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Maternal health care utilization in Viet Nam: increasing ethnic inequity
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, International Maternal and Child Health (IMCH). (Internationell barnhälsa och nutrition/Persson)
World Health Organization, Hanoi, Viet Nam.
United Nations Children’s Fund, Hanoi, Viet Nam.
United Nations Children’s Fund, Hanoi, Viet Nam.
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2013 (English)In: Bulletin of the World Health Organization, ISSN 0042-9686, E-ISSN 1564-0604, Vol. 91, no 4, 254-261 p.Article in journal (Refereed) Published
Abstract [en]

Objective

To investigate changes that took place between 2006 and 2010 in the inequity gap for antenatal care attendance and delivery at health facilities among women in Viet Nam.

Methods

Demographic, socioeconomic and obstetric data for women aged 15–49 years were extracted from Viet Nam’s Multiple Indicator Cluster Survey for 2006 (MICS3) and 2010–2011 (MICS4). Multivariate logistic regression was performed to determine if antenatal care attendance and place of delivery were significantly associated with maternal education, maternal ethnicity (Kinh/Hoa versus other), household wealth and place of residence (urban versus rural). These independent variables correspond to the analytical framework of the Commission on Social Determinants of Health.

Findings

Large discrepancies between urban and rural populations were found in both MICS3 and MICS4. Although antenatal care attendance and health facility delivery rates improved substantially between surveys (from 86.3 to 92.1% and from 76.2 to 89.7%, respectively), inequities increased, especially along ethnic lines. The risk of not giving birth in a health facility increased significantly among ethnic minority women living in rural areas. In 2006 this risk was nearly five times higher than among women of Kinh/Hoa (majority) ethnicity (odds ratio, OR: 4.67; 95% confidence interval, CI: 2.94–7.43); in 2010–2011 it had become nearly 20 times higher (OR: 18.8; 95% CI: 8.96–39.2).

Conclusion

Inequity in maternal health care utilization has increased progressively in Viet Nam, primarily along ethnic lines, and vulnerable groups in the country are at risk of being left behind. Health-care decision-makers should target these groups through affirmative action and culturally sensitive interventions.

Place, publisher, year, edition, pages
2013. Vol. 91, no 4, 254-261 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-198183DOI: 10.2471/BLT.12.112425ISI: 000317889800006OAI: oai:DiVA.org:uu-198183DiVA: diva2:615385
Available from: 2013-04-10 Created: 2013-04-10 Last updated: 2017-12-06Bibliographically approved

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