Urban-rural disparities in acceptance of human papillomavirus vaccination among women in Can Tho, Vietnam

Background

In Vietnam, cervical cancer is a significant public health concern for women. Unfortunately, despite the availability of the HPV vaccine, low vaccination rates persist.

Objectives

This study investigates the discrepancy between urban and rural areas in the willingness to receive HPV vaccination with or without fees.

Methods

A cross-sectional study was conducted on a sample of 648 women aged between 15 and 49, living in two urban and two rural Vietnamese districts of Can Tho, between May and December 2021.

Results

The overall vaccination rate was 4%, with urban women having a higher rate of 4.9% compared to rural women at 3.1%. Among unvaccinated women, those from rural areas expressed a significantly higher desire to receive the free vaccine (91.4%) than urban women (84.4%). However, the intention to vaccinate declined when rural women and urban women were advised to pay the cost (63.4% and 57.1%, respectively). A strong correlation was found between a positive attitude and intention for vaccination, irrespective of its price or free availability. Education and access to information about the HPV vaccine were also identified as the most significant factors influencing the intention to vaccination among urban and rural women.

Conclusion

The low HPV vaccination rates among women aged 15-49 living in both urban and rural regions of Vietnam are a notable public health concern. These outcomes emphasize the critical need for effective programs of vaccine laterization, as an introduction to the offer of affordable and accessible HPV vaccines for women in Can Tho, Vietnam.

Using the Stage-Based Approaches to Predict Breast Self-Examination Among Rural Vietnamese Women

A stages-of-change approach would be helpful to understand cancer screening behaviors. This study aimed to identify the compliance and determinants of breast self-examination (BSE) based on transtheoretical model (TTM) and health belief model (HBM). A cross-sectional study was conducted with 296 rural Vietnamese women using a self-administered questionnaire consisting of Champion's HBM scales, breast cancer knowledge (BCK), integrated connection to neighborhood storytelling networks (ICSN), and TTM stages of BSE. A generalized ordered logistic regression was conducted to identify factors associated with TTM stages of BSE. About 61% of women did not currently perform BSE. Perceived benefit was significant in all stages changes. When changing to the action stage, perceived benefits, self-efficacy, and BCK were significant. When changing to the maintenance stage, perceived susceptibility, benefits, self-efficacy, and ICSN were significant. Determinants influencing BSE behavior were different in each TTM stage, indicating that educational programs should be introduced with stage-matched strategies to increase BSE.

Perception of Climate Risk among Rural Farmers in Vietnam: Consistency within Households and with the Empirical Record

Rural farmers in Vietnamese communes perceive climate risk and potential impacts on livelihood within a complex context that may influence individual and household decisions. In a primary survey of 1,145 residents of the Thach Ha district of Ha Tinh province, we gathered data regarding perception about stability in climate, potential risks to livelihood, demographic characteristics, orientation toward risk, and interest in expanding economic activity. Temporal analysis of meteorological and economic indicator data forms an empirical basis for comparison with human perception. We ask the basic question: Are rural farmers' perceptions of climate consistent with the historical record and reproducible within households? We find that respondents do perceive climate anomalies, with some anchoring on recent extreme events as revealed by climate observational data, and further that spouses disproportionately share perceptions relative to randomly simulated pairings. To put climate-related risk perception in a larger context, we examine patterns across a range of risks to livelihood faced by farmers (livestock disease, pests, markets, health), using dimension reduction techniques. We find that our respondents distinguish among potential causes of low economic productivity, with substantial emphasis on climate-related impacts. They do not express uniform concern across risks, but rather average patterns reveal common modes and distinguish climate concern. Still, among those expressing concern about climate-related risks to livelihood we do not find an association with expressed intention to pursue changes in economic activity as a risk management response.

Handwashing among schoolchildren in an ethnically diverse population in northern rural Vietnam

Background

Handwashing with soap (HWWS) is a simple and effective measure to prevent transmission of fecal–oral disease and other infectious diseases in school-age children. To promote the behavior, we need to understand their HWWS compliance. The aim of this article is to describe handwashing behavior and HWWS compliance and to identify associated factors among schoolchildren in the multiethnic rural area of northern Vietnam.

Methods

The study was conducted in six primary and secondary schools and in the homes of four ethnic villages in northern Vietnam. Quantitative methods included face-to-face interviews with, and demonstration of handwashing protocol to, 319 schoolchildren in first, fourth, and seventh grades. Qualitative methods included structured observations at six schools and 20 homes comprising 24 children. The dependent variable was the self-reported HWWS behavior (yes/no). The independent variables included grade, school type, gender, ethnicity group, owning home latrine, and household assets. Logistic regression modelling was performed to examine associations between HWWS behavior and demographic factors.

Results

Among the 319 schoolchildren interviewed, 66% reported HWWS. Through the demonstration protocol, only 10 out of 319 schoolchildren, performed HWWS satisfactorily. The percentage of students who washed their hands at recommended times (30–60 sec) was 58%. This proportion increased by grade (from 34% among grade 1 to 67% among grade 7; p<0.05). Correlates of self-reported HWWS were more common in higher grades [grade 4 vs. grade 1: odds ratio (OR)=4.14 (2.00–8.56), grade 7 vs. grade 1: OR=7.76 (3.67–16.4)] and less common in ethnic minority groups [Xa Phó vs. Kinh-Tay: OR=0.28 (0.11–0.70)]. All 20 homes of schoolchildren visited had soap and water but none of the six schools had soap for handwashing.

Conclusions

This article describes poor compliance of schoolchildren with HWWS in a multiethnic population in Vietnam. Education on handwashing needs to be prioritized among multiethnic children at school.