Vietnam Project

Asthma International’s inaugural Vietnam project (2018-2020) treated 92 children aged between 3 and 15 from low-income backgrounds. Vietnam has a particularly high incidence of childhood asthma: children in Vietnam aged 12-13 have the highest incidence of asthma in Asia, at 29%. As with children anywhere, children in Vietnam need to have control of their asthma to enable them to attend school, or, if already at school, to gain the greatest benefit from their education. Well-controlled asthma also facilitates good night-time sleep with consequent positive effects on day-time performance. 

The initial cohort

The cohort of 92 children were confirmed as having asthma using spirometry (a diagnostic tool based on exhaled air volume and requiring a piece of equipment called a spirometer). They were then treated using up-to-date ‘combination’ therapies that include a reliever and a preventer drug (such as Seretide) and followed up over two years. After the two years of treatment had elapsed, their asthma in almost all cases was appropriately controlled. Subsequently their care was passed on to local ACOCUs, or Asthma/COPD Care Units, non-governmental Vietnamese clinics in which patients get treatment covered by basic (or free) insurance, and where the same level of treatment could be continued at low or at no cost. 

Local partner

The outreach, prescribing and administration was conducted by our Vietnamese partners at the Community Health Centre, District 10, Ho Chi Minh City, Vietnam, under the supervision of our Vietnamese partner, Professor Le Thi Tuyet Lan PhD, Chairwoman of the University Medical Centre of Ho Chi Minh City Respiratory Care Centre. Professor Lan is an Assembly Member of the international campaigning and advisory group the Global Initiative on Asthma, as well as being one of the most respected figures in the worldwide asthma community.

Asthma International's role

Asthma International played a gap-filling role by 1) identifying children from difficult-to-reach poor communities, 2) intervening early in life, 3) giving them free treatment (i.e. not under any form of insurance) and 4) ensuring their treatment was carried out under the World Health Organization Stepwise programme, which after two years meant that the participating children were receiving and using an appropriate dose of medication for their particular needs. These four points are often overlooked, leading to life-long adverse consequences for children. 

The programme budget

The budget was £21,570 in Vietnam directly, with a further £3,200 on fundraising and administration, including two trips to Vietnam for Asthma International volunteers. On these trips the programme could be seen working, patients could be interviewed (please see the YouTube video with footage of this) and records could be inspected. The total cost was £134 per child per year.

A spreadsheet detailing how the money was spent can be seen here. Sample patient records (names redacted) can be seen here.

Goals for improvement

The Vietnam project was considered by the board of Asthma International to be a successful learning experience, in fundraising, administration and execution, given that 92 children who may not have received early or appropriate asthma treatment, or any asthma treatment at all, were treated, with consequent positive results for their development. However, emerging from it were seven goals for improvement:

1. Asthma International should achieve more oversight of the day-to-day running of future programmes, through a partner in the clinic with better and more frequent communication links to Asthma International staff and volunteers (ideally a partner based both in-country and in the UK);
2. Asthma International should decrease the cost per patient per year, which might mean increasing the number of patients;
3. It should work with poorer and more disadvantaged communities than those in Vietnam, with no access to health insurance and thus completely uncontrolled asthma;
4. It should scale the programme up from a pilot two-year programme to a larger and more ambitious rolling operation;
5. It should achieve better monitoring and data collection for use in evaluation;
6. It should write up the project as an academic paper to be published in a journal;
7. It should achieve match-funding, even if only as a small percentage of the total budget, either from governmental or other non-profit sources.

In order to achieve these goals we have now identified a new partner based in Kenya. This is the Dreamland Hospital Mission (DMH), near Kimililli in Western Kenya. The DMH is part of IcFEM  Mission, a UK registered charity, number 1107038.