Role of Community Health Workers in the delivery of the hepatitis B vaccine in Vietnam

In Vietnam, the rate of transmission of hepatitis B virus (HBV) from mother-to-newborn is high. Studies have shown that people infected with HBV during early infancy are more likely to become chronically infected than those exposed later in life. Mother-to-newborn transmission of hepatitis B can be prevented by vaccination soon after birth. Vaccinating newborns against hepatitis B within 24 hours of delivery (as recommended by the World Health Organization) in rural Vietnam places great stress on the health workers. The objective of this research was to examine and compare strategies used by rural community health centers (CHCs) to administer birth-doses of the hepatitis B vaccine. The research team conducted key informant interviews, focus group discussions and surveys among community health workers (CHWs) and mothers of infants in four provinces of Vietnam. The team found that birth-dosing was more successfully implemented in communes where a network of village health workers (VHWs) exists than where it does not. VHWs reported and updated CHCs on the status and stage of pregnancies of women in their commune. The pregnancy tracking procedure assured that CHC staff were able to administer a birth-dose of hepatitis B vaccine to newborns, regardless of the place of birth. VHWs, the local public health agent in the commune, provided basic health education to the community and promoted immunization programs, especially birth-dosing, to expectant women and families. This assessment demonstrates the need for and importance of community-based health workers for successful implementation of national immunization programs in developing countries.