Advocacy for smoke free restaurant in Vietnam

Tobacco is one the leading causes of death – already killing one in 10 adults worldwide. By 2030, perhaps a little sooner, one in six or 10 million deaths per year will be attributable to smoking, more than any single cause of death. Whereas until recently this epidemic of chronic disease and premature death mainly affected developed countries, it is now rapidly shifting to developing world. By 2020, seven out of 10 people killed by smoking will be in low- and middle – income nations. China, India, Southeast Asia and the Western Pacific will be particularly affected by the tobacco epidemic

Vietnam is found in this high-risk region with a smoking rate in men of 56.1%¹ and in women of 1.8%¹. Its is estimated by the world Health Organization that around 8 million Vietnamese people alive today, or 10% of the population, will die of smoking related disease. . Health effects of active and passive smoking has been increasing and becoming a very important public health issue. Results of many studies show that passive smokers have higher risk of having lung cancer, acute coronary diseases and other effects like asthma and reduced lung function compared to non – smokers.

Numerous studies have found that tobacco is a major contributor of indoor air pollution and that breathing secondhand smoke (SHS), also known as environment tobacco smoke or ETS, is a cause of disease in healthy non-smokers, including heart disease, stroke, respiratory disease and lung cancer. Article 8 of the WHO Framework Convention on Tobacco Control (FCTC), adopted by all WHO members in May 2003 stated the right of having clean air for non smokers:1. Parties recognise that scientific evidence has unequivocally established that exposure to tobacco smoke causes death, disease and disability.2. Each Party shall adopt and implement in areas of exiting national jurisdiction as determined by national law and actively promote at other jurisdictional levels the adoption and implementation of effective legislative, providing for protection from exposure to tobacco smoke in indoor workplaces, public transport, indoor public places and, as appropriate. other public places

From February 2004 to May 2005, with financial support from Health Canada and technical support from WHO, Vietnam HealthBridge Canada.( formerly named Path Canada Vietnam) conducted a project entitled “ Expansion of Smoke free Restaurant an Hotel in Vietnam”. Experience from the implementation of this project can be used for further expanding of smoke free restaurants in Vietnam as well as for advocating the use, the need and the feasibility of implementing smoke free regulation

General objective:The project aim to create smoke – free areas at all restaurants in Vietnam in order to reduce active and passive smoking and its health effects

Specific objectives

• Raising awareness of the Ministry of Trade and Vietnam Food Administration of the need of having smoke – free restaurants regulation in Vietnam

• Building capacity on advocating of setting up regulation on tobacco control in Vietnam

ACTIVITIES

Activity 1: Review and Revise available materials/guidance to implement smoke – free Restaurants HealthBridge Canada in Vietnam has established several smoke free restaurants from 2004 to the early 2005. Therefore, all of the guidance, materials on setting up and implement a smoke free restaurant have been developed. All of the materials will also be revised to match with the current context. To be able to apply those materials to other restaurants in Vietnam, further revision based on results of the survey indicated in activity 2 is also needed.

Activity 2: Rapid survey on Public Demand, and willingness of restaurant workers, and supportive managers setting up a feasible smoke – free model at all restaurants in Vietnam The aim of the survey is to see whether the public has a demand for smoke free air, particularly in smoke free restaurants and to know whether the model of smoke free restaurant developed by Vietnam HealthBridge Canada with all of its components can be applied to other restaurants. Target group for this survey is responsible person at Ministry of Trade, Vietnam Food Administration, restaurant workers and managers and customers. The information can be collected through mail or telephone contact, interview, collection sheet. The result of the survey will be much helpful for newspaper, and smoke free restaurant advocacy.

Activity 3: Conference to introduce the some of the smoke free restaurants in Vietnam, other restaurant will also be introduced A conference will be conducted to introduce the model of smoke free restaurant in Vietnam. Strength, weakness, opportunity and threat of implementing and expanding this model will also be discussed. Managers from some other restaurants in Vietnam, Vietnam Food Administration; VINACOSH; ; media; NGO advocates as well as from the Ministry of trade will also be invited to the conference.

