Congenital adrenal hyperplasia (CAH) has the potential to place an enormous burden on families in resource-poor countries, and the aim of this survey was to provide more specific insights into the difficulties faced by families living with CAH in Vietnam. It is hoped that this information will be used to ensure that future efforts to reduce the burden of CAH are as effective, sustainable and appropriate as possible. A questionnaire-based needs assessment survey was offered to parents of children with CAH who were attending the Annual CAH Support Group Meeting held at the National Hospital of Pediatrics (NHP) in Hanoi, Vietnam, on 10th June 2005. Fifty-three families responded to the questionnaire. Information pertaining to the purchase and use of medication to treat CAH, access to medical care, surgical treatment for girls, and a wide range of parental concerns was collected. This survey highlights the heavy burden that CAH places on families in Vietnam, and provides significant insights into various initiatives that could well help ease this suffering. In particular, efforts must be made to ensure essential medication is affordably available, communication of important messages to parents is enhanced, local support groups encouraged, and early diagnosis and medical treatment of CAH optimized so as to reduce morbidity and mortality.

CLAN (Caring and Living as Neighbours) is an Australian-based non-governmental organisation (NGO) committed to equity for children living with chronic health conditions in resource-poor settings. Since 2004, CLAN has collaborated with a broad range of partners across the Asia Pacific region to improve quality of life for children living with congenital adrenal hyperplasia (CAH). This exploratory case study uses the Knowledge to Action (KTA) framework to analyse CLAN’s activities for children living with CAH in the Asia Pacific. The seven stages of the KTA action cycle inform a systematic examination of comprehensive, collaborative, sustained actions to address a complex health challenge. The KTA framework demonstrates the “how” of CLAN’s approach to knowledge creation and exchange, and the centrality of community development to multisectoral collaborative action across a range of conditions, cultures and countries to redressing child health inequities. This includes a commitment to: affordable access to essential medicines and equipment; education, research and advocacy; optimisation of medical management; encouragement of family support groups; efforts to reduce financial burdens; and ethical, transparent program management as critical components of success. Improvements in quality of life and health outcomes are achievable for children living with CAH and other chronic health conditions in resource-poor settings. CLAN’s strategic framework for action offers a model for those committed to #LeaveNoChildBehind.

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Childhood diabetes care may be suboptimal in resource-poor countries. A cross-sectional study of youths with diabetes aged ≤19 years attending the three major paediatric centres in Vietnam was performed. Diabetes management was documented by questionnaire. Glycated haemoglobin (HbA1c) was measured with a fingerprick blood sample. Multiple linear regression analysis was used to examine factors associated with glycaemic control. In total, 105 patients participated, comprising 93 with type 1 diabetes and 12 with neonatal diabetes. The median age was 11.5 years [interquartile range (IQR) 6.4–14.5 years] and the median duration of diabetes was 2.6 years (IQR 1.5–6.1 years). Patients with type 1 diabetes performed few blood glucose tests per month (median 8, IQR 4–30). Mean HbA1c was higher in patients with type 1 diabetes compared with neonatal diabetes (9.9% vs. 7.5%; P = 0.01). In type 1 diabetes using multivariate analysis, higher HbA1c was associated with older age (β = 0.3, 95% CI 0.2–0.4; P < 0.001), lower frequency of blood glucose monitoring (β = –0.06, 95% CI –0.10 to 0.12; P = 0.01) and use of pre-mixed insulin (β = −1.7, 95% CI −3.4 to 0.0; P = 0.05). In conclusion, international glycaemic control targets for childhood diabetes (HbA1c <7.5%) are not being achieved in Vietnam, and intensive diabetes management is rare. There is an urgent need to address barriers to achieving optimal control in this population.