Hoang Van Minh, MD, PhD, Do Van Dung, MD, PhD, Nguyen Viet Hung, PhD, Osman Sankoh, DSc

 

An important factor for monitoring health transition is the collection of valid and reliable population data over time.1 However, given the weaknesses of the national health information systems in low- and middle-income countries such as Vietnam, especially in the area of generating high-quality population-based information, health and demographic surveillance systems (HDSSs) have been shown to generate high-quality population-based data and scientific evidence on the levels, patterns, and trends in health and health care transitions in a country.1,2

 

One such HDSS is the Chi Linh Health and Demographic Surveillance System (CHILILAB), located in Chi Linh district, Hai Duong province, Vietnam, which was established in 2004. It is a member of the International Network of field sites for continuous Demographic Evaluation of Populations and Their Health (INDEPTH) (http://www.indepth-network.org). Based on the HDSS data from the latest survey conducted in 2016 of CHILILAB, this supplement presents analyses of the levels and patterns of health and health care transitions in Chi Linh district, Hai Duong province of Vietnam.

 

The findings from CHILILAB clearly show the pattern of change in socioeconomic status as well as in population compositions in the study area. Minh et al3 report that the educational level and economic status of people in CHILILAB in 2016 have improved. There was no significant difference in the household size of 3.23 and gender composition of 48.5 male/51.5 female of the population in CHILILAB in 2016 as compared with that of previous survey periods.3 The national average of household size was 3.64 and gender composition was 49.3 male/50.7 female.4 However, Vui et al5 indicate that sex ratio at birth in Chi Linh dramatically increased to the imbalance of 114 boys to 100 girls. It was higher than the national data of 112.2 boys/100 girls reported in 2013.6 The article by Minh et al also demonstrates that the Chi Linh population is undergoing a strong “aging” trend. The proportion of people aged 65 years increased from 7.3% in 2004 to 12.3% in 2016),3 similar to the national figure of 7.1%.4 The importance of quality of life for elderly people was studied by Huong et al7 and they report statistically significant associations between lower health-related quality of life and older age (≥80 years), lower education, no pension, and chronic diseases.7

 

CHILILAB’s data also prove the fact that the burdens caused by noncommunicable diseases (NCDs) have been increasing. Lan et al8 report that prevalence of impaired fasting glycemia was 11.8% and of diabetes was 12.1% (higher than the national figure of 4.1% having raised blood sugar or were currently on medication for diabetes9). Kien et al10 reveal that households self-reporting NCD diagnosis had the highest association with both catastrophic health expenditure and impoverishment.10 Huong11 found the prevalence of smoking, the most important risk factor for NCD, was 16.1% (34.7% for men, 0.9% for women). The national prevalence of smoking in Vietnam was 22.5% overall, 45.3% among men, and 1.1% among women.12

 

While NCDs are increasing in the district, access to the health services by NCD patients is still limited. Lan et al8 demonstrate that only 16.8% diabetes cases detected in this study was diagnosed before, indicating a high level of unmet needs for detecting/managing diabetes in Chi Linh population. Nga et al13 also reveal that the capacity for prevention and control of NCDs in community health stations was inadequate. The national data indicate that 31.1% of diabetes previously diagnosed by doctors and 28.9% reported that they are currently being managed at a health facility for their raised blood glucose.9 Limitation in access to health services was not only for NCD but also for other health conditions. Quynh et al14 report that 47.5% of people in working age in CHILILAB treated themselves at least once during one previous year. The result is similar to a previous study in Vietnam that reported that 40% to 60% of people in Vietnam depend on self-medication.15

 

Duc et al16 report a stable mean birth weight over the years and a significant change in delivery rate at hospitals and cesarean section rate and significant associations between delivery practices with child sex, mother age, and household income. These findings are different from previous studies in Vietnam, which found increases in the mean birth weight and reductions in the incidence of low birth weight over time periods with improved economy.17

 

In CHILILAB, livestock (pigs and poultry) are predominantly produced by small-scale farmers, creating challenges for zoonotic disease management. Sinh et al18 provide good data on livestock ownership, biogas production, and practices common to food animal rearing. The authors mention some health issues and suggest measures to improve the control zoonotic disease transmission and commune drinking water/wastewater infrastructure.18

 

In summary, this supplement, based on HDSS data generated by CHILILAB, provides a comprehensive picture of health and health care transitions in Chi Linh district, Hai Duong province of Vietnam. The evidence from this supplement could be used in national health planning and decision-making processes. It also contributes to enriching information in a larger context of INDEPTH Network, and is useful information to apply for other similar contexts in low- and middle-income countries.

 

Full-text link:

• http://journals.sagepub.com/doi/full/10.1177/1010539517720550
• https://www.ncbi.nlm.nih.gov/pubmed/28719775

 

 

Source: Center for Population Health Sciences (CPHS) – Hanoi University of Public Health