Sustainability of Public Health Interventions to Reduce the Risk of Dioxin Exposure at Severe Dioxin Hot Spots in Vietnam
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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.
KeywordsDioxin risk reduction Public health intervention Sustainability Dioxin hot spots in Vietnam
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.
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