Established in 2005, PSI/Vietnam is affiliated with an international network spanning more than 50 countries around the world. PSI/Vietnam has used social marketing techniques to fill market gaps and motivate improved health behaviors related to safe water and hygiene, undernutrition, hypertension, tuberculosis, HIV/AIDS, and viral hepatitis. With the goal of strengthening the national health system, PSI/Vietnam’s interventions focus on building the private sector’s capacity and commitment to providing quality, affordable health products and services. Communications campaigns designed around insights about what matters most to underserved consumers position healthier behaviors in terms that resonate with target audiences and, together with improved access to essential products and services, prompt behavior change. Behavioral and market-transformation results achieved by PSI/Vietnam have been acknowledged by the Ministry of Health and other partners within Vietnam and have been published in international peer-reviewed journals.
Despite impressive improvements in Vietnam’s development and health macro-indicators over the past decade, gains have not been equitable, and significant unmet health needs remain. 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 eleventh highest tuberculosis burden globally, and the national prevalence rate of hepatitis C is ten times that of HIV. Stroke is the leading cause of death among adult men and women in Vietnam — largely linked to undiagnosed and untreated hypertension. Only 43% of adults with hypertension in Vietnam have been diagnosed, and of these only 14% are on treatment.
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.
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
PSI/Vietnam applies global best practices to motivate private clinics to provide quality, affordable services designed to address key national health priorities including child health, reproductive health, tuberculosis, and hypertension. In 2012, PSI/Vietnam launched the Good Health, Great Life social franchise network. It represents smaller, community-level, private clinics accessible to low-income, uninsured and marginalized communities. The Good Health, Great Life network has since grown to include over 280 private clinics in five provinces around Vietnam. In 2016, franchise clinics detected more than 1,318 tuberculosis cases and 13,273 hypertension cases. Their efforts also represent a 40% increase in private provider capacity to deliver preventive child health services, including appropriate use of Lyzivita micronutrient powder to prevent undernutrition among rural children.
PSI/Vietnam’s Good Health, Great Life franchise has shown itself to be a highly sustainable program. This is demonstrated by the fact that even after specific project funding for hypertension work ended in 2014, our franchised clinics continue to treat hypertension and report cases back to PSI/Vietnam. To date, more than 41,000 clients have been served through its Good Health, Great Life private clinic social franchise network for hypertension, tuberculosis and family planning.
Vietnam’s abortion rate is the fifth highest in the world, with an estimated 300,000 cases every year among 15-19-year-olds alone. About 40% of pregnancies are terminated each year in Vietnam, and the women most likely to have an unmet need for contraception are young, unmarried and rural., In order to improve the ability of Vietnamese women to have access to the contraceptive method that is right for them, PSI/Vietnam launched its Expanding Contraceptive Choice program in March 2016. This was with support from the Merck Foundation’s MSD for Mothers and MSD Vietnam. The main objectives of this program are to expand access to historically underused contraceptive methods in Vietnam, including injectables, implants, as well as post-partum intrauterine devices (IUD) and post-partum implants; create informed demand for contraceptive choice; and generate increased public and private stakeholder support for the growth and diversification of the Vietnamese contraceptive market. PSI/Vietnam will utilize and expand its existing network of franchised Good Health, Great Life private clinics and nearby pharmacies in four provinces: Hanoi, Ho Chi Minh City (HCMC), An Giang, and Thai Nguyen. In addition, PSI will collaborate with the largest gynecological hospitals in the country, including Tu Du Hospital in HCMC and Hanoi OB/GYN Hospital to integrate immediate post-partum IUD and implant services into routine antenatal (counseling) and delivery services.
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 priority populations, such as male clients of sex workers. It’s estimated that there are currently 227,000 individuals living with HIV in Vietnam, of which up to 65% are injecting drug users. Additionally, according to 2009 data, 58% of people who inject drugs in Vietnam are infected with hepatitis C (HCV). Rates of HIV and HCV co-infection 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 has worked in multiple areas of HIV/HCV prevention and is leveraging its expertise to implement an ambitious and innovative project that will increase the use of safer syringes among injection drug users, improve public awareness of HIV and personal knowledge of one’s HIV status, and connect HIV-positive individuals to treatment.
Low Dead-Space Syringes
In response to input from people who inject drugs and market surveys, PSI/Vietnam launched the world’s first low dead-space syringe (LDSS) social marketing program in 2012 to reduce supply- and demand-side barriers to using safer needles and syringes. The World Health Organization recommends LDSS distribution given that they contain an estimated 100 times less fluid compared to high dead-space syringes, thus drastically reducing the risk of both HIV and HCV transmission.
