Improving the health outcomes of neonates across Vietnam through innovative partnerships.
Vietnam has made successful strides to reduce its infant mortality rate from 44.4 per 1,000 live births in 1990 to 15.5 per 1,000 in 2005. The country still has much work to do, however, as it is ranked at #93 in the United Nations’ infant mortality country list.
For Vietnam to reach the UN Millennium Development Goal (MDG) target of reducing the infant mortality rate by two-thirds by 2015, it will require greater efforts and assistance, particularly in rural and ethnic minority areas.
Da Nang is Vietnam’s third largest city and its main hospital, the Da Nang General Hospital, serves a local population of 887,069, as well as infants and children from the central and highland areas. The hospital’s Pediatric Department is the largest in central Vietnam and cares for an average of 400-500 in-patients per day, despite having only 220 beds.
The Department of Pediatrics neonatal team has received world-class training from experts such as Dr. Steven Ringer, Chief of Neonatology at Harvard’s Brigham and Women’s Hospital, who praised the team’s skill, dedication, and hunger for knowledge and new strategies to improve their capacity.
Training and equipment support from generous donors and volunteers has contributed significantly to the relatively high level of care currently provided by the Pediatric Department. As a result, from 2004 to 2009 the hospital’s infant mortality rate was greatly reduced, from 14/1000 to 8/1000. In 2012, the mortality dropped 25% to 6.2/1000. The reality remains, however, that compared with the minimum hospital and health care standards in developed countries, the Da Nang Department of Pediatrics is severely under-resourced.
In 2009, the Da Nang Department of Health, in recognition of the needs of the infants and children of central Vietnam and the work of the Department of Pediatrics, decided to create the Women’s and Children’s Hospital. The hospital turned to the VinaCapital Foundation and the Royal Melbourne Institute of Technology in Vietnam (RMIT) for assistance in ensuring that the new hospital’s Neonatal Intensive Care Unit (NICU) and the High Dependency Unit (HDU) would be on a par with the best facilities in Hanoi and Ho Chi Minh City, enabling Da Nang to move closer to international standards of pediatric care.
RMIT and VCF completed the designs for the NICU and the HDU. The designs follow best practices for Australasia and include elements standard in developed countries, such as one incubator per baby with a backup power system, a clean air system, and multiple sinks for hand washing to reduce infection, and controllable lighting. The new units provided care for up to 50 critically-ill babies.
Completion of the construction upgrades to the new facility to encompass the above best practices was completed and the new facility was opened in April 2011.
The new facilities have greatly improved the care and survival of infants in central Vietnam and is helping the hospital meet its target of reducing infant mortality by a minimum of 1% per year. The creation of a more controlled environment through management of access, lighting, and noise will significantly improve the health outcomes of neonates, and improved infection control ensures that the infants’ recovery is not compromised by cross-infections.
The RMIT/VCF design also closely involves parents in the health care and management of their babies, which aligns with international best practices as well as with traditional Vietnamese culture in which the family is the core unit of attachment.
The new Neonatal Intensive Care and High Dependency Units has become a regional center of excellence in health care and medical training. The doctors and nurses there will directly save the lives of thousands of infants and children, including the most disadvantaged ones in the region’s rural and ethnic minority areas, and help drastically further reduce Vietnam’s infant mortality rate.
The total cost of construction changes to develop these two units was $120,000, and the total cost of equipping them is approximately $800,000 which includes essentials such as complex diagnostic equipment to detect fetal congenital defects, neonatal resuscitation equipment, incubators and ventilators.
In 2012 and 2013 VCF continued to add equipment to the neonatal team’s unit. Equipment needs still total over $350,000.
In 2013, in conjunction with the acclaimed newborn care team at Harvard Medical School’s teaching hospital Brigham and Womens, led by Steven Ringer, MD PhD, VCF began to offer a blended learning program which includes:
- A 7 session telemedicine symposia series on Neonatal Care
- An onsite Train the Trainer medical mission with the newborn care team here in Vietnam training trainers on neonatal procedures
- Trainers will be encouraged and facilitated to spread the training in their region
This program is funded by a grant from World Bank and Australian Aid and the above will be completed in 2013. We hope to continue the effort in coming years with a similar format and continue to give equipment.
In 2012, the Danang Woman and Childrens NICU saw a 60.2% rise in cases and a 25% decrease in neonatal mortality in the unit down to an outstanding 6.2/1000. The national average is 16/1000. The NICU has become the referral source for 5 surrounding provinces.
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