The Association Between Gender Inequalities and Women's Utilization of Maternal Health Services: A Cross-Sectional Survey in Eight South Central Coast Provinces, Vietnam

The utilization of maternal health services at primary healthcare setting in Southeast Asian Countries: A systematic review of the literature

The reduction of Maternal Mortality Ratio (MMR) remains a global health issue. Although major progress has been achieved in the past 15 years, the ratio is still high, especially in Low Middle-Income Countries. In the Southeast Asian region, most of the countries have not reached the Sustainable Development Goals target yet. Although the countries have several similarities in many aspects, such as community characteristics, cultural context, health systems, and geographical proximity, the MMR in the region presents interesting variations. The scope of this systematic review is to explore published literature on the utilization of maternal health services at the community healthcare centre setting in Southeast Asian countries. The databases PubMed, Web of Science, and Google Scholar were searched systematically to identify quantitative, qualitative and mixed methods studies published in 2000-2020. A total of 1876 records were found, out of which 353 full text were screened. Finally, 27 studies on utilization of maternal health services met the inclusion criteria and were selected for analysis from seven Southeast Asian countries: Cambodia, Indonesia, Lao PDR, Myanmar, The Philippines, Timor Leste and Vietnam. Most of the articles focused on the utilization of maternal health services at primary health care setting. Several themes on maternal health services utilization in the countries emerged, including cultural and socioeconomic factors contributed to the utilization of maternal health services, factors associated with the low utilization of ANC, determinants affected place of delivery and delivery assistance choice. The utilization of maternal health services at primary healthcare setting in seven Southeast Asian countries was identified in a small number of studies. Sociocultural barriers and disparities of health services provision are the major factors associated with low utilization of the services. Further research on strengthening the role of primary healthcare in maternal health services provision is required.

Trends in Socioeconomic Inequalities in the Use of Antenatal Care Services by Women Aged 15 to 49 Years in Vietnam

Despite considerable variations in the use of antenatal care (ANC) services in Vietnam, limited information is available on socioeconomic inequalities concerning the use of ANC services. This study aimed to assess the trends and changes in socioeconomic inequalities in the use of ANC services by women aged 15 to 49 years in Vietnam from 2006 to 2014. We used data from the Multiple Indicator Cluster Survey conducted in 2006, 2011, and 2014. The percentage of women who received ANC services increased significantly from 26.5% in 2006 to 42.7% in 2011 and reached 56.6% in 2014. We found a decreasing trend in the concentration indices of the use of ANC services from 0.36 in 2006 to 0.19 in 2014. The common factors significantly associated with the higher percentage of the use of ANC services in 2006, 2011, and 2014 were women belonging to the Kinh and Hoa ethnic groups and belonging to wealthier groups. Our study showed a reduction in socioeconomic inequality in the use of ANC services between 2004 and 2014. However, significant inequalities still exist in the use of ANC services based on women’s education, ethnicity, and economic status.