Activity 4: Meeting with Ministry of Trade and Vietnam Food Administration to advocate on the need of a regulation on setting up smoke free areas at all restaurants in Vietnam It is expected that persons in charge of the Ministry of Trade and Vietnam Food Administration well recognize the need of having regulation on setting up smoking rooms in all restaurants to protect non-smokers and protect clean air of restaurants. Meetings are needed to present health effects of active and passive smoking, feasibility of implementing smoke free regulation at all restaurants in Vietnam, the smoke free restaurant model and other international models, applying smoke free regulation as a standard in the standardization of all restaurants. Advocating through meeting and business meals is to convince the need of smoke free regulation for all restaurants in Vietnam Activity 5: Sharing information and promoting smoke – free restaurants among restaurants through Newspaper and leaflet. Model of smoke free restaurant will be introduced and shared with other restaurants through Newspaper and leaflet. The restaurants will be encouraged and supported to implement some pilot smoke free models at their own restaurants.

A report of this activity with some expected outcomes will be prepared after at least one year of this project. It is expected that based on some pilot models of smoke free restaurants implemented, a feasible model of smoke free restaurants can be developed thus be able to apply to all restaurants in Vietnam. This will be submitted to the Ministry of trade and Vietnam Food Administration for advocating purpose.

POLICY TRANSLATION

It is expected that through all activities of this project, awareness of the in charge persons at Ministry of Trade and Vietnam Food Administration about the need of smoke free regulation is raised. Development of regulation on smoke free is recognized as their own need for the improvement of academic environment at all retaurants in Vietnam. The feasibility and availability of the regulation in some developed countries will be strong support for the advocating process.

 

Advocacy for smoke free university in Vietnam

Health effects of active and passive smoking has been increasing and becoming a very important public health issue. Results of many studies show that passive smokers have higher risk of having lung cancer, acute coronary diseases and other effects like asthma and reduced lung function compared to non – smokers. Article 8 of the WHO Framework Convention on Tobacco Control (FCTC), adopted by all WHO members in May 2003 stated the right of having clean air for non smokers:1. Parties recognise that scientific evidence has unequivocally established that exposure to tobacco smoke causes death, disease and disability.2. Each Party shall adopt and implement in areas of exiting national jurisdiction as determined by national law and actively promote at other jurisdictional levels the adoption and implementation of effective legislative, providing for protection from exposure to tobacco smoke in indoor workplaces, public transport, indoor public places and, as appropriate. other public places Vietnam, a country with smoking prevalence (at 15+ years of age) in males was 56.1%, in females was 1.8%[1] has regognised the impact of tobacco on population health and development. In August 2000, the Government inked Resolution No 12/NQ-CP on National Tobacco Control Policy which regulates that “smoking is banned at meetings, offices, health facilities, schools, kindergartens, cinema theatres and on public transport means, crowded places. Smoking areas should be regulated.”[2] Following the issuance of the Resolution, the ministries of Health, Education and Training, Information and Culture, and Transportation released instructions to implement the smoking ban in their working places.

Although the Ministry of Education and Training has been indicated to release instructions to implement the smoking ban in all schools and kindergartens, study in schools of 5 provinces in Vietnam in 2003 showed that the prevalence of smoking in male students was 3 – 8% and in male teachers was 50% and 40% of teachers still smoked in the school areas.

The prevalence of smoker is much higher in universities and colleges but those areas are not a target for the regulation. A complement regulation is needed to set for all universities and colleges in order to achieve the aim of protecting the right of non smokers at all universities and colleges.

