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Trang DTH, Ha BTT, Vui LT, Chi NTQ, Thi LM, Duong DTT, Hung DT, de Chavez AC, Manzano A, Lakin K, Kane S, Mirzoev T. Understanding the barriers to integrating maternal and mental health at primary health care in Vietnam. Health Policy Plan 2024:czae027. [PMID: 38597872 DOI: 10.1093/heapol/czae027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/27/2024] [Accepted: 04/08/2024] [Indexed: 04/11/2024] Open
Abstract
The prevalence of common perinatal mental disorders in Vietnam ranges from 16.9% to 39.9%, and substantial treatment gaps have been identified at all levels. This paper explores constraints to the integration of maternal and mental health services at the primary healthcare level and the implications for the health system's responsiveness to the needs and expectations of pregnant women with mental health conditions in Vietnam. As part of the RESPONSE project, a three-phased realist evaluation study, we present Phase One findings which employed systematic and scoping literature reviews, and qualitative data collection (focus groups and interviews) with key health system actors, in Bac Giang province, Vietnam, to understand the barriers to maternal mental healthcare provision, utilisation, and integration strategies. A four-level framing of the barriers to integrating perinatal mental health services in Vietnam was used in reporting findings, which comprised individual, socio-cultural, organisational, and structural levels. At the socio-cultural and structural levels, these barriers included: cultural beliefs about the holistic notion of physical and mental health, stigma towards mental health, biomedical approach to healthcare services, absence of comprehensive mental health policy, and a lack of mental health workforce. At the organisational level, there was absence of clinical guidelines on the integration of mental health in routine antenatal visits, a shortage of staff, and poor health facilities. Finally, at the provider level, a lack of knowledge and training on mental health was identified. The integration of mental health into routine antenatal visits at the primary care level has the potential help to reduce stigma towards mental health and improve health system responsiveness by providing services closer to the local level, offering prompt attention, better choice of services, and better communication while ensuring privacy and confidentiality of services. This can improve the demand for mental health services and help reduce the delay of care-seeking.
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Affiliation(s)
- Do Thi Hanh Trang
- Hanoi University of Public Health, 1A Duc Thang, Bac Tu Liem, Ha Noi 10000 Vietnam
| | - Bui Thi Thu Ha
- Hanoi University of Public Health, 1A Duc Thang, Bac Tu Liem, Ha Noi 10000 Vietnam
| | - Le Thi Vui
- Hanoi University of Public Health, 1A Duc Thang, Bac Tu Liem, Ha Noi 10000 Vietnam
| | | | - Le Minh Thi
- Hanoi University of Public Health, 1A Duc Thang, Bac Tu Liem, Ha Noi 10000 Vietnam
| | - Doan Thi Thuy Duong
- Hanoi University of Public Health, 1A Duc Thang, Bac Tu Liem, Ha Noi 10000 Vietnam
| | - Dang The Hung
- Hanoi University of Public Health, 1A Duc Thang, Bac Tu Liem, Ha Noi 10000 Vietnam
| | - Anna Cronin de Chavez
- London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, United Kingdom
| | - Ana Manzano
- School of Sociology & Social Policy, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - Kimberly Lakin
- Nossal Institute for Global Health Melbourne School of Population and Global Health, The University of Melbourne, Victoria 3010 Australia
| | - Sumit Kane
- Nossal Institute for Global Health Melbourne School of Population and Global Health, The University of Melbourne, Victoria 3010 Australia
| | - Tolib Mirzoev
- London School of Hygiene and Tropical Medicine, Keppel St, London WC1E 7HT, United Kingdom
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Lakin K, Ha DT, Mirzoev T, Ha BTT, Agyepong IA, Kane S. "We can't expect much": Childbearing women's 'horizon of expectations' of the health system in rural Vietnam. Health Place 2024; 85:103166. [PMID: 38101200 DOI: 10.1016/j.healthplace.2023.103166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023]
Affiliation(s)
- Kimberly Lakin
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Australia
| | - Dinh Thu Ha
- Hanoi University of Public Health, Hanoi, Viet Nam
| | - Tolib Mirzoev
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | - Sumit Kane
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Australia.
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Oanh LTK, Thao TTP, Ha BTT, Ha NT, Duong DTT, Long KQ, Trang NTT, Quang CH, Van Minh H. Disparities in Gynecological Healthcare Service Utilization Among Ethnic Minority Women in Vietnam. J Racial Ethn Health Disparities 2023; 10:2155-2166. [PMID: 36018452 DOI: 10.1007/s40615-022-01395-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 07/22/2022] [Accepted: 08/17/2022] [Indexed: 10/15/2022]
Abstract
The study aimed to investigate differences in the prevalence of gynecological healthcare service utilization in 12 ethnic minority groups and associated socio-demographic correlates with gynecological healthcare service utilization in Vietnam. Based on the national survey on healthcare utilization among 6912 people in 12 ethnic minorities, 900 women aged 21-49 years were included in the final analysis. Prevalence of gynecological healthcare service utilization in 12 ethnic minority groups was measured, based on the question "Have you ever used any gynecological healthcare services?" Socio-demographic characteristics including region, ethnicity, age, marital status, literacy level, education level, languages spoken, occupation, religion, household economy status, using contraception, and distance to the nearest healthcare facility were examined. The association between gynecological healthcare service utilization and socio-demographic characteristics was assessed by using logistic regression. The results showed that the prevalence of gynecological healthcare service utilization was 62.0% (95% CI: 58.7-65.2%), which ranged from 36.5 (Mnong) to 87.7% (Bru Van Kieu). Bru Van Kieu women had significantly higher odds of gynecological healthcare service utilization (OR = 9.42, 95% CI = 3.71-23.91), compared to those in Khmer ethnicity. Besides, Ba Na, Cham Ninh Thuan, and Dao women also had significantly higher odds of gynecological healthcare service utilization (Ba Na: OR = 5.73, 95% CI = 2.15-15.26; Cham Ninh Thuan: OR = 4.24, 95% CI = 1.79-10.06; Dao: OR = 3.43, 95% CI = 1.49-7.90), compared to those in Khmer ethnicity. Getting married, being older, being not poor, and using contraception had significantly higher odds of using gynecological healthcare services. Health education specialists and healthcare workers should be aware of these issues so that they can provide appropriate gynecological healthcare services and ensure high coverage of routine gynecological exams in ethnic minority women in reproductive age.
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Affiliation(s)
- Luu Thi Kim Oanh
- Faculty of Health Policy and Economics, Hanoi University of Public Health, 1A Duc Thang Road, Duc Thang District, North Tu Liem, Hanoi, 100000, Vietnam.
| | - Tran Thi Phuong Thao
- Faculty of Health Policy and Economics, Hanoi University of Public Health, 1A Duc Thang Road, Duc Thang District, North Tu Liem, Hanoi, 100000, Vietnam
| | - Bui Thi Thu Ha
- Faculty of Health Policy and Economics, Hanoi University of Public Health, 1A Duc Thang Road, Duc Thang District, North Tu Liem, Hanoi, 100000, Vietnam
| | - Nguyen Thanh Ha
- Faculty of Health Policy and Economics, Hanoi University of Public Health, 1A Duc Thang Road, Duc Thang District, North Tu Liem, Hanoi, 100000, Vietnam
| | - Doan Thi Thuy Duong
- Faculty of Health Policy and Economics, Hanoi University of Public Health, 1A Duc Thang Road, Duc Thang District, North Tu Liem, Hanoi, 100000, Vietnam
| | - Khuong Quynh Long
- Faculty of Health Policy and Economics, Hanoi University of Public Health, 1A Duc Thang Road, Duc Thang District, North Tu Liem, Hanoi, 100000, Vietnam
| | - Nguyen Thi Thu Trang
- Faculty of Health Policy and Economics, Hanoi University of Public Health, 1A Duc Thang Road, Duc Thang District, North Tu Liem, Hanoi, 100000, Vietnam
| | - Cao Huu Quang
- Faculty of Health Policy and Economics, Hanoi University of Public Health, 1A Duc Thang Road, Duc Thang District, North Tu Liem, Hanoi, 100000, Vietnam
| | - Hoang Van Minh
- Faculty of Health Policy and Economics, Hanoi University of Public Health, 1A Duc Thang Road, Duc Thang District, North Tu Liem, Hanoi, 100000, Vietnam
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Vui LT, Duc DM, Quynh CTT, Tuan DK, Huong NM, Thanh NTM, Hung NM, Minh HV, Ha BTT. Ante-, Peri-, and Neonatal Factors Associated with Autism Spectrum Disorders in Vietnam: A Population-Based Cross-Sectional Survey. Iran J Public Health 2023; 52:950-959. [PMID: 37484714 PMCID: PMC10362219 DOI: 10.18502/ijph.v52i5.12711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 03/15/2022] [Indexed: 07/25/2023]
Abstract
Background Autism Spectrum Disorders (ASDs) are common behavioral syndromes but limited critical evidence in Vietnam. This study aimed to identify ante-, peri- and neonatal factors for ASDs amongst children in Vietnam. Methods This population-based study applied the cross-sectional design with a multistage sampling in 21 urban and rural districts in seven cities/provinces in Vietnam during 2017-2018. Overall, 42,551 children age 18 to 30 months were enrolled in the study. Two phases of assessment using Modified Checklist for Autism in Toddlers (M-CHAT) for screening and diagnostic assessment using Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for confirmation. We employed univariate and binary logistic regression to identify. Results Our study showed a fast-growing trend of ASDs amongst children age 18 and 30 months (75.8 per 10,000 individuals). Nine ante-, peri-, and neonatal factors were associated with ASDs: five factors of antenatal period (history of miscarriage/abortion or stillbirth, children conceived by assisted reproduction technologies, having cold, flu or acquiring virus during pregnancy, having gestational diabetes, toxemia, high blood pressure or pre-eclampsia during pregnancy, and having stress or mental disorders during pregnancy); one factors of perinatal period (mode of delivery); and three factors of neonatal period (jaundice, respiratory distress, and newborn seizures). Conclusion This first large-scale survey in Vietnam confirms some prenatal, perinatal, and postnatal factors with ASDs amongst children age 18 and 30 months. Future interventions should focus on these factors to early diagnosis and intervention to improve functional outcomes for risky children.
