According to health statistic of Dien Bien province reported in 2008, mortality rate of children under 1 year of age (36/1000 of live births) and children under 5 years old (50/1000) at Dien Bien higher than average proportion of the country (15/1000). In fact the actual mortality rate is considered much higher than the reported data. The provincial report also shows that acute respiratory infections, diarrhea and malnutrition are the three primary causes of death in children. The shortage of high quality and timely health services for mothers and newborns is considered to be a contributing factor leading to this situation.



Although the national programs on acute respiratory infections and clostridium difficile diarrhoea have made concerted efforts in training the human resource and supplying equipment for the primary health system during the recent years (MOH, 2009), the effect of the programme has not been enough for real demand of the locality. Dien Bien does not have updated trainers on Integrated Management of Childhood Illness (IMCI) and needs support from national trainers or trainers from neighbouring provinces in provision of IMCI courses. Meanwhile, ethnic minorities are often hesitant to use the district and provincial hospitals because of the distance from their homes, high expenses and the unfamiliarities with procedures (caused by language barriers). Most of them usually practices traditional health care at home or come to commune health station for treatment, when the diseases become worse (UNICEF, 2011). Therefore, to reduce the rate of child mortality and enhance the knowledge of child health care for ethnic minority families, it is necessary to deliver the IMCI, Peadiatric Life Support (PLS), Neonatal Resuscitation and Essential Newborn Care (NR & ENC) services to commune health stations and exchange counseling skills to the health station staff.
 

The project has two objectives: (1) Strengthen the treatment incorporating common childhood diseases, pediatric first aid, to recover and critical care for newborns, (2) Improve the medical staff’s quality of consultancy and advice in regard to family prevention, early detection and care for sick children.

The project provides six training courses under three topics (1) IMCI, (2) PLS and (3) NR & ENC in four months (Sept – Dec 2011).

After training, it is expected that:

·         90% of medical staff practices proper techniques in IMCI including pneumonia, diarrhea, malaria, measles, dengue fever and malnutrition;

·         80% of medical staff practices proper techniques in PLS;

·         80% of medical staff practices proper techniques in NR & ENC;

·         95% of health station workers improves their family counseling skills required for the effective prevention, early detection and care of childhood illness;

·         100% trained provincial pediatric staff is able to provide technical guidance for officials and commune health stations in the active communication across the health departments in the future.

 
Target groups:

·         Women and 4,300 children are the targeted objects of this project. The application of healthcare services for newborns and children under 5 in commune health stations will increase the chance of access to quality health care services for girls (accounted for 52% in total 4,300 children) – who have less chance of receiving healthcare than boys.

·         Approximately 1,290 children and 300 women in 16 communes will be provided more quality counseling from commune health staff and they will become more confident in preventing, providing practical care of children with illnesses, and decision-making of using higher level health services.

The combination of three training course provision to a health staff in a short period with follow-up supportive supervision is an innovative idea of this proposal. It is also a different point of this project to focus on the commune health station performance rather than the district or provincial level like other projects. It is believed that it will help to increase the accessibility and availability of quality health service to the ethnic minorities and reduce the overload situation at district and provincial hospitals.