Maternal and Child Health Program and projects
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Dien Bien Phu Project
Dien Bien Province, in the remote, mountainous north-west of Vietnam, is home to 21 ethnic minority groups with low literacy levels and poor access to health care. The province has one of the highest rates of maternal (4 per 1000) and infant (>35 per 1000) mortality in the world. However, health professionals have few educational opportunities and limited equipment.
A multi-disciplinary group from Sydney conducted an educational needs assessment in 2005. The group subsequently developed and delivered a tailored, interactive, skill-based, small group education programs to clinicians throughout Dien Bien Province (60 doctors and nurses in 2006- 2007) using the SCORPIO (Structured, Clinical, Objective-Referenced, Problem-oriented, Integrated, Organised) method. Diagnosis and management of conditions most commonly responsible for disease and death in mothers and babies in Vietnam (including infection, post-partum haemorrhage, anaemia, and inadequate or inappropriate resuscitation) are targeted by this program. Donations of equipment valued at $A3,636.00 were made to the Dien Bien Provincial Health Department in 2007
The Học Mãi Foundation, through the Dien Bien Phu Project, has provided educational opportunities not otherwise available for doctors and nurses in Vietnam, documented gains in knowledge and skills among course participants and increased use of evidence-based practices in Dien Bien Province. Our trainees’ skills have been recognised in Vietnam, where two trainees reached the finals of a National competition for Excellence in Nursing contested by over 40,000 nurses. Midwife Hoang Thu Ha, who won first place, said “I owe my achievement and success especially to your (Học Mãi‘s) contribution”.
2009 Annual Report Maternal and Child Health (MCH)
The highlight of a busy and successful year for the Maternal and Child Health team was our visit in November, 2009 to Dien Bien Province (DBP). During this visit we ran two Maternal and Child Health Workshops for 40 health professionals. These workshops were specifically developed in 2009 by the Hoc Mai MCH team following a request from the Provincial Health Department to deliver additional education programs in acute paediatrics, neonatal care and obstetric emergencies to doctors and nurses in both the major provincial hospital and surrounding district hospitals. A particular request was to conduct workshops in district hospitals, to negate the need to transport participants from remote areas and accommodate them in DBP for the course. The first workshop was run in a new district hospital in mountainous Tuan Giao, several hours drive from DBP and included participants from three surrounding districts. For this setting basic and emergency neonatal care was the focus. The team used best evidence for teaching methods, clinical practice and content; and this was supported by the donation of a much needed neonatal resuscitaire for the newly built labour ward.
The second workshop was conducted at Dien Bien Provincial Hospital in the provincial capital Dien Bien Phu, which is situated some 500 km north west of Hanoi. In addition to this workshop Hoc Mai donated a neonatal pulse oximeter for monitoring oxygen saturation in sick babies, and phototherapy equipment to treat jaundiced newborns. We were privileged to be visited there by the Australian Ambassador to Vietnam, Mr Allaster Cox and his team, who were able to observe first hand a SCORPIO workshop in neonatal resuscitation, and to join with the team for lunch. This was an opportunity for the Hoc Mai MCH Team to demonstrate the efficacy of the interactive SCORPIO method in this setting. Professor Bruce Robinson, Dean of the Sydney Medical School, joined the MCH team in DBP observing the SCORPIO workshop on the management of acute gastrointestinal infections in children, and to join the participants and the teaching team at the course dinner.
Other activities by team members included:
- April 2009: Visits to Dien Bien Phu and Tuan Giao by Elizabeth Elliot, Heather Jeffery to identify the priority of needs with the Heads of the DBP and TG Hospitals and the Director of Public Health for the Province.
- April, July 2009: Contribution as trainers in both Hanoi (April) and at RNSH, Sydney (July): (Professors Elliot, Jeffery and Hill), in the Hanoi-Sydney Medical School intensive post graduate program entitled “Medical Curriculum Development and Enhancing Clinical Teaching Methods in Vietnam’. This was initiated by Emeritus Professors Kerry Goulston and Kim Oates.
- October 2009: University of Sydney International Development Program Grant awarded for the development of the Diagnostic Microbiology Laboratory at DBP awarded to Dr Monica Lahra, Professors Peter McMinn, Heather Jeffery and Elizabeth Elliott.
- November 2009: Team members joined the Dean Professor Bruce Robinson to attend the opening of the water fountain at Bac Mai Hospital by Her Excellency the Governor, Professor Marie Bashir, and 10th anniversary dinner, and Fellows dinner.
- November 2009: Nomination of DBP Hospital as one of the ten best in Vietnam where attributes included developing international relationships.
- November – December 2009: Hoc Mai Scholarship funded Master of International Public Health student Scott Mills for his praxis at DBP and Hanoi on the advertising and social marketing of Breastfeeding in Vietnam.
Hoc Mai MCH Team 2009: Professor Elizabeth Elliott, Professor Heather Jeffery, Dr Monica Lahra, Dr Jane Hirst, Dr Gaston Arnolda, Hon Associate Professor David Hill, Ms Jenni Bonnitcha, Dr Ha.
Interpreters: Dr Ngai, Dr Nga, Dr Van Anh, Dr Tan, Dr Lam.
Thanks to our colleagues in Vietnam, with whom we have enjoyed such a successful collaboration since the commencement of the MCH Project. We are especially indebted to Dr Son (Director, Dien Bien Provincial Hospital) and Professor Liem (Head, The National Hospital Paediatrics in Hanoi).
Dr Jane Hirst
Dr Hirst is the recipient of the RANZCOG Early Career Researcher Award 2010 for her presentation "Stillbirth In Vietnam" at the RANZCOG Annual Scientific Meeting in Adelaide. This award was worth $1000.