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Affiliation(s)
- Le Thi Vui
- Department of Population and Reproductive Health, Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Duong Minh Duc
- Department of Population and Reproductive Health, Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Chu Thi Thuy Quynh
- Department of Population and Reproductive Health, Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Duong Kim Tuan
- Department of Epidemiology, Faculty of Fundamental Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nguyen Mai Huong
- Department of Psychiatry, National Hospital of Pediatrics, Hanoi, Vietnam
| | - Nguyen Thi Minh Thanh
- Department of Research Management and Cooperation, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nguyen Minh Hung
- Department of Science and Technology for Economic Branches, Ministry of Science and Technology, Hanoi, Vietnam
| | - Hoang Van Minh
- Department of Health Policy and Economics, Health Management Training Institute, Hanoi University of Public Health, Hanoi, Vietnam
| | - Bui Thi Thu Ha
- Department of Population and Reproductive Health, Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam
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Do TTH, Bui QTT, Ha BTT, Le TM, Le VT, Nguyen QCT, Lakin KJ, Dang TT, Bui LV, Le TC, Tran ATH, Pham HTT, Nguyen TV. Using the WHO Self-Reporting Questionnaire-20 (SRQ-20) to Detect Symptoms of Common Mental Disorders among Pregnant Women in Vietnam: a Validation Study. Int J Womens Health 2023; 15:599-609. [PMID: 37082234 PMCID: PMC10112468 DOI: 10.2147/ijwh.s404993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/06/2023] [Indexed: 04/22/2023] Open
Abstract
Purpose Detection of antenatal common mental disorders in low-resource settings like Vietnam is important and requires a reliable, valid and practical screening tool. Currently, there is no such tool validated for use among pregnant women in Vietnam. This study aims to assess the validity of the Vietnamese version of the 20-item Self Reporting Questionnaire (SRQ-20) by evaluating its reliability, factorial structure, and performance in detecting common mental disorder (CMD) symptoms, thereby identifying the optimum cut-off score for CMD screening among pregnant women in Vietnam. Participants and Methods A total of 210 pregnant women from four rural communes participated in a face-to-face interview using the Vietnamese version of the SRQ-20, followed by a clinical diagnostic interview based on ICD-10 diagnostic criteria of CMDs. The reliability of the SRQ-20 was assessed by calculating the scale's Cronbach's alpha to measure internal consistency. Factor analyses were undertaken to examine the factor structure of the instrument. The Receiver Operating Characteristic (ROC) curve analysis was performed to assess the performance of the SRQ-20 against the clinical diagnosis and to identify the optimum cut-off score. Results Internal consistency was good, with a Cronbach's alpha of 0.87. Factor analyses resulted in a 4-factor solution. The area under the ROC curve (AUC) for detection of CMDs was 0.90. The optimum cut-off score of the SRQ-20 for detection of CMD symptoms among Vietnamese pregnant women was 5/6. Conclusion The Vietnamese version of the SRQ-20 has the capacity to detect CMDs among pregnant women effectively and is recommended for use as a screening tool for CMDs in antenatal care settings in Vietnam.
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Affiliation(s)
- Trang Thi Hanh Do
- Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Quyen Thi Tu Bui
- Faculty and Fundamental Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Bui Thi Thu Ha
- Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Thi Minh Le
- Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Vui Thi Le
- Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Quynh-Chi Thai Nguyen
- Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Kimberly Joyce Lakin
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
| | - Tung Thanh Dang
- The National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - Loi Van Bui
- The National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - Thien Cong Le
- The National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - An Thi Ha Tran
- The National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - Hien Thi Thu Pham
- The National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
| | - Tuan Van Nguyen
- The National Institute of Mental Health, Bach Mai Hospital, Hanoi, Vietnam
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Ha TTN, Thanh PQ, Huong TL, Anh VT, Tu NM, Tien PH, Ha BTT. Nurses' perceptions about patient safety culture in public hospital in Vietnam. Appl Nurs Res 2023; 69:151650. [PMID: 36635007 DOI: 10.1016/j.apnr.2022.151650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 09/27/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022]
Abstract
AIM This paper is aimed to assess nurses' perceptions of patient safety culture in four public general hospitals in Hanoi, Vietnam. BACKGROUND Patient safety culture is a vital component in ensuring high quality and safe patient care. Assessment of nurses' perceptions on existing hospital patient safety culture (PSC) is the first step to promote PSC. METHODS The cross-sectional study surveyed 705 nurses utilizing the validated Hospital Survey on Patient Safety Culture (HSOPSC) in an online format. RESULTS The average positive response rate was high at 72.8 % and varied from 52.9 % to 93.4 %. The strongest areas are teamwork within units (93.7 %) and supervisor/manager expectations and actions promoting patient safety (85.0 %). The areas for improvement are staffing (52.9 %) and non-punitive response to error (57.6 %). The communication openness, staffing, frequency of events reported, lengths of services in hospital and unit are significant factors that predict the overall patient safety grade. CONCLUSIONS Initiatives are necessary to improve response to errors, staffing, and error reporting. Nurse managers could develop and implement interventions and program to improve patient safety, including providing education related to patient safety culture, encouraging staff to notify incidents and avoiding punitive responses.
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Affiliation(s)
- Tran Thi Nhi Ha
- Hanoi Department of Health, No 4 Son Tay, Ba Dinh, Hanoi 100000, Viet Nam.
| | - Pham Quoc Thanh
- Hanoi University of Public Health, 1A Duc Thang road, Bac Tu Liem district, Hanoi 100000, Viet Nam.
| | - Tran Lien Huong
- Saint Paul Hospital, No. 12 Chu Van An, Ba Dinh district, Hanoi 100000, Viet Nam
| | - Vu Tuan Anh
- Genetal Hospital of Agricultural, Thanh Tri district, Hanoi 100000, Viet Nam
| | - Nguyen Minh Tu
- Phuc Tho Hospital, Phuc Tho Town, Phuc Tho District, Hanoi 100000, Viet Nam
| | - Pham Hung Tien
- Hanoi University of Public Health, 1A Duc Thang road, Bac Tu Liem district, Hanoi 100000, Viet Nam
| | - Bui Thi Thu Ha
- Hanoi University of Public Health, 1A Duc Thang road, Bac Tu Liem district, Hanoi 100000, Viet Nam
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Duong DTT, Binns C, Lee A, Zhao Y, Pham NM, Hoa DTP, Ha BTT. Intention to Exclusively Breastfeed Is Associated with Lower Rates of Cesarean Section for Nonmedical Reasons in a Cohort of Mothers in Vietnam. Int J Environ Res Public Health 2022; 19:ijerph19020884. [PMID: 35055705 PMCID: PMC8776101 DOI: 10.3390/ijerph19020884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/05/2022] [Accepted: 01/10/2022] [Indexed: 12/01/2022]
Abstract
Background: Breastfeeding brings benefits to both mothers and children in the short term and long term. Unnecessary cesarean sections can bring risks to both parties. This study was undertaken to examine the relationship between exclusive breastfeeding intention and cesarean delivery. Methods: We analyzed data collected from 554 single mothers who delivered in Dong Anh General District Hospital or Hanoi Obstetrics and Gynecology Hospital, Vietnam, in 2020–2021. The relationship between exclusive breastfeeding intention and cesarean delivery for nonmedical reasons was adjusted for maternal education, maternal age, parity, history of fetal loss, having at least eight antenatal contacts, hospital of delivery, child sex, and birth weight. Results: Antenatally, 34.8% (184/529) of mothers intended to breastfeed exclusively until 6 months and 30.8% (84/274) underwent cesarean section for a nonmedical reason. After adjusting for other factors, mothers who intended to breastfeed exclusively until 6 months were less likely to undergo cesarean delivery for nonmedical reasons (OR = 0.55, 95% CI: 0.31–0.96, p = 0.034). Conclusions: This study adds to the growing evidence related to unnecessary cesarean sections and routine over-medicalization of normal birth in the urban areas of Vietnam. The association between breastfeeding intentions and a lower rate of cesarean section suggests that education on breastfeeding could be a useful intervention for reducing the rate of cesarean sections and improving maternal and child health.
