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Background: To support informal dementia carers, the World Health Organization (WHO) developed 'iSupport for Dementia' online skills training program, culturally adaptable to local contexts. Several WHO Member States are adapting the program. This study was conducted to draw lessons about iSupport adaptation in Australia, Brazil, Indonesia, New Zealand, and Qatar. Method: A short questionnaire regarding modifications made to the WHO iSupport adaptation methodology, changes made to the WHO iSupport manual, and the enablers of and barriers to the iSupport adaptation process was sent to the iSupport adaptation research teams in the five countries. Data were analysed thematically. Result: Countries modified the WHO adaptation methodology, undertaking more focus group discussions (FGDs) than recommended. Prior to the FGDs, iSupport manual was divided into smaller, more manageable sections. Individual participants only reviewed a section rather than the entire manual to reduce burden. Common adaptation includes changes to language and terminology used in the manual to be more empathetic and person‐centred. In Australia, and later New Zealand, an additional module was added about person‐centred care principles and access to formal care services. In Brazil, additional topics such as fall prevention were suggested. Four countries identified short video clips as a method to increase usability of and real‐time access to the iSupport manual. In Australia, scenarios from the Australian adapted iSupport manual were translated into scripts then storyboards and 50 animations were produced via an iterative, ongoing stakeholder feedback process. Themes emerged include an emphasis on carers understanding of the disease, validating their experiences and emotions and creating authentic content that genuinely reflects caring for someone with dementia. In New Zealand and Indonesia, Australian animations were used and adjusted to suit the local contexts through modifications to terminology and animation characters. Qatar developed five short videos, each reflecting a module of the iSupport, to encourage carers to seek further information in the adapted iSupport program. Conclusion: Modifications of the current WHO iSupport Adaptation and Implementation Guidelines are needed. There is a need to improve the accessibility and usability of the iSupport online program, with the inclusion of short video clips being one possible solution. [ABSTRACT FROM AUTHOR]

Background: As part of the effort to gather research evidence for the development of Vietnam's National Dementia Plan, a systematic review was conducted to map dementia research in Vietnam or among the Vietnamese diaspora. This paper aimed to report the qualitative research evidence on the life experiences of people with dementia in Vietnam and among the Vietnamese diaspora. Method: Systematic searches were conducted in June 2019 using Medline, Embase, Emcare, PsycINFO and Cochrane electronic databases, as well as grey literature. Keywords and Medical Subject Headings [MeSH terms] for dementia and associated terms were combined with keywords for Vietnam and its provinces. Qualitative research articles published in English or Vietnamese were included to examine evidence on the life experiences of Vietnamese people with dementia using thematic analysis. Result: Our searches resulted in 3,940 papers, from which 21 qualitative research studies were included for final analysis. The majority of research has not been undertaken in Vietnam but with the Vietnamese diaspora in Western countries and has taken a cultural perspective to analyses. Research in Western countries has focused on the need for culturally adapted and culturally sensitive models of care. Emerging themes about the life experiences of Vietnamese people with dementia identified from the studies included: many people do not have diagnostic terms for dementia but use the descriptive language of symptoms; stigma was a reported problem and on occasions can be observed in the descriptive language used for people with dementia; cultural and traditional values create both an opportunity and a barrier, supporting compassion, family care and relaxation, but creating barriers to accessing health services or long‐term residential care. Conclusion: This is the first systematic review reporting evidence on the life experiences of people with dementia in Vietnam and among the Vietnamese diaspora. Future research is needed on the voice of people with dementia themselves and their caregivers particularly in low and middle‐income countries with regards to living with dementia, pathways to care from diagnosis, treatment, care and support, additional social care and preparedness for end of life care for people with dementia. [ABSTRACT FROM AUTHOR]

Background: Vietnam is facing rapid population ageing, with one in four Vietnamese citizens being over 60 years old by 2050. This has contributed to a boom of chronic and non‐communicable diseases, such as dementia. In order to develop a national dementia plan as recommended by the World Health Organization (WHO) and increase the preparedness of the healthcare system to tackle dementia, a situational analysis of the current healthcare services related to dementia is needed. Method: In late 2019, we conducted a situational analysis desk review of the healthcare system in Vietnam, focusing on health service delivery for the elderly, using the guidance developed by the Strengthening Responses to Dementia In Developing Countries (STRiDE) project. The WHO's six‐building‐block framework was used to analyse the healthcare system in Vietnam, followed by the thematic and SWOT (Strengths, Weaknesses, Opportunities and Threats) analyses of dementia‐related healthcare services. Result: Although Vietnam has achieved significant improvement in healthcare in general, there are still inefficiencies in health service delivery. There are also discrepancies in health service readiness and quality across areas of healthcare. Despite of extensive primary healthcare system, grassroots‐level facilities have inadequate infrastructure required for basic care delivery and none for dementia. There are few healthcare facilities at central and provincial levels, mainly located in the three biggest cities of Hanoi, Ho Chi Minh and Danang, providing services for people with dementia. There is limited training in dementia diagnosis and management for health professionals. Conclusion: Developing a national dementia plan, including transforming the current healthcare services to better cope with rapid population ageing and dementia disease is urgently needed in Vietnam. Integrating dementia services into existing health and social services for the elderly and the disabled, making use of the extensive primary healthcare system in detection, early interventions, management and support for people with dementia at community level are strategic solutions to deal with dementia in a sustainable way. To this end, a whole‐system approach in transformation and operation with implementing a patient centred care model is necessary. [ABSTRACT FROM AUTHOR]

Background: Vietnam has decided to develop an integrated national action plan that integrates dementia into existing non‐communicable diseases (NCD) initiatives. Prior to formulating an effective plan, however, reliable information on current situation of dementia care, treatment and support in Vietnam is needed. This study was conducted to better understand the context, barriers and opportunities for improving dementia care, treatment and support in Vietnam and guide the plan development. Method: A desk review was conducted using the Situational Analysis Desk Review Topic guide developed by the Strengthening responses to dementia in developing countries (STRiDE) project. Key WHO Global Dementia Observatory (GDO) indicators were collected, focusing on Policy, Service Delivery and Epidemiological assessments. Result: Vietnam has a high level institutional and policy framework on aging, NCD, mental health and disability including the 2009 Law on the Elderly, which provides the legal umbrella for policies on older people. However, no dementia‐specific policy exists and policies to promote healthy brain remain weak. Rapid aging significantly contributes to the explosion of NCD including dementia in Vietnam. There are 660000 Vietnamese people estimated to be living with dementia, with resultant dementia related costs of US$ 960 million. The healthcare system is not yet prepared for the shift to NCD from an acute, communicable disease burden in the past. Health service delivery is hospital‐centric, with over‐reliance on hospitals and under‐utilization of primary care system that in turn is fragmented and poorly prepared to address the rising challenge of dementia. Social care and support specific for dementia is lacking although there is an impressive grassroots organisation of older people with nearly 100,000 branches. Conclusion: To allow for a more harmonized response across the health sector and more effective use of limited resources, an integrated national action plan for dementia is sensible. However, Vietnam should take into consideration the potential for fragmentation and lack of dedicated resources being allocated to dementia. A new, integrated model of care focusing on a stronger primary healthcare system, community‐based social care and a healthy aging approach is needed to improve dementia prevention, care, treatment and support in Vietnam. [ABSTRACT FROM AUTHOR]