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Breastfeeding practices in urban and rural Vietnam.
Nordic Council of Ministers, Nordic School of Public Health NHV. Research Institute for Child Health, National Hospital of Pediatrics, 18/879 La Thanh road, Hanoi, Dong Da district, Vietnam..
Nordic Council of Ministers, Nordic School of Public Health NHV.
Nordic Council of Ministers, Nordic School of Public Health NHV. Family Medicine Department, Hanoi Medical University, Vietnam.
Nordic Council of Ministers, Nordic School of Public Health NHV.
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2012 (English)In: BMC public health, ISSN 1471-2458, Vol. 12, 964- p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The aim of this study was to describe and compare breastfeeding practices in rural and urban areas of Vietnam and to study associations with possibly influencing person and household factors. This type of study has not been conducted in Vietnam before.

METHODS: Totally 2,690 children, born from 1st March 2008 to 30th June 2010 in one rural and one urban Health and Demographic Surveillance Site, were followed from birth to the age of 12 months. Information about demography, economy and education for persons and households was obtained from household surveys. Standard statistical methods including survival and regression analyses were used.

RESULTS: Initiation of breastfeeding during the first hour of life was more frequent in the urban area compared to the rural (boys 40% vs. 35%, girls 49% vs. 40%). High birth weight and living in households with large number of assets significantly increased the probability for early initiation of breastfeeding. Exclusive breastfeeding at three months of age was more commonly reported in the rural than in the urban area (boys 58% vs. 46%, girls 65% vs. 53%). The duration of exclusive breastfeeding as well as of any breastfeeding was longer in the rural area than in the urban area (medians for boys 97 days vs. 81 days, for girls 102 days vs. 91 days). The percentages of children with exclusive breastfeeding lasting at least 6 months, as recommended by WHO, were low in both areas. The duration of exclusive breastfeeding was significantly shorter for mothers with three or more antenatal care visits or Caesarean section in both areas. High education level of mothers was associated with longer duration of exclusive breastfeeding in the rural area. No significant associations were found between duration of exclusive breastfeeding and mother's age, household economy indicators or household size.

CONCLUSION: Intervention programs with the aim to promote breastfeeding are needed. Mothers should particularly be informed about the importance of starting breastfeeding early and to prolong exclusive breastfeeding. In order to reach the WHO recommendation of six months exclusive breastfeeding, we propose an extended maternity leave legislation to at least six months.

Place, publisher, year, edition, pages
2012. Vol. 12, 964- p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:norden:org:diva-3597DOI: 10.1186/1471-2458-12-964PubMedID: 23140543OAI: oai:DiVA.org:norden-3597DiVA: diva2:781428
Available from: 2015-01-16 Created: 2015-01-16 Last updated: 2015-01-20Bibliographically approved
In thesis
1. Birth weight and growth during the first two years of life: a study in urban and rural Vietnam
Open this publication in new window or tab >>Birth weight and growth during the first two years of life: a study in urban and rural Vietnam
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Differences in health and living conditions between urban and rural settings can be seen as an important example of gaps between population groups. Birth weight and child growth are important predictors for the future health of a person and at aggregate level, for the public health of a population.The general aim of this thesis is to describe and discuss birth weight, physical growth and breastfeeding of children, as well as associated factors, from birth to 24 months of age in urban and rural areas of Vietnam, thus contributing to the evidence base for health strategy and policy.

Methods: Two Health and Demographic Surveillance Sites in Hanoi were used; urban Dodalab and FilaBavi in the rural part. To study rural birth weight 1999 to 2010 information was obtained for 10,114 newborn in FilaBavi. To study urban rural growth disparities 2008-2010, 1,466 children were followed for two years after birth with measurements of weight and length. A study of breastfeeding included 2,572 mothers followed for one year after delivery. Background information about households and mothers was taken from routine surveys in the two sites.

Results: The mean birth weight in FilaBavi remained stable at about 3,100 grams, over the 12 years studied despite rapid economic and technological development. At the individual level we found birth weight to be associated with household economy and the education of mothers. In the urban rural comparison, the mean birth weight for urban boys and girls were 3,298 and 3,203 g as compared with 3,105 and 3,057 g for the rural infants. Children in the urban area grew faster than those in the rural area. There were markedly higher frequencies of stunting in the rural area compared with the urban. The initiation of breastfeeding during the first hour of life was more frequent in the urban area. Exclusive breastfeeding during the first three months of age was more commonly reported in the rural than in the urban area. Both birth weight and child growth were statistically significantly and positively associated with economic conditions and mother’s education.

Conclusion: The results of the studies presented in this thesis show that there are large and important differences in child birth weight, child growth and infant breastfeeding between urban and rural areas. There are also major differences between the areas with respect to education and economic resources. All predictors of child birth weight and growth discussed are directly or indirectly associated with the social and economic conditions. Globalization and urbanization means obvious risks for increasing gaps between as well as within the rural and urban areas. Large discrepancies in a society will lead to serious public health problems in all segments of the population, not only the underprivileged.

Place, publisher, year, edition, pages
Nordic School of Public Health NHV Göteborg, Sweden, 2014. 64 p.
Series
NHV Reports and Doctor of Public Health-Theses, ISSN 0283-1961 ; NHV Report 2014:1
Keyword
Key words: Birth weight, child growth, breast feeding, urban rural discrepancy, Vietnam
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:norden:org:diva-3607 (URN)978-91-86739-65-2 (ISBN)
Public defence
2014-03-28, Nordic School of Public Health NHV, Box 12133, 40242 Göteborg, Sweden, 13:45 (English)
Opponent
Supervisors
Available from: 2015-01-20 Created: 2015-01-20 Last updated: 2015-01-22Bibliographically approved

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