VietNamNet Bridge – While the free market for contraceptive products and reproductive health commodities in Viet Nam is growing to meet increasing demand, its safety and quality remains questionable.

A health worker displays a leaflet on family planning and contraceptive products to women in Phuoc Dong Commune, Khanh Hoa Province. Many women use contraception without guidance from doctors, leading to improper use -- Photo: VNA/VNS

A19-year-old freshwoman at the Viet Nam National University, who asked to remain anonymous, said she had a bad experience with low-quality condoms.

"My boyfriend and I once used a free condom offered at a hotel room, but after having sex, we discovered that there were many tiny holes on the surface of the condom," she said.

"I was really in panic and immediately took emergency pills. It was so lucky that we had checked the condom. Otherwise I might have needed to get an abortion, which is so painful and unsafe."

Nguyen Duc Vy, former director of the National Hospital of Obstetrics and Gynecology, said there had been cases of unintended pregnancy that resulted from the use of sub-par condoms that had been punctured or torn during sex.

"I also had to give abortions to several women with unwanted pregnancies who had used substandard contraceptive means, or those whose intra-uterine devices (IUD) had expired," Vy said.

Vy said the use of low-quality goods was partly due to women's lack of knowledge about reproductive health. They used contraception without the guidance of doctors, leading to improper usage.

"Many women asked for my advice only after they had been pregnant," Vy said. "They had bought contraceptive pills without a doctor's prescription. This caused hormonal and menstrual cycle disorders. As a result, pregnancy still occurred, but the women did not even know."

He added that using low-quality contraceptive products would result in a high risk of unwanted pregnancies and unsafe abortions, especially in young adults who have little knowledge about sexual and reproductive health.

"Multiple abortions can cause serious long-term damage or after-effects, even future infertility," Vy said.

Quality lacking

A study conducted by British company Crown Agents made public last year has shown that more than a quarter of the 170 million condoms sold each year in Viet Nam are of substandard quality.

The survey showed that 26 per cent of the 170 million condoms failed to meet international standards (ISO), as well as the technical requirements of World Health Organisation (WHO) and UNFPA.

"The development of science and technology has led to a variety of types and models of contraceptive products," said Ho Chi Hung, deputy head of the General Office for Population and Family Planning (GOPFP). "In addition to standardised items, there are also many unverified low-quality products."

Le Thi Thiem, an expert from GOPFP, said the circulation of contraceptive products and family planning (FP) commodities in the market was not closely controlled. Governmental agencies had yet to build an adequate, transparent and consistent legal framework to handle the sale of unverified, low-quality products, she said.

According to a decision by the Prime Minister in March 2013, GOPFP have to monitor the management and usage of contraceptive products and FP commodities.

Contraceptive products are now divided in two groups. Birth control pills are managed by the Drug Administration, and birth control devices are managed by the Department of Medical Equipment and Health Works.

Some types of contraceptives are still unclassified, such as the Vagina Contraceptive Film (VCF), which is not managed by either agency.

Some products are monitored by both groups, such as contraceptive implants, which are considered both a drug and medical equipment. Thiem said the management of contraceptive products is often intricate with duplicated efforts.

Qualified products

Hung from GOPFP said that meeting consumers' current need for contraceptive products and FP commodities is a big challenge for the Viet Nam's National Programme on Population and Family Planning.

"The State Budget can only provide contraceptive products and FP commodities to social policy beneficiaries. The rest have to pay from their own pockets," Hung said.

According to Ritsu Nacken, acting representative of UNFPA in Viet Nam, there has been a significant reduction in international aid and the government's subsidies for funding in family planning programmes and services in Viet Nam in recent years.

Nacken said close co-operation among relevant health agencies can ensure that safety and qualified RH/FP commodities were always available in accordance with customers' demand.

Contraception

A programme called the Quality Award, which will be awarded to contraceptive products and Family-Planning (FP) commodities that are qualified and trusted in Viet Nam, is being organised in a move to enhance the quality of contraceptive products.

This programme was co-organised by the Ministry of Health, the Viet Nam Family Planning Association, Marie Stopes International in Viet Nam (MSIVN) and the United Nation Population Fund (UNFPA).

Hung said the programme would help to increase people's accessibility to modern, safe and effective contraceptive methods.

In addition, the Ministry of Health will co-ordinate with the Ministry of Industry and Trade, especially the Market Administration, to enhance the control over substandard contraceptive and FP commodities.

On the other hand, the Ministry of Health is working on building a list of contraceptive products that attain the national quality standard. Only products that are qualified can be circulated in the market.

VNS