Table 1 Summarizing the status of implementation of each of the six areas and related barriers to progress

Leadership/governance

Released the policy/action plan (NAPCA)

Establish working groups

Run project 4041

Cooperation among implementation bodies was not good

Project objective was not feasible

Health workforce

National manual on antibiotic use, a manual on clinical microbiology testing techniques, and several guidelines on infection control were developed and used in short courses for practicing doctors and pharmacists at national and provincial hospitals

The doctor, pharmacist and other health professionals at the district and lower levels had less chance to get training on AMR topics compared to those working in provincial and national hospitals

Medications and technologies

Government agencies issued regulations indicate that antibiotics only sold under prescription

Antibiotics can still be bought and sold freely in almost all retail pharmacies throughout the country

Imported drugs were preferred to locally-manufactured drugs because of the belief that the former are always of better quality

Service delivery

Up to 2019, half of hospitals from national to district levels in Vietnam had formed an AMS team

A small number of Vietnamese hospitals have taken proactive steps in introducing AMS to implement the NAPCA in their facilities

The shortages in human resource at both higher- and lower-level hospitals

Health financing

Expenditure on antibiotics comprised one third of total drug costs

Perverse incentives exist that may drive inappropriate antibiotic use

Information

An AMR surveillance system extracting data from project hospitals was established and operated during the period of 2013 to 2016

Communication plan for AMR prevention is issued annually and its objectives are customised for each period

AMR surveillance system experienced delays in data submission from several hospitals to the MOH. Some hospitals did not find the feedback resulted in benefits to them