Hanoi School of Public Health is the unique university in Public Health in Vietnam. The school has very actively involved in protecting population health. Regarding tobacco control measures, the school has set to become the first smoke free university in Vietnam with all instructions and guidance for implementation. The model of HSPH has been applied for nearly one year and run into final assessment in the end of this year. Experience from the implementation of this model can be used for further expanding of smoke free university in Vietnam as well as for advocating the use, the need and the feasibility of implementing smoke free regulation

General objective:The project aim to create smoke – free areas at all universities in Vietnam in order to reduce active and passive smoking and its health effects

Specific objectives

• Raising awareness of the Ministry of Education and Training (MOET) of the need of having smoke – free university regulation in Vietnam

• Expanding the model of smoke free university using the pilot model applied at Hanoi School of Public Health

• Building capacity on advocating of setting up regulation on tobacco control in Vietnam

ACTIVITIES

Activity 1: Review and Revise available materials/guidance to implement smoke – free university Hanoi School of Public Health (HSPH) has applied the model of smoke free university since the early 2005. All of the guidance, materials on setting up and implement a smoke free university have been developed. After one year of implementation, an assessment will be conducted to assess the outcomes of the project. All of the materials will also be revised to match with the context of the school. To be able to apply those materials to other universities in Vietnam, further revision based on results of the survey indicated in activity 2 is also needed.

Activity 2: Rapid survey on setting up a feasible smoke – free model at all universities in Vietnam The aim of the survey is to see whether the model of smoke free university at HSPH with all of its components can be applied to other university. Target group for this survey is responsible person at some of universities in Vietnam. The survey can be conducted in an annual meeting of Vietnam Public Health association where director board of some medical universities are invited, or information can be collected through mail or telephone contact. Self – administrative questionnaires will also be delivered to representatives of Student Union at selected universities. The aim of this self – reported survey is to identify the roles of Student Union in implementing such kind of activity, how to integrate this tobacco control activity with other activities at the universities like English club, Dancing club etc.

Activity 3: Conference to introduce Hanoi School of Public Health as the first smoke free university in Vietnam, other smoke free universities (if available) will also be introduced A conference will be conducted at HSPH to introduce the model of first smoke free university in Vietnam. Strength, weakness, opportunity and threat of implementing and expanding this model will also be discussed. In charge persons from some other universities in Vietnam, Ministry of Culture & Information; Ministry of Health; VINACOSH; university student leaders/unions; media; NGO advocates as well as from the Ministry of education and training will also be invited to the conference.

Activity 4: Meeting with MOET to advocate on the need of a regulation on setting up smoke free areas at all universities in Vietnam It is expected that persons in charge of the MOET well recognize the need of having regulation on prohibiting smoking for the clean air of all universities’ environment. Meetings are needed to present health effects of active and passive smoking, feasibility of implementing smoke free regulation at all university in Vietnam, HSPH model and other models (national and international), applying smoke free regulation as a standard in the standardization of all universities and colleges. Advocating through meeting and business meals is to convince the need of smoke free regulation for all university and colleges in Vietnam

Activity 5: Sharing information on smoke – free universities among university through Student union network Model of smoke free university in HSPH will be introduced and shared with other university through student union network. Members of the union committee and representatives from some university and colleges will also be invited to participate to the workshop. Advocating experiences will also be shared among all of the participants. This activity is different from activity 3. This workshop will target on implementing persons at the university like Student Union, representative from Department of Education and Training at universities. In this workshop, participants will be equipped some skills on advocating, implementing and monitoring tobacco control activities. After this workshop, participants will be encouraged and supported to implement some pilot smoke free models at their own institutions.

A report of this activity with some expected outcomes will be prepared after at least one year of this project. It is expected that based on some pilot models of smoke free universities implemented, a feasible model of smoke free university can be developed thus be able to apply to all universities and colleges in Vietnam. This will be submitted to the Ministry of Education and Training for advocating purpose.  

POLICY TRANSLATION

It is expected that through all activities of this project, awareness of the in charge persons at MOET about the need of smoke free regulation is raised. Development of regulation on smoke free is recognized as their own need for the improvement of academic environment at all universities and colleges in Vietnam. The feasibility and availability of the regulation in some developed countries will be strong support for the advocating process.

