Bringing haemophilia care closer to home
Access to care should not depend upon where you live. That simple idea is the driving force behind NNHF’s vision and the third supported project in Vietnam. Since 2018, the team have been working towards one goal: enabling people with bleeding disorders across the country to access basic multidisciplinary care and faster emergency treatment closer to home.
Building on a complete care model
Ten new satellite centres for haemophilia care are being established, anchored around the previously set-up regional referral centres in Hanoi, Hue and Ho Chi Minh.
Dr Nguyen Thi Mai from Hanoi, who has been partnering with NNHF on projects since 2008, explains: “We developed these regional centres to provide a complete care model for multidisciplinary care, and now we are collaborating with them to build a training model and patient organisation clubs across the country.”
In 2020, a total of 20 healthcare professionals from eight provinces received multidisciplinary training at the National Institute of Haematology & Blood Transfusion (NIHBT) in Hanoi. Assessment visits by HCPs from Hanoi were carried out to follow up on diagnosis and care at four of the new satellite centres.
People with bleeding disorders are already beginning to benefit from shortened travel times to receive care and treatment. One such person is Tran Huu Chang, who lives in Hai Phong province on the Red River Delta in northern Vietnam. He is unable to walk due to severe arthropathy in both ankles, caused by not always being able to travel to Hanoi to receive care when bleeds occur. Another is Bui Minh Thang, who relies on an electric scooter to get around since arthropathy from haemophilia caused serious damage to his hip joints. Both men are typical of those most likely to benefit from the decentralisation of multidisciplinary care in Vietnam.
Preventing damage to target joints
In the case of arthropathy, prevention is key. Musculoskeletal care can make the difference by strengthening the large target joints and muscles of the lower extremities to prevent damage caused by unmanaged bleeds. The project team has therefore included specialised physiotherapy exercises as an integral part of the training initiatives organised within the project framework.
Decentralising care also means involving the entire community of people living with bleeding disorders in remote areas. A key focus in 2020 was the establishment of patient organisation chapters in the provinces of Phu Tho, Nghe An, Thai Binh and Hai Phong. This work is set to continue in 2021 with further visits from the existing referral centres to all ten satellite treatment centres and the new patient clubs anchored around them.