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Affiliation(s)
- Doan Thi Thuy Duong
- Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, 1A Duc Thang Street, Bac Tu Liem District, Hanoi 10000, Vietnam; (D.T.T.D.); (B.T.T.H.)
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (A.L.); (Y.Z.); (N.M.P.)
| | - Colin Binns
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (A.L.); (Y.Z.); (N.M.P.)
- Correspondence: (C.B.); (D.T.P.H.)
| | - Andy Lee
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (A.L.); (Y.Z.); (N.M.P.)
| | - Yun Zhao
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (A.L.); (Y.Z.); (N.M.P.)
| | - Ngoc Minh Pham
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (A.L.); (Y.Z.); (N.M.P.)
- Department of Epidemiology, Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen 250000, Vietnam
| | - Dinh Thi Phuong Hoa
- Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, 1A Duc Thang Street, Bac Tu Liem District, Hanoi 10000, Vietnam; (D.T.T.D.); (B.T.T.H.)
- Correspondence: (C.B.); (D.T.P.H.)
| | - Bui Thi Thu Ha
- Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, 1A Duc Thang Street, Bac Tu Liem District, Hanoi 10000, Vietnam; (D.T.T.D.); (B.T.T.H.)
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Thi Vui L, Duc DM, Thuy Quynh N, Giang NTH, Mai VTT, Ha BTT, Van Minh H. Early screening and diagnosis of autism spectrum disorders in Vietnam: A population-based cross-sectional survey. J Public Health Res 2021; 11. [PMID: 34850618 PMCID: PMC8973207 DOI: 10.4081/jphr.2021.2460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/10/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Early detection of autism spectrum disorders (ASDs) is essential given the under-reported cases in low- and middle-income countries. This first national representative survey was conducted to explore the prevalence of ASDs amongst 18 and 30 months in seven provinces in Vietnam. Design and methods: During 2017-2018, a national cross-sectional and population-based survey for autism spectrum disorder (ASD) amongst 40,243 children aged 18 to 30 months was conducted in 7 provinces representing the socio-economic regions of Vietnam. M-CHAT was used to screen children and then confirmed by diagnostic assessment using DSM-IV criteria. Results: The prevalence of ASDs amongst children aged 18 and 30 months in Vietnam was high (0.758% or 1 in 132 children). Urban setting, male gender, and hereditable genes were associated with ASD prevalence. Conclusions: ASDs amongst children aged 18 and 30 months in Vietnam tend to be increasing and are similar to this rate in other middle-income countries but lower than that in Western countries. This under-recognized public health problem amongst children should be addressed by early detection and intervention for families with affected children. Significance for public health This first nationally representative and population-based survey adds empirical data about autism spectrum disorder (ASD) amongst children aged 18 to 30 months in Vietnam. Using M-CHAT as screening tool and DSM-IV criteria for confirmation, ASD amongst children aged 18 and 30 months shows an increasing trend with the prevalence as high as 0.758% in 2018. Early detection and intervention should be conducted to provide affected child with the potential for a better life.
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Affiliation(s)
- Le Thi Vui
- Hanoi University of Public Health, Hanoi.
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Ha BTT, Ngoc Quang L, Quoc Thanh P, Duc DM, Mirzoev T, Bui TMA. Community engagement in the prevention and control of COVID-19: Insights from Vietnam. PLoS One 2021; 16:e0254432. [PMID: 34495962 PMCID: PMC8425553 DOI: 10.1371/journal.pone.0254432] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 06/26/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction Community engagement (CE) is an effective public health strategy for improving health outcomes. There is limited published knowledge about effective approaches to CE in ensuring effective responses to COVID-19 throughout lockdowns, travel restrictions and social distancing. In this paper, we contribute to bridging this gap by highlighting experience of CE in Vietnam, specifically focusing on migrant workers in Vietnam. Methods A cross-sectional qualitative study design was used with qualitative data collection was carried out during August-October 2020. Two districts were purposefully selected from two large industrial zones. Data was collected using in-depth interviews (n = 36) with individuals and households, migrants and owners of dormitories, industrial zone factory representatives, community representatives and health authorities. Data was analyzed using thematic analysis approach. The study received ethics approval from the Hanoi University Institutional Review Board. Results The government’s response to COVID-19 was spearheaded by the multi-sectoral National Steering Committee for the Prevention and Control of COVID-19, chaired by the Vice Prime Minister and comprised different members from 23 ministries. This structure was replicated throughout the province and local levels and all public and private organizations. Different activities were carried out by local communities, following four key principles of infection control: early detection, isolation, quarantine and hospitalization. We found three key determinants of engagement of migrant workers with COVID-19 prevention and control: availability of resources, appropriate capacity strengthening, transparent and continuous communication and a sense of trust in government legitimacy. Discussion and conclusion Our results support the current literature on CE in infection control which highlights the importance of context and suggests that future CE should consider five key components: multi-sectoral collaboration with a whole-of-community approach to strengthen governance structures with context-specific partnerships; mobilization of resources and decentralization of decision making to encourage self-reliance and building of local capacity; capacity building through training and supervision to local institutions; transparent and clear communication of health risks and sensitization of local communities to improve compliance and foster trust in the government measures; and understanding the urgent needs ensuring of social security and engaging all parts of the community, specifically the vulnerable groups.
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Affiliation(s)
- Bui Thi Thu Ha
- Hanoi University of Public Health, Hanoi, Vietnam
- * E-mail:
| | | | | | | | - Tolib Mirzoev
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Mirzoev T, Cronin de Chavez A, Manzano A, Agyepong IA, Ashinyo ME, Danso-Appiah A, Gyimah L, Yevoo L, Awini E, Ha BTT, Do Thi Hanh T, Nguyen QCT, Le TM, Le VT, Hicks JP, Wright JM, Kane S. Protocol for a realist synthesis of health systems responsiveness in low-income and middle-income countries. BMJ Open 2021; 11:e046992. [PMID: 34112643 PMCID: PMC8194331 DOI: 10.1136/bmjopen-2020-046992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Health systems responsiveness is a key objective of any health system, yet it is the least studied of all objectives particularly in low-income and middle-income countries. Research on health systems responsiveness highlights its multiple elements, for example, dignity and confidentiality. Little is known, however, about underlying theories of health systems responsiveness, and the mechanisms through which responsiveness works. This realist synthesis contributes to bridging these two knowledge gaps. METHODS AND ANALYSIS In this realist synthesis, we will use a four-step process, comprising: mapping of theoretical bases, formulation of programme theories, theory refinement and testing of programme theories using literature and empirical data from Ghana and Vietnam. We will include theoretical and conceptual pieces, reviews, empirical studies and grey literature, alongside the primary data. We will explore responsiveness as entailing external and internal interactions within health systems. The search strategy will be purposive and iterative, with continuous screening and refinement of theories. Data extraction will be combined with quality appraisal, using appropriate tools. Each fragment of evidence will be appraised as it is being extracted, for its relevance to the emerging programme theories and methodological rigour. The extracted data pertaining to contexts, mechanisms and outcomes will be synthesised to identify patterns and contradictions. Results will be reported using narrative explanations, following established guidance on realist syntheses. ETHICS AND DISSEMINATION Ethics approvals for the wider RESPONSE (Improving health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam) study, of which this review is one part, were obtained from the ethics committees of the following institutions: London School of Hygiene and Tropical Medicine (ref: 22981), University of Leeds, School of Medicine (ref: MREC19-051), Ghana Health Service (ref: GHS-ERC 012/03/20) and Hanoi University of Public Health (ref: 020-149/DD-YTCC).We will disseminate results through academic papers, conference presentations and stakeholder workshops in Ghana and Vietnam. PROSPERO REGISTRATION NUMBER CRD42020200353. Full record: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020200353.
