The lessons learned from Vietnam, a country that the world acclaimed for its management of the fight against COVID-19, could stand out as an example of how to do more with less. The Vietnamese government has acted swiftly at the very early stage of the pandemic with a focus on containment efforts and extensive public health measures, particularly (1) the commitment from the government with a multisectoral approach; (2) a timely, accurate, and transparent risk communication; (3) active surveillance and intensive isolation/quarantine operation, case management with tracing all new arrivals and close contact up to three clusters; and (4) suspension of flights, shutting schools, and all nonessential services.
An important factor for monitoring health transition is the collection of valid and reliable population data over time. 1 However, given the weaknesses of the national health information systems in low-and middle-income countries such as Vietnam, especially in the area of generating high-quality population-based information, health and demographic surveillance systems (HDSSs) have been shown to generate high-quality population-based data and scientific evidence on the levels, patterns, and trends in health and health care transitions in a country.
BackgroundThe National Hospital of Pediatrics in Vietnam performed >200 exchange transfusions annually (2006–08), often on infants presenting encephalopathic from lower-level hospitals. As factors delaying care-seeking are not known, we sought to study care practices and traditional beliefs relating to neonatal jaundice in northern Vietnam.MethodsWe conducted a prospective, cross-sectional, population-based, descriptive study from November 2008 through February 2010. We prospectively identified mothers of newborns through an on-going regional cohort study. Trained research assistants administered a 78-item questionnaire to mothers during home visits 14–28 days after birth except those we could not contact or whose babies remained hospitalized at 28 days.ResultsWe enrolled 979 mothers; 99% delivered at a health facility. Infants were discharged at a median age of 1.35 days. Only 11% received jaundice education; only 27% thought jaundice could be harmful. During the first week, 77% of newborns were kept in dark rooms. Only 2.5% had routine follow-up before 14 days. Among 118 mothers who were worried by their infant’s jaundice but did not seek care, 40% held non-medical beliefs about its cause or used traditional therapies instead of seeking care. Phototherapy was uncommon: 6 (0.6%) were treated before discharge and 3 (0.3%) on readmission. However, there were no exchange transfusions, kernicterus cases, or deaths.ConclusionsEarly discharge without follow-up, low maternal knowledge, cultural practices, and use of traditional treatments may limit or delay detection or care-seeking for jaundice. However, in spite of the high prevalence of these practices and the low frequency of treatment, no bad outcomes were seen in this study of nearly 1,000 newborns.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2431-14-264) contains supplementary material, which is available to authorized users.
The remarkable increase in Vietnamese economic conditions can increase the birth weight in neonates and better delivery practices among women. The Chi Linh Health and Demographic Surveillance System started in 2004. An open cohort of data consisting of about 57 561 people from 17 993 households has been followed primarily with respect to demography, economy, and education. The aim of this research is to study secular trends in delivery practice and birth weight in the past decade (2005-2012) in Chi Linh. We found a significant change in delivery rates at hospitals and cesarean section rates, but the birth weights over a decade of drastic economic development were stable. Furthermore, the findings show significant associations of birth weight and delivery practices with the child's sex, mother's age, and household income. Our results might be considered as representative for other similar periurban settings in Vietnam. We suggest that appropriate policies should be developed given the reduction in the use of delivery services in commune health centers in urban areas.
In this pilot study, home-use icterometry may help improve parental detection of jaundice in rural Vietnam. However, larger studies are necessary to determine the changes in recognition, care seeking and treatment.
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