 

Applying Public Health approach to reduce burden/harmful risks of the Dioxin in an isolated hospot - Bien Hoa, Dong Nai -

INTRODUCTION OF THE PROJECT

SUMMARY OF BASELINE STUDY RESULTS

Narrative Report 

	Activities/Issues Addressed
	Pretest data collection tool of base line survey: The tool for data collection was carefully tested in Bien Hoa. After testing, the tool was revised to fit with the culture and context of Bien Hoa, minor revision was made for the structure of the tool.-          Conducting base line survey: o    Training for interviewers: two – day workshop for training of the tool was conducted in Bien Hoa. Twenty interviewers were collected from staff of commune health center as well as provincial health service of Dong Nai. The interviewers were trained in class, conducted role play and pilot in small sample of a commune of Bien Hoa, after the training, two interviewers were withdrawn for their inadequate practice, 13 interviewers were used for data collection o    Implement the survey: 400 residents of two commune of Bien Hoa city were randomly selected for interview by well trained interviewers. The survey was conducted with strict supervision process by VPHA staff as well as provincial Public Health Association. The data were cleaned immediately in field by supervisors and then were cleaned the second time in office before processing Writing quantitative report: data were processed by Stata software 9.0 and SPSS 13.0. Quantitative report was prepare as in attached file Conducting qualitative survey: In order to design a communication campaign to address the issue, a supplementary qualitative survey was conducted in representative of local authority as well as resident of Bien Hoa, Dong Nai. The qualitative survey provides perception of the community toward the issue as well as suggestion for intervention using community participation. -          Organizing dissemination workshop: findings of combine qualitative and quantitative report were disseminated to the local authorities and residents in a dissemination workshop organized in Bien Hoa, Dong Nai. Participants of the workshop were highly appreciated the project. The workshop did also provide opportunity for them to participate in making plan for intervention. Local authorities and resident discussed and agreed on three main intervention approaches: advocating for new regulation issued by Dong Nai People committee on prohibiting all type of cultivation in Bien Hoa, communication using local loud speaker, leaflets, health education by PHA volunteers, TOT training for PHA volunteer.-          Disseminate findings in the National Conference on People with Disability – A focus on the Impact of Agent Orange: findings of the survey were presented in the National Conference on People with Disability – A focus on the Impact of Agent Orange in December 18, 2007 -          Develop intervention plan: Based on findings of quantitative and qualitative surveys as well as results of the dissemination workshop, an intervention plan was developed with three main focuses on Advocacy, Communication and Health education. Materials has been developing by project team and invited experts for further dissemination to target population
	Expected Outcomes
	The following outcomes were achieved -          A well structured epidemiological study is design-          Questionnaires (checklist where needed) are developed based on the objective and indicators of the study -          Tools are tested, revised and ready to use for data collection -          All interviewer are familiar with the tools -          The survey is completely conducted. All needed information about  KAP of target population is collected -          Supervisions conducted by local PHA’s key members -          Randomly supervision from VPHA is conducted -          Data collected are cleaned, entered and analyzed. -          For each step of the processing of data, monitoring and supervision is implement to make sure the information reflect the real situation of the population -          Report is prepare and revised by professionals -          Results of the survey are shared with Public Health Professionals and are disseminated to the local authorities and stakeholders -          PH professional  and local authorities and stakeholders are aware of the real situation of KAP of people in hotspot area -          A strategic plan for intervention is developed in detailed  Compared to the proposal, there were some unexpected issue: Problem: The secretary of Dong Nai PHA was quite inactively involved in the project while Dong Nai PHA board were busy with other commitment and did not devote adequate time for the project. The project was 5 months behind the schedule. Respond: VPHA vice president has suggested Dong Nai PHA for a more active working mechanism. Changing personnel was also suggested, a new secretary of the project in Bien Hoa was indicated by Chaiman of Dong Nai PHALesson learnt: Clear working mechanism should be stated at the beginning of the project. Time frame should be carefully developed concerning local context as well as the nature of intervention issue Actual Results to Date
	Reflections
	Increased  capacity at both national and local levels of improving community health in terms of reducing harmful effects of Agent Orange has been recognized as the most significant contribution of  project activities. Through the past activities, Vietnam Public Health Association have chances to  advance skills and experience to conduct scientific research and do administration activities. Awareness of Authorities and members of Dong Nai Association at the local level toward to the importance of Public Health approach to improve community health has been much increased. It is very promising  that members of the provincial public health association will actively participate in further activities in the future due to growing awareness. In addition, the project also has advanced achievement of our long term goals. All of information/ experience of the past activities has been recorded in order to expand lesson learnt in other hotspots in the future. Moreover, through the project, Vietnam Public Health Association  had opportunities to build relationships and work with other state agencies working in Dioxin related issues like  Committee 33, Dialogue Groups, National Nutrition Institute…Those are the firm foundation for Vietnam Public Health Association to conduct further activities and reach long term goals. In terms of external events, Vietnam Public Health Association also joined the National  conference of Disability held in December 18th to disseminate results of the baseline study. This presentation has been highly appreciated at the conference and draw much attention form mass media agencies. Through this conference, Vietnam Public Health Association, a new born organization, has been publicly  recognized through some press news.