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Affiliation(s)
- Tolib Mirzoev
- Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Anna Cronin de Chavez
- Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Ana Manzano
- School of Sociology and Social Policy, University of Leeds, Leeds, UK
| | - Irene Akua Agyepong
- Research and Development Division, Ghana Health Service, Accra, Greater Accra, Ghana
| | - Mary Eyram Ashinyo
- Department of Quality Assurance, Institutional Care Directorate, Ghana Health Service, Accra, Ghana
| | | | | | - Lucy Yevoo
- Research and Development Division, Ghana Health Service, Accra, Greater Accra, Ghana
| | - Elizabeth Awini
- Research and Development Division, Ghana Health Service, Accra, Greater Accra, Ghana
| | - Bui Thi Thu Ha
- Department of Population and Reproductive Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Trang Do Thi Hanh
- Department of Environmental Health, Hanoi University of Public Health, Hanoi, Viet Nam
| | | | - Thi Minh Le
- Department of Population and Reproductive Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Vui Thi Le
- Department of Population and Reproductive Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Joseph Paul Hicks
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK
| | - Judy M Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Sumit Kane
- Nossal Institute for Global Health, University of Melbourne Queen's College, Parkville, Victoria, Australia
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Mirzoev T, Manzano A, Ha BTT, Agyepong IA, Trang DTH, Danso-Appiah A, Thi LM, Ashinyo ME, Vui LT, Gyimah L, Chi NTQ, Yevoo L, Duong DTT, Awini E, Hicks JP, Cronin de Chavez A, Kane S. Realist evaluation to improve health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam: Study protocol. PLoS One 2021; 16:e0245755. [PMID: 33481929 PMCID: PMC7822243 DOI: 10.1371/journal.pone.0245755] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/18/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Socio-economic growth in many low and middle-income countries has resulted in more available, though not equitably accessible, healthcare. Such growth has also increased demands from citizens for their health systems to be more responsive to their needs. This paper shares a protocol for the RESPONSE study which aims to understand, co-produce, implement and evaluate context-sensitive interventions to improve health systems responsiveness to health needs of vulnerable groups in Ghana and Vietnam. METHODS We will use a realist mixed-methods theory-driven case study design, combining quantitative (household survey, secondary analysis of facility data) and qualitative (in-depth interviews, focus groups, observations and document and literature review) methods. Data will be analysed retroductively. The study will comprise three Phases. In Phase 1, we will understand actors' expectations of responsive health systems, identify key priorities for interventions, and using evidence from a realist synthesis we will develop an initial theory and generate a baseline data. In Phase 2, we will co-produce jointly with key actors, the context-sensitive interventions to improve health systems responsiveness. The interventions will seek to improve internal (i.e. intra-system) and external (i.e. people-systems) interactions through participatory workshops. In Phase 3, we will implement and evaluate the interventions by testing and refining our initial theory through comparing the intended design to the interventions' actual performance. DISCUSSION The study's key outcomes will be: (1) improved health systems responsiveness, contributing to improved health services and ultimately health outcomes in Ghana and Vietnam and (2) an empirically-grounded and theoretically-informed model of complex contexts-mechanisms-outcomes relations, together with transferable best practices for scalability and generalisability. Decision-makers across different levels will be engaged throughout. Capacity strengthening will be underpinned by in-depth understanding of capacity needs and assets of each partner team, and will aim to strengthen individual, organisational and system level capacities.
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Affiliation(s)
- Tolib Mirzoev
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, United Kingdom
- * E-mail: (TM); (SK)
| | - Ana Manzano
- School of Sociology and Social Policy, University of Leeds, Leeds, United Kingdom
| | - Bui Thi Thu Ha
- Department of Population and Reproductive Health, Hanoi University of Public Health, Hanoi, Vietnam
| | | | - Do Thi Hanh Trang
- Department of Undergraduate Education, Hanoi University of Public Health, Hanoi, Vietnam
| | | | - Le Minh Thi
- Department of Population and Reproductive Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Mary Eyram Ashinyo
- Department of Quality Assurance, Institutional Care Directorate, Ghana Health Service, Accra, Ghana
| | - Le Thi Vui
- Department of Population and Reproductive Health, Hanoi University of Public Health, Hanoi, Vietnam
| | | | - Nguyen Thai Quynh Chi
- Department of Population and Reproductive Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Lucy Yevoo
- Research and Development Division, Ghana Health Service, Accra, Ghana
| | - Doan Thi Thuy Duong
- Department of Population and Reproductive Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Elizabeth Awini
- Research and Development Division, Ghana Health Service, Accra, Ghana
| | - Joseph Paul Hicks
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, United Kingdom
| | - Anna Cronin de Chavez
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, United Kingdom
| | - Sumit Kane
- Nossal Institute for Global Health, University of Melbourne, Melbourne, VIC, Australia
- * E-mail: (TM); (SK)
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Tran TPT, Hoang Thi NA, Khuong QL, Thi Thu Ha B, Thanh Ha N, Duong DTT, Trung T, Thi Huong H, Van Huan N, Thi Tuyet Hanh T, Kim Khanh Ly D, Thi Kim Oanh L, Thi Thu Trang N, Huu Quang C, Bao Ngoc N, Hong Hanh H, Tuan Anh T, Mai Huong N, Hoang VM. Tobacco and Alcohol Use Among Ethnic Minorities in Vietnam. Asia Pac J Public Health 2020; 32:387-397. [PMID: 32911992 DOI: 10.1177/1010539520956444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study investigates the prevalence of tobacco and alcohol uses and associated factors among 12 ethnic minorities in Vietnam in 2019. A cross-sectional survey was conducted among 5172 people aged ≥15 years. The prevalence of smoking and drinking was 19.7% and 29.9%, respectively, and significantly higher among men than women. These numbers were heterogeneous across ethnic minorities. Smoking prevalence was high among Ba Na (25.9%), Cham An Giang (22.3%), Khmer (23.5%), La Hu (26.3%), Ta Oi (30.7%), and Bru Van Kieu (29.6%) ethnicities whereas that of Gie Trieng and Mnong ethnicities was low (3.7% and 9.5%, respectively). Drinking prevalence ranged from 1.4% in Cham An Giang ethnicity to 68.6% in Ba Na ethnicity. A wide ethnic disparity on tobacco and alcohol use could be explained by the ethnic variation of lifestyles, social norms, and cultural features. Our findings suggest the need to develop ethnic-specific interventions to mitigate the smoking and drinking prevalence.
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Affiliation(s)
- Thi Phuong Thao Tran
- Hanoi University of Public Health, Hanoi, Vietnam.,National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | | | | | | | | | | | - Tran Trung
- Vietnam Academy for Ethnic Minorities, Hanoi, Vietnam
| | - Hoang Thi Huong
- University of Economics and Business-Vietnam National University, Hanoi, Vietnam
| | | | | | - Dang Kim Khanh Ly
- University of Social Sciences and Humanities-Vietnam National University, Hanoi, Vietnam
| | | | | | | | | | | | | | - Nguyen Mai Huong
- General Office for Population and Family Planning, Hanoi, Vietnam
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Van Minh H, Long KQ, Ha NT, Duong DTT, Trung T, Huong HT, Van Huan N, Hanh TTT, Lan VTH, Huong NM, Oanh LTK, Trang NTT, Quang CH, Thanh ND, Anh BTM, Ha BTT. Self-reported non-communicable diseases and associated socio-demographic status among ethnic minority populations in Vietnam, 2019. Health Psychol Open 2020; 7:2055102920954707. [PMID: 32974039 PMCID: PMC7495520 DOI: 10.1177/2055102920954707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to report the prevalence of self-reported
non-communicable diseases among ethnic minority populations in Vietnam and
related factors. A total of 5033 individuals aged 15 years and older who
belonged to ethnic minority populations from 12 provinces in Vietnam completed a
household survey. The overall prevalence of self-reported non-communicable
diseases was 12.4% (95% CI: 11.5%–13.4%). Cardiovascular diseases were the most
prevalent, followed by diabetes. Ethnicity was shown to have an independently
significant correlation to having any non-communicable diseases. Older people,
near-poor and non-poor people had significantly higher odds of having
non-communicable diseases as compared to younger and poor people.
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Affiliation(s)
| | | | | | | | - Tran Trung
- Vietnam Academy for Ethnic Minorities, Hanoi, Vietnam
| | | | - Nguyen Van Huan
- Committee on Ethnic Minority Affairs of Vietnam, Hanoi, Vietnam
| | | | | | - Nguyen Mai Huong
- General Office for Population and Family Planning, Hanoi, Vietnam
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Duong DTT, Van Minh H, Long KQ, Ha NT, Trang NTT, Quang CH, Duc DM, Anh BTM, Hung PT, Nga NT, Ha BTT. The Utilization of Maternal Healthcare Services Among Ethnic Minority Populations in Vietnam. J Racial Ethn Health Disparities 2020; 8:723-731. [PMID: 32757144 DOI: 10.1007/s40615-020-00832-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Previous studies have observed lower utilization of maternal healthcare services by ethnic minority groups in Vietnam compared with the majority Kinh community. This study sought to assess the utilization of maternal healthcare service-associated factors within 12 ethnic minority groups. METHOD The cross-sectional study enrolled 996 women from 12 ethnic minority groups in Vietnam in 2019. Women had pregnancy outcomes in the last 5 years. The two variables for maternal healthcare utilization were [1] a minimum of four antenatal contacts and [2] health facility-based delivery. We examined the association of individual characteristics of maternal healthcare services using multilevel modeling. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported. RESULTS This nationally representative study found that 34.1% of women from ethnic minority backgrounds had four or more antenatal contacts during pregnancy, ranging from 8.3% in Mong community to 80.2% in Cham An Giang. Most of the women (94.4%) delivered at health facilities. Factors independently correlated with having fewer than four antenatal contacts included being illiterate, early marriage, unemployment, religious affiliation, household economy, and distance to the nearest health facility. Factors significantly associated with home delivery were living in the most disadvantaged areas and having fewer than four antenatal contacts. CONCLUSION Substantial inequity exists in antenatal coverage both within ethnic minority groups and between socio-economic groups. The low coverage of having at least four antenatal contacts and its' correlates with facility-based delivery suggests that the government should focus efforts on increasing the number of antenatal contacts for ethnic minority women.
