The Birth Control Trust of the Galton Institute

Viet Nam is the second most populous country in South East Asia. Still recovering from years of war and international isolation, the country has undertaken a massive programme to reduce its rapid rate of population increase. However, changing economic policies in the last decade have led to deterioration in the country’s health systems. Under the former communist regime, the Government was able to provide high quality primary healthcare services through an extensive network of village clinics. With a partly privatised economy, the system is experiencing a severe lack of funding. As a result, clinics rarely have the necessary drugs or equipment essential to their functioning. This in turn has lead to a fall in the number of patients accessing their services.

The shrinking of governmental health provision has encouraged the expansion of private healthcare services which are easily accessible for those who can afford to pay. Although knowledge of family planning is high in Viet Nam, the lack of contraceptive choice and the shortage of supplies have contributed to the fact that Vietnamese women rely heavily on abortion as a birth control method. The Government of Viet Nam, in its effort to address these issues, welcomes the assistance of NGO implementing agencies to provide affordable, effective and good quality reproductive health services.

It is in this context that MSI was invited in early 1995 by Vietnamese authorities to extend its maternal and child health family planning services by establishing three new reproductive healthcare clinics for women and their families in the provinces of Ha Tinh, Nam Dim and Thai Binh. Partly funded by the European Union, the project is a replication of the successful and innovative model for service provision set up by MSI Viet Nam’s existing clinic and outreach activities located in the Nghe An Province.

The project aims to address the unmet need for Reproductive Health Services in the targeted provinces. The project is based on MSI Viet Nam’s in depth experience of working with local communities, infrastructures, community groups and governmental authorities.

The main users of the projects are women and their families living in urban, semi-urban and rural areas of these provinces where there is a high unmet demand for reproductive health services.

The project is co-ordinated by MSI Viet Nam, Marie Stopes International’s representative in Viet Nam. MSI Viet Nam is officially recognised by the Government.

The Nam Dinh clinic officially opened on 19 June 1998. Representatives of the European Commission, the British Embassy and local authorities attended the ceremony. The opening of the clinic in Thai Binh was delayed until 2 October 1998 due to problems in obtaining permission for clinic operation.

All three clinics are currently open from 7.30 to 17.00 Monday to Saturday.

The clinics are entirely staffed by qualified local Vietnamese who help the development of a local skills base and avoid the high cost of employing expatriates. In line with MSI’s traditional values of staff participation, flexibility and teamwork, the teams have undergone training in areas such as counselling techniques, health education skills, client relations, service promotions and clinic administration. They are therefore able to carry out each other’s tasks (apart from specific doctor tasks).

All the three clinics are now open and fully equipped to provide a comprehensive range of reproductive health services.

At the moment a mobile team is operating in Ha Tinh, taking services to remote underserved peri-urban and rural areas. Liaising with local government health workers in some districts, they have secured government facilities which they use as sites for the mobile services in the region. During the reporting period they have:

• Successfully carried out 137 male voluntary surgical contraception procedures;

• Advised and provided a range of temporary family planning methods to local communities;

• Provided general healthcare services.

In the other provinces, research and negotiations are still ongoing to recruit Volunteer Health Workers (VHW) who will help to establish family planning networks at a district and community level within the provinces. These networks will encourage the referral of clients to MSI clinics, therefore assisting the project to reach a large number of people.

Marie Stopes International believes that monitoring, reporting and evaluation are fundamental for projects to develop a high level of achievement. For that reason, the project performance has been monitored both in country and in MSI London through monthly management, financial and narrative reports supplemented by regular telephone, fax and email contacts. This has enabled MSI London to assess the ongoing needs for managerial and technical assistance and has provided the means for continuous assessment of the project.

The generous donation of the Institute has helped fund the mobile unit. Two much needed vehicles were purchased with the grant. They ensure the transport of everything required to provide services at the sites, including medical equipment, staff and IEC materials. Drugs and suitable tools for outreach services were also acquired. Part of the grant was used to organise Information, Education and Communication training sessions with the VHW’s in order to improve their knowledge of family planning practices and communication skills so that they in turn can carry out IEC seminars.

Supported by the grant of The Galton Institute, The European Union and other private donors, MSI’s programme in Viet Nam continues to make progress in meeting the family planning needs of local communities.

We hope that The Galton Institute is pleased with the investment it has made in this very successful programme in Viet Nam. Our work in Viet Nam has gone a long way to help meet the ever-increasing need for family planning services in the country.

For the coming year, our efforts will be orientated towards consolidating clinical reproductive health provision, developing and expanding IE & C provision to more remote areas, in order to fully implement the outreach component in all three provinces.

We would like to thank The Galton Institute for its continued generous support.