Innovation summary

More than 1.5 millions babies are born in Vietnam each year and 27,000 of which die due to preventable health problems and poor care.1 Recent research conducted in Vietnam point to eight major risks to optimal early childhood brain development around the time of birth in resource-constrained settings which can increase the number of children that are able reach a higher developmental potential.2-4 These 8 major risks are intrauterine growth restriction, stunting, iron deficiency anaemia, iodine deficiency, unresponsive care-giving, insufficient cognitive stimulation, maternal mental health problems and exposure to family violence.3-7

Capitalizing on more than 15 years of experience in rural Vietnam, the Learning Clubs for Women and Infants innovation aims to pioneer a low-cost initiative addressing all eight risks to optimal early childhood brain development through a structured, universal program combining information, learning activities and social support with groups of women at the same life stage.

The program comprises of five modules with 24 sessions that involve 1) facilitated small group discussions with visual material aids and 2) follow up home-visits to understand the progress made by women and to provide additional support if needed.  

Impact summary

  • 300 mothers and 100 fathers/grandparents will be enrolled in learning clubs
  • 95% child-rearing families that participated in the intervention are expected to adopt the child-friendly home environment and practices on child play and stimulation 

“This Learning Club program is so interesting. It not only provides women knowledge but also allow them to practice on doll and children in class, practice until they know what to do. I wish that we had had this program 10 years earlier.”

- Ms. Phung – a Club Facilitator

​This innovation is funded by Grand Challenges Canada.

Innovation details

Innovation Content

The innovation consists of a first-of-its-kind, visual-based comprehensive package that offers knowledge and skills in early childhood development to pregnant and child-bearing women in rural Vietnam. The educational package includes five modules, consisting of 24 sessions.  Module 1 (four sessions) is for women in their early or mid-pregnancy. Module 2 (five sessions) targets late-pregnancy and newborn care. Module 3 (four sessions) aims to provide women with children 3-6 months of age child care knowledge and skills. Module 4 (five sessions) engages with families who have children 7-12 months of age, and the final Module 5 (six sessions) targets families with  children 13-24 months. All 24 sessions aim to change the behaviors of families toward better care for pregnant women and children, to stimulate child growth and brain development. The psycho-social educational package includes 24 topics covered in five modules:

Module 1:

Women in early to mid-pregnancy

  1. Pregnancy and development
  2. Pregnancy, family life and thinking healthy
  3. Pregnancy and illness prevention

Husband, and in-laws  of women in early to mid-pregnancy

  1. Family support for pregnant women

Module 2:

Women in late pregnancy

  1. Depression and anxiety during pregnancy and postpartum, and thinking healthy
  2. Fetus development in late pregnancy and preparing for labour
  3. Infant development, play and stimulus: 0-3 months of age
  4. Breastfeeding
  5. Newborn care and illness

Module 3:

Women rearing children 3– 6 months of age

  1. Sleeping and crying therapy
  2. Breastfeeding and supplementation
  3. Infant dental care
  4. Play and stimulation: 3-6 months of age

Module 4:

Women rearing children 7 – 12 months

  1. Complementary and feeding training
  2. Care for common child illness
  3. Play and stimulation 7-12 months: speech, hearing and social stimulus
  4. Play and stimulation 7-12 months: motor and self-help skill stimulus

Husband and grandparents of children 7-12 months

  1. Family support for women and children care and development

Module 5:

Women rearing children 13 – 24 months

  1. Play and stimulation 13-24 months: language and growth
  2. Play and stimulation 23-24 months: social and emotional
  3. Play and stimulation 23-24 months: gross and fine motor and self-help skills
  4. Play and stimulation 23-24 months: cognitive development
  5. Child injury prevention and first aids
  6. Feeding therapy for picky eaters

The educational package includes a DVD with instructions for skills formation, together with posters and take-home leaflets. The contents have been developed from the international standard packages such as the Care for Child Development by WHO and UNICEF, Thinking Healthy Program, Pregnancy Childbirth Postpartum and Newborn Care – A guide for essential practice by WHO, Mental Health-GAP Instruction Guide by WHO, Integrated Management of Child Illness by WHO, Vietnam’s national nutrition program, and the national child injury prevention program.

Approach of Program

The Learning Clubs are facilitated by the Women’s Union staff (community-based lady social workers) and Commune Health Clinic staff (community-based medical doctor or nurses) who are trained in six courses to deliver the program. The first five courses taught the program content and focused on how to facilitate the modules. The last course provided training about Learning Club operation, monitoring and supervision.

Learning Clubs are organized at the community meeting hall and the community health clinic site. DVD players are provided by the local authorities. Laptop and projectors are provided by the project.

Facilitators use the DVD as a means to teach skills, instruct the practice of new skills on dolls and on children directly, facilitate the discussions after practice and provide take-home messages. Each session lasts for about 90 to 120 minutes.

After the class session, facilitators visit households to see how women adopt the new skills at home and provide additional support until new skills become habits. Women with mental disorders, sick children, difficult toddlers, or poor skills in personal and child care, and women who suffer from domestic violence, extreme financial hardship, or family crises, will be prioritized to receive a home visit. Each facilitator will conduct 2 home visits per month.

