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Secondary cities are home to most of the world's urban populations vulnerable to climate change, yet researchers and policymakers have devoted less attention to them than large and megacities. To help address this gap, this paper explores the relationship between incomplete decentralized governance, climate change, and urban resilience. It does through the case studies of secondary cities of Cambodia, Myanmar, Thailand, and Vietnam. Secondary cities are of importance because they are the fastest growing cities in the Global South but also because they have weaker capacity to address climate risks. Through these case studies, the paper draws comparisons between the different cases to look at the linkages between decentralization and urban resilience in secondary cities. Overall, it argues that climate governance, due to the retention of power and resources by central bureaucrats along with fragmented governance structures, and misaligned incentive structures which prioritize economic growth over climate protection have undermined resilience building and contributed to the uneven distribution of climate risks in these cities. [ABSTRACT FROM AUTHOR]

The project 'Quality Decision-making by women and providers' (QUALI-DEC) combines four non-clinical interventions to promote informed decision-making surrounding mode of birth, improve women's birth experiences, and reduce caesarean sections among low-risk women. QUALI-DEC is currently being implemented in 32 healthcare facilities across Argentina, Burkina Faso, Thailand, and Viet Nam. In this paper, we detail implementation processes and the planned process evaluation, which aims to assess how and for whom QUALI-DEC worked, the mechanisms of change and their interactions with context and setting; adaptations to intervention and implementation strategies, feasibility of scaling-up, and cost-effectiveness of the intervention. We developed a project theory of change illustrating how QUALI-DEC might lead to impact. The theory of change, together with on the ground observations of implementation processes, guided the process evaluation strategy including what research questions and perspectives to prioritise. Main data sources will include: 1) regular monitoring visits in healthcare facilities, 2) quantitative process and output indicators, 3) a before and after cross-sectional survey among post-partum women, 4) qualitative interviews with all opinion leaders, and 5) qualitative interviews with postpartum women and health workers in two healthcare facilities per country, as part of a case study approach. We foresee that the QUALI-DEC process evaluation will generate valuable information that will improve interpretation of the effectiveness evaluation. At the policy level, we anticipate that important lessons and methodological insights will be drawn, with application to other settings and stakeholders looking to implement complex interventions aiming to improve maternal and newborn health and wellbeing. Trial registration: ISRCTN67214403. [ABSTRACT FROM AUTHOR]

The Kontum massif plays a key role in the tectonic development of the central Vietnam terrane. However, most of the northern part of the Kontum massif is covered by sediments. In this paper, we determine for the first time the subsurface structures of the area using aeromagnetic data. We have evaluated the effectiveness of six enhancement techniques on a synthetic model before applying these techniques to real aeromagnetic data of the study area. The results obtained from these techniques show that the study area is dominated by E-W and ENE-WSW trending lineaments and the depths of most of these structures range from 50 to 550 m. The findings also show some probable granitic intrusions in the study area. Our study provides the first magnetic interpretation for a better understanding of the structural features of the northern Kontum massif. [ABSTRACT FROM AUTHOR]

This paper presents the determination of the Moho and basement depths of Tuchinh-Vungmay basin (TCVMB) offshore southeastern Vietnam by the three dimension direct gravity inversion. The Moho depth was predicted from the mantle residual gravity anomaly with the lithosphere thermal gravity correction. The downward continuation of the basement residual gravity anomaly is also applied to enhance the basement topography's resolution. The mean depths of the basement and Moho surfaces were constrained by the power density spectrum (PDS) of the residual gravity anomalies and the oceanic bottom seismic (OBS) data. The predicted Moho depth varies from 13.5 km to 23 km and the basement depth is from some hundred meters to 8.5 km. The gravity basement topography has higher resolution and detail than the National Oceanic and Atmospheric Administration (NOAA) seismic basement. [ABSTRACT FROM AUTHOR]

The impacts of development-induced resettlement disproportionately affect women, as they frequently face more difficulties than men to cope with disruption and changes. Women's situation might further deteriorate if there is no mechanism for affected households to enjoy meaningful participation and consultation in the resettlement process. This paper is the result of policy analysis, project implementation experience, and findings of a cross-sectional survey of 876 affected households in Vietnam. We examine women's participation in resettlement processes in large infrastructure projects in Vietnam. The survey findings revealed the limited participation of women in the resettlement processes from all perspectives (meeting attendance, resettlement implementation, and making decisions) at community and household levels. Gender-stereotyped prejudice from community members and the gender-ascribed household division of labour were key factors inhibiting women's meaningful participation. The paper also discusses the implications of the findings for impact assessment practice. We call for a shift in how resettlement is prepared and implemented towards a more comprehensive and gender-informed approach, with a view to making affected people genuine beneficiaries of resettlement programmes. [ABSTRACT FROM AUTHOR]

