Occupational Health and Disease Prevention in Vietnam: A Mid-term Evaluation of the National Action Plan (2020 - 2030) and Policy Implications

Background Vietnam is undergoing rapid industrial transition, with the occupational health burden shifting from accidents to work-related diseases. To strengthen occupational safety and health, the government enacted the National Program on Occupational Safety and Health (Decision 659/QD-TTg). This study assessed mid-term implementation using the WHO Health System Building Blocks framework. Methods We conducted a mixed-methods mid-term evaluation. Phase 1 used administrative data from all 63 provinces and centrally governed cities, including a 2020 baseline and 2021–2025 implementation data. Indicators were grouped into four WHO-adapted domains: governance, financing, service delivery, and information systems. Quantitative data were analyzed using descriptive statistics, trend analysis, and achievement rates against program targets. Phase 2 involved field verification in six purposively selected provinces; qualitative feedback from provincial occupational health officials was analyzed thematically. Results Provincial policy commitment increased, with approved action plans rising from 46.2% of provinces in 2020 to 88.5% in 2025. Budget allocation also expanded, although disbursement remained inconsistent. Service delivery was uneven: environmental monitoring exceeded targets, with an achievement rate of 143.4%, whereas occupational disease screening reached only 46.6% of planned targets. Information systems showed limited digitization, with completion rates below 20%, potentially contributing to under-ascertainment of occupational diseases, particularly among workers in SMEs. Conclusion Decision 659 strengthened governance and resource mobilization but has not yet translated these inputs into effective occupational health surveillance and service coverage. For 2026–2030, priorities should include digitizing the OSH registry, strengthening occupational disease detection, and shifting from punitive inspection toward technical support for SMEs.