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Journal of Community Health

, Volume 40, Issue 4, pp 652–659 | Cite as

Sustainability of Public Health Interventions to Reduce the Risk of Dioxin Exposure at Severe Dioxin Hot Spots in Vietnam

  • Tran Thi Tuyet-Hanh
  • Le Vu-Anh
  • Michael Dunne
  • Leisa-Maree Toms
  • Thomas Tenkate
  • Fiona Harden
Original Paper
  • 302 Downloads

Abstract

Severe dioxin contamination at Bien Hoa and Da Nang airbases, Vietnam is of international concern. Public Health risk reduction programs were implemented in Bien Hoa in 2007–2009 and in Da Nang in 2009–2011. In 2009 and 2011 we reported the encouraging results of these interventions in improving the knowledge, attitude and practices (KAP) of local residents in reducing the dioxin exposure risk through foods. In 2013 we revisited these dioxin hot spots, aimed to evaluate whether the results of the intervention were maintained and to identify factors affecting the sustainability of the programs. To assess this, 16 in-depth interviews, six focus group discussions, and pre and post intervention KAP surveys were undertaken. 800 respondents from six intervention wards and 200 respondents from Buu Long Ward (the control site) were randomly selected to participate in the surveys. The results showed that as of 2013, the programs were rated as “moderately sustained” with a score of 3.3 out of 5.0 (cut off points 2.5 to <3.5) for Bien Hoa, and “well sustained” with a score of 3.8 out of 5.0 (cut off points 3.5 to <4.5) for Da Nang. Most formal intervention program activities had ceased and dioxin risk communication activities were no longer integrated into local routine health education programs. However, the main outcomes were maintained and were better than that in the control ward. Migration, lack of official guidance from City People’s Committees and local authorities as well as the politically sensitive nature of dioxin issues were the main challenges for the sustainability of the programs.

Keywords

Dioxin risk reduction Public health intervention Sustainability Dioxin hot spots in Vietnam 

Notes

Acknowledgments

The authors gratefully thank the Queensland University of Technology, Australian Development Scholarship, and The NCCR–North South Program and the Center for Environmental Monitoring (Vietnam Environment Administration) for financially and/or technically supporting this study. We would also sincerely thank the staff of Vietnam Public Health Association and provincial branches in Dong Nai and Da Nang for their supports throughout the data collection phase in 2013. The authors specially thank Ms. Nguyen Ngoc Bich, related departments at Bien Hoa and Da Nang cities, staff at local commune health stations and the local people for supporting, providing information and feedback during this assessment.

Conflict of interest

The authors declare that they have no conflicts of interest.

