Despite progressive economic and social development gains during recent years, public health challenges continue to limit progress in Vietnam. Limited sanitation services, unsafe water and poor hygiene practices are leading causes of pneumonia and diarrhea, which account for nearly one-third of deaths among children under five years old in Vietnam.
One in three children is undernourished, contributing to high national rates of stunting. Rapid development is also ushering in a host of new health challenges to the Vietnamese people, such as an escalating HIV epidemic in most-at-risk populations. Vietnam has the twelfth highest tuberculosis burden globally, and the national prevalence rate of Hepatitis C is ten times that of HIV.
More than a third of adolescent females have unmet need for contraception, and maternal mortality rates in rural areas are three times that of urban provinces.
Launched in 2005 to respond to the unmet health needs of Vietnam’s low-income and underserved communities, PSI/Vietnam implements social marketing programs in 17 provinces.
PSI/Vietnam estimates that in 2015, its products and services helped avert 33,309 DALYs, including, by health area:
- 33,278 HIV DALYs
- 31 WASH DALYs
The HIV epidemic in Vietnam is highly concentrated in most-at-risk populations (MARP), including people who inject drugs, sex workers, men who have sex with men, and the sexual partners of vulnerable groups, such as male clients of sex workers. It’s estimated that there are currently 260,000 individuals living with HIV in Vietnam, of which up to 65% are injecting drug users. According to 2009 data, 58 percent of people who inject drug in Vietnam are infected with Hepatitis C (HCV). Rates of co-infection of HIV and HCV among MARPs have emerged as an urgent health issue, and HCV is quickly becoming a leading cause of death among people living with HIV. PSI/Vietnam promotes HIV and HCV programs and services to empower MARPs to lead healthier lives. Highlights from each of these program areas include:
HIV & HCV Prevention Product Social Marketing: Condoms and Syringes
In addition to promoting condom use through targeted behavior change communication activities, PSI/Vietnam works to increase condom availability in high-risk areas and non-traditional outlets including guest-houses, hotels, street vendors, cafes and massage parlors. By convincing owners of non-traditional outlets and entertainment establishments to purchase and promote condoms, PSI/Vietnam’s social marketing program is promoting a sustainable approach to HIV programming in the private sector. PSI/Vietnam works closely with USAID, Vietnam Administration of HIV/AIDS Control and the provincial government to provide technical assistance, develop social marketing programs and coordinate condom distribution. PSI/Vietnam also promotes female condoms for sex workers and water-based lubricants co-packaged with male condoms for men who have sex with men and sex workers. In 2013, over 8.7 million male and female condoms were sold and circulated to over 4,200 hotels/guesthouses and other non-traditional outlets accessible to key populations in nine provinces that are a priority for the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).
In response to input from people who inject drugs and market surveys, PSI launched the world’s first low dead-space syringe (LDSS) social marketing pilot in 2013 to reduce supply- and demand-side barriers to using safer needles/syringes. The World Health Organization recommends LDSS distribution, given that they contain an estimated 100 times less fluid compared to high dead-space syringes, drastically reducing the risk of both HIV and HCV transmission. Increasing convenient access to quality and affordable LDSS coupled with behavior change communication promoting safe non-sharing behaviors has reduced reported needle/syringe sharing rates by half in the first year. The pilot has been extremely successful, generating over 720,000 LDSS sold and 6,000 averted DALYs in the first year.
HIV Prevention Behavior Change Communication
PSI/Vietnam’s communications support for HIV services have included the development of a national Chan Troi Moi (New Horizons) brand and multiple campaigns to promote the benefits learning HIV status among MARP individuals and couples. In 2013, the Ministry of Health endorsed the Chan Troi Moi campaign as a national campaign and facilitated placement in non-PEPFAR supported provinces, thereby dramatically increasing campaign coverage and contributions to national HIV/AIDS program goals. PSI has developed multiple campaigns to address barriers to consistent condom use, including the “Nho Toi Moi Lan” (Remember Me Every Time) campaign designed to address the misperception that familiar or healthy-looking partners have low risk of HIV transmission; as well as the “Yes! Condom” campaign designed to reposition condoms as a sign of a modern, positive lifestyle (vs. a health product.)
PSI also implemented the only targeted outreach initiative focusing on reaching female injecting drug users who also work as commercial sex workers. The Song Dep program pioneered the use of the Unique Identifier Code (UIC) monitoring system to track outreach coverage.
Water, Sanitation and Hygiene
Over 90 percent of Vietnam’s rural population is not serviced by piped water supply systems, and the consumption of contaminated river water contributes to nearly 7 million cases of diarrhea annually. Limited sanitation services, unsafe water and poor hygiene practices are leading causes of pneumonia and diarrhea, which account for nearly one-third of deaths among children under five-years-old in Vietnam. Since 2005, PSI has distributed and promoted SafeWat, a locally-manufactured household water treatment product originally developed by the CDC and World Health Organization in 1990, and licensed by the MOH/VIHEMA in Vietnam. One bottle of SafeWat provides quality drinking water to a family of six people for an entire month. In 2013 over 62,000 bottles of SafeWat were sold, protecting over 5,200 rural families.
Since 2011, PSI has partnered with Unilever and Lifebuoy soap to promote handwashing with soap – and household water treatment – in 2 rural provinces using an integrated approach through multiple communication channels accessible to rural families, including commune loudspeaker campaigns, illustrated leaflets, outdoor billboards near rural markets and community events. Interactive community events are designed to build household level commitment to treat water correctly and consistently, and to wash hands at critical junctures. In 2013 alone, PSI and Unilever organized 26 events in rural districts where families have limited access to piped water, reaching an estimated 7,000 rural caretakers and young children. In 2014 this partnership will benefit 160,000 rural caregivers in Hau Giang and Vinh Long provinces.
