Vietnam is located in the eastern portion of Southeast Asia, sharing its borders with countries China, Laos and Cambodia. With an estimated population of 96 million, it ranks 15th most populous country in the world. Located in the north is Vietnam’s capital city Hanoi, and in the south is the most populated city, Ho Chi Minh City (formerly Saigon).
The importance of Eye health in Vietnam is developing. Visual disability represents 12.8% of all disability in Vietnam. It is also estimated 21 million people require refractive error services, with 3 million of those being children. The development of optometry is needed within the health care system in Vietnam to meet the eye care needs of the population, now and in the future.
In Vietnam, there is an identifiable gap in provision of eye care services for the rapidly increasing population. Optometry services such as eye examinations, including refraction, and the supply of prescription glasses are not readily available to the people. The burgeoning national eye health need has determined provision of care to be mainly focused on treating eye diseases and conditions, and little to no focus on the high levels of uncorrected refractive error – which is the need for glasses.
These staggering statistics motivated Brien Holden Foundation to engage in collaborative work to increase eye care services within Vietnam to help eliminate avoidable blindness due to refractive error.
We began working in Vietnam in 2008, initially focusing on increasing the eye care workforce through education and training courses. Optometry is still not an established profession in Vietnam and training courses on refraction and spectacle dispensing are not readily available.
The optometry program is the culmination of a ten-year plan to introduce optometry to the country, with the primary goal of alleviating the burden of uncorrected refractive error in Vietnam in line with the Vietnamese National Eye Health Plan. It is a joint initiative between Brien Holden Foundation, the Pham Ngoc Thach University of Medicine (UPNT) and the Ho Chi Minh City Eye Hospital.
In 2016-2017, the established Optometry education program at Hanoi Medical University (HMU) and University of Medicine Pham Ngoc Thach was implemented independently with close monitoring and support from the Institute. We have been working closely with UPNT and HMU to monitor the Optometry education program with regular meetings and discussions on the training timetables, allocation of teachers for relevant teaching subjects, equipment purchase and textbooks preparation.
The development of qualified optometrists will make an exceptional contribution to the vision care needs of Vietnam. Optometrists will relieve ophthalmologists from the management of basic and common eye conditions, allowing them to focus on their areas of specialty – medical and surgical treatment. The training of skilled optometrists will in time increase the efficiency of eye care services in Vietnam and improve the health system’s cost-effectiveness.
Advocacy and agency
We actively took part in various activities/programs to advocate for Vietnam eye health strategic plan (2016 -2020) to be approved by the Prime Minister including taking part in advocacy workshops and meetings with Ministry of Health and other stakeholders working in eye care in Vietnam. The strategic plan was approved by the Prime Minister in June 2017.
We also participated in the advocacy workshop run by Orbis in 2017 to advocate for insurance covering of eye care services including spectacle and RE examination for children.
For the Vietnam National Ophthalmology Conference of October 2016, the Foundation was invited to present about Myopia management which helped raise the Institute’s profile as the leading agency in myopia research.
Intervention of care and sustainability
Specific provision was made to bring eye care services to the remote, underserved or disabled members of the communities within the three districts of Ba Ria-Vung Tau. Discussions with local partners and community members assisted the planning and execution of outreach screening, referral pathways and dispensing of glasses or low vision devices for hard-to-reach patients in need of eye care.
Our driving objective in developing the vision centre model was to ensure the centres became permanent, locally run facilities, providing affordable and culturally appropriate eye care services for the community. They needed to be sustainable and include cost-recovery mechanisms that helped ensure financial independence over time, while also providing local people with training and employment opportunities to increase the workforce and strengthen health care systems.