Newborn Care in Vietnam Presented at A Global Conference on NB Care Johanesburg April 14- 19, 2013

Vinh Nguyen Duc MD; MPH MCH Dept., MOH Government of Vietnam

MOH

MCH Department

Central Ob/Gyn Hos.

Central Pediatrict Hos

NIN

Provincial Hos.
Ped. Dept Ob/Gyn Dept.

Provincial RHC Center

2nd Med. School

Ped. faculty Ob/Gyn Faculty

Dist. hospital
Ped. unit Ob/gyn unit

RHC Unit

Midwifery unit

chc

Poly clinic

Midwifery unit

Vilaage health worker

MMR Trends in VN (Inter-agencies estimations in 2012)

300

250

240

200

160
MMR 150

100
100

74

59

59.3

50

1990

1995

2000
Year

2005

2010

2015 Target

Child Mortality Trend in Viet Nam

(Source: UN Inter-Agency Group for Child Mortality Estimation 2011)
60 51 50

40

37

U5MR (%o) 30 23 20 23 19 17 IMR (%o) NMR (%o)

14.8
12 10

0 1990 2010 Target 2015

Inequity in NMR (MOH 2009)

95% CI NMR/ 1000 live births Lower National Mountainous rural Plain rural Urban/city 7 10 5 4 5 8 3 2 Upper 9 13 8 7

Causes of neonatal death national data Survey on maternal and neonatal mortality 2006-2008, MOH

Policy and Strategies

Law on health Insurence; Labor Law; Advertisement Code; GoV Decree 21 National Strategy on RH Care (including Newborn Care) for the period 2011 2020. National RH Service Standard. Child Survival Master Plan 2009- 2015. National Plan for safe motherhood and newborn care 2011-2015 (Safe motherhood Master Plan in 2003).

National Plan for Safe Motherhood & Newborn Care 2011-2015

1. Increase investment in SM and newborn care. 2. Improve accessibility and quality of MNCH services at grassroot level, special attention to remote villages (village midwife network and community-based referral system). 3. Strengthen the referral network of the health system to ensure complications be promptly managed and referred. 4. Establish Neonatal Care Unit (NCU) at district hospitals. 5. Strengthen competencies of health providers.

Challenges
Disparity in terms of health status and mortality of mother and newborn across regions. U5MR and IMR reduced strikingly, but NMR is still high and accounted for 70% of IMR and 50% of U5MR. Government budget allocated for MNCH. Capacity of health staff at district and grassroots levels. KAP of mother and community people on MNCH care are needed to improve.

Activities in the years to come to reach MDG5

Approach: Life cycle interventions and HHCC. IEC/BCC to increase political wills and community support. Pregnancy and childbirth care to reduce premature births and stillbirths Early Essential Newborn Care and care for sick newborn (at district hospital) to reduce neonatal deaths, particularly in the 1st week of life
Scaling up mother-newborn care interventions at birth including:

Active Management of the Third Stage of Labor (AMTSL); Delay cord clamping; Skin to skin contact; and Early initiation of breastfeeding

Strengthening Newborn Resuscitation, routine Newborn Care, including postnatal visits Scaling up Kangaroo Mother Care to reduce death due to low birth weight and premature births

M& E

Integrated MNCH services package through womens life cycle

Households Prepregnancy Commune health stations District hospital s Provincial hospitals

Pregnancy
Life Cycle Delivery care Postnatal care Newborn care Child care Mother, her newborn, children receive health services whenever they need

Family planning, ANC, delivery care, Essential Newborn Care , EmONC, IYCF, Maternal and Child nutrition, child immunization, management of childhood disease, PMTCT

Lets bring SMILES to Mother and Newborn! Special Tks to UNICEF, WHO and all other IDPs to support MNCH in VN!