The seventy-third session of the World Health Organization (WHO) Regional Committee for the Western Pacific will discuss major health issues in the Region, including reaching the unreached, mental health, primary health care, cervical cancer and noncommunicable diseases (NCDs). This story is part of a series examining how each health topic affects people in the Region.
Traditional birth attendant Vang Nutua is determined to make sure no one in her remote village in the Lao People’s Democratic Republic goes without health care during pregnancy or childbirth
This can be a challenge in Khang Khao. The village is tucked in the remote northeast province of Houaphanh, on the border with Viet Nam. It is about 650km from the capital, Vientiane, a journey that takes at least 15 hours by car.
Many women in the village’s mainly Hmong ethnic community work in rice fields, which can take a day and a half to reach on foot, so they usually sleep there during the rainy season from June to September.
They try to return to the village to give birth, but some are unable. Even when they do return to the village to give birth, many are unable to get to the hospital that is 24 kilometres away, because of time and expense. Other women stay away because they are not familiar with the process and fear misunderstanding, or they do not speak the same language as the health workers there.
“Since I began to work as a birth attendant in my community, I’ve been able to educate Hmong women to understand the importance of antenatal care and delivering at the hospital. Now they know that a hospital delivery is safer for the mum and baby,” said Mrs Nutua, whom villagers call Pa Vang.
“Still, some women can’t go for antenatal care or hospital delivery because they don’t have enough money or access to transportation. Another difficulty is that they have limitations with the Lao language. They can’t understand the doctor and vice versa,” she said. “So, I often accompany those who do not know what to do at the hospital. I speak with the doctor, and I help to fill out forms.”
Pa Vang is committed to making sure parents and infants are healthy. She uses the country’s mother and child monitoring handbook, known as “the pink book ” to guide and record information for the health of mothers and their children. She translates parts from Lao into the Hmong language for people, improving their access to information and playing a crucial role in reaching the unreached by building trust and relationships between the community and health services.
“What makes me most happy about being a birth attendant is seeing a healthy mother and child,” she said.
Reaching unreached people of all ages is a priority this year for the Regional Committee, which will discuss the draft Regional Framework for Reaching the Unreached in the Western Pacific (2022 – 2030).
The COVID-19 pandemic has disrupted lives across all countries and communities and negatively affected global economic growth. Inequality widened within and between countries, and those already left behind were disproportionately affected.
The challenges of the Western Pacific Region’s recovery and reaching the unreached are compounded by pre-existing issues, such as globalization, climate change, rapid and unplanned urbanization, population ageing and the increasing prevalence of noncommunicable diseases, including mental health issues.
WHO in the Western Pacific believes that a concerted effort is now needed to build back better and transform health systems. This will mean ensuring that health sectors have the capabilities to routinely identify who is unreached – whether due to situations or settings in which people are born, grow, live, work and age, stigma or discrimination – and overcome the barriers to reaching them.
As countries grapple with how to build back better, investing in health, particularly in the health of those unreached, will produce significant returns, enable effective responses to future health emergencies and help safeguard sustainable development in the Region.
The draft Regional Framework for reaching the unreached aims to support transformed health-care delivery and health systems across the Region. It calls on Member States, partners and stakeholders to: transform health systems to reach everyone, everywhere and support equitable health outcomes; demonstrate political commitment and leadership to overcome barriers to reaching unreached groups; engage stakeholders within and beyond the health sector to achieve equity in health outcomes; build strong data and evidence systems that support and monitor ongoing improvements to reach unreached groups.
WHO supports countries to reach the unreached and create a world in which development is sustainable and no one is left behind.