Perinatal services and outcomes in Quang Ninh province, Vietnam

Nga, Nguyen Thu; Eriksson, Leif; Hoa, Dinh Phuong; Johansson, Annika; Wallin, Lars; Persson, Lars‐Åke; Ewald, Uwe

doi:10.1111/j.1651-2227.2010.01866.x

Cited by 19 publications

(25 citation statements)

References 20 publications

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“…Health care is available at hospitals at regional, provincial and district level, and in each commune there is a commune health centre (CHC) providing primary health care [29]. The reproductive health care at the CHCs includes antenatal, delivery and post-natal care.…”

Section: Methodsmentioning

confidence: 99%

Lessons learned from stakeholders in a facilitation intervention targeting neonatal health in Quang Ninh province, Vietnam

Eriksson

Đức

Eldh

et al. 2013

BMC Pregnancy Childbirth

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BackgroundIn northern Vietnam the Neonatal health - Knowledge Into Practice (NeoKIP, Current Controlled Trials ISRCTN44599712) trial has evaluated facilitation as a knowledge translation intervention to improve neonatal survival. The results demonstrated that intervention sites, each having an assigned group including local stakeholders supported by a facilitator, lowered the neonatal mortality rate by 50% during the last intervention year compared with control sites. This process evaluation was conducted to identify and describe mechanisms of the NeoKIP intervention based on experiences of facilitators and intervention group members.MethodsFour focus group discussions (FGDs) were conducted with all facilitators at different occasions and 12 FGDs with 6 intervention groups at 2 occasions. Fifteen FGDs were audio recorded, transcribed verbatim, translated into English, and analysed using thematic analysis.ResultsFour themes and 17 sub-themes emerged from the 3 FGDs with facilitators, and 5 themes and 18 sub-themes were identified from the 12 FGDs with the intervention groups mirroring the process of, and the barriers to, the intervention. Facilitators and intervention group members concurred that having groups representing various organisations was beneficial. Facilitators were considered important in assembling the groups. The facilitators functioned best if coming from the same geographical area as the groups and if they were able to come to terms with the chair of the groups. However, the facilitators’ lack of health knowledge was regarded as a deficit for assisting the groups’ assignments. FGD participants experienced the NeoKIP intervention to have impact on the knowledge and behaviour of both intervention group members and the general public, however, they found that the intervention was a slow and time-consuming process. Perceived facilitation barriers were lack of money, inadequate support, and the function of the intervention groups.ConclusionsThis qualitative process evaluation contributes to explain the improved neonatal survival and why this occurred after a latent period in the NeoKIP project. The used knowledge translation intervention, where facilitators supported multi-stakeholder coalitions with the mandate to impact upon attitudes and behaviour in the communes, has low costs and potential for being scaled-up within existing healthcare systems.

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Section: Methodsmentioning

confidence: 99%

Lessons learned from stakeholders in a facilitation intervention targeting neonatal health in Quang Ninh province, Vietnam

Eriksson

Đức

Eldh

et al. 2013

BMC Pregnancy Childbirth

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“…These districts are divided into ninety (90) communities, each with a health centre (CHC) and in each district there is a district hospital. Each CHC has a number of village health workers (VHW) employed to provide preventive care at village level, and in general the coverage of health workers is good [22]. It is also assigned to the VHWs to keep records of and report reproductive health events from their area of responsibility once a month to the midwife at the CHC.…”

Section: Methodsmentioning

confidence: 99%

“…Around half of the population is however not included in the health insurance system, but the government covers health care costs for children <6 years and for others who are classified as poor. The cost of delivery varies considerably between different service facilities [22]. The coverage of ambulance services is concentrated in the major hospitals and transportation for referrals is therefore mainly for the families themselves to arrange, even in emergencies.…”

Section: Methodsmentioning

confidence: 99%

“…Preliminary results from the initial part of the trial indicate that ethnic group and health system utilisation before and at delivery were major determinants of neonatal survival [21]. We have also shown a strong negative association at baseline between home delivery rate and the chances of neonatal survival [22] and that a quarter of the mothers losing their baby in the neonatal period did not have any contact with the health system prior to death [23]. In this study we further investigate the determinants of neonatal mortality, including the care seeking behaviour at delivery by the addition of GIS data and analysis techniques.…”