Given the rapid spread of the COVID-19 pandemic and the huge negative impacts it is causing, researching on COVID-19-related issues is very important for designing proactive and comprehensive public health interventions to fight against the pandemic. We describe the characteristics of COVID-19 patients detected in the two phases of the epidemic in Vietnam. Data used in this paper were mainly obtained from the official database of the Ministry of Health of Vietnam. Descriptive statistics were carried out using Stata 16 software. As of 18 May 2020, the cumulative number of COVID-19 cases detected in Vietnam was 324, 16 cases from 4 cities and provinces in the first phase (during 20 days, 0.8 cases detected per day) and 308 cases from 35 cities, provinces in the second phase (during 76 days, 4.1 cases detected per day). Vietnam has mobilized its entire political system to fight the COVID-19 and achieved some initial successes. We found both similarities and differences between the two phases of the COVID-19 epidemic in Vietnam. We demonstrated that the situation of the COVID-19 epidemic in Vietnam is getting more complicated and unpredictable. [ABSTRACT FROM AUTHOR]

In Vietnam, the fire protection for steel structures is relativity much; thus, the study of fire protection solutions for the load-bearing steel structures (beams, columns) is considered very important in the safety of the buildings. One possible solution is the use of gypsum plasterboard. Up to now, the engineers use the constant thermal conductivity to verify the fire resistance of steel structures protected by gypsum plasterboard. However, the thermal conductivity depends on many factors such as temperature, moisture, thickness, type of plasterboard, manufacturer, heating rate. This paper presents an experimental identification of the thermal conductivity of gypsum plasterboard fabricated under fire conditions. [ABSTRACT FROM AUTHOR]

This paper uses a case study of the H...ôi An-Da Nang corridor in Qu...ang Nam province, Vi...êt Nam, to examine some of the pressures that whale worship - a traditional cultural practice of coastal fishing communities in central and southern Vi...êt Nam - has faced since the Đ...ôi M...ói reforms of 1986. Whale temples, the physical manifestation of the veneration of the whale as an ancestor of fishers, are coming under increasing pressure as tourism development displaces coastal communities from the shores and as the younger generations turn their back on the sea as a source of livelihood. The paper seeks to draw attention to a locally important manifestation of intangible cultural heritage, the existence of which is threatened even before the country's first tentative efforts at cultural heritage conservation come into full swing. [ABSTRACT FROM AUTHOR]

Introduction: There remains a lack of information on economic aspects of chronic diseases. This paper, by gathering available and relevant research findings, aims to report and discuss current evidence on economic aspects of chronic diseases in Vietnam. Methods: Data used in this paper were obtained from various information sources: international and national journal articles and studies, government documents and publications, web-based statistics and fact sheets. Results: In Vietnam, chronic diseases were shown to be leading causes of deaths, accounting for 66% of all deaths in 2002. The burdens caused by chronic disease morbidity and risk factors are also substantial. Poorer people in Vietnam are more vulnerable to chronic diseases and their risk factors, other than being overweight. The estimated economic loss caused by chronic diseases for Vietnam in 2005 was about US$20 million (0.033% of annual national GDP). Chronic diseases were also shown to cause economic losses for families and individuals in Vietnam. Both population-wide and high-risk individual interventions against chronic disease were shown to be cost-effective in Vietnam. Conclusion: Given the evidence from this study, actions to prevent chronic diseases in Vietnam are clearly urgent. Further research findings are required to give greater insights into economic aspects of chronic diseases in Vietnam. [ABSTRACT FROM AUTHOR]

Women in Viet Nam have long had to face various sexual and reproductive health problems, ranging from abortion to reproductive tract infections (RTIs) and sexual coercion. These issues have increasingly been addressed by scholars in the fields of public health and social sciences through sexual and reproductive health research and in other ways. Despite this, there remains a lack of in-depth information on attitudes and practices regarding sex and sexuality of Vietnamese women today. This paper in part responds to the knowledge gap by reporting on findings from qualitative research on sexual attitudes and practices among rural married women in a Northern rural community, measured against the broader social and cultural context. Twenty-five women in total were interviewed; and two focus group discussions were conducted. The findings show that women generally believe that men are (or should be) the initiators in sexual relations. Many women feel reluctant to refuse sex to their husbands or communicate openly about sex and sexuality. However, this paper also demonstrates that women are not totally passive in sexual relations. Women in this study used a range of strategies to negotiate their sexual life, and sometimes 'silence' is used as a form of agency in order to maintain harmony and happiness within the family. [ABSTRACT FROM AUTHOR]

