clear authority for each organization and individual.

Compared to the targets outlined in Resolution No. 72, Dong Nai has even set several more ambitious goals. For example, by 2030, the average life expectancy of residents is expected to reach 77.67 years, while by 2026, health insurance coverage is projected to exceed 96% of the population.

Le Truong Son, Member of the City Party Standing Committee and Vice Chairman of the City People’s Committee, emphasized that the city’s implementation plan focuses on six major groups of tasks and solutions. These include improving institutions in a timely manner; strengthening the healthcare system, particularly preventive and grassroots healthcare, while promoting the strengths of traditional medicine, enhancing medical ethics and developing a well-coordinated, high-quality healthcare workforce capable of meeting patient expectations and international integration standards. Other tasks and solutions prioritize accelerating administrative reform and ensuring sustainable health insurance policies; making breakthroughs in science, technology, innovation, and comprehensive digital transformation in healthcare; and promoting private healthcare development while effectively mobilizing all resources for healthcare development.

To promptly supplement high-quality personnel for commune and ward HSs, the Department of Health has agreed to transfer 80 staffing positions from regional HCs to grassroots facilities. In addition, many officials from the City Center for Disease Control have voluntarily registered to work at the grassroots level. According to the plan, from now until the end of 2026, Dong Nai will dissolve six regional HCs, including Dinh Quan, Long Thanh, Long Khanh, Phu Rieng, Dong Xoai, and Bu Gia Map. All personnel, machinery, and equipment from these dissolved centers will be transferred to commune and ward HSs. The goal is to turn every HS into a ‘fortress’ safeguarding community health, with sufficient capacity for residents to confidently seek treatment close to home.

Doctor Duong Minh Tan, Director of Long Thanh Regional HC, said that after dissolution, 50 staff members from the center will be distributed evenly among five local HSs. By then, each HS is expected to have between three and six doctors – a “dream number” that grassroots healthcare has never previously achieved.

Doctor Do Thi Nguyen, Director of the Department of Health, said that this represents an opportunity for Dong Nai to comprehensively restructure its healthcare sector. Beyond grassroots healthcare, the city also faces the requirement of developing provincial-level hospitals into regional HCs in order to reduce pressure on central hospitals and retain high-quality personnel through sufficiently attractive incentive policies.

“Resolution No. 72 has truly sparked a revolution in mindset within Dong Nai’s healthcare sector. From a system primarily focused on large hospitals, it is now undergoing a strong transformation aimed at reinforcing the ‘foundation’ of grassroots healthcare and the ‘shield’ of preventive medicine. With the determined involvement of the entire political system and concrete implementation steps, people in Dong Nai – whether in urban areas or remote border regions – can have full confidence in a modern, equitable, and effective healthcare system in the near future,” emphasized Doctor Do Thi Nguyen.

By Hanh Dung – Translated by Minh Hong, Thu Ha

Final Part: Building a sustainable healthcare ecosystem