Vietnam Childhood Asthma Project

The initial cohort

The initial 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 was 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's role consisted of 1) identifying children from difficult-to-reach poor communities, 2) intervening early in life, 3) giving them free treatment (i.e. not dependent on any form of insurance) and 4) ensuring this 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 in operation, patients could be interviewed and records could be inspected. The project delivery cost was £117 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 indeed any asthma treatment at all, had their clinical needs met, with consequent positive results for their development. However, emerging from it were six goals for improvement:

1. Asthma International should decrease the cost per patient per year, which might mean increasing the number of patients;
2. It should work with poorer and more disadvantaged communities than those in Vietnam, with no access to health insurance and thus completely uncontrolled asthma;
3. It should scale the programme up from a pilot two-year programme to a larger and more ambitious rolling operation;
4. It should ensure that data is available in real time to trustees in the UK, helping in project evaluation;
5. It should ‘soft publish’ the project as a Quality Improvement project or audit. Later there could be a publication in an academic journal;
6. 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 Asthma International has now identified a new partner based in Kenya. This is the Dreamland Hospital, near Kimilili in Western Kenya. The Dreamland Hospital is part of IcFEM, a UK registered charity, number 1107038.