Restructure of the provincial preventive medicine system in Vietnam: Implication for the HIV/AIDS human resources.

Recently, Vietnam has issued Joint Circular No. 51/2014/TTLTBYT-BNV 11/12/2015 and Circular No. 26/2017/TT-BYT dated 26/6/2017 to reform the preventive medicine system at the provincial level. This study analyzed the impact of these policies on the HIV/AIDS prevention health workforce (HW) and provided the lesson learnt from the restructure process. The annual health reports of 22 selected provinces were reviewed for the analysis of the changes in human resources of the HIV/AIDS network after the establishment of the provincial Center for Diseases Control (CDC). We conducted 19 in-depth interviews and 2 focused group discussions in CDCs of 6 provinces that have high HIV incidence. The results showed that the merger of preventive medicine centres into one provincial CDC has brought substantial challenges for the HW in the HIV/AIDS network. This made a negative impact on the worker motivation and competency and the coordination in HIV/AIDS prevention activities. Our results suggested that the restructure of health systems in countries with limited resource settings like Vietnam needs to pay attention to the arrangement of human resources and the coordination between newly formed units. [ABSTRACT FROM AUTHOR]