Journal of Rural and Tropical Public Health JRuralTropPublicHealth 2011, VOL 10, p. 15 ‐ 20 copyright Published by the Anton Breinl Centre of Public Health and Tropical Medicine, James Cook University 15 ORIGINAL RESEARCH MATERNAL REPORTS OF CHILD HEALTH PRACTICES IN HO CHI MINH CITY, VIETNAM CLARICE N. CHAU 1 , KATHRYN H. JACOBSEN 1 and BAO NGOC VU 2 1 Department of Global & Community Health, George Mason University, Fairfax, Virginia, USA and 2 Center of Preventive Medicine, Khanh Hoi, Ho Chi Minh City, Vietnam. Corresponding author: Dr Kathryn H. Jacobsen (kjacobse@gmu.edu ) ABSTRACT Objectives: To examine current rates of participation in several child health practices promoted in the 1980s in urban Vietnam as part of the GOBI (growth monitoring, oral rehydration therapy, breastfeeding, immunisation) initiative. Methods: In the 1980s during the GOBI campaign, District 4 of Ho Chi Minh City offered community-based child health classes focused on the four GOBI areas. In 2008, 297 mothers of children aged 5 or younger in District 4 were interviewed about their child health practices. Results: In total, 84% of mothers reported using a growth chart for their child, 56% reported treating diarrhoea with oral rehydration therapy, 75% reported breastfeeding their child for at least some duration, and 98% said their child had received at least one immunisation. Additionally, nearly all women reported treating drinking water, about three-quarters reported washing their hands regularly, over two-thirds reported using insecticides in the home, and just over half reported that they and their children slept under a bed net. Conclusions: Mothers in the 2000s reported fairly high levels of adherence to the core child health practices promoted by the GOBI initiative in the 1980s. The rates of healthy parenting practices in this study appeared similar to those reported in the 1990s and higher than those from the early 1980s prior to the implementation of GOBI. KEY WORDS: Child health; GOBI; Maternal knowledge; Health behaviour; Vietnam. SUBMITTED: 27 October 2010; ACCEPTED: 8 February 2011 INTRODUCTION Several major global initiatives aimed at increasing child health and survival have been implemented in recent decades. While participating countries are typically asked to create routine statistical reports on the impacts of programs during the initiative, reporting usually does not continue after the conclusion of the global initiative. As a result, it can be challenging to demonstrate whether behavioural changes related to the global programs are sustained after the end of these initiatives. In the 1980s, UNICEF set the target of significantly increasing child health status in developing nations, and identified four key target areas for child health and survival, known by the acronym “GOBI”: Growth monitoring, Oral rehydration therapy (ORT) for diarrhoea, Breastfeeding, and Immunisations to prevent infectious diseases (UNICEF, 1983; Cash et al., 1987). GOBI was designed to involve families and communities in improving child nutrition and health status and to expand access to primary health care and to low-cost interventions (UNICEF, 1983). Each of the four GOBI areas had a low supply cost and a high effectiveness rate (UNICEF, 1983; Cash et al., 1987). Simple growth charts are effective in identifying children with or at risk of nutritional and growth deficiencies so that they can receive nutritional support. A solution of clean water, sugar, and salt made from ingredients that are usually readily available in the home can significantly decrease the risk of dehydration in children with diarrhoea when provided by caregivers (Fontaine et al., 2007). Exclusive breastfeeding of infants through their first six months of life is a low-cost way to ensure adequate nutrition and reduce the risk of diarrhoea associated with unclean water. Immunisation against six important preventable diseases that can cause death or long-term disability (tuberculosis, diphtheria, tetanus, pertussis, polio, and measles) became feasible as vaccine production costs became lower (UNICEF, 1983). Since the 1980s when the GOBI initiative was implemented, significant improvements in child health and child survival have been achieved worldwide. By 2000, most countries across the globe had incorporated growth monitoring and early intervention for at-risk children into routine child health care practices (de Onis et al., 2004). The annual number of worldwide deaths from diarrhoea had decreased by about 65% from 1980 levels as ORT use in developing countries increased in about 70% of cases (Victora et al., 2000). About 40% of infants in their first six months of life in developing countries were exclusively breastfed (Lauer et al., 2004), and about three-quarters of children in developing countries had been vaccinated against the six infections that were part of the initial GOBI vaccination package (Ehreth, 2003). Still, while the success of the GOBI program was due to its simple focus on a limited number of health issues, GOBI was a limited approach to child health and survival precisely because it focused on such a narrow number of interventions. In response, in 1992 UNICEF and the World Health Organization (WHO) phased out GOBI and initiated a new child health care approach called Integrated Management of Childhood Illness (IMCI), which aimed to improve family and community health practices, increase the case management skills of health workers, and build capacity in health care systems for the prevention and treatment of common causes of child morbidity and mortality (Lambrechts et al., 1999). Before IMCI, many of the world’s prevention programs were