User:Gecshaw/sandbox

Health in Vietnam

I want to expand many of the sections on the page including "Healthcare system" and "Private sector" and make sure there is a balance between the private and public sector sections. Then I would like to add several sections about specific health concerns that are pertinent to present day Vietnam, for instance, Agent Orange and Prenatal Screening.

What's missing from current article? Wide breath of topics, Updates/recent sources, More on healthcare for the poor, More on water, More on funding, Elaborate on stigmatization for HIV, do we need midwifery section/is it important to Vietnam specifically? Elaborate on why birth mortality rates are going up, add section for public sector in addition to list of hospitals, private sector should be better written.

Update: Healthcare system, Private Sector

Added to Intro:

Life expectancy has risen by two years for males and females in Vietnam between 2000 and 2012.[1] This is half of the average rise in life expectancy for other parts of the world during the same time period.[1]

In 2012, almost 22% of deaths could be attributed to strokes. This leading cause of death was followed by heart disease with 7% of deaths, and Chronic obstructive pulmonary disease with 4.9% of deaths.[1] The two largest risk factors for adults are tobacco use and raised blood pressure.[1]

Contraception is widely used and most births are attended to by trained healthcare providers. Only about 60% of women receive antenatal care during their pregnancies.[1]

Agent Orange
Several health defects have been correlated with the use of the chemical dioxin, also known as Agent Orange, during the Resistance War Against America (Vietnam War). Dioxin was used in the war as a defoliant and is now considered a carcinogen.[5] Major differences in dioxin levels have been measured in the blood and breast milk of those living in areas that had been sprayed with Agent Orange when compared to other areas of Vietnam.[5] This carcinogen is associated with tumors, immune deficiency, reproductive and developmental disorders, nervous system defects, and a variety of other birth defects including Spina bifida.[5][6] Agent Orange continues to be a risk factor in Vietnam today because of its continued presence in soil, wildlife, and food.[6] In addition, the effects continue to be seen in generations born to those exposed to Agent orange. [6] Beginning in 2007, Vietnam Veterans are now compensated for detrimental health effects due to Exposure.[5]

Tuberculosis
The Viet Nam National Tuberculosis Control Program (NTP) worked with a control strategy recommended by the World Health Organization to lower Tuberculosis (TB) rates, and successfully exceeded target goals in 1997.[7] However, although there was a decrease in TB incidence among women and persons over 35, the rates of Tuberculosis among young men in Vietnam significantly increased during this time causing a stabilization of the overall rate.[7] According to the World Health Organization, Vietnam has the 12th highest incidence of Tuberculosis worldwide. There are an estimated 89 positive cases for every 100,000 individuals.[7] With an intensified vaccination program, better hygiene, and foreign assistance, Vietnam hopes to sharply reduce the number of TB cases and annual number of new infections.[2]

A 2012 study of tuberculosis control in Vietnam, identified a shortcoming in the current strategy of attending solely to symptomatic patients, as it has not been marked by any significant decrease in TB rates. Instead the authors of the research advocated for a strategy of contact tracing that would focus on household members of Tuberculosis patients in Hanoi. The study found a high incidence of TB rates in the household contacts tested and concluded that household contact investigation would be a feasible disease management strategy in Vietnam.

Prenatal Screening
Tine M. Gammeltoft, an anthropologist at the University of Copenhagen has described the interplay between the individual and the state during prenatal screening, "In the realm of reproduction, intense sentiments of anxiety, dread, desire, ambition, and hope tie together the state and [Vietnam's] citizens, animating individual aspirations as well as national population policies".

An increase in the prevalence of ultrasound technology in the country has led to more screening for abnormal fetuses.[9] While women in the Western world are commonly offered one or two ultrasounds throughout the entire duration of their pregnancy, it is not uncommon for Vietnamese women to have more than 20 ultrasounds during one pregnancy.[9] The focus of these ultrasounds are often much different than in Western countries, where parents look forward to determining the sex of their baby or seeing photos of the developing fetus. Because of the prevalence of birth defects due to Agent Orange in Vietnam, ultrasounds are often a means for quelling the fears of expectant mothers.[9] The Vietnamese Commission for Population, Family, and Children, gave a statement in 2004 describing their support for prenatal screening in hopes that it may promote population quality that would allow Vietnam to enter into a phase of modernization and industrialization alongside other Southeast Asian countries.[9] This focus on Vietnam's national "stock" was in part based off of Japan's efforts beginning in 1945 to strengthen the physicality and quality of their population through genetics programs, encouraging scientists to have many children, and the legalization of marriage with foreigners.[9]

Because of the particularly high prevalence of HIV infections in women of childbearing age world wide, in addition to Vietnam's high HIV/AIDS diagnosis rate, health counseling during the prenatal period is also focused on HIV positive expectant mothers. Since 1996, women have had access to programs designed to reduce transmission of HIV from mother to child, but still face the decision of whether or not to terminate their pregnancy out of concern for the child's long term care. Many women decide to have an abortion because of the fear that they will not be able to care for the child. This is common even when the family desires to have a child.

Additional sources for Agent orange:

Fuller, Thomas. (2012, August 10). 4 decades on, U.S. starts cleanup of Agent Orange in Vietnam. The New York Times, p. A4.

Dwyer, J., & Flesch-Janys, D. (2014). Agent Orange in Vietnam. 1995. American Journal of Public Health, 104(10), 1857-60.

Additional sources for prenatal screening:

Rajmaan (talk) 19:48, 7 July 2014 (UTC)Agent Orange and Prenatal Screening

Other sources:

https://extranet.who.int/sree/Reports?op=Replet&name=/WHO_HQ_Reports/G2/PROD/EXT/TBCountryProfile&ISO2=VN&outtype=html

Malaria http://www.who.int/malaria/publications/country-profiles/profile_vnm_en.pdf?ua=1

Non-infectious Disease http://www.who.int/nmh/countries/vnm_en.pdf?ua=1

Alcohol http://www.who.int/substance_abuse/publications/global_alcohol_report/profiles/vnm.pdf?ua=1

Traffic injuries http://www.who.int/violence_injury_prevention/road_safety_status/2013/country_profiles/viet_nam.pdf?ua=1

Tabaco http://www.who.int/tobacco/surveillance/policy/country_profile/vnm.pdf?ua=1

Breast Feeding http://www.who.int/features/2016/Viet-Nam-breastfeeding-campaign/en/

Health infastructure file:///Users/graceshaw/Downloads/Pam%20Le%20Tuan%202015%20(1).pdf