The Birth Control Trust of the Galton Institute

Viet Nam is a country working hard to recover from the ravages of thirty years of war and international isolation. A package of economic reforms has begun to revitalise the economy. Still, Viet Nam has the lowest per capita income in Asia. The introduction of market reforms in the former communist regime has affected the system of state welfare services such as healthcare.

There is a serious shortage of medical equipment supplies and qualified personnel. Although knowledge of family planning is high, the choice of methods is extremely limited and contraceptive supplies seldom available. High quality health care services, including family planning and reproductive health care are easily accessible for those who can afford to pay, and almost unavailable for the vast majority of poor and needy Vietnamese. Therefore, there is a heavy reliance on abortion as a birth spacing method.

Marie Stopes International (MSI) has been working in Viet Nam since 1990.

In early 1995 official government delegations visited one of MSI's clinics in Vinh City, to observe MSI Viet Nam's style of service provision. The visit led to the request for assistance in Ha Tinh, Nam ha (now called Nam Ding and Ha Nam) and Thai Binh provinces. As a result MSI designed a project to provide affordable high quality family planning and reproductive health care services to the population of these areas.

The choice of the three locations by MSI and government officials was motivated by a high unmet need for family planning and reproductive health services recorded in these regions.

The provinces of Thai Binh, Ha Tinh and Nam Ha all suffer from the highest population densities in Viet Nam, and high population increases as well as a disproportionately high number of women in reproductive age group (15-49). There is also a high percentage of adolescents. All three districts lack access to basic health services and there are no active NGOs in the field of reproductive health care services provision.

Furthermore, the authorities' goals of increasing access to family planning and reproductive healthcare services in these areas has been hampered by the lack of financial and human resources.

The first of the three clinics opened on 22 October 1997 in Ha Tinh, in the presence of senior members of the Peoples Committee for Ha Tinh and Dr Tim Black, Chief Executive for Marie Stopes International.

The clinic commenced services, opening from 07.30 to 17.00, Monday to Saturday. At this initial implementing stage medical supplies and other equipment were purchased along with drugs to enable the medical team to provide a broad range of services such as

• One to one counselling sessions

• Temporary methods of family planning including oral and injectable/implantable contraception

• Permanent methods of family planning such as sterilisation and vasectomy

• Gynaecological examination and treatment of sexually transmitted diseases (STDs)

• Prevention and early detection of STDs and HIV/AIDS

• Antenatal and Postnatal care

• Well woman/man check ups

As part of MSI's commitment to the countries in which it works, MSI places great emphasis in capacity building and training in order to establish a pool of trained family planning professionals. The aim is to build transferable skills that may not have previously existed in that country. To that end, MSI ensures that training in such things as accounting, management, fundraising and customer relations, as well as specific clinic services, provides constant development for its employees. This process helps the country to develop its own capacity for service provision, reducing the need for support from the West.

During this period, a local clinic nurse and a receptionist have been recruited. The nurse undertook one week assessment and refresher training in all aspects of family planning service provision at MSI's Nghe An Clinic. The receptionist also attended training on customer relations at the same clinic. The local government, has assisted MSI Viet Nam in finding a local, experienced Doctor. In March 1998, he underwent assessment and undertook refresher training at the Nghe An Clinic. The Clinic manager also attended training sessions on the reporting requirements of MSI Viet Nam and MSI London. The London programme manager responsible for South East Asia also visited the programme in November 1997. The visit was to provide support in terms of clinical evaluation and monitoring, and to assess training needs.

The financial support of the Galton Institute has helped MSI Viet Nam to recruit and train the nurse and pay her salary for the whole year. It also contributed to the cost of transport for the Manager, the Doctor and the receptionist from Ha Tinh province to Nghe An province to undergo training. The cost of monitoring and evaluating the first six months of the operation was covered by this donation. MSI Viet Nam was also able to purchase a comprehensive range of good quality medical supplies with which service provision was able to start. Moreover, with the first tranche of the Galton Institute donation of £12,990 Marie Stopes International was able to lever an additional £73,610 from the European Union.

Without the generous support of the Galton Institute, MSI Viet Nam and Marie Stopes International would have experienced enormous difficulties in bringing family planning and reproductive healthcare services to the people of these rural regions of Viet Nam. For this, we sincerely thank the Galton Institute and its members.