References

  1. 1.
    Stellman, J., et al. (2003). The extent and patterns of usage of Agent Orange and other herbicides in Vietnam. Nature, 422, 681–687.PubMedCrossRefGoogle Scholar
  2. 2.
    U.S. Vietnam Dialogue Group on Agent Orange/Dioxin. Hot spots: Cleaning up dioxin-contaminated soils. 2013 [cited 2014 10 January]; Available from: http://www.aspeninstitute.org/policy-work/agent-orange/cleaning-dioxin-contaminated-soils.
  3. 3.
    Hatfield Consultants and Office of the National Steering Committee 33 MONRE, Comprehensive Assessment of Dioxin Contamination in Da Nang Airport, Viet Nam: Environmental levels, human exposure and options for mitigating impacts, 2009.Google Scholar
  4. 4.
    Hatfield Consultants and Office of the National Steering Committee 33 MONRE, Environmental and Human Health Assessment of Dioxin Contamination at Bien Hoa Airbase, Vietnam, 2011, Hatfield Consultants and Office of the National Steering Committee 33.Google Scholar
  5. 5.
    Schecter, A., et al. (2003). Food as a source of dioxin exposure in the residents of Bien Hoa City, Vietnam. Journal of Occupational and Environmental Medicine, 45(8), 781–788.PubMedCrossRefGoogle Scholar
  6. 6.
    Minh, N. H., Son, L. K., & Nguyen, P. H. (2008). Dioxin contamination in Bien Hoa Airbase and its vicinities: Environmental levels and implication of sources. Organohalogen Compound, 70, 000543–000546.Google Scholar
  7. 7.
    Tuyet-Hanh, T. T., et al. (2010). Environmental health risk assessment of dioxin exposure through foods in a dioxin hot spot—Bien Hoa City, Vietnam. International Journal of Environmental Research and Public Health, 7, 2395–2406.PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Vu Anh, L., et al. (2010). Public health intervention program to reduce the risk of dioxin exposure through goods in Bien Hoa City Vietnam: Encouraging results after 1 year of intervention. Organohalogen Compounds, 72, 24–28.Google Scholar
  9. 9.
    Vu Anh, L., et al. (2010). Knowledge, attitude and practices of local residents at four wards, Da Nang City–Vietnam on preventing dioxin exposure through foods. Organohalogen Compounds, 72, 29–32.Google Scholar
  10. 10.
    Tuyet-Hanh, T. T., Ngoc-Bich, N., & Vu-Anh, L. (2013). New strategy toward dioxin risk reduction for local residents living surrounding severe dioxin hot spots in Vietnam. Global Health Action 6, 21105. http://dx.doi.org/10.3402/gha.v6i0.21105.
  11. 11.
    Vu-Anh, L., et al. (2011). Public health intervention program to reduce the risk of dioxin exposure through foods in Da Nang hot spot. Organohalogen Compounds, 73, 1757–1760.Google Scholar
  12. 12.
    Tuyet Hanh, T. T. (2013). The effectiveness of an intervention to reduce risk of dioxin exposure in Da Nang: Changes in community knowledge, attitudes and prevention practices after 2.5 years. Vietnam. Journal of Public Health, 1(1), 12–21.Google Scholar
  13. 13.
    Tuyet-Hanh, T. T., et al. (2014). Dioxin risk reduction program at the most severe dioxin hot spot in Vietnam: Residual knowledge, attitude and practices five years post intervention. Global Public Health (under review).Google Scholar
  14. 14.
    Schecter, A., et al. (2001). Recent dioxin contamination from Agent Orange in residents of a southern Vietnam city. Journal of Occupational and Environmental Medicine, 43(5), 435–443.PubMedCrossRefGoogle Scholar
  15. 15.
    Vu Anh, L., et al. (2011). Post intervention survey on the knowledge, attitude and practice among local residents living at four wards near Danang Airbase on preventing dioxin exposure through consumming contaminated foods (pp. 24–70). Hanoi: Vietnam Public Health Association.Google Scholar
  16. 16.
    Rizkallah, M. C. S., & Bone, L. R. (1998). Planning for the sustainability of community-based health programs: Conceptual frameworks and future directions for research, practice and policy. Health Education Research Theory and Practice, 13(1), 87–108.CrossRefGoogle Scholar
  17. 17.
    Bamberger, M., & Cheema, S. (1990). Case studies of project sustainability: Implications for policy and operations from asian experience. Washington, DC: The World Bank.CrossRefGoogle Scholar
  18. 18.
    Tuyet-Hanh, T. T., et al. (2009). Development of a framework for evaluating the sustainability of community-based dengue control projects. The American Journal of Tropical Medicine and Hygiene, 80(2), 312–318.Google Scholar
  19. 19.
    Kay, B. H., et al. (2010). Sustainability and cost of a community-based strategy against Aedes aegypti in northern and central Vietnam. The American Journal of Tropical Medicine and Hygiene, 82(5), 822–830.PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    Tuyet-Hanh, T. T. (2014). Dioxin exposure risk assessment and the sustainability of public health interventions at severe dioxin hot spots in Vietnam. School of Clinical Sciences 2014. The Queensland University of Technology.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Tran Thi Tuyet-Hanh
    • 1
    • 4
  • Le Vu-Anh
    • 2
  • Michael Dunne
    • 3
  • Leisa-Maree Toms
    • 4
  • Thomas Tenkate
    • 5
  • Fiona Harden
    • 4
  1. 1.Hanoi School of Public HealthHanoiVietnam
  2. 2.Vietnam Public Health AssociationHanoiVietnam
  3. 3.School of Public Health and Social WorkThe Queensland University of TechnologyBrisbaneAustralia
  4. 4.School of Clinical Sciences and Institute of Biomedical InnovationThe Queensland University of TechnologyBrisbaneAustralia
  5. 5.Ryerson UniversityOntarioCanada

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