Chieng Den commune in the Northwestern Mountainous region of Son La Province, Vietnam, is characterized by a unique set of living conditions. Situated in a rural area, the commune is made up of a group of eight villages, and is home to around 6,000 residents, all of whom are from the Thai ethnic minority community. For the majority of residents living in Chieng Den, agriculture serves as the main source of livelihood and the villagers often engage in agricultural activities, primarily cultivating rice, corn and other crops.

The living conditions in the villages that make up Chieng Den commune present both opportunities and challenges for its residents. One notable aspect of the living conditions in Chieng Den is the strong sense of community and traditional way of life. However, despite the commune's natural beauty and cultural heritage, there are several challenges that affect the living conditions of its residents. Access to basic infrastructure, such as clean water, electricity, and sanitation facilities, remains limited in some areas of the villages. This can impact the overall well-being and quality of life for the villagers, particularly in terms of health and sanitation.

Vietnam is home to 53 different ethnic groups, and 75% of ethnic minorities live in the Northern Mountainous and Central Highland regions including Son La Province. The isolated geography of these regions has contributed to persistent inequities in poverty, health and nutrition among the local communities. Historically, language and cultural barriers, inadequate quality of services and lack of trust have contributed to worse health outcomes among ethnic minority groups than the majority population.

Health services in many of the villages in Chieng Den are insufficient, especially in terms of specialized medical care and access to health facilities. This means that timely and adequate health services, particularly for more serious health conditions or emergencies, are often lacking. Access to primary health services including reproductive health services is also limited, which leads to challenges in managing family size, spacing pregnancies, and receiving adequate antenatal and postnatal care which is essential for healthy pregnancies and the health of mothers and children. Adolescents are often unable or unwilling to access reproductive health services due to stigma, judgement from health staff, and feelings of embarrassment. Lack of access to adolescent reproductive health services and information can lead to negative consequences such as early pregnancy and childbearing. Promoting reproductive health education and reproductive health rights, and ensuring access to reproductive health services, are crucial to improve the wellbeing of the community and to empower individuals to make informed decisions about their reproductive health.

HealthBridge Vietnam, in collaboration with the Centre for Disease Control (CDC) of Son La Province, are working together to address the gaps in essential reproductive health services by partnering on a project to “Improve reproductive health and prevent child marriage”. This project works closely with health providers in the project communes to deliver education and services to village residents. Each commune is home to a team of health educators including two health staff (either a doctor, nurse or a midwife), one youth union representative, and one women’s union representative. This team is responsible for organizing and delivering reproductive health education sessions in their villages and improving the overall health in their community.

Mr. Lo Van Anh is an essential member of this team of community health workers. As the youth health leader for Chieng Den commune, Mr. Anh is an active member of the community who motivates youth in the villages to make informed decisions about reproductive health.

Mr. Anh was born and raised in a farming family in Phieng Tam village, Chieng Den commune, Son La city, Son La province. He is 28 years old and graduated from Son La Medical College in 2016. He works as a member of the health staff at the Chieng Den commune health station. The health station services include epidemic prevention, tuberculosis program, environmental sanitation, school health, vitamin A, and deworming. In addition to these day-to-day tasks at the health station, Mr. Anh, together with his colleagues in the reproductive health program, travels to villages in the commune to deliver reproductive health education sessions. These sessions include topics such as family planning methods, proper reproductive hygiene, gender equality, and relationships.

While Chieng Den’s natural beauty and close-knit community contribute to its charm, limited access to infrastructure, education, and healthcare services remain areas that require attention and investment to enhance the well-being and quality of life for its residents. Efforts by the local CDC, HealthBridge and other stakeholders, in collaboration with the local community, are important for improving health outcomes. It is also important to recognize the resilience and determination of the residents and community workers in Chieng Den which contribute significantly to the overall development of the community.

Interview with Mr. Anh

What motivates you to continue the work that you do in the reproductive health program?

Currently, child marriage has decreased in the area a lot, and compared to previous years, old customs and habits seem to have disappeared such as forced marriage. However, knowledge on reproductive health of adolescents and young adults is still limited. Many children get pregnant unexpectedly while still in school, and some teenagers leave high school early to go to work or get married. While participating in the training about reproductive health for adolescents, I have learned a lot about reproductive health and communication skills, and I feel more confident speaking in front of a large crowd, especially because of what we learned from the training sessions.

What do you like the most about the program?

Through the project I already participated in three training classes, a course on adolescent reproductive health, a course on adolescent communication skills, and a refresher training on adolescent communication skills and improving adolescent reproductive health. The project also provides many useful tools for communication such as loud speakers, training materials, a flipchart on Reproductive Health, and stationary for education sessions.

So far I have reached about 200 people in the community. All of them were very sociable and expressed a willingness to make positive changes in their behaviors. Also, for the first time, we have used our communication training to implement education sessions in a novel and more interactive way in the village, through organizing games and group discussions. This mode of education was a lot more fun for the participants and resulted in active and open participation.

What are some difficulties you face in delivering reproductive health education in your commune?

We had many difficulties traveling to remote villages, mobilizing male friends to participate, and making time for the education sessions. As there are still many tasks at the heath center to attend to, sometimes we had to carry out education sessions during holidays.

Organizing education sessions for villagers was not easy. Many of the villagers are farmers, they often go to work on their farms from early morning and it is not easy to meet with them. Youth from 10 to 18 years old are also hard to reach since they are at school or working outside of the village.