ADB-supported interventions in Viet Nam’s Central Highlands have significantly improved people’s well-being and access to medical help, reduced infant mortality, and inspired the government in its quest for universal health care coverage.

In the early 2000s, doctors and nurses at the Dak Ha District Hospital were wrestling with an obstacle more complex than their lack of resources.

Some people in the rural communities in Viet Nam’s Central Highlands they served still sought treatment for themselves and sick children from untrained traditional village practitioners. They preferred herbal remedies over modern medicines. The belief that diseases came from ghosts was common, and it exacerbated a lack of awareness about the threat of poor hygiene to health.

Nurse Nguyen Thi Luyen, 41, says attitudes to medicine and health issues in general changed with the implementation of the ADB-supported Health Care in the Central Highlands Project during 2004-2010.

Information campaign

Medical staff used project funds to set up an information, education, and communications center in the hospital to make people aware of the importance of hygiene. The center also informed local families of the benefits they could reap from modern medical care. Villages in surrounding areas were provided with at least one health worker each and nurses were trained in patient management techniques.

Since then, the hygiene problem has been resolved, and local communities report lower rates of disease and infant mortality, says Thi Luyen, who with her patients are among the 5.1 million people in Viet Nam that have benefited from the project in five provinces: Dak Lak, Dak Nong, Gia Lai, Kon Tum, and Lam Dong.

Reaching out to ethnic communities

The project built hospitals and medical schools in areas where infrastructure needs had been largely neglected, training doctors and medical staff and increasing public investment in primary health care. Its cost was $28 million, $18.6 million or 66% of which was financed by a loan from ADB. The Government of Sweden provided a grant of $5.6 million and the Government of Viet Nam contributed $3.9 million.

The intervention was badly needed in the Central Highlands where more than four million ethnic minority people live in scattered, remote communities and the rates of gross poverty have long been far higher than the nationwide average of 13.4%.

The intervention was badly needed in the Central Highlands where more than four million ethnic minority people live in scattered, remote communities and the rates of gross poverty have long been far higher than the nationwide average of 13.4%.

Working in partnership, staff from the Ministry of Health and provincial health departments were responsible for implementing and overseeing a vast array of initiatives. Twelve district health centers were provided with new facilities and inpatient wards, and solid waste management and water and sanitation systems were upgraded. The project funded the construction of two provincial preventive health centers, three social disease centers, and four information centers. Secondary medical schools were built in Gia Lai and Dak Lak provinces.

Upgrading the skills of health workers

The project also trained frontline health workers and other staff and upgraded the skills of doctors.

Nguyen Thi Ven, director of the Department of Health in the province of Kon Tum, has seen the results at Ngoc Hoi District Hospital personally. “More than 20 specialists were trained with the help of ADB funds in fields such as obstetrics, pediatrics, and infection control,” she says. “The money was also invested in information and social disease centers, wastewater treatment plants, and vehicles. It had a great influence on our province.”

One medical professional who gained valuable skills was 40-year-old Nay Lin Da, who works as a doctor at the Pleiku Health Center in Gia Lai Province. After completing her medical degree, she received a scholarship from the project for a specialization course in Ha Noi and became an obstetrician.

Lin Da has observed a change in the attitudes of local people to medical care. In the past, many mothers would do nothing to prepare for the arrival of newborns. Today, with her help and support from midwives, they are generally doing what they should to take care of themselves and deliver healthy babies.

The list of improvements attributable directly and indirectly to the project is impressive, as everyone involved proudly acknowledges. For example there have been substantial reductions in diseases in the project provinces. Since 2006, the decrease in illness has been 10% higher in these provinces when compared with others, and infant mortality in the highlands has declined from 60 to 41 per 1,000 live births.

As a result of such achievements, the government changed its health care finance and insurance laws to ensure that services for the poor continued to be subsidized in all provinces. The success has also encouraged the government to test strategies that will allow it to realize an even more ambitious goal -universal health care coverage.

This article was originally published in Together We Deliver, a publication highlighting successful ADB projects across Asia and the Pacific that demonstrated development impacts, best practice, and innovation.