“Extended arm” connecting the health system with the people

Village health workers (VHS) are considered the “extended arm” of the health sector in providing health care to the people. They are an important “link” in the grassroots health system, a bridge between the health system and the people.

Mr. Dieu De (Hai Can village, Phu Nghia commune, Dong Nai province) supports the staff of the Commune Health Station in receiving and collecting information from people bringing their children for vaccination. Photo: Contributor

With a low allowance (0.3 or 0.5 times the basic salary depending on the area), the YTTB team must be truly dedicated and responsible in taking care of the people in order to stick with and be attached to this "carrying prison and general goods" job.

Dedicated, enthusiastic, responsible

On September 17, Phu Nghia Commune Health Station deployed medical staff to Hai Can village to vaccinate children. At nearly 5 p.m., Mr. Dieu De, a YTTB staff member, also went to the homes of households with children of vaccination age to mobilize parents to take their children for vaccination. Mr. Dieu De is one of three S'tieng YTTB staff members of Phu Nghia Commune. Although he is old, he is still attached to the job because he is a prestigious person among the S'tieng people, enthusiastic, responsible and has a good understanding of YTTB activities, thanks to which he carries out YTTB tasks very effectively.

In addition to Mr. Dieu De, Phu Nghia commune also has two YTTB staff of the Stieng ethnic group, Mr. Dieu Chanh in Thac Dai village and Mr. Dieu Dong in Dak Khau village.

Bachelor of Midwifery Nguyen Hoai Nam, Acting Director of Phu Nghia Commune Health Station, shared: For villages with a large number of Stieng people, it is better for the health workers to be Stieng. They are prestigious people in the community, understand the customs and practices; have a firm grasp of the area... so it is very convenient for the work of propaganda, education and health care for the people.

In Loc Quang commune, Ms. Le Thi Kim Dung (68 years old) is the longest-serving YTTB worker, for 30 years. Currently, she is in charge of Hiep Hoan hamlet with 430 households and more than 1,500 people. To do a good job of promoting vaccination and nutrition for children, Ms. Dung has set up a Zalo group of mothers with children under 5 years old. All information about vaccination, vitamin A, disease prevention and control... is sent to this group by her. Thanks to that, Hiep Hoan hamlet's vaccination rate always meets the target. Thanks to her firm grasp of the area, she also promptly supports local medical staff in verifying and handling outbreaks when they occur.

Ms. Dung shared: “Compared to a few decades ago, people's awareness of disease prevention and health care has improved a lot. For example, in vaccination work, many people are willing to pay out of pocket to have their children vaccinated if the commune health station has not been provided with or runs out of vaccines in the Expanded Immunization Program. In the past, there were mothers who fed their children porridge when they were only 3 months old with the hope that their children would be strong, but now the majority of mothers understand the benefits of breastfeeding... Seeing the effectiveness of YTTB work has given me more joy and motivation to stick with this job.”

Looking forward to the new allowance

As the “extended arm” of the commune and ward health stations, the role of YTTB is most clearly demonstrated in preventive medicine campaigns and disease prevention, especially in remote areas and ethnic minority areas. With the advantage of being local people, understanding the local language and culture, YTTB staff can easily convey messages about environmental sanitation, vaccination, and disease prevention to the people. They are also an important “link” in the disease surveillance system. By knowing the households well, even by name, when an epidemic occurs in the area, YTTB staff will quickly identify the outbreak to help the health sector handle it promptly...

Except during epidemics, in general, the work of YTTB is not difficult but requires close adherence and a firm grasp of the area; a sense of responsibility and enthusiasm. In fact, if these factors are lacking, they will not be able to stick with the job, because the allowance for YTTB is currently very low.

Mr. Dieu De (Hai Can village, Phu Nghia commune) talks with people taking their children for vaccination. Photo: Contributor

Ms. Nguyen Thi Hoa, a YTTB worker at Trung Tam hamlet, Bau Ham commune, said: She has been working in the health sector for nearly 8 years, in charge of a hamlet consisting of 24 residential groups with 860 households. Currently, she receives an allowance of 702 thousand VND/month.

“This allowance has increased compared to previous years. I accepted to work as a YTTB because I like to participate in movements and do social work, but this allowance is not commensurate with the work that YTTB has to do,” Ms. Hoa said.

According to midwifery bachelor Nguyen Hoai Nam, Phu Nghia commune was formed on the basis of merging 3 communes of the old Bu Gia Map district: Phu Nghia, Phu Van and Duc Hanh. The whole commune has 23 villages but currently has only 11 YTTB staff. For villages without YTTB, the Commune Health Station uses a team of population collaborators and assigns the station's medical staff to be in charge of the area.

The commune has 20 YTTB staff/20 hamlets, including those who work as part-time population collaborators. YTTB staff effectively implement the programs that the Commune Health Station deploys to the people such as: calling children to get vaccinated, taking vitamin A; providing nutrition counseling to reduce the rate of malnourished children... The advantage of the YTTB team is enthusiasm, working for the movement, for the community.

Specialist Doctor I TRAN VAN THI , Head of Loc Quang Commune Health Station

“The YTTB team are very enthusiastic people despite the low allowance. The commune and the commune health station really need this team. Normally, when there is no epidemic, this team does not have to work too hard, but now, with many types of epidemics, the YTTB work very hard. We hope that the health sector will open more classes to train YTTB for the villages and increase the allowance so that the YTTB team has more motivation to work,” Ms. Nam expressed.

In fact, due to the low monthly allowance, which is not really enough to motivate and encourage the spirit, many YTTB staff have quit their jobs or are still working but not really enthusiastic. Currently, the Ministry of Health is drafting a decree stipulating a number of special allowance regimes for civil servants, public employees, and workers in public health facilities, anti-epidemic allowance regime; support regime for village and residential group health workers and village and hamlet midwives. In which, the proposed monthly support level for village and residential group health workers and village and hamlet midwives is 0.7 and 0.5 times the basic salary.

Hai Yen

Source: https://baodongnai.com.vn/xa-hoi/202509/canh-tay-noi-dai-ket-noi-he-thong-y-te-voi-nhan-dan-4da7777/