 

Diversity

The project get involvement of diverse participants: -          Researchers from Hanoi School of Public Health -          Expert from National Institute of Nutrition -          Dong Nai Public Health Association -          Health volunteers in Dong NaiIn the intervention planning process as well as further implementation of intervention activities, there has been the involvement of:          +Dong Nai provincial People’s Committee          + Provincial and Commune Health service           +  Provincial and Commune Culture and Information Service          + Women Union              + Representative of Market Management Service       + Commune Health center

 

Building a pilot community based of utilizing safe insecticide

Building a pilot community based of utilizing safe insecticide

Impact of Tobacco growing on livelihood and health of Tobacco farmers, environment - A preliminary study in Vietnam

For decades, in search of even more profits, tobacco industry has been encouraging countries and farmers to grow more tobacco. hey have been promoting tobacco growing as a panacea, claiming that it will bring unparalleled prosperity to farmers, their communities, and their countries. Viet Nam, a developing country with a tropical climate and hard-working laborers- which seems appropriate for tobacco cultivation, is not outside the target of cigarette companies.  order to enforce the policies on tobacco control in Vietnam, reliable information on health and economic hazards associated with tobacco farming are urgently needed by those with advocacy’s responsibility as well as for society in general. However, even though the number of research on tobacco in Vietnam has recently increased rapidly, to our knowledge, there remains no research on this area. The high quality evidence on health and economic hazards associated with tobacco farming is believed to be a firm background for advocacy process against tobacco use in Vietnam.

General objective

To preliminarily investigate the impacts of tobacco growing on the livelihood and health of tobacco farmers, and environment in Vietnam.

Specific objectives

1. To describe the livelihood of the tobacco farmers in Vietnam.
2. To estimate the amount of pesticide and fertilizers used in tobacco farming households.
3. To explore the association between tobacco farming and self-reported illness.
4. To describe the roles of child and woman labor in tobacco farming.

 With funding support from the South East Asian Tobacco Control Alliance (SEATCA), this study is led by the Vietnam Public Health Association with participations of 2 others institutes including Hanoi School of Public Health and Hanoi Medical University. This is A mixed methods design (13) including qualitative method (in-depth interview and focus group discussion) and cross-sectional household survey will be employed. Mixed methods designs allow researchers to develop a more comprehensive understanding of the complexity of human behaviors and experiences. Incorporation of qualitative method in the present study adds a cultural dimension on the impacts of tobacco farming on livelihood, health and environment of the farmers. Two districts including Vo Nhai district, Thai Nguyen province in the North and Cam My district, Dong Nai province in Southern part of Vietnam were purposefully selected (see map attached in appendix 1) because of the feasibility of the project and the representativeness of tobacco farming in the two main parts of Vietnam. Two communes, one is tobacco farming and one is non-tobacco farming (for comparison) which have similar geographical and socio-economical characteristics in each selected district were chosen. As a result, total of 4 communes were selected for the present study.

