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Technology Preference in Choices of Delivery Care Utilization from User Perspective: A Community Study in Vietnam
Nordic Council of Ministers, Nordic School of Public Health NHV. Family Medicine Department, Hanoi Medical University (HMU), Hanoi, Vietnam.
Nordic Council of Ministers, Nordic School of Public Health NHV.
The National Hospital for Pediatrics, Hanoi, Vietnam.
Family Medicine Department, Hanoi Medical University (HMU), Hanoi, Vietnam.
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2013 (English)In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 1, no 1, p. 10-17-Article in journal (Refereed) Published
Abstract [en]

Choices for delivery care are made based on the available resources and influence health outcomes of women and their children. The aim of the paper is to study utilization and preference for delivery care and related factors in one urban and one rural area of northern Vietnam. Two cohorts of pregnant women were carried out in DodaLab and FilaBavi Health and Demographic Surveillance Sites (HDSS) in Hanoi, Vietnam from April 2008 to December 2009. Together, 2515 pregnant women were identified and followed until delivery through quarterly household interviews using structured questionnaires. Almost all women delivered at health care facilities. Most of the rural women gave birth at primary health care facilities (88.5%) while urban women primarily used secondary and tertiary hospitals (93.6%). Caesarean section (CS) was used for 38.5% of births in the urban area and 12.4% in the rural. Giving birth in hospitals and CS were more common among highly educated women, employed women, women living in households or communities with good economic conditions, and women expected to give birth to a son. Technology preference in delivery care was associated with better socioeconomic conditions and expecting a boy. Improving the quality and reputation of primary health care facilities, informing women about CS risks and monitoring indications of CS are important policy issues.

Place, publisher, year, edition, pages
2013. Vol. 1, no 1, p. 10-17-
Keywords [en]
Technology preference, delivery care utilization, hospital delivery, caesarean section, rural and urban, Vietnam
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:norden:org:diva-3599DOI: DOI: 10.12691/ajphr-1-1-2OAI: oai:DiVA.org:norden-3599DiVA, id: diva2:781911
Available from: 2015-01-19 Created: 2015-01-19 Last updated: 2017-12-05Bibliographically approved
In thesis
1. ANTENATAL AND DELIVERY CARE UTILIZATIONIN URBAN AND RURAL CONTEXTS IN VIETNAM: A study in two health and demographic surveillance sites
Open this publication in new window or tab >>ANTENATAL AND DELIVERY CARE UTILIZATIONIN URBAN AND RURAL CONTEXTS IN VIETNAM: A study in two health and demographic surveillance sites
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background. Pregnant women need adequate antenatal care (ANC) and delivery care fortheir own health and for healthy children. Availability of such care has increased in Vietnam but maternal mortality remains high and variable between population groups.

Aims. The general aim of this thesis is to describe and discuss the use of antenatal and delivery care in relation to demographic and socio-economic status and other factors in two health and demographic surveillance sites (HDSS), one rural and one urban. One specificaim of the thesis is to present experiences of running the urban HDSS.

Methods. Between April 2008 and December 2009, 2,757 pregnant women were identifiedin the sites. Basic information was obtained from 2,515 of these. The use of ANC was followed to delivery for 2,132. Three indicators were used. ANC was considered overall adequate if the women started ANC within the first trimester, used three or more visits and received all the six recommended core services at least once during pregnancy. Delivery care was studied for all the 2,515 women.

Main Findings. Nearly all 2,132 participants used ANC. The mean numbers of visits were 4.4 and 7.7 in the rural and urban areas. Mainly due to less than recommended use of core ANC services, overall ANC adequacy was low in some groups, particularly in the rural area (15.2%). The main risk factors for not having adequate ANC were (i) living in a rural area,(ii) low level of education, (iii) low economic status and (iv) exclusive use of private ANC providers. Rural women accessed ANC mainly at commune health centers and private clinics. Urban women accessed ANC and gave birth at central hospitals and provincial hospitals. Caesarean section (CS) was common among urban women (38.5%). Good socioeconomic condition and male babies were associated with delivery in hospitals and CS births. Almost all women had one or more antenatal ultrasound examination, the mean was about 4.5. Rural women spent 3.0% and 19.0% of the reported annual household income percapita for ANC and delivery care, respectively, compared to 6.1% and 20.6% for urbanwomen. The relative economic burden was heaviest for poor rural women.

Conclusion. The coverage of ANC was high in both contexts but with large variations between population subgroups. The major concerns are that poor women in the rural area received incomplete services according to recommendations and that many women, particularly the well-off, in the urban area appeared to overuse technology, ultrasound scanning, delivery in highlevel health care and CS delivery. National maternal healthcare programs should focus on improving ANC service content in rural areas and controlling technology preference in urban. The pregnant women with relatives and friends as well as ANC providers share the responsibility for a positive development. All parties involved must be targeted to improve knowledge, attitudes and practices.

Place, publisher, year, edition, pages
Göteborg: Nordic School of Public Health NHV Göteborg, Sweden, 2012. p. 68
Series
NHV Reports and Doctor of Public Health-Theses, ISSN 0283-1961 ; NHV Report 2012:7
Keywords
Antenatal care, delivery care, utilization, adequacy, hospital delivery, caesarean section, health and demographic surveillance site, rural and urban, Vietnam.
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:norden:org:diva-3612 (URN)978-91-86739-41-6 (ISBN)
Public defence
2012-09-10, Nordic School of Public Health NHV, Box 12133, 402 42 Göteborg, Sweden, 13:00 (English)
Opponent
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Available from: 2015-01-22 Created: 2015-01-22 Last updated: 2015-01-22Bibliographically approved

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