Grant Projects: Activities

An On-site Look at the Vietnamese Maternal and Child Health Handbook Program


From October 16 to October 21, 2009, Program Officer Kenta Kusuda visited Akemi Bando (doctoral candidate, Osaka University; secretary general, Support of Vietnam Children Association), who is doing important work in Vietnam with the help of a Toyota Foundation grant.

Ms. Bando taught special education classes in Japanese public elementary schools for some three decades before taking early retirement not long ago. Since 1990, she has also been actively involved with Vietnam. From 2006 to the present, the Toyota Foundation's Research Grant Program has supported her research projects, aimed at expanding the Maternal and Child Health (MCH) Handbook program throughout Vietnam.

The site of Ms. Bando's most recent grant project is Ha Giang Province, located in the northernmost region of Vietnam, along the border with China, about six hours from Hanoi by car. A mountainous province populated mainly by ethnic minorities, Ha Giang would seem to pose serious challenges for those seeking to expand the MCH Handbook program, owing to poor transportation, low literacy rates, and inefficient information and communication systems. But this is why it was chosen. The purpose of the project is to overcome the varied challenges encountered here and, in the process, develop a general model for expanding the program to every province in Vietnam.

Not long ago the maternal and child health unit at the Vietnamese Ministry of Health, working in collaboration with Osaka University, developed Vietnam's first MCH Handbook. In June 2009, a variety of training programs were launched in Ha Giang Province under the ministry's guidance to provide people with the skills needed at various levels to establish the MCH Handbook program in every village in the province. Ms. Bando's current research project focuses on 12 villages with diverse geographical conditions, selected from the 195 villages scattered across Ha Giang Province's 11 districts. Written questionnaires and interviews were used to conduct an exhaustive survey of obstetric and pediatric healthcare personnel in provincial and district hospitals and commune health centers, village volunteer health workers stationed in smaller villages, and expectant and new mothers who have begun using the MCH Handbook. The purpose is to evaluate the situation soon after institution of the MCH Handbook program to identify problems and gain insights that can be applied to subsequent efforts to expand the program nationwide.

According to Ms. Bando's report, as soon as the survey was finished her team worked with health officials in Ha Giang to hold a conference of healthcare representatives from each district in the province with the purpose of sharing information on issues that had come to light as a result of the survey. Since the conference, a number of steps have already been undertaken to enhance the program's efficiency, including instructing private as well as public healthcare facilities to make use of the handbooks, and instructing healthcare workers to transfer data from prenatal examinations predating the program to the new handbooks.

Accompanying Ms. Bando in the field, I was struck by the collaborative way in which she is carrying out the project, actively involving officials from the provincial government (health officials in Ha Giang) and local staff, as her team copes with the unique circumstances of that area, including long hours spent traveling on unpaved roads and two-stage interpreting (English to Vietnamese and Vietnamese to the minority language). I was also impressed by how conscientiously the new mothers take care of their handbooks.

At around the time of my visit, it was officially stipulated in a national plan for children's health drawn up by the Vietnamese Ministry of Health that MCH Handbooks will be introduced in every province by 2015. Because Vietnam is a socialist country, once a plan is adopted by the state, it tends to be transmitted to the provinces and implemented with relatively little delay. We look forward to watching the expansion of an activity that grew out of Ms. Bando's personal initiative, providing an example of how, over time, such modest efforts can impact an entire nation.

A description of Ms. Bando's project can be accessed from the project search page on the Toyota Foundation website (Akemi Bando).

left:In an area with a high rate of illiteracy, local healthcare workers help people complete their questionnaires.

right:Vietnamese women hold their new Maternal and Child Health Handbooks. (Vi Xuyen District, Ha Giang Province)