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Affiliation(s)
- Doan Thi Thuy Duong
- Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, Hanoi, Vietnam.
| | - Hoang Van Minh
- Faculty of Health Management and Policy, Hanoi University of Public Health, Hanoi, Vietnam
| | - Khuong Quynh Long
- Center for Population Health Center, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nguyen Thanh Ha
- Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nguyen Thi Thu Trang
- Department of Postgraduate Education, Hanoi University of Public Health, Hanoi, Vietnam
| | - Cao Huu Quang
- Department of Examination & Quality Assurance, Hanoi University of Public Health, Hanoi, Vietnam
| | - Duong Minh Duc
- Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, Hanoi, Vietnam
| | - Bui Thi My Anh
- Faculty of Health Management and Policy, Hanoi University of Public Health, Hanoi, Vietnam
| | - Phung Thanh Hung
- Faculty of Health Management and Policy, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nguyen Thi Nga
- Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, Hanoi, Vietnam
| | - Bui Thi Thu Ha
- Faculty of Social Sciences, Behavior and Health Education, Hanoi University of Public Health, Hanoi, Vietnam
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Huong LTT, Tuyet-Hanh TT, Minh HV, Ha BTT, Anh NQ, Huong NT, Trang PTT, Long KQ, Ha NT, Trang NTT, Quang CH, Oanh LTK, Thuy TTT. Access to Improved Water Sources and Sanitation in Minority Ethnic People in Vietnam and Some Sociodemographic Associations: A 2019 National Survey. Environ Health Insights 2020; 14:1178630220946342. [PMID: 32821114 PMCID: PMC7412927 DOI: 10.1177/1178630220946342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 06/25/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Achieving access to clean water and basic sanitation remains as major challenges in Vietnam, especially for vulnerable groups such as minority people, despite all the progress made by the Millennium Development Goal number 7.C. OBJECTIVES The study aimed to describe the access to improved water sources and sanitation of the ethnic minority people in Vietnam based on a national survey and to identify associated factors. METHODS A cross-sectional study was conducted in 2019 with a sample size of 1385 ethnic minority households in 12 provinces in Vietnam. Multivariate logistic regression modeling was performed to examine the probability of having access to improved water sources and sanitation and sociodemographic status at a significance level of P < .05. RESULTS The access to improved water sources and sanitation was unequal among the ethnic minority people in Vietnam, with the lowest access rate in the northern midland and mountainous and Central Highland areas and the highest access rate in the Mekong Delta region. Some sociodemographic variables that were likely to increase the ethnic minority people's access to improved water sources and/or sanitation included older age, female household heads, household heads with high educational levels, religious households, and households in not poor status. CONCLUSION AND RECOMMENDATIONS The study suggested more emphasis on religion for improving the ethnic minority's access to improved water sources and sanitation. Besides, persons of poor and near-poor status and with low educational levels should be of focus in future water and sanitation intervention programs.
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Affiliation(s)
| | - Tran Thi Tuyet-Hanh
- Tran Thi Tuyet-Hanh, Department of Environmental Health, Hanoi University of Public Health, 1A Duc Thang Road, Duc Thang District, Hanoi, 100000, Vietnam.
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Ha BTT, Pham Van T, Mirzoev T. <p>Implementation of Health Policy on Establishment of Provincial Center of Diseases Control (CDC) in Vietnam</p>. Healthc Policy 2020; 13:915-926. [PMID: 32801966 PMCID: PMC7406358 DOI: 10.2147/rmhp.s250748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 07/14/2020] [Indexed: 01/17/2023] Open
Abstract
Purpose Methods Results Conclusion
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Affiliation(s)
- Bui Thi Thu Ha
- Hanoi University of Public Health, Hanoi, Vietnam
- Correspondence: Bui Thi Thu Ha Hanoi University of Public Health, No. 1A Duc Thang Road, Duc Thang Ward, North Tu Liem District, Hanoi, VietnamTel +84-0913363603 Email
| | - Tac Pham Van
- Department of Manpower, Ministry of Health, Hanoi, Vietnam
| | - Tolib Mirzoev
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK
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Abstract
The lessons learned from Vietnam, a country that the world acclaimed for its management of the fight against COVID-19, could stand out as an example of how to do more with less. The Vietnamese government has acted swiftly at the very early stage of the pandemic with a focus on containment efforts and extensive public health measures, particularly (1) the commitment from the government with a multisectoral approach; (2) a timely, accurate, and transparent risk communication; (3) active surveillance and intensive isolation/quarantine operation, case management with tracing all new arrivals and close contact up to three clusters; and (4) suspension of flights, shutting schools, and all nonessential services.
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Affiliation(s)
| | - Vui Thi Le
- Hanoi University of Public Health, Hanoi, Vietnam
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18
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Ha BTT, Ngoc Quang L, Mirzoev T, Tai NT, Thai PQ, Dinh PC. Combating the COVID-19 Epidemic: Experiences from Vietnam. Int J Environ Res Public Health 2020; 17:ijerph17093125. [PMID: 32365851 PMCID: PMC7246912 DOI: 10.3390/ijerph17093125] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 04/22/2020] [Accepted: 04/27/2020] [Indexed: 01/08/2023]
Abstract
The COVID-19 pandemic is spreading fast globally. Vietnam’s strict containment measures have significantly reduced the spread of the epidemic in the country. This was achieved through the use of emergency control measures in the epidemic areas and integration of resources from multiple sectors including health, mass media, transportation, education, public affairs, and defense. This paper reviews and shares specific measures for successful prevention and control of COVID-19 in Vietnam, which could provide useful learning for other countries.
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Affiliation(s)
- Bui Thi Thu Ha
- Department of Reproductive Health, Hanoi University of Public Health, Hanoi 100000, Vietnam;
| | - La Ngoc Quang
- Department of Epidemiology, Hanoi University of Public Health, Hanoi 100000, Vietnam
- Correspondence:
| | - Tolib Mirzoev
- Nuffield Centre for International Health & Development, Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9NL, UK;
| | - Nguyen Trong Tai
- School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam;
| | - Pham Quang Thai
- Communicable Disease Control Department, National Institute of Hygiene and Epidemiology, Hanoi 100000, Vietnam;
| | - Phung Cong Dinh
- National Agency for Science and Technology Information, Ministry of Science and Technology, Hanoi 100000, Vietnam;
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Hai TL, Hung LC, Phuong TTB, Ha BTT, Nguyen BS, Hai TD, Nguyen VH. Multiwall carbon nanotube modified by antimony oxide (Sb2O3/MWCNTs) paste electrode for the simultaneous electrochemical detection of cadmium and lead ions. Microchem J 2020. [DOI: 10.1016/j.microc.2019.104456] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Ba NV, Minh HV, Quang LB, Chuyen NV, Ha BTT, Dai TQ, Duc DM, Quynh NT, Khanh PG. Prevalence and correlates of multimorbidity among adults in border areas of the Central Highland Region of Vietnam, 2017. J Comorb 2019; 9:2235042X19853382. [PMID: 31192142 PMCID: PMC6542113 DOI: 10.1177/2235042x19853382] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 04/26/2019] [Indexed: 12/12/2022]
Abstract
Introduction: The objectives of this study are to estimate the prevalence of multimorbidity (MM) among adults in the Central Highland Region (a poor region) of Vietnam in 2017 and to identify the sociodemographic correlates of these conditions. Methods: We used data from a cross-sectional study conducted in 2018 on health status among people in four provinces in the Central Highlands Region (Tay Nguyen) of Vietnam. A sample of 1680 adults (aged 15 years and older) were randomly selected for this study. Respondents were asked whether they had been told by a health worker that they had cancer, heart and circulatory conditions, chronic joint problems, chronic pulmonary diseases, chronic kidney problems, chronic digestive problems, psychological illness, diabetes, and/or other chronic conditions. Results: The prevalence of MM among the study participants was 16.4% (95% confidence interval (CI): 14.6%–18.2%). By looking at the 95% CIs, the differences in MM prevalence between the groups classified by gender, age, education, and occupation were not statistically significant. Only the difference in MM prevalence between farmers and government staff was statistically significant. Multivariate logistic analyses show education and occupations were shown to be significant correlates of MM. Conclusion: MMs were quite common among the adult populations in the study area, especially among people with lower socioeconomic status. Given the evidence, actions to reduce levels of MM in the setting are clearly urgent. The interventions should address all people in society, with focus on disadvantaged groups, like those with lower education and farmers.
