SPEECH PATHOLOGY
TRAINING IN VIET NAM:
Implications of the WHO World Report on
Disability for Curriculum Development,
Sustainability and Impact
A/Prof Lindy McAllister, School of Medicine, The University of
Queensland and Director Trinh Foundation Australia
Ms Marie Atherton, Speech Therapy Program Director,
Pham Ngoc Thach University of Medicine, Viet Nam
Ms Karen Wylie, University of Queensland, Australia
Mrs Sue Woodward, Director Trinh Foundation Australia
Dr Alison Winkworth, Director Trinh Foundation Australia
 Disability Prevalence of between 5.8% (World
Health Survey, 2002-2004), 6% (Ministry of
Labour & Social Affairs, 1994-5) and 6.4%
(national survey, 2005)
 Communication & swallowing difficulties can
be expected to affect about 13 million people
in Viet Nam (WHO 2009)
(about 1 in 7 of the population)
Speech Therapy
Training in Viet Nam
• 1st University based ‘Speech Therapy Training Program’ opens
with 18 students at Pham Ngoc Thach University of Medicine,
HCMC, Sept 2010
• Partnership between PNTU, ENT Hospital of HCMC, AVI and
TFA
INTERNAL PRESSURES
TOP DOWN
RESULTING CHANGE
BOTTOM UP
EXTERNAL PRESSURES
EXTERNAL PRESSURES
EXTERNAL PRESSURES
EXTERNAL PRESSURES
Based on Dunphy, Griffiths and Benn (2003)
External Drivers for speech
therapy services & courses
• UN Millenium Development Goals – primary
motivator to reduce poverty
– education seen as one means to achieve MDGs
• Globalisation
• IT and Internet access
• NGOs and foreign aid agendas
Speech Therapy in Developing Contexts:
Some Examples of Internal Drivers
1. Policy and legislation changes
2. Increasing diversification and specialization of
medical professions
3. Political stability and safety
4. Increasing affluence
5. Increasing education levels
6. Increasing awareness of disability issues
7. Advocacy and grass roots organisations
Internal Drivers for Speech
Therapy Training & Services
in Viet Nam
• VN Government Education Reform Agenda
– VN has more than doubled its spending on
education since 2000
– Fastest growth in education sector has been at
upper levels of education (World Bank, 2009)
• The emergence of the private higher education
sector
• 2006-2020 Socio-economic Development Plan
Internal Drivers cont’d
• Health professionals already providing speech
therapy services -> profile of the profession
raised, together with community expectations
• Shifting perception of disability
• Grass roots organisations resulting in
increasing advocacy for services
Who leads and sustains
the change?
1. Change Initiator
2. Change Agent
3. Sponsor
4. Champion
(McNamara, 2005)
The Change Initiators & Champions
for Speech Therapy Training
The Program
• 2 years duration – alternating 3
months at PNTU, 3 months in workplaces with workbased clinical education
• Lectures provided by staff at PNTU (Anatomy,
Linguistics, Normal Speech Development, Audiology,
Psychology)
• Lectures for specific speech pathology subjects
provided by Program Coordinator and visiting lecturers
from Australia
• Clinical education supervision provided by visiting
Australian clinicians supported by TFA
18 students graduate doctors,
nurses and
physiotherapists
Implications of the WHO World Report
For an SLT program in a medical school
• ICF is used as curriculum framework
• Disability issues are foregrounded
• Interprofessional team work is foregrounded
• and all 3 are very well understood by the students
• So we have students educated to work within a framework of
values and practice at odds to that of the medical school and to
the hospitals and health care system to which they will return
• PNTU is investing in the development of specialist programs and
services (WRD Recommendation 2)
in speech therapy BUT sees this as
preparing a new profession as a
‘sub-specialty of medicine’
• Does Viet Nam need speech therapists
OR speech therapy services?
• What about PWD who need services outside hospitals?
– unmet need
• How can the program work within a medical model but prepare
graduates to meet the ‘unmet need’?
– Involvement of PWD and families in the teaching program (WRD
Recommendation 4)
– Prepare students for health promotion and education roles within the
community, and lobbying and advocacy roles (WRD Recommendation 7)
– Provide students with research skills to collect data on prevalence,
incidence, needs, QOL etc of People with Communication and Swallowing
Disability (WRD Recommendation 8) and research on lives of PWD and
appropriate, effective and
affordable speech therapy services
for Viet Nam (WRD Recommendation 9)
• Also need to work with Vietnamese
agencies to develop standards for
training at different levels (WRD Rec 5)
– mid-level workers, assistants