In 2015, PSI/Vietnam conducted a landscaping study in targeted provinces exploring the sanitation demand and supply chain supporting the application and scaling up of sustainable models of sanitation.
More on PSI/Vietnam’s social marketing programs to improve water, sanitation and hygiene.
About one in three children under five years of age in Vietnam is stunted, whose undernutrition and micronutrient deficiency impairs intellectual development and increases the risk of morbidity and mortality. In this context, PSI/Vietnam in collaboration with the National Institute of Nutrition (NIN), the Global Alliance for Improved Nutrition (GAIN), and the Intitut de Recherche pour le Developpement (IRD) implemented a pilot project with support from Irish Aid. Over the pilot period, the project used commercial distribution channels combined with evidence-based behavior change communications (BCC) to motivate lactating/pregnant women and children under five to practice healthier nutrition behaviors, including correct and consistent use of Lyzivita micro-nutrient powder. Over 84,000 Lyzivita sachets were sold to commercial outlets accessible to rural caregivers of children under five during the first 9 months of the pilot. Additionally, 886 commercial outlets were motivated to stock Lyzivita and display BCC materials designed to promote improved complementary feeding, including 686 rural pharmacies, 148 rural fast-moving consumer goods outlets and 52 rural private clinics. Nearly 7,000 caregivers were reached through market and community-based events in 2013.
PSI applies global best practices to motivate private clinics to provide quality, affordable services designed to address key national health priorities including child health, tuberculosis and hypertension. Launched in 2012, the Good Health, Great Life social franchise network represents smaller, community-level private clinics accessible to low-income, uninsured and marginalized communities in five provinces. In 2013, franchise clinics detected more than 1,000 TB cases and treated more than 6,000 hypertension cases. Their efforts also represent a 40 percent increase in private provider capacity to deliver preventative child health services, including appropriate use of Lyzivita micronutrient powder to prevent under nutrition among rural children.
- World Health Organization
- Australian Government
- Traffic – World Wildlife Trade Monitoring Network
- Soros Foundation
- Procter and Gamble
- U.S. Agency for International Development
- GAIN/Irish AID
- Orchestra Networks
- Government of Vietnam, including national & provincial agencies
- Commercial partners including BBVN, commercial distributors & creative agencies
- Malaria Elimination: Who is Really at Risk?
This document presents an alternative approach to thinking and talking about malaria risk factors affecting mobile and migrant populations in the Greater Mekong Subregion, and how this can be translated into strategy and action.
- The GEMS Program: Greater Mekong Subregion Elimination of Malaria through Surveillance
In 2016, PSI launched GMS Elimination of Malaria through Surveillance (GEMS) in Cambodia, Lao PDR, Myanmar and Vietnam to strengthen case management and surveillance in the private sector to accelerate malaria elimination. This project brief describes each component of GEMS project in detail.
- PSI Vietnam: Social Marketing for Improved Water, Sanitation, and Hygiene
To address unsafe water, poor hygiene and limited sanitation in rural communities, PSI Vietnam launched a market based sanitation initiative in rural areas of the Mekong Delta and Central Highlands.
- Increasing Private Sector Contributions to 90-90-90 Goals to Stop HIV & AIDS in Vietnam
This four page document looks at how PSI VIetnam is extending and linking its low dead space syringe outlet network to HIV
testing for greater program impact and efficiency for people who inject drugs.
- Making Data Work for Malaria Elimination: Surveillance in the Private Sector
This two-page brief describes the importance and usefulness of the Malaria Case Surveillance App and provides a case study of how it has been used in Cambodia.
- SanMark Study to Assess Demand and Supply Chain Barriers among Rural Communities in Three Provinces in Central Vietnam
In 2015, PSI/Vietnam conducted a landscaping study in targeted provinces exploring the sanitation demand and supply chain supporting the application and scaling up of sustainable models of sanitation
- PSI/Vietnam: Social Marketing for Improved Water, Sanitation and Hygiene
This brief outlines all that PSI/Vietnam is doing to improve Water, Sanitation and Hygiene in Vietnam through evidence-based social marketing of health products, services and behaviors.
- Cases Supplement on the Total Market Approach
PSI sponsored two articles in a special supplement on the total market approach (TMA) in the Cases in Public Health Communications and Marketing journal. The first recounts PSI's experience in the markets for male condoms in Myanmar and Vietnam, and the second proposes a universal set of indicators to measure the success of TMA initiatives.
- Rural Sanitation Rapid Market Scan Report
In 2014, PSI/Vietnam conducted a rapid market scan to identify market barriers and potential opportunities to improve rural sanitation access in Dien Bien and Vinh Long, two provinces with the worst sanitation indicators in all of Vietnam. Leveraging PSI/Vietnam’s understanding of rural markets and consumers, the rapid sanitation market scan was designed to identify practical insights from rural households and community influencers, as well as rural supply chain actors linked to sanitation product and service provision. This report describes the market scan findings and offers concrete recommendations to inform future programs.
- Behavioral Survey Among Female Sex Workers and Female Sex Workers Who Inject Drugs: Vietnam
In 2012, PSI/Vietnam conducted the third and final round of a survey among FSW and FSW-PWID to evaluate the correlation between exposure to the USAID Social Marketing for HIV Prevention Project and changes in behavior.