Viet Nam has received global recognition for its COVID-19 response during the initial months of the outbreak, and continues to remain vigilant. Previous experience with public health emergencies and disease outbreaks, enabled an early, proactive response and contributed to Viet Nam’s effective management of COVID-19. Among the many interventions attributable to Viet Nam’s success are innovative approaches taken to train and prepare Viet Nam’s health workforce, in particular primary health workers.

Accelerating health workforce preparedness is a pivotal measure in effectively managing COVID-19. During the initial months of the outbreak, health practitioners were grappling with a novel disease and treatment was new, as well as rapidly changing. It was therefore crucial to build the capacity of health workers to respond to the outbreak, while simultaneously enabling uninterrupted provision of essential health services. Among the health workforce, primary care workers emerged as crucial first responders in preventing wider community transmission. Primary care workers play a significant role in gatekeeping: making an early diagnosis, responding to those most vulnerable and reducing the demand for hospital services. It was therefore vital to train this segment of the health workforce in disease management guidelines, IPC and treatment protocols.

Viet Nam was additionally challenged by a shortfall of trained primary care workers, particularly in remote regions. Challenges include how to raise the quality of healthcare services, including strengthening the skill sets of primary care workers given they have more limited qualifications and learning opportunities. Health statistics indicate that nurses, midwives, medical technicians and pharmacists in these remote regions have only secondary- or elementary-level training.

Prior to COVID-19, the WHO Viet Nam Country Office with support from the ‘India, Brazil and South Africa Facility for Poverty and Hunger Alleviation’ (IBSA) Fund, Hai Phong Medical and Pharmaceutical University (HPMU) and the Ministry of Health (MOH) of Viet Nam established the IBSA e-learning platform for health workers in 2015. The platform provides online lectures for medical students and primary care workers in northern coastal provinces of the country. It serves as an innovative approach to strengthen health workforce capacity through South-South cooperation.

In 2020, in light of the increasing demand to level-up knowledge among primary care workers, the WHO Country Office and HPMU leveraged the existing IBSA e-learning platform to disseminate additional training modules on COVID-19. Technical officers from the WHO country office translated COVID-19 courses developed by the OpenWHO into Vietnamese[1], enhanced the cultural-relevance of practices outlined in these courses and incorporated suggestions from health care workers during the pilot-testing phase. Further, WHO supported HPMU to develop COVID-19 training materials specifically for PHC workers and repackage these materials to match online learning formats. Given that NCDs are risk factors for severe COVID-19 cases, training courses on NCD management were also updated and disseminated via the same platform. WHO’s country office team relayed COVID-19 updates to the MOH on an ongoing basis to facilitate better preparedness across the country.

As a result of these efforts, the IBSA e-learning platform saw an increase in uptake by health care workers in Viet Nam.  More than 4200 health care workers have accessed the COVID-19 courses, including over 200 primary care workers serving at the community level. Results from assessments by conducted by HPMU for the formal e-learning courses on COVID-19 show a high pass rate of 96%.

Furthermore, the initiative stimulated a shift in the use of e-learning in Viet Nam. Prior to the COVID-19 pandemic, traditional learning approaches for health workers relied heavily on face-to-face training, and it was challenging to get buy-in for the e-learning platform. However, since the pandemic, there has been greater interest and willingness to utilize e-learning modalities for workforce training and peer-learning, as well as using e-health and telemedicine for service delivery. The WHO Country Office is working to promote these innovations to increase uptake of e-learning offered via the platform through, for example, proactive communication with District Health Centres to promote e-learning among health workers at Community Health Centres across the country. Other efforts include accreditation of training modules, which in turn will increase uptake from health workers. Given that the quality and format of training material also influences uptake, efforts are being made to make lectures available in video format and accessible via smart phones. Building on the success of this initiative, the WHO Country Office is now planning to support the MOH and other medical universities to introduce tele-health/telemedicine within the primary health care system.

Well-trained and motivated health workers are foundational to accelerating Universal Health Coverage and achieving the goals of the GPW 13 and the SDGs. This requires rethinking traditional models of education and service delivery, to utilize innovative approaches that can help build the workforce in underserved areas or specialties, thus strengthening health service delivery. E-learning proved effective in training health workers across Viet Nam during the pandemic, particularly primary health workers. COVID-19 worked as a stimulus for the Vietnamese government to accelerate digitalization and IT applications within the health sector; WHO’s long-term investment in e-learning prior to the pandemic paid off. Further efforts are now needed to monitor and improve effectiveness of e-learning innovations aimed at enhancing health service delivery.