Current status of policies and Conditions to ensure the operation of school health in Vietnam

Background: Good health care and education for students promotes the improvement of the quality of the country's future human resources. School health has received the attention of the Party and the Government as reflected in laws, resolutions, and decisions facilitating the legal framework in the implementation. However, there are still many difficulties and challenges in the implementation. This paper reviews existing policies and guidelines on school health in Vietnam; assesses the implementation of school health activities, difficulties, and challenges in the implementation. Methods: Descriptive study design combining desk review, and qualitative and quantitative methods were applied. In-depth interviews and focus group discussions with leaders of health sectors, education sectors, home affairs, and social insurance sectors at commune, district, and provincial levels; School administrators, school health staff at all levels of education from kindergarten, primary school, and secondary school, and high school have been implemented in 5 provinces of 5 regions of Vietnam. Results: The policy documents on school health in Vietnam have been issued quite fully, which were the legal basis for localities to perform well. However, there were still many difficulties and challenges due to gaps in regulations on conditions to ensure the operation of school health. Survey results in 05 provinces in 2017 with 5.540 schools at all levels show that: 89.9% of schools have school health staff; 56.5% of the schools have school-based health staff and the rest is contracted. The rate of non-medical school staff is 37.5%. Regarding the benefits and regimes of schools, health staff is facing many difficulties. The training was implemented annually; however, the training quality is not enough. The budget for investment in school health activities is still difficult, not meeting the demand. Conclusions: the legal documents were adequate to facilitate the implementation of school health activities. However, there are still many difficulties and challenges in some localities and schools in the implementation. Therefore, it is necessary to promulgate policies more practical. The coordination between the health and education sectors was still not close and lacked consistency and synchronization.