Facilitating factors and barriers to the implementation of hypertension prevention programs in Vietnam: lessons learned from the Communities for Healthy Hearts program

Background: Non-communicable disease (NCD) is the greatest contributor to premature deaths worldwide, with hypertension at the forefront. There was a need for a new model to help battle the burden of hypertension. In 2016, an innovative service delivery communitybased model was launched in Ho Chi Minh City, Vietnam: "Communities for Healthy Hearts (CH2) program." This qualitative study's focus is on the facilitators and barriers of the 5 aims of the Program. Methods: We purposively selected 39 key participants, 20 for focus group discussions, and 19 for semi-structured interviews. We employed thematic content analysis and used NVIVO12 for data analysis. Results: Overall, the diverse communication activities, training courses, and general support by key stakeholders were highlighted as the facilitators of the CH2 program. Barriers reported by interviewees were heavy workloads and the lack of financial incentives among the network, poor and inadequate referral services for patients, and the pending application of the digital registry for patient management. Overall, many informants were satisfied with the communication strategies, the increased accessibility of the hard-to-reach groups, the increased knowledge of residents, and early detection of hypertension; however, they expressed their concern about the long-term sustainability of this innovative model and the potential for scale-up.