Roadmap for the Future

This model will go through three phases:

  • 2014-2015: development, field testing and pilot testing on a small scale
  • 2016-2018: randomized control trial to examine the effectiveness and cost effectiveness of the program
  • 2020: advocacy for the project to be fully integrated into a national policy on care for child development

From 2014-2015 the project will focus on producing a low-cost, easily understood, structured curriculum for the Learning Clubs to be operated by the Community Women's Union with evidence from field and pilot testing the project in  three rural communes randomly selected in Ha nam province.

By the end of 2015, the five modules, the manuals and materials, and the Learning Clubs Operation manual will be ready for scale. 

Key drivers

International Agencies Collaboration

Strong collaboration with international agencies to provide technical backstopping for the innovation design (Monash University, University of Melbourne, and WHO Vietnam)

Endorsement, Collaboration and/or Participation of Key Vietnamese Authority Organizations

The draft innovation structure was consulted with Department of Health and Women’s Union and endorsed by local authority.  

Endorsement and direct participation of local authority (Community People’s Committee) since the project commencement (workshop, implementation) to chair and coordinate the collaboration between community health clinic and women’s union

Endorsement and involvement of national-level agencies (Vietnam Medical Association, Hanoi Medical School, Women’s Union Federation, Ministry of Health – Department of Maternal and Child Health, Ministry of Labor – Department of Child Care and Protection and WHO Vietnam) at the project commencement to ensure receptive and sustainable pathway to scale and integration into national policy

Enthusiastic Team Members

An enthusiastic selection of active, innovative, and inspired local team members for the project implementation and management


Standard Assessment Tool: Unforeseen Delays

Obtaining permission to translate and use the standard assessment tool (Bayley, ASQ) took time and prolonged the project preparation.


During the implementation of this project, the resources from the innovation will be shared with NGOs in Vietnam to anticipate scale up. In addition, the innovation and the resources will be shared with the Ministry of Health’s Department of Maternal and Child Health for endorsement and usage for national-scale projects/programs.

At the end of this project, the team plans to:

  • Scale up this innovation to the whole province of Ha Nam at the end of this project
  • Offer this innovation and visual materials to the Provincial Medical High School (where all village health workers are trained) and to the National Women’s Union Management School (where all women’s union staff are trained) so that they are able to use the project materials as the key resource for community-based health/social workers to use to educate the rural population


Delivery Partners

  • Research and Training Centre for Community Development (Vietnam)
  • Ha Nam Women’s Union (Vietnam)
  • Jean Hailes Research Unit, Monash University (Australia)
  • Department of Medicine, University of Melbourne (Australia)


  • Grand Challenges Canada
  • Research and Training Centre for Community Development (Vietnam)
  • Jean Hailes Research Unit, Monash University (Australia)
  • University of Melbourne (Australia)
  • World Health Organization (Vietnam office)
  • Ha Nam Women’s Union (Vietnam)​
  • Ha Nam Provincial Centre for Preventive Medicine (Vietnam)

Evaluation methods

This innovation will be evaluated through a randomized controlled trial. There will be three channels to evaluate the intervention impact:

Baseline and Final Assessment

The project will apply the baseline and final assessment in both control and intervention sites. The baseline and final evaluation will be conducted in six communes (three intervention communities and 3 control communities). Assessment will be carried out in four target groups: (1) pregnant women; (2) families with children 0-6 months; (3) families with children 7-12 months and (4) families with children 13-24 months. Assessment measures will include the Ages and Stages Questionnaire, HOME inventory, Depression Anxiety Stress Scale (DASS-21) anthropometry, and socio-economic status section.

Module-Based Assessment

After each module completion, a small survey conducted by an independent team (Provincial Center for Preventive Medicine) will be carried out to measure the behavior changes in parents who attended the Learning Clubs, identify barriers for the behavior changes and generate suggestions for improvement.

Monitoring and Supervision System

Together with the assessment survey, the project will use a computer-based monitoring system where the rate of participation in Learning Club Sessions, number of home visits, and problems and recommendation for changes are recorded and emailed to district/province Women’s Union and the project management team. The monitoring outputs will provide additional background to explain the project results and figures. 

Cost of implementation

The project will record the detailed and separated costs for (1) material development, review and approval; (2) capacity building – training courses; (3) learning club operation; (4) supervision; (5) dissemination and advocacy.

The financial recording system will ensure the project team to identify the needed costs for the scaling-up phase.

A cost analysis to understand the cost effectiveness of the program will be conducted during the second phase of the innovation.

Impact details

As of now (month 12 of the project), the following progress has been made:

  • 80% visual materials have been developed and pre-tested, printed out for the clubs
  • 5 training courses have been conducted for 30 facilitators. They will go through another training course in November 2014
  • The first Learning Club session was carried out in 30-31 August 2014.  224 participants (early-to-mid pregnancy) attended the Learning Clubs in the first month of operation  
  • 29 out of 30 local facilitators performed well at the Learning Clubs

Anticipated impact of GCC- funded phase 1 of project:

  • 300 mothers and 100 fathers/grandparents will be enrolled in learning clubs
  • 21 community-based Women’s Union and Health Workers will be trained as learning club facilitators and 9 district/provincial Women’s Union staff will be trained as supportive supervisors
  • 95% child-rearing families that participated in the intervention are expected to adopt the child-friendly home environment and practices on child play & stimulation
  • 20% of children with parents that participated in the intervention are expected to have  improved cognitive, motor, language, social-emotional functions


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