BackgroundHigh quality maternal health care is an important tool to reduce maternal and neonatal mortality. Services offered should be evidence based and adapted to the local setting. This qualitative descriptive study explored the perspectives and experiences of midwives, assistant physicians and medical doctors on the content and quality of maternal health care in rural Vietnam.MethodThe study was performed in a rural district in northern Vietnam. Four focus group discussions with health care professionals at primary health care level were conducted. The data was analysed using qualitative manifest and latent content analysis.ResultTwo main themes emerged: "Contextual conditions for maternal health care" and "Balancing between possibilities and constraints". Contextual conditions influenced both pregnant women's use of maternal health care and health care professionals' performance. The study participants stated that women's uses of maternal health care were influenced by economical constraints and cultural norms that impeded their autonomy in relation to childbearing. Structural constraints within the health care system included inadequate financing of the primary health care, resulting in lack of human resources, professional re-training and adequate equipment.ConclusionContextual conditions strongly influenced the performance and interaction between pregnant women and health care professionals within antenatal care and delivery care in a rural district of Vietnam. Although Vietnam is performing comparatively well in terms of low maternal and child mortality figures, this study revealed midwives' and other health care professionals' perceived difficulties in their daily work. It seemed maternal health care was under-resourced in terms of staff, equipment and continuing education activities. The cultural setting in Vietnam constituting a strong patriarchal society and prevailing Confucian norms limits women's autonomy and reduce their possibility to make independent decisions about their own reproductive health. This issue should be further addressed by policy-makers. Strategies to reduce inequities in maternal health care for pregnant women are needed. The quality of client-provider interaction and management of pregnancy may be strengthened by education, human resources, re-training and provision of essential equipment.
This qualitative study of pregnant women in rural Vietnam indicates how women create a strategy to promote a healthy pregnancy through lifestyle adjustments, gathering of information, and seeking timely medical care. Insight into pregnancy-related conditions was sought from various sources and influenced both by local traditions and modern medical knowledge. Public knowledge about different symptoms during pregnancy and a high confidence in maternal health care are the most likely contributing factors to the relatively good maternal health status in Vietnam.
Background: Mycoplasma can be isolated with considerable frequency from the female urogenital tracts. Ureaplasma urealyticum and Mycoplasma hominis are important genital mycoplasmas and known as sexually transmitted agents, causing mainly urethritis, pelvic inflammatory disease, spontaneous abortion, pyelonephritis, infertility, stillbirth, low birth weight, neonatal meningititis, and neonatal pneumonia. The aim of this study was to evaluate the incidence of Mycoplasma infections in women of reproductive age.Methods: Vaginal and cervical specimens were collected from 130 women, aged between 20 and 50 years, who referred to our laboratory during a 12-month period. Every woman was tested for the presence of Mycoplasma with culture method. Endocervical and vaginal swab samples were taken from patient, and transported with mycoplasma transport media then filtered and cultured on H&U agar. Isolates tested for Ureaplasma urealyticum and Mycoplasma hominis with urea and arginin hydrolysis respectively.Results: Of the 130 patients studied, 29(22.33%) were positive for U.urealyticum and 37(28.4%) were positive for M. hominis. 25(18.4%) of patients presented both organisms or both genital mycoplasmas.The highest prevalence of both organisms was seen in the married women in 21-30 age group.Conclusions: In our study there is a expected prevalence of genital Mycoplasma. Because of the potential adverse effects of mycoplasmas on the success rate of highly specialized infertility treatment, and its causal roles in several maternal complications of pregnancy and in neonatal morbidity and mortality, the detection of mycoplasmas in women could be important and necessary.
Introduction: This study investigates the processes regarding changing malaria treatment policies in Vietnam. Moreover, it explores the feasibility of introducing triple artemisinin-based combination therapies (TACTs) in Vietnam to support the national malaria control and elimination plan. Methods Data were collected through desk review of policy documents in combination with 12 in-depth interviews with key stakeholders. Results TACTs are considered as a useful backup strategy in case future treatment failures with current artemisinin-based combination therapies (ACTs) would occur. Moreover, TACTs are also considered as a promising strategy to prevent the re-establishment of malaria. However, regulatory procedures and implementation timelines for TACTs were expected to be lengthy. Therefore, stakeholder engagement strategies should be initiated soon, stipulating the benefits of TACTs deployment. A simplified validation of registration or an import permit without registration that has been applied to the introduction of artesunate-pyronaridine was proposed to accelerate the introduction of TACTs. Global-level support through WHO recommendations and prequalification were considered critical for supporting the introduction of TACTs in Vietnam. Conclusions Appropriate approach strategies and early stakeholder engagement will be needed to accelerate the introduction of TACTs in Vietnam.
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