A doctor takes an ultra-sound of a woman in northern Nam Định Province. About 1,000 women in 10 districts are given reproductive health examination and consultation free of charge. VNA/VNS Photo Văn Đạt

HÀ NỘI — Việt Nam needs to develop a policy to encourage husbands and wives-to-be to register for pre-marital health tests, so that they will be more prepared both psychologically and physically for their married life without causing burdens on themselves and society.

Đỗ Thị Quỳnh Hương, Deputy Director of the General Department of Population and Family Planning’s Population Structure and Quality Office said pre-marital health tests are the first forms of screening, which help create a sustainable and happy married life and contribute to improving the quality of the population.

Hương said many couples only focus on preparing financially for their new life and pay little attention to health issues, especially reproductive health.

Due to the lack of knowledge about reproductive healthcare, especially screening and early detection of children's diseases in the fetal stage, many couples have had children with birth defects, brain hernia, hydrocephalus, cerebral palsy, musculoskeletal defects, cleft lips, malformations of limbs or genital organs.

It is worth mentioning that most of these issues can be prevented if husbands and wives-to-be receive good premarital guidance and care for their reproductive health.

“In developed countries, pre-marital health tests are mandatory. However, in our country, many couples have not taken this issue seriously,” she said.

“Many young people do not have sufficient information and knowledge about pre-marital health examination. Most are afraid of being caught by their relatives and friends or worried that the disease discovered may ruin their marriage plans while others think the issue of check-ups will likely be misunderstood as lacking trust in the other. Therefore, the number of couples going for pre-marital health check-ups remains very low.”

In remote and mountainous areas, this issue is even worse. Due to customs and habits, many people do not fully understand the importance of pre-marital health checks, and prenatal and newborn screening, leading to the birth of children with birth defects.

It is estimated that each year, Việt Nam has about 40,000 babies born with birth defects. Common diseases are Down's, Edwards syndrome, neural tube defects, congenital hypothyroidism, G6PD enzyme deficiency, and severe congenital hemolysis.

Hương said the purpose of pre-marital counseling and medical examination is to prepare the knowledge and psychology for married sex life, detect and treat early (if possible) some diseases that can affect sex problems, pregnancy, and childbirth later, prepare wives with health conditions for safe pregnancy and prevent birth defects for future children.

A doctor gives reproductive counselling to a woman in northern Nam Định Province. — VNA/VNS Photo Văn Đạt

During the pre-marital health check-up, couples are given a general health check and reproductive health check (ultrasound of the uterus, ovaries, semen analysis), and assess the possibility of carrying the disease gene based on their family’s medical history.

This will help avoid having children with some common genetic diseases such as color blindness, thalassemia, Down's, Turner or Edward syndromes and screening for infectious diseases such as hepatitis B and HIV and other sexually transmitted diseases.

Couples with detected reproductive health issues will be able to take measures to increase their chances of pregnancy. In case one or both partners are found to have certain conditions, they will be given timely remedies, she stressed.

Hương said the appropriate time for pre-marital health tests for couples should be at least six months before marriage.

‘Barriers must be lifted’

The Ministry of Health’s General Department of Population and Family Planning has coordinated with localities to implement pre-marital counseling and health examination in 63 cities and provinces since 2013. Thousands of pre-marital counseling and health check-up clubs have been established in 1,400 communes with the participation of millions of young people.

These clubs provide information and advice on reproductive healthcare and family planning and give health examinations for couples preparing for marriage.

Reports on the results of the model in 2011-2015 showed that 78.8 per cent of the participants had knowledge about reproductive healthcare and family planning.

Hương said the results show that young men and women's awareness and practice of seeking counseling services and pre-marital health check-ups remain low.

The service has not yet become a demand due to social prejudices, cultural practices, the disparity in education level, and limited availability of services.

In addition, the number of participants is limited due to the nature of their work and the fear of revealing their identities. A shortage of funding and weak coordination between the related agencies also leads to modest results.

Resolution No 21-NQ/TW issued on October 25, 2017 set out targets that 90 per cent of young men and women receive pre-marital counseling and health check-ups by 2030.

Hương said a lot must be done to lift the barriers and achieve the goals.

It is necessary to develop and expand the services to the community and improve the capacity to provide services at health clinics.

Applying new techniques in screening, diagnosis and treatment of a number of genetic and infectious diseases and developing mechanisms and policies for private businesses to provide pre-marital counseling and health check-up services should be done soon.

In particular, ministries and sectors need to focus on educating and disseminating the issue to attract young people, especially those in disadvantaged and ethnic minority areas, to take pre-marital health tests, she said. — VNS