Infrastructure and Software Skills in the Expanded Program on Immunization at Commune Health Centers in Central Vietnam: A Cross-Sectional Mixed-Methods Study.

The application of the National Immunization Information System at primary health facilities is crucial in improving the quality of medical examinations as well as collecting and reporting immunization information. This study aimed to describe the infrastructure for the Expanded Program on Immunization's software at communes/wards/towns health centers (CHCs) of a province in central Vietnam and to evaluate the capacity of using immunization software of health officers. Another objective was to identify factors associated with skills in using the software of participants. A cross-sectional study combined with qualitative and quantitative methods was conducted, including 237 health officers from 50% (76/152) CHCs of Thua Thien Hue Province. Data were collected through face-to-face interviews using a developed questionnaire and observation via checklists. The results showed that most CHCs had sufficient infrastructure for the Expanded Program on Immunization (EPI). Health officers proficient in using the National Immunization Information System accounted for 74.7%. The CHCs should be equipped with more devices serving the immunization information management system and regularly maintain the equipment and the internet connection. Training health officers at CHCs in the data management of the vaccination system and record tracking ability using the National Immunization Information System is needed.

Characterizing the relationship between temperature and mortality in tropical and subtropical cities: a distributed lag non-linear model analysis in Hue, Viet Nam, 2009-2013.

BACKGROUND: The relationship between temperature and mortality has been found to be U-, V-, or J-shaped in developed temperate countries; however, in developing tropical/subtropical cities, it remains unclear. OBJECTIVES: Our goal was to investigate the relationship between temperature and mortality in Hue, a subtropical city in Viet Nam. DESIGN: We collected daily mortality data from the Vietnamese A6 mortality reporting system for 6,214 deceased persons between 2009 and 2013. A distributed lag non-linear model was used to examine the temperature effects on all-cause and cause-specific mortality by assuming negative binomial distribution for count data. We developed an objective-oriented model selection with four steps following the Akaike information criterion (AIC) rule (i.e. a smaller AIC value indicates a better model). RESULTS: High temperature-related mortality was more strongly associated with short lags, whereas low temperature-related mortality was more strongly associated with long lags. The low temperatures increased risk in all-category mortality compared to high temperatures. We observed elevated temperature-mortality risk in vulnerable groups: elderly people (high temperature effect, relative risk [RR]=1.42, 95% confidence interval [CI]=1.11-1.83; low temperature effect, RR=2.0, 95% CI=1.13-3.52), females (low temperature effect, RR=2.19, 95% CI=1.14-4.21), people with respiratory disease (high temperature effect, RR=2.45, 95% CI=0.91-6.63), and those with cardiovascular disease (high temperature effect, RR=1.6, 95% CI=1.15-2.22; low temperature effect, RR=1.99, 95% CI=0.92-4.28). CONCLUSIONS: In Hue, the temperature significantly increased the risk of mortality, especially in vulnerable groups (i.e. elderly, female, people with respiratory and cardiovascular diseases). These findings may provide a foundation for developing adequate policies to address the effects of temperature on health in Hue City.