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Affiliation(s)
- Nguyen Van Ba
- Department of Science and Technology Management, Vietnam Military Medical University, Hanoi, Vietnam
| | - Hoang Van Minh
- Department of Science and Technology Management, Hanoi University of Public Health, Hanoi, Vietnam
| | - Le Bach Quang
- Department of Science and Technology Management, Vietnam Military Medical University, Hanoi, Vietnam
| | - Nguyen Van Chuyen
- Department of Science and Technology Management, Vietnam Military Medical University, Hanoi, Vietnam
| | - Bui Thi Thu Ha
- Department of Science and Technology Management, Hanoi University of Public Health, Hanoi, Vietnam
| | - Tran Quoc Dai
- Department of Science and Technology Management, Hanoi University of Public Health, Hanoi, Vietnam
| | - Duong Minh Duc
- Department of Science and Technology Management, Hanoi University of Public Health, Hanoi, Vietnam
| | - Nguyen Thuy Quynh
- Department of Science and Technology Management, Hanoi University of Public Health, Hanoi, Vietnam
| | - Pham Gia Khanh
- Department of Science and Technology Management, Vietnam Military Medical University, Hanoi, Vietnam
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Zodpey S, Lumbiganon P, Evans T, Yang K, Ha BTT, Negandhi H, Chuenkongkaew W, Al-Kabir A. Assessment of health professional education across five Asian countries-a protocol. Hum Resour Health 2018; 16:52. [PMID: 30285862 PMCID: PMC6171128 DOI: 10.1186/s12960-018-0316-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 09/18/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND There is an increasing consensus globally that the education of health professionals is failing to keep pace with scientific, social, and economic changes transforming the healthcare environment. This catalyzed a movement in reforming education of health professionals across Bangladesh, China, India, Thailand, and Vietnam who jointly volunteered to implement and conduct cooperative, comparative, and suitable health professional education assessments with respect to the nation's socio-economic and cultural status, as well as domestic health service system. METHODS The 5C network undertook a multi-country health professional educational study to provide its countries with evidence for HRH policymaking. Its scope was limited to the assessment of medical, nursing, and public health education at three levels within each country: national, institutional, and graduate level (including about to graduate students and alumni). RESULTS This paper describes the general issues related to health professional education and the protocols used in a five-country assessment of medical, nursing, and public health education. A common protocol for the situation analysis survey was developed that included tools to undertake a national and institutional assessment, and graduate surveys among about-to-graduate and graduates for medical, nursing, and public health professions. Data collection was conducted through a mixture of literature reviews and qualitative research. CONCLUSIONS The national assessment would serve as a resource for countries to plan HRH-related future actions.
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Affiliation(s)
| | - Pisake Lumbiganon
- Department of Ob & Gyn, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Tim Evans
- World Bank, Washington, DC United States of America
| | - Ke Yang
- Peking University Health Science Center, Beijing, China
| | | | - Himanshu Negandhi
- Public Health Foundation of India, Delhi, NCR India
- Indian Institute of Public Health, Public Health Foundation of India, Plot No 47, Sector 44, Institutional Area, Gurgaon, Haryana 122 002 India
| | - Wanicha Chuenkongkaew
- Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Ahmed Al-Kabir
- Research, Training and Management (RTM) International, Dhaka, Bangladesh
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Affiliation(s)
| | | | | | - Nguyen Duy Anh
- Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam
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Canh Chuong N, Minh Duc D, Anh ND, Thi Vui L, Pham Sy Cuong L, Thi Thuy Duong D, Thi Thu Ha B. Amniocentesis test uptake for congenital defects: Decision of pregnant women in Vietnam. Health Care Women Int 2018; 39:493-504. [PMID: 29319434 DOI: 10.1080/07399332.2018.1424168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Our study aimed to identify the knowledge, attitude, and factors associated with uptake of amniocentesis test amongst pregnant women of advanced maternal age (35+ years old). A cross-sectional survey was performed on 481 participants in 2016. Women with higher educational attainment, higher income level, having a baby with congenital defects, and women with better knowledge and/or attitude about amniocentesis test were more likely to accept the test. Our study suggested the importance of counseling for women and more time should be given for them to absorb information before they make their decision to uptake the amniocentesis test.
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Affiliation(s)
- Nguyen Canh Chuong
- a Center for Prenatal Diagnosis and Testing, Hanoi Obstetrics & Gynecology Hospital , Ba Dinh District, Hanoi , Vietnam
| | - Duong Minh Duc
- b Department of Reproductive Health , Hanoi University of Public Health , Bac Tu Liem District, Hanoi , Vietnam.,c International Maternal and Child Health (IMCH), Department of Women's and Children's Health , Uppsala University , Uppsala , Sweden
| | - Nguyen Duy Anh
- d Department of Assisted Reproductive Techniques , Hanoi Obstetrics & Gynecology Hospital , Ba Dinh District, Hanoi , Vietnam
| | - Le Thi Vui
- b Department of Reproductive Health , Hanoi University of Public Health , Bac Tu Liem District, Hanoi , Vietnam
| | - Le Pham Sy Cuong
- a Center for Prenatal Diagnosis and Testing, Hanoi Obstetrics & Gynecology Hospital , Ba Dinh District, Hanoi , Vietnam
| | - Doan Thi Thuy Duong
- b Department of Reproductive Health , Hanoi University of Public Health , Bac Tu Liem District, Hanoi , Vietnam
| | - Bui Thi Thu Ha
- b Department of Reproductive Health , Hanoi University of Public Health , Bac Tu Liem District, Hanoi , Vietnam
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Ha BTT, Huong NTT, Duong DTT. Prenatal diagnostic services in three regional centers in Vietnam. Int J Public Health 2016; 62:27-33. [PMID: 27628489 DOI: 10.1007/s00038-016-0897-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 08/16/2016] [Accepted: 09/03/2016] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES This study aims to give information on the prenatal diagnostic (PND) services provided in three major regional PND centers in Vietnam. METHODS This cross-sectional study was conducted in early 2014. An inventory of services, human resources, facilities, and equipment and in-depth interviews were carried out. RESULTS Three regional PND centers were set up between 2007 and 2014, and technical guidelines on PND tests were released by the Ministry of Health in 2010. There were a variety of services among centers, and the number of services provided by the three PND centers was far below the target set by the Ministry of Health. There is still limited capacity of human resources, facilities, and equipment in PND centers. Different measures were implemented by hospitals to improve capacity, including counseling. CONCLUSIONS Despite a late start, with government support, PND services in Vietnam have developed quickly. However, to reach the objectives of 15 % of women receiving PND services by 2015 and 50 % by 2020, several actions should be taken to expand the service coverage and capacity of centers.
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Rabbani F, Shipton L, White F, Nuwayhid I, London L, Ghaffar A, Ha BTT, Tomson G, Rimal R, Islam A, Takian A, Wong S, Zaidi S, Khan K, Karmaliani R, Abbasi IN, Abbas F. Schools of public health in low and middle-income countries: an imperative investment for improving the health of populations? BMC Public Health 2016; 16:941. [PMID: 27604901 PMCID: PMC5015344 DOI: 10.1186/s12889-016-3616-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 08/30/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Public health has multicultural origins. By the close of the nineteenth century, Schools of Public Health (SPHs) began to emerge in western countries in response to major contemporary public health challenges. The Flexner Report (1910) emphasized the centrality of preventive medicine, sanitation, and public health measures in health professional education. The Alma Ata Declaration on Primary Health Care (PHC) in 1978 was a critical milestone, especially for low and middle-income countries (LMICs), conceptualizing a close working relationship between PHC and public health measures. The Commission on Social Determinants of Health (2005-2008) strengthened the case for SPHs in LMICs as key stakeholders in efforts to reduce global health inequities. This scoping review groups text into public health challenges faced by LMICs and the role of SPHs in addressing these challenges. MAIN TEXT The challenges faced by LMICs include rapid urbanization, environmental degradation, unfair terms of global trade, limited capacity for equitable growth, mass displacements associated with conflicts and natural disasters, and universal health coverage. Poor governance and externally imposed donor policies and agendas, further strain the fragile health systems of LMICs faced with epidemiological transition. Moreover barriers to education and research imposed by limited resources, political and economic instability, and unbalanced partnerships additionally aggravate the crisis. To address these contextual challenges effectively, SPHs are offering broad based health professional education, conducting multidisciplinary population based research and fostering collaborative partnerships. SPHs are also looked upon as the key drivers to achieve sustainable development goals (SDGs). CONCLUSION SPHs in LMICs can contribute to overcoming several public health challenges being faced by LMICs, including achieving SDGs. Most importantly they can develop cadres of competent and well-motivated public health professionals: educators, practitioners and researchers who ask questions that address fundamental health determinants, seek solutions as agents of change within their mandates, provide specific services and serve as advocates for multilevel partnerships. Funding support, human resources, and agency are unfortunately often limited or curtailed in LMICs, and this requires constructive collaboration between LMICs and counterpart institutions from high income countries.
