Family planning in Vietnam
Feuerstein, M.T.
Lancet 342(8865): 188-189
1993
ISSN/ISBN: 0140-6736 PMID: 8100922 DOI: 10.1016/0140-6736(93)92290-aDocument Number: 327613
A trial of nearly 32,000 quinacrine pellet female sterilizations in Vietnam has occurred in the context of a country in transition to modernization. The main objectives of population and family planning (FP) policies are a two-child family, reduction of the infant mortality rate from 45 to 25/1000, reduction of child malnutrition rates from 50% to 25%, reduced maternal mortality from 120 to 50/100,000, increase in contraceptive use by 20% from the present rate of 33%, and reduction in the fertility rate from 4.0 to below 3 by the end of the century. Without vigorous FP, the population could double to 170 million within 30 years. The government has trebled its population and FP budget, but neighboring countries spend 6-10 times as much. The search is on to broaden the range of FP methods currently in use. In 1990, there were reported to be about 1 million abortions, another million insertions of IUDs around 223,000 oral contraceptive users, and 23,000 sterilizations. Menstrual regulation is legal, free, and available in communes where there is a three-year trained health worker. Research is in progress on injectable and implanted contraceptives. Acceptance of male sterilization is increasing. In field trials of quinacrine pellet nonsurgical female sterilization, physicians and midwives trained in IUD insertion were used. (The country is currently in the midst of a major overhaul of health manpower and health facilities.) Further research is required on the effects of insertion technique on the efficacy of quinacrine pellet sterilization and on the concentration of quinacrine in the uterine cavity in relation to placement and efficacy. The field trial also suggests that around 242 maternal deaths may have been averted during the study. It is estimated that 1300 clinicians doing 100 quinacrine pellet insertions sterilizations a month could meet vietnam's unmet need for female sterilization, thus contributing substantially to the country's FP needs.