Factors associated with community health workers’ confidence in addiction service provision in Vietnam: a cross-sectional study

Background Community health workers play a critical role in expanding access to addiction services in Vietnam, particularly in the context of recent health system reforms that strengthen community-level healthcare delivery. To optimize the effectiveness of service delivery for people who use drugs in community settings, it is essential to understand factors that shape community health workers’ confidence in providing addiction-related services. This study examined individual and work-related correlates of their confidence in service provision. Methods We utilized baseline data from an intervention trial conducted in three provinces of Vietnam. A total of 174 community health workers from 58 community health centers participated in the study. Multivariable linear regression models were employed to examine associations between confidence in service provision and key factors, including job satisfaction, training related to addiction services, attitudes toward methadone maintenance treatment, and demographic characteristics. Results Higher confidence in addiction service provision was significantly associated with older age (β = 0.31, p < 0.01) and prior addiction-related training (β = 0.18, p < 0.05). More positive attitudes toward methadone maintenance treatment were associated with greater confidence in bivariate and partially adjusted models (β = 0.18, p < 0.05), but this relationship was attenuated after accounting for job satisfaction. Job satisfaction remained positively associated with confidence in the final adjusted model (β = 0.18, p = 0.05). Confidence was not significantly associated with gender, professional role, or length of employment. Conclusions This study highlights the importance of job satisfaction and addiction-related training in strengthening community health workers’ confidence to deliver addiction services. Supportive work environments and strategies may be particularly critical for building a confident and effective community health workforce amid Vietnam’s recent health system reforms. Trial registration Not applicable.