Viet Nam: Hospitals adopt air quality initiatives for safer health care and healthier communities

Viet Nam is highly vulnerable to the health impacts of climate and environmental change – including its impacts on health services. For this reason, the World Health Organization (WHO) has been working with the Government of Viet Nam for several years to pilot climate-resilient and environmentally sustainable health-care facilities.

As part of this work, with support from WHO and partners, the Ministry of Health has helped install air quality sensors in three hospitals, a small but important step toward understanding and improving air quality for patients, staff and communities.

The sensors deliver real-time data to help the hospitals track air quality trends, compare indoor and outdoor conditions, and identify potential risks to patients, staff and visitors.

Technician Phan Le Huong checks an air sensor installed on the roof of the waste management unit at Yen Thanh District Hospital so staff can monitor air quality. The other two sensors are at the entrance and the outpatient department, where people gather in large numbers. Photo credit: WHO / Ho Chi Cuong

At Yen Thanh General Hospital in Nghe An Province in northern Viet Nam, Director Dr Luyen Van Trinh said, “Air pollution affects everyone. We’ve seen an increase in respiratory and cardiovascular diseases, and while there are many contributing factors, poor air quality is certainly one of them.”

“We’ve always been concerned about air quality, but until now, we had no data. Thanks to WHO, we now have three monitoring points: one at the waste treatment area, one at the hospital entrance, and one in the outpatient department, where people gather in large numbers.

“The equipment is compact, affordable, and effective. It helps us protect our staff, our patients, and our community.”

Monitoring air quality in real time allows the hospital to track pollution trends, compare indoor and outdoor conditions, and identify potential risks to patients, staff and visitors. Photo credit: WHO / Loan Tran  

Improving air quality for patients

The sensors are part of WHO’s work with the Viet Nam Administration of Disease Prevention (formerly the Ministry of Health’s Health Environment Management Agency, VIHEMA) since 2021 to pilot WHO's Climate Resilient and Environmentally Sustainable Health-Care Facilities (CRESHCF) framework. Its elements include water, sanitation, hygiene and health-care waste management; sustainable energy services; and infrastructure, technologies and products; and the health workforce. Joining Yen Thanh General Hospital in the pilot are Cu Lao Minh Area General Hospital in Vinh Long Province (formerly Ben Tre Province) and Bac Ha District Hospital in Lao Cai Province.

As well as being affected by climate change, hospitals themselves are a source of air pollution – and greenhouse gas emissions. As part of a broader commitment by the Government of Viet Nam to reducing emissions, the Ministry of Health has committed to reducing emissions from the health care sector, including by banning incineration of waste from 2028. Reducing health-care facilities’ emissions of carbon dioxide (CO2) and other climate pollutants can also reduce air pollution – a win-win for both climate and health.

Good air quality is important for safe recovery in hospital, such as for these patients in the Intensive Care Unit at Yen Thanh General Hospital. Short-term health effects of poor air quality include breathing difficulties, respiratory infections, and exacerbation of pre-existing conditions such as asthma. Long term health risks from prolonged exposure include stroke, heart disease, lung cancer and chronic obstructive pulmonary disease. Photo credit: WHO / Ho Chi Cuong 

Cleaner waste management: moving beyond incineration

Along with installing air quality sensors, improving water, sanitation and hygiene, and generating solar energy, Yen Thanh Hospital has changed how it deals with its waste, thanks to the CRESHCF pilot programme.

Many hospitals in Viet Nam burn infectious medical waste, as they lack feasible alternatives. But the costs – both environmental and financial – are steep.

“The combustion process was fuel-intensive and emitted large amounts of smoke and dust,” said Dr Trinh.

“It was costly, inefficient and posed risks to both staff and the surrounding community.”

Yen Thanh Hospital often had to store infectious waste for days due to limited incinerator capacity, and when systems failed, it had to outsource waste disposal – adding further expense and complexity. Ash produced by incineration remained hazardous and difficult to manage.