Results of the study show that tobacco planters are not wealthier than the other farmers. In fact, tobacco farming does not bring much benefit to the planters. The benefit the farmers can get would have been much higher if they had done some things else or even hired by some one for some physical works instead of investing in tobacco farming. However, an issue of concern here is the fact that tobacco farmers did not know what to do instead of tobacco farming. Initiatives should be implemented to replace tobacco farming. Tobacco market place is not stable and the farmers do not have truly bargaining power that can make tobacco farmer’s livelihoods even become worse. Further, tobacco farming has also had harmful effects on farmers’ health and environment.  Child and woman labor is widespread and essential an all stages of tobacco farming which raises important issues related to gender equality, social and health impact of tobacco growing on these vulnerable groups.

Results of this study will be also disseminated at the workshop titled “ Tobacco control – scientific evidence – policy implementation in Viet Nam” to be held by the Vietnam Public Health Association and HealthBrdige Canada in March,2008. In addition, results of the study will be widely disseminated to stakeholders and policy makers through some communication channels like newsletter, website, international and local journals… It is expected that the scientific evidence of this study on impacts of tobacco farming on farmer’s livelihood will be firm background for tobacco control advocacy in Viet Nam

Mainstreaming project

The World Health Organization (WHO) estimated that the tobacco epidemic in Vietnam will kill 8 million people alive today or 10 percent of the current population. The disparity between the magnitude of the tobacco epidemic and the attention and resources available for its control reflects lack of awareness of the link between tobacco and ill health as well as the strength and dominance of the tobacco industry in Vietnam.Mainstreaming Tobacco Control in Vietnam (MTC project) funded by Rockefeller Foundation, is an effort to strengthen tobacco control in Vietnam through mobilizing greater involvement and participation of key government agencies, UN agencies, NGOs, and donors and through capacity building and skill development of the Tobacco Control Working Group (TCWG) members. PATH Canada is partnering with the Vietnam Public Health Association (VPHA) to implement the project

Project Goal: The overall goal of the program is to strengthen and expand tobacco control in Vietnam through integration of tobacco control into existing programs and through expansion of the number of key organizations and individuals in the North and South of Vietnam actively and effectively involved in tobacco control.

Project objectives:

1. To increase integration of tobacco control into government programs (including mass organizations) and to increase the number of key agencies (international, UN, INGOs, and donors) that include tobacco control as a part of their activities.

2. To improve the capacity of the TCWG members and tobacco control researchers

3. To expand the number of tobacco control intervention and research projects that support tobacco cessation, strong health warnings, smoke-free places, and tobacco tax increase.

4. To expose tobacco industry strategies in the media and gain support for strong tobacco control laws by policy makers as a counter-offensive to the threat of increased tobacco trade, consumption, and promotion.

5. To examine the social costs of tobacco, especially the impact of tobacco on the livelihoods of the poor, as a means to generate public and donor support for tobacco control (This objective had been completed after the first year of project implementation.

