| 词条 | Health in Vietnam |
| 释义 |
Life expectancy has risen by two years for males and females in Vietnam between 2000 and 2012.[1] This is half of the average rise in life expectancy for other parts of the world during the same time period.[1] Malnutrition is still common in the provinces, and the life expectancy and infant mortality rates are stagnating. In 2001 government spending on health care corresponded to just 0.9 percent of gross domestic product (GDP). Government subsidies covered only about 20 percent of health care expenses, with the remaining 80 percent coming out of individuals’ own pockets.[2]In 2012, almost 22% of deaths could be attributed to strokes. This leading cause of death was followed by heart disease with 7% of deaths, and Chronic obstructive pulmonary disease with 4.9% of deaths.[1] The two largest risk factors for adults are tobacco use and raised blood pressure.[1] Contraception is widely used and most births are attended to by trained healthcare providers. Only about 60% of women receive antenatal care during their pregnancies.[1] IssuesBeginning in the late 1980s, the quality of health care began to decline as a result of budgetary constraints, a shift of responsibility to the provinces, and the introduction of charges. Inadequate funding has led to delays in planned upgrades to water supply and sewage systems. Consequently, almost half the population has no access to clean water, a deficiency that promotes such infectious diseases as malaria, dengue fever, typhoid, and cholera. Additionally, inadequate funding has contributed to a shortage of nurses, midwives, and hospital beds. In 2000, Vietnam had only 250,000 hospital beds, or 14.8 beds per 10,000 people, a very low ratio among Asian nations, according to the World Bank.[2] Government expenditure on health has declined and the health system is largely financed through user-fees, which has direct implications for the rural poor, deterring them from accessing health care.[3] Agent OrangeSeveral health defects have been correlated with the use of the chemical dioxin, also known as Agent Orange, during the Resistance War Against America (Vietnam War). Dioxin was used by U.S military forces in the war as a defoliant and is now considered a carcinogen.[4] Major differences in dioxin levels have been measured in the blood and breast milk of those living in areas that had been sprayed with Agent Orange when compared to other areas of Vietnam.[4] This carcinogen is associated with tumors, immune deficiency, reproductive and developmental disorders, nervous system defects, and a variety of other birth defects including Spina bifida.[4][5] Agent Orange continues to be a risk factor in Vietnam today because of its continued presence in soil, wildlife, and food.[5] In addition, the effects continue to be seen in generations born to those exposed to Agent orange.[5] Beginning in 2007, Vietnam Veterans are now compensated for detrimental health effects due to Exposure.[4] MalariaVietnam has made progress in combating malaria, for which the mortality rate declined sharply, to about 5 percent of the rate in the early 1990s, after the country introduced antimalarial drugs and treatment. TuberculosisThe Viet Nam National Tuberculosis Control Program (NTP) worked with a control strategy recommended by the World Health Organization to lower Tuberculosis (TB) rates, and successfully exceeded target goals in 1997.[7] However, although there was a decrease in TB incidence among women and persons over 35, the rates of Tuberculosis among young men in Vietnam significantly increased during this time, causing a stabilization of the overall rate.[7] According to the World Health Organization, Vietnam has the 12th highest incidence of Tuberculosis worldwide. There are an estimated 89 positive cases for every 100,000 individuals.[7] With an intensified vaccination program, better hygiene, and foreign assistance, Vietnam hopes to sharply reduce the number of TB cases and annual number of new infections.[2] A 2012 study of tuberculosis control in Vietnam identified a shortcoming in the current strategy of attending solely to symptomatic patients, as it has not been marked by any significant decrease in TB rates.[6] Instead, the authors of the research advocated for a strategy of contact tracing that would focus on household members of Tuberculosis patients in Hanoi.[6] The study found a high incidence of TB rates in the household contacts tested and concluded that household contact investigation would be a feasible disease management strategy in Vietnam.[6] HIV and AIDSAs of January 2005, Vietnam had diagnosed 101,291 human immunodeficiency virus (HIV) cases, of which 16,528 developed acquired immune deficiency syndrome (AIDS) and 9,554 died. But the actual number of HIV-positive individuals is estimated to be much higher. An average of 40–50 new infections are reported every day in Vietnam. Vietnam hopes to contain the HIV infection rate at the current official rate of 0.35 percent, which is about average worldwide, by limiting the disease as much as possible to sex workers and intravenous drug users. However, if the current trend continues, the number of infected persons could reach 1 million by 2010. One of the impediments to containing HIV/AIDS is that the victims face discrimination and stigmatization that are more severe than almost anywhere else in the world, according to a United Nations official. However non-governmental organizations, like the Supporting Community Development Initiatives (SCDI) for example, are devoted to improve the situation and quality of life of HIV/AIDS affected people. In June 2004, the Bush Administration announced that Vietnam would be one of 15 nations to receive funding as part of a US$15 billion global AIDS plan.[2] Dengue FeverVietnam experienced a boom of dengue fever when 181,054 infection cases and 30 deaths were reported in almost localities in Hanoi and Ho Chi Minh City. As many as 14,079 dengue fever cases with three deaths have been reported this year so far across the country.[7] References{{commons category}}1. ^1 2 3 4 {{Cite web|url=http://www.who.int/gho/countries/vnm.pdf?ua=1|title=Viet Nam: WHO statistical profile|last=|first=|date=January 2015|website=World Health Organization|publisher=World Health Organization|access-date=Oct 28, 2016}} 2. ^1 2 Vietnam country profile. Library of Congress Federal Research Division (December 2005). This article incorporates text from this source, which is in the public domain. 3. ^{{cite journal|last=Huong|first=D|title=Ensuring health care for the rural poor: Social aims and commercial means in Vietnam and China|journal=Int J of Health Services|year=2007|volume=37|issue=3|pages=555–572|url=http://www.futurehealthsystems.org/publications/ensuring-health-care-for-the-rural-poor-social-aims-and-comm.html|accessdate=26 May 2012|display-authors=etal|doi=10.2190/h0l2-8004-6182-6826}} 4. ^1 2 3 {{cite journal|last1=Dwyer|first1=J. H.|last2=Flesch-Janys|first2=D.|title=Agent Orange in Vietnam|journal=American Journal of Public Health|date=1995|volume=85|issue=4|doi=10.2105/ajph.85.4.476}} 5. ^1 2 {{Cite web|url=https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2014/07/29/13/22/agent-orange|title=Agent Orange|date=2016|website=American Public Health Association: For science. For action. For health.|publisher=American Public Health Association|access-date=Oct 11, 2016}} 6. ^1 2 {{Cite journal|last=Fox|first=Gregory|last2=Viet Nhung|first2=Nguyen|last3=Ngoc Sy|first3=Dinh|last4=Thi Lien|first4=Luu|last5=Kim Cuong|first5=Nguyen|last6=Britton|first6=Warwick|last7=Marks|first7=Guy|year=2012|title=Contact Investigation in Households of Patients with Tuberculosis in Hanoi, Vietnam: A Prospective Cohort Study|url=|journal=PLOS ONE|volume=7|pages=1–7|via=|doi=10.1371/journal.pone.0049880}} 7. ^{{Cite news|url=https://english.vov.vn/society/three-deaths-of-dengue-fever-reported-so-far-in-2018-372338.vov|title=Three deaths of dengue fever reported so far in 2018|date=2018-04-10|work=VOV - VOV Online Newspaper|access-date=2018-09-12}} External links
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