2007
‘Train-the-Trainer courses’ (Professor Heather Jeffery)
In Hanoi in 2007, a team of Health professional and medical educators trained 80 clinical leaders in Vietnam in teaching methods. This activity was funded in part by the United Nations Population Fund (UNFPA) on the basis of the Học Mãi Foundation track record in education. Subsequently, the UNFPA adopted the SCORPIO method for use in seven of Vietnam’s poorest provinces. Our interpreter program strengthened collaboration with the National Institute of Paediatrics (Hanoi Medical University), the National OBGYN Hospital Hanoi and Tu Du Hospital in Ho Chi Minh City and provided opportunities for clinicians to improve their use of the English language and their teaching skills.
Other 2007 achievements
- Our activities have been publicised in Australia and Vietnam, in the Dien Bien Provincial newspaper and television and through presentations at scientific meetings, at one of which Dr Foster was awarded a prize for best presentation.
- Prof Jeffery won the 2006 Học Mãi Australia Vietnam Foundation Chair’s Award for Achievement and Dr Kirsty Foster & Louise Cocoran won the 2007 Học Mãi Australia Vietnam Foundation Chair’s Award for Achievement and for contribution to the project
- Dr Lahra won a scholarship from the Royal Australasian College of Physicians to evaluate pathology services in Dien Bien Province.
- One of our interpreters (Dr Phuc) won a Hoc Mai Foundation Scholarship (AusAid funding) for 3 months in Australia.
- Medical student Elizabeth Pearce (supervised by Prof Jeffery) completed a research project and presentation to identify gaps in use of evidence-based interventions in perinatal management at Tu Du Hospital, Ho Chi Minh City on a Hoc Mai student scholarship and Dr Hirst undertook a clinical exchange at Tu Du Hospital to complete a research project on Perinatal Outcomes for Preterm Premature Rupture of Membranes.
Acknowledgements
This project was supported financially by the University of Sydney’s International Program Development Fund, the United Nations Population Fund and, in kind, by the Faculty of Medicine (Disciplines of Paediatrics and Child Health, Perinatal Medicine, Obstetrics and Gynaecology and Public Health); NSW Health (Children’s Hospital at Westmead, Royal North Shore Hospital, Royal Prince Alfred Hospital); Học Mãi Australia Vietnam Medical Foundation; and the Office of the NSW Governor.
Equipment has been donated by Laerdel, Dräger Medical and Welch Allyn.
In kind support was provided by the Vietnamese Ministry of Health; Vietnamese Consul in Australia; Prof Liem National Institute of Paedaitrics (Hanoi Medical University); Dr Koi, Dien Bien Provincial Health Department; Dr Son, Dien Bien Phu Provincial Hospital; Tu Du Hospital, Ho Chi Minh City; The National OBGYN Hospital, Hanoi; The People’s Committee in Dien Bien Phu; and the Vietnam Women’s’ Union.
| Team members 2007 |
Interpreters 2007 |
|---|---|
|
Prof Elizabeth Elliott |
Dr Nguyen Thi Thu Ha Dr Tran Duc HauDr Nguyen Xuan Hoi Ms Pham Thi Mai Huong Dr Le Kien Ngai Dr Nguyen Tien Dzung Dr Vo Thi Kim Hue Dr Phan Huu Phuc Dr Le Thanh Hai Ms Pham Thi Mai Huong. |
Tu Du Hospital Project - Ho Chi Minh City (HCMC)
In 2007, The Học Mãi Foundation was successful in its application to the University of Sydney’s International Programme Development Fund for a project that will strengthen ties with the largest maternity hospital in Vietnam, Tu Du Hospital in Ho Chi Minh City. There are over 40,000 babies born at this remarkable hospital every year, with many women travelling considerable distances to receive their medical care.
The aims of the project are to:
- introduce small group multidisciplinary teaching to Tu Du Hospital;
- train local doctors and nurses in new educational methods; and
- lower perinatal mortality and morbidity.
Specifically, a workshop will be held at Tu Du Hospital in 2008 that will focus on the teaching of important perinatal skills such as fetal welfare assessment, emergency obstetric management and neonatal resuscitation. These techniques in perinatal care have been successfully used by Học Mãi Foundation teachers in Dien Bien Phu and Hanoi and have been well received by the participants. The Học Mãi Foundation teachers will have skills in educational methods as well as expertise in obstetrics, midwifery, neonatology and nursing. It is hoped that such an educational interventional will encourage further uptake of evidenced based practice.
The project will also develop the teaching skills of a number of scholars from Tu Du Hospital who were recently in Australia as part of the AUSAID programme. Their ongoing involvement will ensure that capacity is built within Tu Du Hospital for modern educational methods. Strategically this is very important and the Học Mãi Foundation is excited by the potential for the work at Tu Du Hospital to have an impact on the health and wellbeing of many of Vietnam’s mothers and babies.
The team led by Professor Jonathan Morris visited TuDu Hospital from 10 to 14 Novemeber 2008.
2007- A visit to TuDu Hospital - HCMC
During November 2007, Dr Jane Hirst (then a Senior Registrar, Obstetrics & Gynaecology, Royal North Shore Hospital) was fortunate enough to spend three weeks in Tu Du Maternity Hospital Ho Chi Minh City. Click on the image at right to read more.
In 2008, Dr Jane Hirst's work with and committment to Maternal and Child Health in Vietnam through the Học Mãi Foundation has been recognised and she has been awarded the Christopher Kohlenberg Medal at the RANZCOG NSW/Qld Annual Scientific Meeting and the Shan S Ratnam Young Gynaecologist Award to attend the Asia Oceania Federation of Obstetrics & Gynaecology Biannual scientific meeting.