This report covers the period from June 1, 2005 to April 30, 2006

Project activities:

Project team has continued to collaborate with VPHA in implementing the project components. The activities were designing toward the extension of tobacco control to other provinces with coordinating role of Provincial Public Health Associations (PPHA). During the period of one year, three new PPHA s have been founded making all together six PPHA (Da Nang, Hai Duong, Thai Binh, Dong Thap, Khanh Hoa, Yen bai). The project team worked closely with VPHA and PPHA to identify the opportunities for tobacco control in PPHA agenda and help them to develop tobacco control program. The TCWG in Hanoi has been continued to meet regularly. The project team keeps close contact with TCWG members and TCWG coordinating group members to identify the issues and opportunities for tobacco control advocacy. The network with media has been maintained and extended. The information on tobacco control was provided to media on regular basis with the help of tobacco control fact sheet. The close contact with South East Asian Tobacco Control Alliance has been maintained to get the support form SEATCA and identify the opportunity for capacity building. The team actively response to the call for grant application of major funding organization such as RITC, Atlantic Philanthropies, UICC… trying identify the resource for tobacco control activities.

Outcomes: - VPHA became the main coordinator of TCWG, working actively with local and international partners to identify the opportunity in tobacco control. It is also very active in supporting PPHA to design tobacco control program. - A comprehensive tobacco control program has been developed by three newly founded PPHA (Dong Thap, Khanh Hoa, Yen Bai) making all together six PPHA having tobacco control program in their agenda.

The program generally include

1) foundation of TCWG;

2) Implementation of smoke free policy at work places (hospitals and/or offices) and public places ;

3) support the partner to implement other TC policies;

4) anti-smoking campaign activities.

- Five meetings of TCWG had been organized in the period under the report. the main contains of these meetings were updating on FCTC implementation of partners; sharing of research finding; Sharing the information on the workshops/ conference on tobacco control attended by the members

- Five new projects had been funded. two were developed by the newly-founded PPHAs, of which, one has been implemented, one is under development.

- The network built with journalists has been strengthened and extended. The information on the issues of tobacco control has been disseminated to media with the help of fact sheet. In total five fact sheets had been developed covering the topics: tax policy; economic cost of smoking; benefit from tax raising; cigarette smuggling prevention; women and tobacco control

- A media surveillance is being continued covering 40 newspapers; From June 2005 to the middle of April 2006, 426 articles covering tobacco control issues and tobacco industry issues have been identified, of them 80 articles (18%) were promoting tobacco industry which were considered as “negative”; 2% was considered as neutral; 50 articles used directly information from fact sheets.

- IEC materials development and printing: o 500 booklets “Guideline for development the club of “women having no smoking relatives”o 500 booklets “Guideline for Elderly Association in the development of smoke free community”o 10,000 “No smoking” stickers5,500 “No smoking” banner

Reducing Social acceptability of smoking in Vietnam

This project complements the efforts of HealthBridge and the Vietnam Public Health Association (VPHA) to foster the implementation of smoke-free policy in Vietnam and to support the long-term national plans to decrease the social acceptability of smoking in the country. It is hoped that these efforts will lead to declines in smoking rates and in passive smoking. In addition to the anticipated long-term effects on smoking, this project also seeks to increase the capacity of the Vietnam Public Health Association to work in tobacco control.

Objectives

The objectives of the project are to:

• Improve current levels of public awareness of health consequences of active smoking and secondhand smoke exposure (SHS);
• Increase public support of smoking bans in the public places;
• Improve the behavior of smokers (not to smoke in the vicinity of others) and non-smokers (confident to request smokers not to smoke in their vicinity);
• Build capacity of the Viet Nam Public Health Association to work effectively in tobacco control.

Results

Progress towards the goal of reducing the social acceptability of smoking is being achieved through the following strategies:

Production of evidence-based media products: The findings from a formative research and baseline survey were used to develop materials and to design a media campaign. Some images used in the Australian campaign, "Every cigarette kills", were adapted for use in the Vietnamese campaign. The main messages used for the campaign were "Speak up for your health and your beloved" and "Speak up for your health and your surroundings". The project team produced seven TV spots, three radio spots, and one poster. In addition, they produced talk shows, television and radio education sessions, leaflets targeting children and women, and training materials.

