News

Eleanor Levine, ’98 M.P.H. (Division of Health Policy and Administration), Travels to Vietnam to Assess Doctors of the World Maternal and Child Health Intervention

Eleanor Levine, '98MPH, recently returned to New York City from nearly two months in Vietnam, where she was a Pfizer Global Health Fellow collaborating with Doctors of the World (DOW) to assess a three-year DOW intervention aimed at improving the maternal and child health of ethnic minorities in the Mai Chau district of northern Vietnam.

Provision of health care is difficult in Mai Chau due to rugged terrain, the district’s remote location, and the differing attitudes that various ethnic groups in the area have about health care. Each district has a government-run health care system centralized at a hospital and staffed by district health workers (DHWs). Districts are made up of communes, which have a Commune Health Station staffed by commune health workers (CHWs), who serve as primary health care providers for members of the commune. CHWs supervise village health workers (VHWs), who provide in the field basic health care and triage for more acute conditions.

DOW partnered with the district health care system, and worked with DHWs to train CHWs and VHWs. The CHWs and VHWs received training in, among other things, recognizing danger signs during and after delivery, and using clean delivery kits, designed to decrease the chance of infection in deliveries performed in homes. In addition, they received training in a variety of health care techniques important to mothers and young children, such as how to breast-feed and how to keep a clean water supply. The CHWs and VHWs then taught mothers in their local areas these skills. DOW directly trained mothers, in conjunction with the Women’s Union (a loose political organization sanctioned by the government to deal with issues of importance to women), to put on drama shows. Drama shows are used in Vietnamese culture as an educational tool to convey important messages, and were used by DOW to teach mothers the importance of having 3 antenatal care visits during pregnancy, of breast-feeding and of immunizing the baby. DOW also reached out directly to mothers in the most remote commune, Hang Kia, to teach mothers how to use clean delivery kits.

DOW’s intervention targeted 10 of Mai Chau’s 22 communes, and Levine assessed the intervention’s impact in 6 communes. She found that one of the intervention’s objectives, improving the quality of health workers’ knowledge, was not fully met. Interviews indicated that although the health workers attended trainings, their knowledge was uniformly fairly poor, prompting Levine to recommend refresher training and cue cards for health workers. However, Levine found that the knowledge and behavior of mothers were positively impacted by the intervention, as they had good knowledge of the basic public health techniques taught and were using clean delivery kits where appropriate. A fortuitous success of the intervention was an improvement in the communication and management capacity between health workers at the village, commune and district levels, which DOW helped to facilitate.

The Pfizer Global Health Fellowship Program is a new program in which Pfizer Inc. matches employees chosen through a rigorous application process to non-governmental, volunteer health organizations with which the employees work for up to six months. Levine was in the first wave of approximately 17 Global Health Fellows to participate in the program.

For Levine’s personal experiences and observations in Mai Chau, as well as for additional information about the intervention and her assessment, please click on the links to Levine’s journal entries below.

Journal Entries:
Mai Chau PDF

Hang Kia PDF

-Story by Christy Gordon. Sources:

Levine, Eleanor, '98MPH, Pfizer Global Health Fellow. Phone Interview. November 6, 2003.

Levine, Eleanor. (2003). Final Assessment of DOW Intervention in Mai Chau District, Hoa Binh Province (draft).