The Utilization of Maternal Healthcare Services Among Ethnic Minority Populations in Vietnam

Abstract

Background Previous studies have observed lower utilization of maternal healthcare services by ethnic minority groups in Vietnam compared with the majority Kinh community. This study sought to assess the utilization of maternal healthcare service-associated factors within 12 ethnic minority groups. Method The cross-sectional study enrolled 996 women from 12 ethnic minority groups in Vietnam in 2019. Women had pregnancy outcomes in the last 5 years. The two variables for maternal healthcare utilization were [1] a minimum of four antenatal contacts and [2] health facility-based delivery. We examined the association of individual characteristics of maternal healthcare services using multilevel modeling. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported. Results This nationally representative study found that 34.1% of women from ethnic minority backgrounds had four or more antenatal contacts during pregnancy, ranging from 8.3% in Mong community to 80.2% in Cham An Giang. Most of the women (94.4%) delivered at health facilities. Factors independently correlated with having fewer than four antenatal contacts included being illiterate, early marriage, unemployment, religious affiliation, household economy, and distance to the nearest health facility. Factors significantly associated with home delivery were living in the most disadvantaged areas and having fewer than four antenatal contacts. Conclusion Substantial inequity exists in antenatal coverage both within ethnic minority groups and between socio-economic groups. The low coverage of having at least four antenatal contacts and its' correlates with facility-based delivery suggests that the government should focus efforts on increasing the number of antenatal contacts for ethnic minority women.

The Magnitude of Optimal Antenatal Care Utilization and Its Associated Factors among Pregnant Women in South Gondar Zone, Northwest Ethiopia: A Cross-Sectional Study

“…The educational level of women was the factor to receive four and above antenatal care visits. This finding was consistent with the study conducted in Amhara regional states, Ethiopia [29], Ethiopia [30], and Vietnam [31]. It showed that the increased educational level increases women's received optimal ANC visits.…”

“…Women who were exposed to the media were more likely to use four and more ANC services than women who were not exposed to the media. This finding is similar to studies conducted in Ethiopia [30], Vietnam [31], and Tanzania [35]. Access to the media may have resulted in the more frequent use of ANC visits because the media may have offered relevant health promotion messages, such as the advantages of ANC and information on the danger signs of probable pregnancy problems [35].…”

Adapting and Scaling a Digital Health Intervention to Improve Maternal and Child Health Among Ethnic Minority Women in Vietnam Amid the COVID-19 Context: Protocol for the dMOM Project

“…Shaped by decades of structural deprivation and social exclusion, specific factors contributing to the profound MNCH disparities faced by ethnic minority populations are limited access to education, economic marginalization, remote and rural residence (where there are fewer and lower capacity health centers and a documented shortage of health workers [ 5 , 6 ]), limited access to MNCH information, low reproductive health knowledge, language barriers, and poor access to and uptake of perinatal care services [ 2 , 3 , 5 , 7 , 8 ]. A 2021 study found that economic marginalization and living over 5 km from the nearest health facility were associated with having fewer than 4 antenatal care visits [ 7 ]. Importantly, documented inequities along ethnic lines in health care seeking and utilization, MNCH, nutrition, and oral health and hygiene suggest that minority ethnicity alone is a critical determinant impacting health outcomes [ 9 ].…”

Health care utilization by ethnic minority populations: a narrative review and secondary data analysis

“…Of these barriers, the most prominent was physical access to healthcare services. In general, the further away a healthcare facility is, the less likely one is to use the services offered there [11,[19][20][21]. Poor infrastructure, which includes rugged terrain, poorly maintained roads, and a lack of public transportation facilities, also contributes to physical barriers to health service use by ethnic minority populations [7,8,11,12,14,17,18,21].…”