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Affiliation(s)
- Fauziah Rabbani
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Leah Shipton
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Franklin White
- Pacific Health & Development Sciences Inc., Victoria, Canada
| | - Iman Nuwayhid
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Leslie London
- Division Public Health Medicine, School of Public Health and Family Medicine University of Cape Town, Cape Town, South Africa
| | - Abdul Ghaffar
- Alliance for Health Policy and Systems Research, WHO, Geneva, Switzerland
| | - Bui Thi Thu Ha
- Hanoi School of Public Health, Giang Vo, Ba Dinh, Hanoi, Vietnam
| | - Göran Tomson
- Depts LIME & PHS, Karolinska Institutet Stockholm, Stockholm, Sweden
| | - Rajiv Rimal
- Department of Prevention and Community Health, George Washington University School of Public Health and Health Services, Washington, USA
| | - Anwar Islam
- School of Health Policy and Management, York University, Toronto, Ontario Canada
| | - Amirhossein Takian
- Department of Global Health & Sustainable Development, School of Public Health-Tehran University of Medical Sciences, Tehran, Iran
| | - Samuel Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - Shehla Zaidi
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Kausar Khan
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Rozina Karmaliani
- School of Nursing & Midwifery and Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Imran Naeem Abbasi
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Farhat Abbas
- Medical College, Aga Khan University, Karachi, Pakistan
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Abstract
Studies have shown family planning adoption is likely to be more effective for women when men are actively involved. The transtheoretical model of behavior change was used to examine men’s involvement in general contraception and intrauterine device (IUD) use by their wives. The study was carried out in rural Vietnam with 651 eligible participants. Cons of IUD use for men in precontemplation and contemplation/preparation were significantly higher than those in the action/maintenance stages, whereas the reverse was true for pros of IUD. The self-efficacy for convincing wife to have IUD in precontemplation was significantly lower than for those in higher stages. Women’s education and ages, spontaneous recall of modern contraceptive method, cons for IUD, and self-efficacy for contraception and for convincing wives to get IUD inserted (or continue use) were significant predictors of men’s readiness to accept IUD. Interventions are targeted to reduce cons and increase self-efficacy for IUD use.
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Duc DM, Bergström A, Eriksson L, Selling K, Thi Thu Ha B, Wallin L. Response process and test-retest reliability of the Context Assessment for Community Health tool in Vietnam. Glob Health Action 2016; 9:31572. [PMID: 27293124 PMCID: PMC4904068 DOI: 10.3402/gha.v9.31572] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 04/17/2016] [Accepted: 04/19/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The recently developed Context Assessment for Community Health (COACH) tool aims to measure aspects of the local healthcare context perceived to influence knowledge translation in low- and middle-income countries. The tool measures eight dimensions (organizational resources, community engagement, monitoring services for action, sources of knowledge, commitment to work, work culture, leadership, and informal payment) through 49 items. OBJECTIVE The study aimed to explore the understanding and stability of the COACH tool among health providers in Vietnam. DESIGNS To investigate the response process, think-aloud interviews were undertaken with five community health workers, six nurses and midwives, and five physicians. Identified problems were classified according to Conrad and Blair's taxonomy and grouped according to an estimation of the magnitude of the problem's effect on the response data. Further, the stability of the tool was examined using a test-retest survey among 77 respondents. The reliability was analyzed for items (intraclass correlation coefficient (ICC) and percent agreement) and dimensions (ICC and Bland-Altman plots). RESULTS In general, the think-aloud interviews revealed that the COACH tool was perceived as clear, well organized, and easy to answer. Most items were understood as intended. However, seven prominent problems in the items were identified and the content of three dimensions was perceived to be of a sensitive nature. In the test-retest survey, two-thirds of the items and seven of eight dimensions were found to have an ICC agreement ranging from moderate to substantial (0.5-0.7), demonstrating that the instrument has an acceptable level of stability. CONCLUSIONS This study provides evidence that the Vietnamese translation of the COACH tool is generally perceived to be clear and easy to understand and has acceptable stability. There is, however, a need to rephrase and add generic examples to clarify some items and to further review items with low ICC.
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Affiliation(s)
- Duong M Duc
- Faculty of Social Science - Behaviours and Health Education, Hanoi School of Public Health, Hanoi, Vietnam.,International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden;
| | - Anna Bergström
- International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Institute for Global Health, University College London, London, UK
| | - Leif Eriksson
- International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Katarina Selling
- International Maternal and Child Health, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Bui Thi Thu Ha
- Faculty of Social Science - Behaviours and Health Education, Hanoi School of Public Health, Hanoi, Vietnam
| | - Lars Wallin
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Thi Thu Ha B, Mirzoev T, Morgan R. Patient complaints in healthcare services in Vietnam's health system. SAGE Open Med 2015; 3:2050312115610127. [PMID: 26770804 PMCID: PMC4679333 DOI: 10.1177/2050312115610127] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 09/07/2015] [Indexed: 11/24/2022] Open
Abstract
Background: There is growing recognition of patient rights in health sectors around the world. Patients’ right to complain in hospitals, often visible in legislative and regulatory protocols, can be an important information source for service quality improvement and achievement of better health outcomes. However, empirical evidence on complaint processes is scarce, particularly in the developing countries. To contribute in addressing this gap, we investigated patients’ complaint handling processes and the main influences on their implementation in public hospitals in Vietnam. Methods: The study was conducted in two provinces of Vietnam. We focused specifically on the implementation of the Law on Complaints and Denunciations and the Ministry of Health regulation on resolving complaints in the health sector. The data were collected using document review and in-depth interviews with key respondents. Framework approach was used for data analysis, guided by a conceptual framework and aided by qualitative data analysis software. Results: Five steps of complaint handling were implemented, which varied in practice between the provinces. Four groups of factors influenced the procedures: (1) insufficient investment in complaint handling procedures; (2) limited monitoring of complaint processes; (3) patients’ low awareness of, and perceived lack of power to change, complaint procedures and (4) autonomization pressures on local health facilities. While the existence of complaint handling processes is evident in the health system in Vietnam, their utilization was often limited. Different factors which constrained the implementation and use of complaint regulations included health system–related issues as well as social and cultural influences. Conclusion: The study aimed to contribute to improved understanding of complaint handling processes and the key factors influencing these processes in public hospitals in Vietnam. Specific policy implications for improving these processes were proposed, which include improving accountability of service providers and better utilization of information on complaints.
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Affiliation(s)
| | - Tolib Mirzoev
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Rosemary Morgan
- Global Public Health Unit, The University of Edinburgh, Edinburgh, UK
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Ha BTT, Mirzoev T, Mukhopadhyay M. Shaping the Health Policy Agenda: The Case of Safe Motherhood Policy in Vietnam. Int J Health Policy Manag 2015; 4:741-6. [PMID: 26673334 DOI: 10.15171/ijhpm.2015.153] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 08/13/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Maternal health remains a central policy concern in Vietnam. With a commitment to achieving the Millennium Development Goal (MDG) 5 target of maternal mortality rate (MMR) of 70/100 000 by 2015, the Ministry of Health (MoH) issued the National Plan for Safe Motherhood (NPSM) 2003-2010. In 2008, reproductive health, including safe motherhood (SM) became a national health target program with annual government funding. METHODS A case study of how SM emerged as a political priority in Vietnam over the period 2001-2008, drawing on Kingdon's theory of agenda-setting was conducted. A mixed method was adopted for this study of the NPSM. RESULTS Three related streams contributed to SM priority in Vietnam: (1) the problem of high MMR was officially recognized from high-quality research, (2) the strong roles of policy champion from MoH in advocating for the needs to reducing MMR as well as support from government and donors, and (3) the national and international events, providing favorable context for this issue to emerge on policy agenda. CONCLUSION This paper draws on the theory of agenda-setting to analyze the Vietnam experience and to develop guidance for SM a political priority in other high maternal mortality communities.
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Affiliation(s)
| | - Tolib Mirzoev
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK
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Martineau T, Mirzoev T, Pearson S, Ha BTT, Xu Q, Ramani KV, Liu X. Coherence between health policy and human resource strategy: lessons from maternal health in Vietnam, India and China. Health Policy Plan 2013; 30:111-20. [PMID: 24374717 DOI: 10.1093/heapol/czt102] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The failure to meet health goals such as the Millennium Development Goals (MDG) is partly due to the lack of appropriate resources for the effective implementation of health policies. The lack of coherence between the health policies and human resource (HR) strategy is one of the major causes. This article explores the relationship and the degree of coherence between health policy--in this case maternal health policy--processes and HR strategy in Vietnam, China and India in the period 2005-09. Four maternal health policy case studies were explored [skilled birth attendance (SBA), adolescent and sexual reproductive health, domestic violence and medical termination of pregnancy] across three countries through interviews with key respondents, document analysis and stakeholder meetings. Analysis for coherence between health policy and HR strategy was informed by a typology covering 'separation', 'fit' and 'dialogue'. Regarding coherence we found examples of complete separation between health policy and HR strategy, a good fit with the SBA policy though modified through 'dialogue' in Vietnam, and in one case a good fit between policy and strategy was developed through successive evaluations. Three key influences on coherence between health policy and HR strategy emerge from our findings: (1) health as the lead sector, (2) the nature of the policy instrument and (3) the presence of 'HR champions'. Finally, we present a simple algorithm to ensure that appropriate HR related actors are involved; HR is considered at the policy development stage with the option of modifying the policy if it cannot be adequately supported by the available health workforce; and ensuring that HR strategies are monitored to ensure continued coherence with the health policy. This approach will ensure that the health workforce contributes more effectively to meeting the MDGs and future health goals.
