The Panorama and Outcomes of Pregnancies Within a Well-Defined Population in Rural Vietnam 1999–2004

Graner, Sophie; Klingberg-Allvin, Marie; Phuc, Ho Dang; Krantz, Gunilla; Mogren, Ingrid

doi:10.1007/s12529-008-9026-0

Cited by 11 publications

(13 citation statements)

References 23 publications

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“…There is also evidence of higher stillbirth rates (49) and less use of antenatal care services among ethnic minority groups (50, 51). However, sex ratio at birth is not significantly elevated among ethnic minorities, which has instead been the case in the general population in recent years (52).…”

Section: Resultsmentioning

confidence: 99%

“…However, sex ratio at birth is not significantly elevated among ethnic minorities, which has instead been the case in the general population in recent years (52). The place of delivery is important in relation to health and survival of both mother and child, and a number of studies show that ethnic minority mothers are more likely to deliver at home (49, 50, 53–55). There are a variety of explanations for the preference for home delivery in ethnic minority groups, such as distance and cost of going to the health center, informal payments for treatment and unfamiliarity with the procedures in combination with language barriers, and negative attitudes among health staff (43).…”

Section: Resultsmentioning

confidence: 99%

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Ethnic minority health in Vietnam: a review exposing horizontal inequity

Målqvist

Hoa

Liêm

et al. 2013

Global Health Action

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BackgroundEquity in health is a pressing concern and reaching disadvantaged populations is necessary to close the inequity gap. To date, the discourse has predominately focussed on reaching the poor. At the same time and in addition to wealth, other structural determinants that influence health outcomes exist, one of which is ethnicity. Inequities based on group belongings are recognised as ‘horizontal’, as opposed to the more commonly used notion of ‘vertical’ inequity based on individual characteristics.ObjectiveThe aim of the present review is to highlight ethnicity as a source of horizontal inequity in health and to expose mechanisms that cause and maintain this inequity in Vietnam.DesignThrough a systematic search of available academic and grey literature, 49 publications were selected for review. Information was extracted on: a) quantitative measures of health inequities based on ethnicity and b) qualitative descriptions explaining potential reasons for ethnicity-based health inequities.ResultsFive main areas were identified: health-care-seeking and utilization, maternal and child health, nutrition, infectious diseases, and oral health and hygiene. Evidence suggests the presence of severe health inequity in health along ethnic lines in all these areas. Research evidence also offers explanations derived from both external and internal group dynamics to this inequity. It is reported that government policies and programs appear to be lacking in culturally adaptation and sensitivity, and examples of bad attitudes and discrimination from health staff toward minority persons were identified. In addition, traditions and patriarchal structures within ethnic minority groups were seen to contribute to the maintenance of harmful health behaviors within these groups.ConclusionBetter understandings of the scope and pathways of horizontal inequities are required to address ethnic inequities in health. Awareness of ethnicity as a determinant of health, not only as a covariate of poverty or living area, needs to be improved, and research needs to be designed with this in mind.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Ethnic minority health in Vietnam: a review exposing horizontal inequity

Målqvist

Hoa

Liêm

et al. 2013

Global Health Action

View full text Add to dashboard Cite

show abstract

“…Fertility rates are higher, and the use of modern contraception is lower among minority women as opposed to Kinh women [20,23]. There is also evidence of higher levels of stillbirths [24] and infant mortality among ethnic minority groups [9]. …”

Section: Resultsmentioning

confidence: 99%

“…The place of delivery is important in relation to health and survival of both mother and child and a number of studies show that ethnic minority mothers are more likely to deliver at home [24], [32-36]. Complex rituals surrounding childbirth and strong traditional beliefs in combination with patriarchal structures have been proposed as the main reason for low facility delivery rates among ethnic minority groups [37,38].…”

Section: Resultsmentioning

confidence: 99%

Causes and determinants of inequity in maternal and child health in Vietnam

2012

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BackgroundInequities in health are a major challenge for health care planners and policymakers globally. In Vietnam, rapid societal development presents a considerable risk for disadvantaged populations to be left behind. The aim of this review is to map the known causes and determinants of inequity in maternal and child health in Vietnam in order to promote policy action.MethodsA review was performed through systematic searches of Pubmed and Proquest and manual searches of “grey literature.” A thematic content analysis guided by the conceptual framework suggested by the Commission on Social Determinants of Health was performed.ResultsMore than thirty different causes and determinants of inequity in maternal and child health were identified. Some determinants worth highlighting were the influence of informal fees and the many testimonies of discrimination and negative attitudes from health staff towards women in general and ethnic minorities in particular. Research gaps were identified, such as a lack of studies investigating the influence of education on health care utilization, informal costs of care, and how psychosocial factors mediate inequity.ConclusionsThe evidence of corruption and discrimination as mediators of health inequity in Vietnam calls for attention and indicates a need for more structural interventions such as better governance and anti-discriminatory laws. More research is needed in order to fully understand the pathways of inequities in health in Vietnam and suggest areas for intervention for policy action to reach disadvantaged populations.

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“…The number of stillbirths was underestimated, related to the fact that this information is not requested within the official health information system. Estimates from a health and demographic surveillance system in the Red River delta area indicated an incidence of 16/1000 births, with higher rates associated with ethnic minority groups and home deliveries (15). Information on stillbirth rates and perinatal mortality is needed for a proper evaluation of the effects of a covering and well functioning continuum of care of the pregnant woman, at delivery, and in the immediate postpartum period (16).…”

Section: Discussionmentioning

confidence: 99%