1. IMPROVE HEALTH LITERACY OF MOTHERS IN TERM OF EARLY CHILD DEVELOPMENT IN RURAL VIETNAM: PROGRAM DEVELOPMENT AND EVALUATION OF ACCEPTABILITY AND FEASIBILITY
Prof Jane Fisher*, Tuan Tran, Ha Tran, Thach Tran
Jean Hailes Research Unit, Monash University, Australia
Research and Training Center for Community Development (RTCCD)

2. 8 major risks to optimal early childhood development in rural Vietnam
Early child development
20% low birthweight
7.4% stunted
(6 months)
22% moderate or severe anaemia
80% iodine deficiency
17% iron deficiency anaemia
(pregnancy)
Lack of parenting skills
Unresponsive caregiving
< 1 SD lower in cognitive development (6 months)
30% having common mental disorders
32.7% having physical and sexual violence

3. Comprehensive primary care intervention in English
Project phases
Comprehensive primary care intervention in English
Translation and culture adaptation
Pilot testing
Phase 1
Phase 2
Phase 3

4. Phase 1 - Learning club for early child development4

5. Phase 1 - Intervention included
Literature review:
Interventions
All types of study design
Conducted in resource-constrained settings
Intraute-rine growth
restriction
Stunting
Iron deficiency
anaemia
Iodine deficiency
Unrespon-sive
caregiving
Insufficient cognitive
Develop-ment
Common mental disorders
Domestic
violence
Micro-nutrient supplement
Micro-credit scheme
Care for child development
Thinking healthy
Sister for Life
What were we thinking

6. Phase 2 – Theory of change
Early-mid preg
Late preg & newborn
3-6 month infant
7-12 month infant
13-24 month infant
Phase 2 – Theory of change

7. Phase 2 – 24 session content
Focus on 1000 days
Community-based intervention
Women Union staff as facilitators
Visual package for low literacy people

8. Phase 3 – Pilot testing in rural Vietnam
Participants
n= 270
Intervention
3 communes in Hanam province
Outcome
Club meetings
Learning Club
Consultation and referral
Household visits
 Child development
Acceptability, feasibility, fidelity 8

9. Baby bathing & diaper change
Caring newborns by grandmothers
Exercises during pregnancy

10. Phase 3 – Acceptability
Information was sufficient
Able to apply on a daily basis
“I practiced breathing exercises while in labor with my youngest child and I was happy to give birth naturally without pain”. A 24-year-old teacher in Liem Can commune.
“I was able to learn more about proper infant hygiene and sleeping schedules DVD instructional videos and practice role-plays but also through other members’ experiences”. A 21-year old new mother in Doi Son commune.

11. Facilitators’ capacity:
Phase 3 – Feasibility
Participation rate:
196 pregnant women
175 mothers having children under 2 years old
On average, adherence rate was 4.7 sessions (out of total 24 sessions)
Facilitators’ capacity:
Women Union + commune health station staff
Confidence in health and social topics
Teaching method:
DVDs video instruction  attracts participants

12. Phase 3 – Alignment with the strategic context
Learning club
Social sector/mass organizations
- Assist women in building prosperous, equal, progressive, happy families and income generation
- Collaboration of mass organizations
Local authorities
- Improving quality of human resources
- Poverty alleviation
Health sector
- National program of nutrition
- Breast feeding program
- Reproductive health and maternal and child health program
Education sector
- Early child education

13. Phase 3 – Fidelity Study design Intervention package
Baseline participants refused to join intervention
Fail to conduct economic evaluation
Change from randomized controlled trial  repeated cross-sectional studies
Intervention package
Lack of domestic violence prevention component
Lack of micro-credit scheme

14. DISCUSSION – Content revision
Include component of gender empowerment
Activity –based meetings
Take home materials
Establish “Playing corner”
Competitions and awards among club participants
Broad term of “mothers”  “main caregivers”

15. DISCUSSION – Revision of intervention design
Conditional cash transfer
Include micro-finance scheme
Teach method: DVDs instruction and visual documents
Facilitators:
Women’s Union staff
Kindergarten teachers
Commune health station staff

16. CONCLUSION
Psychoeducational intervention to improve health literacy of women in term of early child development
Acceptable + feasible + alignment with the strategic context in rural Vietnam
Minor modification for scaling up in Vietnam

17. Acknowledgement Grand Challenges Canada
Research and Training Community Development (RTCCD)
Jean Hailes Research Unit
I would like to thank my supervisors for their enormous support and great guidance, to all staff and students at JHRU and the Review committees of SPHPM for very helpful comments, to Monash Uni and Graduate Women Victoria for financial support, to all heads of schools and directs of selected centres and adolescents, and to my family members without whom this project is impossible.