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Affiliation(s)
- Tim Martineau
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, UK Nuffield Centre for International Health and Development, University of Leeds, LS2 9LJ, UK Hanoi School of Public Health, 138 Giang vo - Ba Dinh,Vietnam School of Public Health, Fudan University, Shanghai 200032, P.R. China Public Systems Group, Centre for Management of Health Services, Indian Institute of Management, Ahmedabad 380 015, Gujarat, India and China Centre for Health Development Studies, Peking University, Beijing 100191, P.R. China
| | - Tolib Mirzoev
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, UK Nuffield Centre for International Health and Development, University of Leeds, LS2 9LJ, UK Hanoi School of Public Health, 138 Giang vo - Ba Dinh,Vietnam School of Public Health, Fudan University, Shanghai 200032, P.R. China Public Systems Group, Centre for Management of Health Services, Indian Institute of Management, Ahmedabad 380 015, Gujarat, India and China Centre for Health Development Studies, Peking University, Beijing 100191, P.R. China
| | - Stephen Pearson
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, UK Nuffield Centre for International Health and Development, University of Leeds, LS2 9LJ, UK Hanoi School of Public Health, 138 Giang vo - Ba Dinh,Vietnam School of Public Health, Fudan University, Shanghai 200032, P.R. China Public Systems Group, Centre for Management of Health Services, Indian Institute of Management, Ahmedabad 380 015, Gujarat, India and China Centre for Health Development Studies, Peking University, Beijing 100191, P.R. China
| | - Bui Thi Thu Ha
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, UK Nuffield Centre for International Health and Development, University of Leeds, LS2 9LJ, UK Hanoi School of Public Health, 138 Giang vo - Ba Dinh,Vietnam School of Public Health, Fudan University, Shanghai 200032, P.R. China Public Systems Group, Centre for Management of Health Services, Indian Institute of Management, Ahmedabad 380 015, Gujarat, India and China Centre for Health Development Studies, Peking University, Beijing 100191, P.R. China
| | - Qian Xu
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, UK Nuffield Centre for International Health and Development, University of Leeds, LS2 9LJ, UK Hanoi School of Public Health, 138 Giang vo - Ba Dinh,Vietnam School of Public Health, Fudan University, Shanghai 200032, P.R. China Public Systems Group, Centre for Management of Health Services, Indian Institute of Management, Ahmedabad 380 015, Gujarat, India and China Centre for Health Development Studies, Peking University, Beijing 100191, P.R. China
| | - K V Ramani
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, UK Nuffield Centre for International Health and Development, University of Leeds, LS2 9LJ, UK Hanoi School of Public Health, 138 Giang vo - Ba Dinh,Vietnam School of Public Health, Fudan University, Shanghai 200032, P.R. China Public Systems Group, Centre for Management of Health Services, Indian Institute of Management, Ahmedabad 380 015, Gujarat, India and China Centre for Health Development Studies, Peking University, Beijing 100191, P.R. China
| | - Xiaoyun Liu
- Department of International Public Health, Liverpool School of Tropical Medicine, L3 5QA, UK Nuffield Centre for International Health and Development, University of Leeds, LS2 9LJ, UK Hanoi School of Public Health, 138 Giang vo - Ba Dinh,Vietnam School of Public Health, Fudan University, Shanghai 200032, P.R. China Public Systems Group, Centre for Management of Health Services, Indian Institute of Management, Ahmedabad 380 015, Gujarat, India and China Centre for Health Development Studies, Peking University, Beijing 100191, P.R. China
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Witter S, Thi Thu Ha B, Shengalia B, Vujicic M. Understanding the 'four directions of travel': qualitative research into the factors affecting recruitment and retention of doctors in rural Vietnam. Hum Resour Health 2011; 9:20. [PMID: 21849045 PMCID: PMC3169448 DOI: 10.1186/1478-4491-9-20] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Accepted: 08/17/2011] [Indexed: 05/10/2023]
Abstract
BACKGROUND Motivation and retention of health workers, particularly in rural areas, is a question of considerable interest to policy-makers internationally. Many countries, including Vietnam, are debating the right mix of interventions to motivate doctors in particular to work in remote areas. The objective of this study was to understand the dynamics of the health labour market in Vietnam, and what might encourage doctors to accept posts and remain in-post in rural areas. METHODS This study forms part of a labour market survey which was conducted in Vietnam in November 2009 to February 2010. The study had three stages. This article describes the findings of the first stage - the qualitative research and literature review, which fed into the design of a structured survey (second stage) and contingent valuation (third stage). For the qualitative research, three tools were used - key informant interviews at national and provincial level (6 respondents); in-depth interviews of doctors at district and commune levels (11 respondents); and focus group discussions with medical students (15 participants). RESULTS The study reports on the perception of the problem by national level stakeholders; the motivation for joining the profession by doctors; their views on the different factors affecting their willingness to work in rural areas (including different income streams, working conditions, workload, equipment, support and supervision, relationships with colleagues, career development, training, and living conditions). It presents findings on their overall satisfaction, their ranking of different attributes, and willingness to accept different kinds of work. Finally, it discusses recent and possible policy interventions to address the distribution problem. CONCLUSIONS Four typical 'directions of travel' are identified for Vietnamese doctors - from lower to higher levels of the system, from rural to urban areas, from preventive to curative health and from public to private practice. Substantial differences in income from formal and informal sources all reinforce these preferences. While non-financial attributes are also important for Vietnamese doctors, the scale of the difference of opportunities presents a considerable policy challenge. Significant salary increases for doctors in hard-to-staff areas are likely to have some impact. However, addressing the differentials is likely to require broader market reforms and regulatory measures.
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Affiliation(s)
- Sophie Witter
- Health Portfolio, Oxford Policy Management, 6 St Aldate's Courtyard, 38 St Aldates, Oxford OX1 1BN, United Kingdom of Great Britain and Northern Ireland
| | - Bui Thi Thu Ha
- Hanoi School of Public Health, 138 Giang Vo, Ba Dinh, Hanoi, Vietnam
| | - Bakhuti Shengalia
- Human Development Network, The World Bank, 1818 H St NW Washington, 20433 USA
| | - Marko Vujicic
- Human Development Network, The World Bank, 1818 H St NW Washington, 20433 USA
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Ha BTT, Jayasuriya R, Owen N. Increasing male involvement in family planning decision making: trial of a social-cognitive intervention in rural Vietnam. Health Educ Res 2005; 20:548-56. [PMID: 15687102 DOI: 10.1093/her/cyh013] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
We tested a social-cognitive intervention to influence contraceptive practices among men living in rural communes in Vietnam. It was predicted that participants who received a stage-targeted program based on the Transtheoretical Model (TTM) would report positive movement in their stage of motivational readiness for their wife to use an intrauterine device (IUD) compared to those in a control condition. A quasi-experimental design was used, where the primary unit for allocation was villages. Villages were allocated randomly to a control condition or to two rounds of intervention with stage-targeted letters and interpersonal counseling. There were 651 eligible married men in the 12 villages chosen. A significant positive movement in men's stage of readiness for IUD use by their wife occurred in the intervention group, with a decrease in the proportions in the precontemplation stage from 28.6 to 20.2% and an increase in action/maintenance from 59.8 to 74.4% (P < 0.05). There were no significant changes in the control group. Compared to the control group, the intervention group showed higher pros, lower cons and higher self-efficacy for IUD use by their wife as a contraceptive method (P < 0.05). Interventions based on social-cognitive theory can increase men's involvement in IUD use in rural Vietnam and should assist in reducing future rates of unwanted pregnancy.
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Ha BTT, Jayasuriya R, Owen N. Male involvement in family planning in rural Vietnam: an application of the Transtheoretical Model. Health Educ Res 2003; 18:171-180. [PMID: 12729176 DOI: 10.1093/her/18.2.171] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Various studies have shown that family planning adoption is likely to be more effective for women when men are actively involved. Male involvement in family planning is an instance of behavior change. The Transtheoretical Model of behavior change was used to examine men's involvement in general contraception and intrauterine device (IUD) use by their wives. The study tested whether the constructs of the model, decisional balance and self-efficacy, are sensitive to differences in stages of change. Reliable scales to test decisional balance and self-efficacy were developed. The study was carried out in rural Vietnam with 201 eligible participants. The staging algorithm identified that 25.8% of men were in the precontemplation stage, 10.5% of men were in the contemplation/preparation stages and 63.7% of men were in the action/maintenance stages. Disadvantages of IUD use for men in precontemplation were significantly higher than those in the action/maintenance stages, while the reverse was true for self-efficacy for convincing their wives to use an IUD. Interventions that are targeted to stage of change, that seek to reduce cons and that increase self-efficacy have the potential to influence male involvement in IUD adoption by their wives.
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Affiliation(s)
- Bui Thi Thu Ha
- Hanoi School of Public Health, 138 Giang vo, Badinh, Hanoi, Vietnam.
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