Conduct of a multi channel media campaign. The campaign was run by both central television (VTV1 and VTV3) and provincial television in three provinces (Thai Binh, Da Nang and Ben Tre) using the same TV spots. It was also run by central and local (in Thai Binh province) radio and by one newspaper. The campaign design was based on the knowledge and experience of consultants, information collected from the research, and the best possible arrangements with media agencies. HealthBridge and VPHA made special efforts to mobilize support from powerful political agencies. A monitoring system was set up to assess the media campaign.

Mobilization of community support for the campaign was undertaken in Thai Binh province. Two groups have been mobilized: women through the Women's Union and primary school children through the Department of Education and Training. Representatives of both groups were educated of the harmful effects of smoking and how to avoid exposure to SHS. They also helped to disseminate the message (via a leaflet) to the broader community. Several other community-based activities were also organized by youth and PPHA.

Implementation of a smoke-free policy in several settings, including health facilities, government and party offices, and public transportation, in Thai Binh province. The PPHA took the lead role in implementing the policy, and gained the support of other members of the provincial TCWG.

Progress towards the goal of developing the capacity of the Vietnam Public Health Association is being achieved through the following strategies:

Active involvement of VPHA in all steps of project development and implementation. The knowledge of VPHA staff members of tobacco control has been improved significantly through their active participation in the TCWG meetings and their attendance at important regional and national tobacco control workshops and capacity building programs. Staff skills in planning, coordinating and monitoring project activities, conducting research, developing IEC materials, designing and conducting media campaigns, and mobilizing the public has been also improved.

Networking: The relationship between VPHA with HealthBridge has been strengthened throughout the project implementation. While every organization has clear responsibilities, the two partners have been working as a team throughout the project, sharing ideas, discussing and finding solutions for problems. The relationship of VPHA with VINACOSH and other active agencies in tobacco control has also been developed and extended through the coordinating TCWG meetings. PPHA have also improved their credibility and prestige in tobacco control by playing the lead role in coordinating and implementing tobacco control programs at the provincial level. Relationships with the media have been extended and developed through multi-direction contacts over the life of the project. The visibility of VPHA in the regional and national tobacco control community has been much improved.

The project is ongoing. project's most recent report is available here.

Lessons learned

• The instruments used in research are crucial, and should be carefully developed taking into consideration local cultural context/languages.
• Selecting the field site should be based on the representativeness of the proposed study site, not just on its convenience to the researchers.
• Careful recruitment of interviewers and training is important; however, strict supervision is crucial to detect and manage any problems in a timely manner
• Keeping field intervention bias-free is always a challenge. Working carefully with local partners from an early stage to identify all possible risks and to develop measures to limit the impact of these risks is important.
• Keeping the commitment of VTV (Vietnam TV) to a low cost, appropriate airing campaign was a challenge. Meeting with people in positions of authority to increase their understanding of the importance of the messages being aired and developing a network of supporters is important.
• Support from national committees such as the National Committee for Science and Education and the National Committee for Culture and Sports is very helpful to gain permission from the national television network to air TV spots at reasonable peak times with adequate frequency and at no cost. Advocacy using different channels is a key skill at this interventional stage of the project
• Working closely with local partners could identify opportunities to integrate project activities with low cost and good participation.
• To be cost effective, a media intervention program should be as specifically targeted as possible.
• The ability to remain flexible in staffing arrangements is crucial to successful project implementation.
• Sincerity and openness can help in difficult negotiations. A sense of sharing and helping may have higher value than just salary.

Recommendations

The next phase of campaign should be monitored strictly.

The post intervention evaluation study should be designed early enough to ensure that it is properly designed and finished on time.

 

The modle of dengue fever prevention in Dong Thap - A pilot operational study

The modle of dengue fever prevention in Dong Thap - A pilot operational study

The modle of providing support and home based care to People living with HIV/AIDS in Hai chau distric, Da Nang city 2006-2008

The modle of providing support and home based care to People living with HIV/AIDS in Hai chau distric, Da Nang city 2006-2008