In the northwestern region of Vietnam, which has the highest poverty rate in the country, the quality of medical services was deteriorating due to a serious shortage of medical personnel. Under these circumstances, the Japanese government implemented a technical cooperation project (2004-2009) in Hoa Binh Province, where a referral system between provincial and district hospitals was established through the construction of a network of DOHA (a system in which upper-level hospitals provide guidance and support to lower-level hospitals) at the provincial and district levels and the strengthening of technical skills of medical personnel. On the other hand, the communal system was established at the county level and below. On the other hand, the establishment and expansion of the referral system and the dissemination of the DOHA cycle, including municipalities below the county level, as well as the dissemination of the results within the province to neighboring provinces, were issues. Through this cooperation, we strengthened the capacity of the Ministry of Health (MOH) to manage DOHA, established a referral system in Hoa Binh Province, and spread the referral system to five neighboring provinces, thereby strengthening DOHA and the referral system in the northern mountainous provinces and contributing to the improvement of medical services in the target areas. The project contributed to the improvement of health care services in the target areas.
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