Caring for children and mothers suffering from cardiac disease is highly challenging, with issues including late diagnosis as well as inadequate infrastructure and supply of drugs. We aimed to evaluate maternal outcomes among pregnant women suffering from heart disease with a live birth, and explored the risk factors for fetal growth restriction among these patients. A retrospective study was performed at the National Hospital of Obstetrics and Gynecology (Hanoi, Vietnam) over a 3-year period from 2014 to 2016. A total of 284 patients were enrolled in the study. Overall, most women were aged below 35 years and were diagnosed with heart disease before pregnancy. Of the women experiencing rheumatic heart disease, the prevalence of mitral valve regurgitation was the highest (40.14%), while the figure for aortic valve regurgitation was the lowest (4.23%). Of women with congenital heart defects, the most common defects were ventricular septal defect (VSD) and atrial septal defect (ASD) (19.37% and 16.55%, respectively), while 5.28% of mothers were diagnosed with tetralogy of Fallot and 1.76% with patent ductus arteriosus. Noted clinical presentations of the patients included palpitation (63.38%), breathlessness (23.59%), leg edema (8.45%), and chest pain (8.1%). The common complications in the study population included 16.90% of women having heart failure and 19.37% having arrhythmias. The incidence of fetal growth restriction was 9.15%. Hypertension (odds ratio (OR): 59.75, 95% confidence interval (CI): 9.1–392.17), the heart disease types (ASD (OR: 4.27, 95% CI: 1.19–15.29) and tetralogy of Fallot (OR: 6.82, 95% CI: 1.21–38.55)), and the complications (heart failure (OR: 10.34, 95% CI: 2.75–38.87) and pulmonary edema (OR: 107.16, 95% CI: 4.96–2313.93)) were observed as risk factors for intrauterine growth restriction. This study provides a cornerstone to promote further studies and to motivate people to apply evidence-based medical care for mothers with diagnosed cardiac disease in the antenatal and postnatal periods.

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There has been no report on the situation of socioeconomic inequalities in the full vaccination coverage among Vietnamese children. This study aims to assess the trends and changes in the socioeconomic inequalities in the full vaccination coverage among Vietnamese children aged 12–23 months from 2000 to 2014. Data were drawn from Multiple Indicator Cluster Surveys (2000, 2006, 2011, and 2014). Concentration index (CCI) and concentration curve (CC) were applied to quantify the degree of the socioeconomic inequalities in full immunization coverage. The prevalence of children fully receiving recommended vaccines was significantly improved during 2000–2014, yet, was still not being covered. The total CCI of full vaccination coverage gradually decreased from 2000 to 2014 (CCI: from 0.241 to 0.009). The CC increasingly became close to the equality line through the survey period, indicating the increasingly narrow gap in child full immunization amongst the poor and the rich. Vietnam witnessed a sharp decrease in socioeconomic inequality in the full vaccination coverage for over a decade. The next policies towards children from vulnerable populations (ethnic minority groups, living in rural areas, and having a mother with low education) belonging to lower socioeconomic groups may mitigate socioeconomic inequalities in full vaccination coverage.

Background. This study assesses the prevalence of Vietnamese children receiving the hepatitis B (HepB) vaccine birth dose and explores its associated socioeconomic factors. Methods. We used the data of the Multiple Indicator Cluster Survey, 2014. We estimated the overall percentage of HepB birth dose vaccination among 0–23-month-old children and its percentages according to selected characteristics. Multiple logistic regression was applied. Results. 62.8% of children received the HepB vaccine birth dose. The prevalence rates by selected factors ranged from 35.3% to 76.7%. The categories with the lowest prevalence rates were children who had low birth weight (41.6%), had a mother aged less than 20 years (35.3%), had a mother with primary or less education (42.7%), belonged to ethnic minorities (30.3%), resided in rural areas (59.9%), and were in the 1st quintile of mother’s socioeconomic status (38.6%). Receiving HepB vaccine birth dose was associated with child’s birth weight, mother’s age, mother’s education, socioeconomic status, and ethnicity. Conclusions. This study identified vulnerable groups, upon which policy-makers should focus their efforts to equitably and sustainably tackle birth dose HepB vaccine coverage as well as the full vaccination coverage, thereby promoting long-lasting herd immunity in this country.

Although HIV (human immunodeficiency virus) testing for all women has been promoted by Vietnam’s Ministry of Health since 2000, test acceptance rates in this country were reported to be less than 30% in the community. This country has been facing the barriers to approach the national services towards transmission prevention from mother to child including HIV testing during antenatal care (ANC) towards mothers. Here, we aim to assess the socioeconomic inequalities in HIV testing during ANC among Vietnamese women. This study used available data from the Vietnam Multiple Indicator Cluster Survey 2014. Overall, the prevalence of HIV testing during antenatal care was 30% and the concentrate index (CCI) was 0.1926. There was significant inequality between women classified as poor and rich, and when stratified by social characteristics, inequality was found in women aged 15–49 years (CCI: 0.4), living in rural areas (CCI: 0.3), belonging to ethnic minorities (CCI: 0.5) and having primary or less education (CCI: 0.4). In the multivariate logistic regression analysis, ethnicity and socioeconomic status were significant factors associated with HIV testing during ANC. We found the prevalence of HIV testing during ANC was low, and its inequalities were associated with age, living area, ethnicity, education, and economic status.

Our study aims to measure outpatient waiting times at Vietnam health facilities according to the socioeconomic characteristics. We employed the 2015 Vietnam District and Commune Health Facility Survey which was a cross-sectional study designed by the World Bank in collaboration with the Vietnam Health Strategy and Policy Institute. This survey was designed to be representative of six provinces (Dien Bien, Hanoi, Binh Dinh, Dak Lak, Dong Nai, and Dong Thap) drawn from six distinct geographical regions of Vietnam. Data from 4949 outpatients at district hospitals (DHs) and 1724 outpatients at commune health centers (CHCs) were extracted for final analysis. We recorded average outpatient waiting times of 32.58 min at DHs and of 11.58 min at CHCs. Four hundred and forty-five outpatients at DHs (9.0%) and 720 those at CHCs (42.8%) were examined immediately (waiting time = 0 min). Outpatient waiting times were various in six distinct geographical regions. With an investigation according to several socioeconomic characteristics, significant differences in outpatient waiting times were observed at both two levels of health facilities as measured by province, age, self-reported health status, patient’s wealth, ethnicity, and health insurance. Conclusions. Outpatient waiting times from arrival at health facility until receiving care were significantly distinct amongst two health facility levels, revealing longer at DHs compared to at CHCs. There was significantly higher proportion of outpatients examined immediately at CHCs compared to at DHs. Our study suggests that, vulnerable populations, with longer outpatient waiting time, should be dealt with in appropriate models towards each medical facility according to key socioeconomic factors to contribute to simplify the process of medical examination and treatment for outpatients.

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