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Seasonality in mortality and its relationship to temperature among the older population in Hanoi, Vietnam

View Article: PubMed Central

ABSTRACT

Background: As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area.

Objective: This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues.

Design: This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions) were used to broaden understanding of the quantitative material and to get additional information on actions taken.

Results: 1) Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2) Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3) Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4) Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5) Information and research: Data that can be used for planning and management (including population and epidemiological data) were largely lacking. The district lacked a disease early-warning system. 6) Medical products and technology: Emergency treatment protocols were not available in every studied health facility.

Conclusions: The primary care system capacity in rural Vietnam is inadequate for responding to storm and flood-related health problems in terms of preventive and treatment healthcare. Developing clear facility preparedness plans, which detail standard operating procedures during floods and identify specific job descriptions, would strengthen responses to future floods. Health facilities should have contingency funds available for emergency response in the event of storms and floods. Health facilities should ensure that standard protocols exist in order to improve responses in the event of floods. Introduction of a computerized health information system would accelerate information and data processing. National and local policies need to be strengthened and developed in a way that transfers into action in local rural communities.

No MeSH data available.


Distribution of DF cases in 14 districts of Hanoi from 2002 to 2010.
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F0008_23074: Distribution of DF cases in 14 districts of Hanoi from 2002 to 2010.

Mentions: During the study period from January 2002 to December 2010, there were 28,793 DF cases in which more than 75% of them were aged between 15 and 44 years. Male cases were higher at all years. DF cases occurred mostly in inner districts (72.07%) and the rest belonged to outer districts. Within inner districts, four bordering districts faced recurrent outbreaks over the 9 years. These were Dong Da, Thanh Xuan, Hoang Mai, Thanh Tri, Hai Ba Trung. Within the outer districts, the two bordering areas Thanh Tri and Tu Liem suffered the highest number of DF cases (Map 1). DF cases increased from 125 cases in 2002 to 649 cases in 2005, and after that, DF cases increased with greater magnitude and intensity with the, at the time, record of 2,707 cases in 2006 to become even worse in 2009 with 16,268 cases. The rate of DF cases per 100,000 population per year increased significantly from 2002 to 2010 (p-value of trend test is 0.03) and numbers of DF cases per month increased significantly over 108 months of 9 years (p-value of trend test is <0.000). The highest dengue cases in the study period were reported in September and October 2009 with 4,145 and 4,120 cases, respectively. DF outbreaks occurred in Hanoi from 2006 to 2010 with the number of cases being 4.3, 3.3, 4.1, 25.6, and 5.4 times higher, respectively, compared with previous years (Fig. 1).


Seasonality in mortality and its relationship to temperature among the older population in Hanoi, Vietnam
Distribution of DF cases in 14 districts of Hanoi from 2002 to 2010.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4265652&req=5

F0008_23074: Distribution of DF cases in 14 districts of Hanoi from 2002 to 2010.
Mentions: During the study period from January 2002 to December 2010, there were 28,793 DF cases in which more than 75% of them were aged between 15 and 44 years. Male cases were higher at all years. DF cases occurred mostly in inner districts (72.07%) and the rest belonged to outer districts. Within inner districts, four bordering districts faced recurrent outbreaks over the 9 years. These were Dong Da, Thanh Xuan, Hoang Mai, Thanh Tri, Hai Ba Trung. Within the outer districts, the two bordering areas Thanh Tri and Tu Liem suffered the highest number of DF cases (Map 1). DF cases increased from 125 cases in 2002 to 649 cases in 2005, and after that, DF cases increased with greater magnitude and intensity with the, at the time, record of 2,707 cases in 2006 to become even worse in 2009 with 16,268 cases. The rate of DF cases per 100,000 population per year increased significantly from 2002 to 2010 (p-value of trend test is 0.03) and numbers of DF cases per month increased significantly over 108 months of 9 years (p-value of trend test is <0.000). The highest dengue cases in the study period were reported in September and October 2009 with 4,145 and 4,120 cases, respectively. DF outbreaks occurred in Hanoi from 2006 to 2010 with the number of cases being 4.3, 3.3, 4.1, 25.6, and 5.4 times higher, respectively, compared with previous years (Fig. 1).

View Article: PubMed Central

ABSTRACT

Background: As a tropical depression in the East Sea, Vietnam is greatly affected by climate change and natural disasters. Knowledge of the current capacity of the primary healthcare system in Vietnam to respond to health issues associated with storms and floods is very important for policy making in the country. However, there has been little scientific research in this area.

Objective: This research was to assess primary healthcare system capacities in a rural district in central Vietnam to respond to such health issues.

Design: This was a cross-sectional descriptive study using quantitative and qualitative approaches. Quantitative methods used self-administered questionnaires. Qualitative methods (in-depth interviews and focus groups discussions) were used to broaden understanding of the quantitative material and to get additional information on actions taken.

Results: 1) Service delivery: Medical emergency services, especially surgical operations and referral systems, were not always available during the storm and flood seasons. 2) Governance: District emergency plans focus largely on disaster response rather than prevention. The plans did not clearly define the role of primary healthcare and had no clear information on the coordination mechanism among different sectors and organizations. 3) Financing: The budget for prevention and control of flood and storm activities was limited and had no specific items for healthcare activities. Only a little additional funding was available, but the procedures to get this funding were usually time-consuming. 4) Human resources: Medical rescue teams were established, but there were no epidemiologists or environmental health specialists to take care of epidemiological issues. Training on prevention and control of climate change and disaster-related health issues did not meet actual needs. 5) Information and research: Data that can be used for planning and management (including population and epidemiological data) were largely lacking. The district lacked a disease early-warning system. 6) Medical products and technology: Emergency treatment protocols were not available in every studied health facility.

Conclusions: The primary care system capacity in rural Vietnam is inadequate for responding to storm and flood-related health problems in terms of preventive and treatment healthcare. Developing clear facility preparedness plans, which detail standard operating procedures during floods and identify specific job descriptions, would strengthen responses to future floods. Health facilities should have contingency funds available for emergency response in the event of storms and floods. Health facilities should ensure that standard protocols exist in order to improve responses in the event of floods. Introduction of a computerized health information system would accelerate information and data processing. National and local policies need to be strengthened and developed in a way that transfers into action in local rural communities.

No MeSH data available.