Section: Introductionmentioning

confidence: 94%

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Distance decay in delivery care utilisation associated with neonatal mortality. A case referent study in northern Vietnam

et al. 2010

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BackgroundEfforts to reduce neonatal mortality are essential if the Millennium Development Goal (MDG) 4 is to be met. The impact of spatial dimensions of neonatal survival has not been thoroughly investigated even though access to good quality delivery care is considered to be one of the main priorities when trying to reduce neonatal mortality. This study examined the association between distance from the mother's home to the closest health facility and neonatal mortality, and investigated the influence of distance on patterns of perinatal health care utilisation.MethodsA surveillance system of live births and neonatal deaths was set up in eight districts of Quang Ninh province, Vietnam, from July 2008 to December 2009. Case referent design including all neonatal deaths and randomly selected newborn referents from the same population. Interviews were performed with mothers of all subjects and GIS coordinates for mothers' homes and all health facilities in the study area were obtained. Straight-line distances were calculated using ArcGIS software.ResultsA total of 197 neonatal deaths and 11 708 births were registered and 686 referents selected. Health care utilisation prior to and at delivery varied with distance to the health facility. Mothers living farthest away (4th and 5th quintile, ≥1257 meters) from a health facility had an increased risk of neonatal mortality (OR 1.96, 95% CI 1.40 - 2.75, adjusted for maternal age at delivery and marital status). When stratified for socio-economic factors there was an increased risk for neonatal mortality for mothers with low education and from poor households who lived farther away from a health facility. Mothers who delivered at home had more than twice as long to a health facility compared to mothers who delivered at a health care facility. There was no difference in age at death when comparing neonates born at home or health facility deliveries (p = 0.56).ConclusionDistance to the closest health facility was negatively associated with neonatal mortality risk. Health care utilisation in the prenatal period could partly explain this risk elevation since there was a distance decay in health system usage prior to and at delivery. The geographical dimension must be taken into consideration when planning interventions for improved neonatal survival, especially when targeting socio-economically disadvantaged groups.

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“…In recent years, neonatal mortality has been a priority on the global health agenda [12]. Studies on neonatal mortality in low-middle income countries have increased but are still scarce compared to the magnitude of the problem and most focus on community settings [3–5, 7–10, 13, 14]. …”

Section: Introductionmentioning

confidence: 99%

Low Neonatal Mortality and High Incidence of Infectious Diseases in a Vietnamese Province Hospital

Kruse

et al. 2016

BioMed Research International

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Background. Neonatal deaths constitute the majority of child mortality in Vietnam, but studies are scarce and focus on community settings. Methods. During a 12-month period, all sick neonates admitted to a pediatric department in a province hospital were studied. Potential risk factors of death covering sociodemographic factors, pregnancy history, previous neonatal period, and status on admission were registered. The neonates were followed up until discharge or death or until 28 completed days of age if still hospitalized or until withdrawal of life support. The main outcome was neonatal death. Results. The neonatal mortality was 4.6% (50/1094). In a multivariate analysis, four associated risk factors of death were extremely low birth weight (OR = 22.9 (2.3–233.4)), no cry at birth (OR = 3.5 (1.3–9.4)), and cyanosis (OR = 3.3 (1.2–8.7)) and shock (OR = 12.3 (2.5–61.5)) on admission. The major discharge diagnoses were infection, prematurity, congenital malformations, and asphyxia in 88.5% (936/1058), 21.3% (225/1058), 5.0% (53/1058), and 4.6% (49/1058), respectively. In 36, a discharge diagnosis was not registered. Conclusion. Infection was the main cause of neonatal morbidity. Asphyxia and congenital malformations were diagnosed less frequently. The neonatal mortality was 4.6%. No sociodemographic factors were associated with death. Extreme low birth weight, no cry at birth, and cyanosis or shock at admission were associated with death.

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Perinatal services and outcomes in Quang Ninh province, Vietnam

Abstract: A relatively good coverage of perinatal care was found in a Vietnamese province, but neonatal mortality varied markedly with geography and level of care. A remaining small proportion of home deliveries generated a substantial part of mortality.

Cited by 19 publications

References 20 publications

Lessons learned from stakeholders in a facilitation intervention targeting neonatal health in Quang Ninh province, Vietnam

Lessons learned from stakeholders in a facilitation intervention targeting neonatal health in Quang Ninh province, Vietnam

Distance decay in delivery care utilisation associated with neonatal mortality. A case referent study in northern Vietnam

Low Neonatal Mortality and High Incidence of Infectious Diseases in a Vietnamese Province Hospital

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