One of the main components of PSI/Vietnam’s LDSS social marketing program includes working with manufacturers, distributors and a wide variety of retailers to make LDSS available, accessible and affordable to injecting drug users. PSI is working with a network of more than 1,029 tea stalls and other outlets open late at night after pharmacies close in order to improve access to quality, safer syringes for people who inject drugs (PWID).
In 2015, the results of PSI’s LDSS pilot were published in the peer-reviewed Harm Reduction Journal. To date, over 15,204,690 LDSS have been sold in our project areas. Since the start of the program in 2012, PSI/Vietnam’s HIV behavior change communication and social marketing program saved our target population a total of 106,982 years of healthy life.
In 2015, PSI/Vietnam launched a market-based rural sanitation initiative in the Mekong Delta and Central Highlands regions. At the start of the program, PSI/Vietnam generated the first rural commercial sales for flood-proof plastic toilet tanks, endorsed by the Ministry of Health. They were locally manufactured by PSI/Vietnam’s partner, ROTO, through the establishment of retailers stocking ROTO tanks. By negotiating with ROTO to lower prices for rural customers, recruiting outlets to pilot a flexible payment system for sanitation hardware purchases, and by holding events to target the most impoverished families, PSI/Vietnam is making sanitation an affordable reality for households most in need.
To further develop its rural sanitation supply chain, PSI/Vietnam trains and incentivizes masons to grow the toilet-installation segment of their businesses, in compliance with quality and gender guidelines. PSI/Vietnam’s supply-side operations are supplemented with a demand-generating, social marketing campaign that uses visual media and community events designed to promote investment in sanitation as a way to protect the dignity and privacy of women.
Vietnam has made large gains in malaria control in recent years as malaria-related deaths have declined by more than 85% nationwide since 2000 (WHO, 2013). However, one out of every five of the country’s 90 million inhabitants continue to live in a high transmission area and elimination requires increased coverage of forest goers most at risk (NIMPE/NMCP 2016). As part of a multiple-country, evidence-based malaria elimination initiative, PSI/Vietnam has begun the process of mapping and engaging private clinics, pharmacies and worksites accessible to communities at risk to increase test-treat-track practices. The following objectives guide the Greater Mekong Elimination of Malaria through Surveillance (GEMS) implementation efforts in Vietnam and three other countries in the region:
- Increase appropriate case management of suspected malaria cases within private sector service delivery points.
- Increase reporting of suspected and confirmed cases by the private sector service delivery points into national information systems.
- Improve the evidence base for decision making on effective strategies for private sector engagement and surveillance systems strengthening.
PSI/Vietnam’s malaria elimination program is being implemented in the highest burden districts within five high-risk, border provinces in the Central Highlands area of Vietnam — Binh Phuoc, Gia Lai, Kon Tum, Dak Lak, and Quang Binh.
- Bill & Melinda Gates Foundation
- Elton John AIDS Foundation UK
- Irish Aid
- Maverick Collective
- TB Reach
- S.C. Johnson (SCJ)
- MSD for Mothers
- MSD Vietnam
- Pfizer Inc.
- Open Society Foundation
- Orchestra Networks
- Procter and Gamble
- Traffic – World Wildlife Trade Monitoring Network
- U.S. Agency for International Development (USAID)
- World Health Organization (WHO)
- Government of Vietnam, including national and provincial agencies
- Commercial partners including B. Braun Vietnam (BBVN), commercial distributors and creative agencies
- GEMS Q1 Surveillance Bulletin (2018)
- GEMS 2017 Annual Report
- PSI Increases Private Sector Contributions to HIV/AIDS Prevention and 90-90-90 Targets in Vietnam
In Vietnam, underserved communities lack basic HIV services. PSI Vietnam is working towards its UNAIDS targets by increasing accessibility for underserved communities, increasing the use of private sector outlets. PSI addressed issues such as the misconceptions around HIV, the syringe market, and treatment accessibility and comfortability.
- Building Private Provider Networks to Bring Quality Health Services Closer to Underserved Communities
In Vietnam, the private sector can be utilized to advance health care and services for lower income communities. PSI is using its provider network, including the private sector providers, to bring services to underserved areas.
- How PSI Generates Value for Money through Social Investments
This 2-page brief describes the principles of cost-effectiveness, world-class financial management and risk reduction procedures that PSI uses to deliver cost-efficient impact for our partners.
- PSI Vietnam Worksite Research Report
- 2016 Rural Sanitation and Hygiene Behavioral Study Vietnam
In December 2016, PSI Vietnam conducted a behavioral study among 1,200 rural households in Tien Giang and Dong Thap provinces to assess PSI’s sanitation social marketing program progress and to inform future improvements in coverage and sanitation as well as hygiene behaviors. This study highlights the continuing need for improved sanitation and hand-washing with soap practices among rural families in Vietnam, and identified factors that need to be addressed in order to improve sanitation and hand-washing practices.
- 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.