An important factor for monitoring health transition is the collection of valid and reliable population data over time. 1 However, given the weaknesses of the national health information systems in low-and middle-income countries such as Vietnam, especially in the area of generating high-quality population-based information, health and demographic surveillance systems (HDSSs) have been shown to generate high-quality population-based data and scientific evidence on the levels, patterns, and trends in health and health care transitions in a country.
BackgroundThe National Hospital of Pediatrics in Vietnam performed >200 exchange transfusions annually (2006–08), often on infants presenting encephalopathic from lower-level hospitals. As factors delaying care-seeking are not known, we sought to study care practices and traditional beliefs relating to neonatal jaundice in northern Vietnam.MethodsWe conducted a prospective, cross-sectional, population-based, descriptive study from November 2008 through February 2010. We prospectively identified mothers of newborns through an on-going regional cohort study. Trained research assistants administered a 78-item questionnaire to mothers during home visits 14–28 days after birth except those we could not contact or whose babies remained hospitalized at 28 days.ResultsWe enrolled 979 mothers; 99% delivered at a health facility. Infants were discharged at a median age of 1.35 days. Only 11% received jaundice education; only 27% thought jaundice could be harmful. During the first week, 77% of newborns were kept in dark rooms. Only 2.5% had routine follow-up before 14 days. Among 118 mothers who were worried by their infant’s jaundice but did not seek care, 40% held non-medical beliefs about its cause or used traditional therapies instead of seeking care. Phototherapy was uncommon: 6 (0.6%) were treated before discharge and 3 (0.3%) on readmission. However, there were no exchange transfusions, kernicterus cases, or deaths.ConclusionsEarly discharge without follow-up, low maternal knowledge, cultural practices, and use of traditional treatments may limit or delay detection or care-seeking for jaundice. However, in spite of the high prevalence of these practices and the low frequency of treatment, no bad outcomes were seen in this study of nearly 1,000 newborns.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2431-14-264) contains supplementary material, which is available to authorized users.
Recently, total assets have become a popular method to capture socioeconomic status (SES) for health research/intervention done in developing countries. Although, this method is suitable for areas in a rural setting, there are 2 major issues in applying this method: (a) which durable assets/infrastructure or housing characteristics truly reflect the family SES and (b) how to aggregate different variables to get a derived index of SES and produce a range of critical points differentiating socioeconomic levels. This study aims to validate the use of total asset as proxy for SES by addressing these issues. Results indicated that (a) variables reflecting family SES in rural setting area include variables capturing access to utilities and infrastructure, housing characteristics, and durable asset ownership; (b) principal component analysis is a suitable method to construct a derived index from multiple variables; and (c) the derived index is a valid indicator for SES in rural setting area.
In this pilot study, home-use icterometry may help improve parental detection of jaundice in rural Vietnam. However, larger studies are necessary to determine the changes in recognition, care seeking and treatment.
This study aimed to explore the association of demographic and socioeconomic characteristics and imbalanced sex ratio at birth (SRB) in Chi Linh district, Hai Duong. The data were collected from a longitudinal study using a community-based periodic, referred as Chi Linh Health and Demographic Surveillance System (CHILILAB HDSS) during 2004 to 2013. A total of 7568 children were analyzed. Results showed that SRB in Chi Linh dramatically increased to the imbalanced sex ratio (114.6 boys to 100 girls) by 2013. SRB was associated with birth order and sex of preceding siblings. SRB was extremely high among families without any sons (136/100). SRB was highest among families having third or more children (175/100). Imbalanced SRB was more likely to occur among women working in small business/homemakers and others, women who attained high education level, and women in wealthy households. We suggested further efforts to tackle imbalanced SRB in periurban areas in Vietnam.
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