Waste treatment system operator Ha Danh Cu feeds medical waste into a microwave-based waste treatment system that also crushes waste into safe, non-toxic particles. Photo credit: WHO / Loan Tran 

Recognizing these challenges and to support the Government’s commitment, WHO and partners collaborated with the Ministry of Health on a cleaner and safer alternative – a microwave-based waste treatment system that is more environmentally sustainable and integrates crushing and cutting technologies.

Results have been dramatic.

“This technology treats infectious waste thoroughly every day,” said Dr Trinh.

“After treatment, the waste becomes safe. It doesn’t emit smoke or dust, and it uses only a small amount of electricity. It’s cost-effective and environmentally friendly.”

Technical staff at the hospital echo this sentiment. Mr Ha Danh Cu, who operates the waste treatment system, described the shift as a game-changer.

“Before, we had to wear full protective gear to avoid burns and exposure to toxic fumes. Now, the system is almost fully automated. It’s safe, easy to use and doesn’t produce wastewater or unpleasant odours.”

The hospital’s new system not only strengthens its efforts toward more sustainable operations; it helps protect the surrounding residential neighbourhood from its pollution.

The technology also saves the hospital around 30 million VND (about US $1135) annually, with electricity being the main cost, compared to incineration.

Mr Ha said, “It’s better for the hospital, the staff and the community.”

Waste treatment system operator Ha Danh Cu feeds medical waste into a microwave-based waste treatment system that also crushes waste into safe, non-toxic particles. Photo credit: WHO / Loan Tran 

Opportunity to inspire hospitals across Viet Nam and beyond

WHO Representative in Viet Nam Dr Angela Pratt praised the hospitals’ changes.

“Improving air quality monitoring is a strategy that other hospitals, cities and countries have found effective in understanding air quality levels around the hospital so they can take targeted action to protect people from poor air, especially poor air generated by waste management. This is particularly important for protecting children, older people and pregnant women: when people go to a hospital to receive care, we want to make sure they are not being exposed to things which will actually make them more sick.”  

“WHO is proud to collaborate with the Ministry to pilot the sensors and cleaner waste management – which will we hope will strengthen the ability of hospitals to offer safe care.”

Since many sources of air pollution are also sources of carbon emissions, such as fossil fuels, reducing air pollution and reducing the drivers and impacts of climate change go hand-in-hand, as part of a sound approach to sustainable development.

“The experiences of this pilot project are a model that can inform and inspire hospital leaders around Viet Nam and around the world, to make changes that enable them to keep providing safe health care to their communities in a changing climate,” she said.

“The results of the pilot will feed into guidance that the Government is developing, with WHO technical advice, on climate resilience for hospitals across the country.”

WHO’s work with the Ministry of Health to enhance climate resilience and environmental sustainability of health facilities is made possible with the generous support of the Government of Australia, through the Department of Foreign Affairs and Trade.

The Viet Nam Ministry of Health has joined the Alliance for Transformative Action on Climate and Health (ATACH) to help the health system contribute to the country’s target of achieving net-zero carbon emissions by 2050. WHO established ATACH to help countries deliver on commitments they made at United Nations Climate Change Conference (COP26) on climate change and health. As a steering committee member for the ATACH in the Western Pacific Region, Viet Nam is driving technical cooperation and knowledge exchange regionally to advance low-carbon, climate-resilient health systems.

Proof of concept: Building safer, climate-resilient health care

While low-cost air quality sensors do not directly reduce pollution, their installation has already sparked a shift in awareness among hospital management, health-care workers and patients. This growing awareness is a key objective of the sensor installation, helping staff recognize the risks of poor air quality and advocate for cleaner, safer practices within and beyond hospital walls.

When the other hospitals in the pilot, in Vinh Long and Lao Cai Provinces, improve their waste management too, they will be able to track the improvements to air quality, thanks to the new sensors.

Dr Trinh believes other hospitals could benefit from cleaner waste management .

Improvements to water, sanitation and hygiene, and installation of solar power – all under the pilot programme – are helping the hospital serve nearly twice as many patients, more safely.

“It has significant impact on the hospital, people and medical staff. The number of medical examinations at my hospital is increasing. In 2021, my hospital had only 300 outpatient visits a day, and 250 inpatient beds. But at present, my hospital can care for 600 outpatient visits a day and 400 to 450 inpatients.”