Monsoon rain and traffic jams: thoughts on women’s access to health care in rural Vietnam
By Julia Keast, an intern with HealthBridge Vietnam
Lush greenery, rolling hills, towering mountains and plenty of produce. Our small group of staff from HealthBridge Vietnam (HBV) and the Center for Creative Innovations in Health and Population (CCIHP) had arrived in Son La province for a two-day workshop to launch the new maternal, newborn and child health (MNCH) project, Saving lives of mothers and children in Nepal and Vietnam.
We departed from Hanoi early in the morning; the sun was shining and the roads were clear. About half-way through our 8-hour journey, the skies opened up and heavy rain poured down. This dramatic shift in weather is common in northern Vietnam during the rainy season, which extends from April to August. Driving along a road that winds through the hills, the rain created some problems – water rushing down the hills caused the roads to become muddy, resulting in a traffic jam.
In the half hour or so that we were stuck, Thong and Minh (MNCH Project Manager and Vice Director of CCIHP and specialist in monitoring and evaluation) expressed concern about the upcoming situation assessment and baseline survey: if rain had caused major delays on a main road, imagine how difficult it might be to reach remote communities scattered high in the mountains.
While this delay was a minor inconvenience for us, it got me thinking about how challenging it can be to access health services for those who live in a remote location, even without the added element of weather.
In Son La province, many women (and their children) either aren’t able to access MNCH services, or they choose not to. In some communities as many as 90% of women deliver their babies at home without the assistance of a skilled birth attendant; in others, as many as 70% of mothers and babies are without postnatal care within the recommended six weeks following birth.
Complex barriers to care
Contributing to these dismal figures are a combination of poorly trained health workers and a lack of adequate infrastructure in health centers. Beyond these challenges are even more complex barriers to care, related to gender inequality and cultural practices that likely prevent some ethnic minority women from seeking formal health services in the first place.
But where there are challenges, there are also opportunities for positive change. For example, during the launch workshop participants discussed how they would select ethnic minority women from remote communities to be trained to provide care during pregnancy, delivery and in the postpartum period for women who are unable to make it to a health center.
CCIHP will also harness mobile technology (mHealth) to facilitate the spread of lifesaving health information and key behavior-change messages to anyone who can access a wireless wave. This can greatly expand the reach of important information, which gets people excited.
During the workshop, Thien (CCIHP staff) gave a short demonstration on using Facebook for live streaming. Everyone attending the workshop participated, and seemed hopeful about the potential positive impact that mHealth and the other project activities could have on the health of women and children in Son La.