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DodaLab: an urban health and demographic surveillance site, the first three years in Hanoi, Vietnam.
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.
Nordic Council of Ministers, Nordic School of Public Health NHV. Family Medicine Department, Hanoi Medical University, Hanoi, Vietnam.
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2012 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 8, 765-72 p.Article in journal (Refereed) Published
Abstract [en]

RATIONALE: Health and demographic surveillance sites (HDSSs) are important sources for health planning and policy in many low and middle income countries. Almost all HDSSs are in rural settings. The article aims to present the experiences and some concrete results for the first three years of operation of an urban HDSS in Hanoi, Vietnam, and discuss advantages and disadvantages of conducting health studies in HDSSs.

DESIGN, POPULATION AND SAMPLE SIZE: The DodaLab urban HDSS was established in 2007 in three communes at different economic levels in Dong Da district, Hanoi, Vietnam. Demographic, social and economic information about 10,000 households and their 37,000 persons was obtained through household interviews. Quarterly follow-up was initiated to provide information about vital events, birth, death and migration. A new household survey was undertaken in 2009. The existing rural HDSS FilaBavi, started in 1999, with 12,000 households and 52,000 persons, was used as the blueprint.

CONCLUSIONS: It was possible to establish and run an urban HDSS with experiences from the rural site. The urban and rural contexts are different and demographically, economically and socially complex, but the use of HDSSs can facilitate research beyond very simplified models for comparisons. General statements about external validity of results from the HDSS cannot be made. This issue has to be considered specifically in every situation as an integral part of the research so that the results can be made useful outside the researched HDSS and in performing relevant comparisons.

Place, publisher, year, edition, pages
2012. Vol. 40, no 8, 765-72 p.
Keyword [en]
DodaLab, urban health and demographic surveillance site, validity applicability
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:norden:org:diva-3600DOI: 10.1177/1403494812464444PubMedID: 23117211OAI: oai:DiVA.org:norden-3600DiVA: diva2:781951
Available from: 2015-01-19 Created: 2015-01-19 Last updated: 2015-01-22Bibliographically 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. 68 p.
Series
NHV Reports and Doctor of Public Health-Theses, ISSN 0283-1961 ; NHV Report 2012:7
Keyword
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
Supervisors
Available from: 2015-01-22 Created: 2015-01-22 Last updated: 2015-01-22Bibliographically approved

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