Utilization of Skilled Birth Attendants in Public and Private Sectors in Vietnam

Abstract

The private sector in health care in Vietnam has been increasingly competing with the government in primary health care services. However, little is known about the use of skilled birth attendance or about choice of public and private sectors among those who opt for skilled attendants. Using data from the Vietnam 2002 Demographic and Health Survey, this study examines factors related to women's decision-making of whether to have a skilled birth attendant at a recent childbirth, and if they did, whether it was a public or private sector provider. The study indicates that the use of the private sector for delivery services was significant. Women's household wealth, education, antenatal care and community's wealth were positively related to skilled birth attendance, while ethnicity and order of childbirth were negatively related. Order of childbirth was positively associated with skilled birth attendance in the private sector. Among service environment factors, increased access to public sector health centres was associated with an increased likelihood of skilled birth attendance in general, but a lowered chance of that in the private sector. Further studies are needed to assess the current situation in the private sector, the demand for delivery services in the private sector, and its readiness to provide quality services.

Preference for private hospital-based maternity services in inner-city Lagos, Nigeria: An observational study

“…For instance, while maternal age, ethnicity, religion and social class (or its surrogate such as wealth quintiles) have been reported as socio-demographic/economic factors that differentiate between hospital and non-hospital deliveries in general [23,28], only educational status and standard of living have been previously reported for private versus public hospital deliveries [26,27]. This would appear to be consistent with the findings in this study considering the contribution of maternal education in determining social class.…”

“…Comparable studies on private and public hospitals in urban settings in developing countries are sparse and limited in scope [8,21,22,[26][27][28]. For instance, one study dichotomized health facilities into "appropriate" and "inappropriate" [21] while another simply focused on antenatal and postnatal practices [22] thus making direct comparison difficult.…”

Synthesizing qualitative and quantitative evidence on non-financial access barriers: implications for assessment at the district level

“…Mothers who were Kinh (the majority ethnic group) were more than twice as likely to seek care for children with diarrhoea than mothers of ethnic minorities [33]; professionally attended births were more likely if the mother was Kinh than any other ethnicity [34]; Kinh women were nearly four times more likely than ethnic minorities to give birth at health facilities [35]; and women from ethnic minorities were more likely to attend a commune health centre for delivery than Kinh women [36]. In contrast to the other studies included in the quantitative analysis, only Sepehri et al [35] found no significant effect of ethnicity on prenatal use once other individual, household and commune characteristics had been accounted for.…”

Ethnicity, education attainment, media exposure, and prenatal care in Vietnam

“…Some studies have speculated upon the nature of disparities in health care practices among ethnic minorities and majorities in Vietnam (Trinh, Dibley, and Byles 2007;Sepehri et al 2008;Teerawichitchainan and Phillips 2008;Do 2009;Målqvist et al 2011). These studies, consisting largely of local case studies or regional analyses, have found that ethnic minority pregnant women tend to enter prenatal care at later gestation ages, have fewer pregnancy check-ups, lack adequate vaccinations, prefer home delivery, and rely upon traditional birth attendants during delivery.…”

“…The control variables included in our models are measures of the characteristics of individuals, as well as the households and communities within which they reside as suggested in the previous studies on prenatal care utilization and ethnic disparities in Vietnam (Trinh, Dibley, and Byles 2007;Sepehri et al 2008;Teerawichitchainan and Phillips 2008;Do 2009;Teerawichitchainan and Amin 2010;Målqvist et al 2011;Tran et al 2011). These variables, presented in Table 1, include women's age, birth parity, occupation, and household wealth quintile.…”