Hanoi School Of Public Health

About: Hanoi School Of Public Health is a education organization based out in Hanoi, Vietnam. It is known for research contribution in the topics: Population & Public health. The organization has 182 authors who have published 266 publications receiving 23330 citations.

Using guidelines to improve neonatal health in China and Vietnam: a qualitative study

Abstract: Neonatal health (NH) remains a major problem in many countries. Children dying before 28 days often suffer from conditions that are preventable or treatable with proven, cost-effective interventions. The knowledge gaps are no longer about what should be done, but to understand why guidelines including these interventions are not followed. Using a behaviour change framework, this study explores neonatal health guidelines use and the role of management in supporting effective usage in two rural settings in China and Vietnam. Semi-structured interviews with policy makers, health care managers and providers (n = 49) and focus group discussions with women, husbands and grandmothers who had experienced maternal and NH care services within the last year (n = 7) were conducted. Data were analysed using the framework approach. Guidelines are not readily available at county, township and village levels in the study sites in China, whereas, in Vietnam, guidelines are available, accepted and being used at facility level. Improvements in implementation could be made in both settings. Factors influencing guidelines use common to both settings included: lack of equipment and supplies; shortage of staff with NH care experience; and guidelines not in line with patient practices. Factors specific to China included: poor guidelines dissemination; and disagreement with guidelines. There was limited community engagement in NH services in China, whereas in Vietnam, community members were actively involved in decision making and provision of services. Managers have an important role in supporting NH guidelines use through: ensuring guidelines are available; allocating appropriate resources; supporting and monitoring staff in their use; and engaging with local communities to promote effective practices. Engaging managers to support implementation is crucial. Management systems that provide the necessary resources, competent staff, and monitoring, regulatory and incentive frameworks as well as community engagement are needed to promote adoption of guidelines. Further research on how best to strengthen local level management so that they tailor interventions to support guideline use to their specific context is needed. This will ensure that proven interventions to address NH problems are used, and that countries move closer to achieving the new Sustainable Development Goal 3 target.

Patterns of Mortality in the Elderly in Chi Linh, Hai Duong, Vietnam, Period 2004-2012.

Abstract: Objective: This paper examines the trends of mortality in the elderly people in Chi Linh during period 2004–2012 and identifies a number of factors related to mortality in the elderly. Design: The longitudinal study method is used. The analyzed data is extracted from database of theDemographic—Epidemiologic Surveillance System (DESS) of Chililab. The data is collected from 7 communes/town of Chi Linh district, Hai Duong province during 2004–2012 with all elderly people. Descriptive statistical analysis and survival analysis using Kaplan Meier survival estimates and Cox regression models were used. The indirect standardization was used to compare between the mortality rate of the elderly in Chi Linh and the rates of those in some reference groups. Results: Mortality rate in elderly tend to decrease over the period 2004–2012. In all the time, mortality rate in elderly men is higher than that in the elderly women. Specific mortality rates by age groups have increased in both males and females. The increase Age specific mortality rates in males is higher than females. Indirect standardized mortality data for the elderly in 2009 in Chi Linh, Vietnam, Canada, the United States of America (USA) showed that elderly mortality rate in Chililab in 2009 was lower than that in elderly of Vietnam (standardized mortality ratio—SMR of elderly in Chililab is only by 75% in comparison with elderly of Vietnam), and also lower than that in elderly people in the US, and Canada. Cox regression analysis (multivariate models) show that with every 1 year older, the risk of death in elderly men increased by 9% and 12% increase in elderly female, for both men and women general risk increased by 10% (p < 0.05). Elderly with higher education levels, elderly with better family economic conditions; elderly living with wife/ husband have lower mortality risk than the other counterparts. Conclusions: The research results suggest some recommendations: Strengthening health care programs for elderly people with low education levels, poor economic conditions, and celibacy groups (the vulnerable groups).

Sustainability of public health interventions to reduce the risk of dioxin exposure at severe dioxin hot spots in Vietnam

Abstract: Severe dioxin contamination at Bien Hoa and Da Nang airbases, Vietnam is of international concern. Public Health risk reduction programs were implemented in Bien Hoa in 2007-2009 and in Da Nang in 2009-2011. In 2009 and 2011 we reported the encouraging results of these interventions in improving the knowledge, attitude and practices (KAP) of local residents in reducing the dioxin exposure risk through foods. In 2013 we revisited these dioxin hot spots, aimed to evaluate whether the results of the intervention were maintained and to identify factors affecting the sustainability of the programs. To assess this, 16 in-depth interviews, six focus group discussions, and pre and post intervention KAP surveys were undertaken. 800 respondents from six intervention wards and 200 respondents from Buu Long Ward (the control site) were randomly selected to participate in the surveys. The results showed that as of 2013, the programs were rated as "moderately sustained" with a score of 3.3 out of 5.0 (cut off points 2.5 to <3.5) for Bien Hoa, and "well sustained" with a score of 3.8 out of 5.0 (cut off points 3.5 to <4.5) for Da Nang. Most formal intervention program activities had ceased and dioxin risk communication activities were no longer integrated into local routine health education programs. However, the main outcomes were maintained and were better than that in the control ward. Migration, lack of official guidance from City People's Committees and local authorities as well as the politically sensitive nature of dioxin issues were the main challenges for the sustainability of the programs.

Sustainability of Public Health Interventions to Reduce the Risk of Dioxin Exposure at Severe Dioxin Hot Spots in Vietnam

Abstract: Severe dioxin contamination at Bien Hoa and Da Nang airbases, Vietnam is of international concern. Public Health risk reduction programs were implemented in Bien Hoa in 2007-2009 and in Da Nang in 2009-2011. In 2009 and 2011 we reported the encouraging results of these interventions in improving the knowledge, attitude and practices (KAP) of local residents in reducing the dioxin exposure risk through foods. In 2013 we revisited these dioxin hot spots, aimed to evaluate whether the results of the intervention were maintained and to identify factors affecting the sustainability of the programs. To assess this, 16 in-depth interviews, six focus group discussions, and pre and post intervention KAP surveys were undertaken. 800 respondents from six intervention wards and 200 respondents from Buu Long Ward (the control site) were randomly selected to participate in the surveys. The results showed that as of 2013, the programs were rated as "moderately sustained" with a score of 3.3 out of 5.0 (cut off points 2.5 to <3.5) for Bien Hoa, and "well sustained" with a score of 3.8 out of 5.0 (cut off points 3.5 to <4.5) for Da Nang. Most formal intervention program activities had ceased and dioxin risk communication activities were no longer integrated into local routine health education programs. However, the main outcomes were maintained and were better than that in the control ward. Migration, lack of official guidance from City People's Committees and local authorities as well as the politically sensitive nature of dioxin issues were the main challenges for the sustainability of the programs.