This paper describes experiences and lessons learned about how to establish safe second trimester abortion services in low-resource settings in the public health sector in three countries: Nepal, Viet Nam and South Africa. The key steps involved include securing the necessary approvals, selecting abortion methods, organising facilities, obtaining necessary equipment and supplies, training staff, setting up and managing services, and ensuring quality. It may take a number of months to gain the necessary approvals to introduce or expand second trimester services. Advocacy efforts are often required to raise awareness among key governmental and health system stakeholders. Providers and their teams require thorough training, including values clarification; monitoring and support following training prevents burn-out and ensures quality of care. This paper shows that good quality second trimester abortion services are achievable in even the most low-resource settings. Ultimately, improvements in second trimester abortion services will help to reduce abortion-related morbidity and mortality. Cet article décrit les expériences et les enseignements obtenus sur la création de services sûrs d'avortement du deuxième trimestre en situation de ressources limitées dans le secteur de la santé publique de trois pays : Népal, Viet Nam et Afrique du Sud. Les étapes clés étaient l'obtention des autorisations, la sélection des méthodes d'avortement, l'organisation des centres, l'acquisition des équipements et fournitures nécessaires, la formation du personnel, la mise en place et la gestion des services et la garantie de qualité. Plusieurs mois sont parfois nécessaires pour obtenir l'autorisation d'introduire ou d'élargir les services d'avortement du deuxième trimestre. Des activités de plaidoyer sont souvent requises pour sensibiliser les acteurs clés de l'administration et du système de santé. Les prestataires et leurs équipes exigent une formation approfondie, notamment une clarification des valeurs ; après la formation, un suivi et un soutien préviennent l'épuisement professionnel et garantissent la qualité des soins. L'article montre que des services de bonne qualité d'avortement au deuxième trimestre sont possibles même dans les environnements aux ressources les plus limitées. En fin de compte, les améliorations dans ces services aideront à réduire la morbidité et la mortalité liées à l'avortement. En este artículo se describen las experiencias y lecciones aprendidas sobre cómo establecer servicios seguros de aborto en el segundo trimestre, en lugares con escasos recursos, en el sector salud pública de tres países: Nepal, Vietnam y Sudáfrica. Los pasos fundamentales son: obtener la autorización necesaria, seleccionar los métodos de aborto, organizar los establecimientos de salud, obtener el equipo y los suministros necesarios, capacitar al personal, establecer y manejar los servicios y garantizar la calidad. Posiblemente tome varios meses obtener la autorización necesaria para lanzar o ampliar los servicios en el segundo trimestre. Por lo general, se necesitan esfuerzos de promoción y defensa para concientizar a las partes interesadas del gobierno y del sistema de salud. Los prestadores de servicios y su equipo necesitan capacitación completa, que incluya aclaración de valores; el monitoreo y apoyo post-capacitación ayudan a evitar agotamiento y garantizar la calidad de la atención. Es posible lograr servicios de alta calidad de aborto en el segundo trimestre, incluso en los lugares donde existe la mayor escasez de recursos. A la larga, las mejoras en los servicios de aborto en el segundo trimestre ayudarán a disminuir las tasas de morbilidad y mortalidad relacionadas con el aborto. [ABSTRACT FROM AUTHOR]

This paper analyzes Vietnam's health policies. It adopts an interpretative framework stressing that policy approaches to strategic and commercial services, on one hand, and social services, on the other hand, should be fundamentally different, given the structurally different nature of such diverse services activities. The paper analyzes the evolution of health policies during the doi moi period and reviews the national and international debate on health systems reforms, arguing that an approach prone to blur the intrinsic difference between social and non-social services has led to market-oriented health reforms that are severely flawed in Vietnam, with negative impacts on universality of access, equity, poverty, and efficiency. In sum, social services policies, and policies in the domain of health in particular, appear to constitute the weakest and most contentious component of Vietnam's otherwise extremely successful development strategy. Therefore, they are a prime candidate for critical re-examination. [ABSTRACT FROM AUTHOR]

From mid-1999 to mid-2001, the authors carried out a qualitative study in rural Vietnam to explore relationships between gender equity and reproductive health. One of the study's objectives was to develop culturally appropriate indicators of women's empowerment, specific to the Vietnamese context. This paper describes the process of developing, testing, and refining the empowerment indicators, presents some of the findings, and discusses the methodological challenges that need to be addressed. The paper concludes by recommending a set of Vietnamspecific domains for assessing women's empowerment in the socio-economic sphere as well as in reproductive health. [ABSTRACT FROM AUTHOR]

Background: Since the publication of the reports by the Commission on Social Determinants of Health (CSDH), many research papers have documented inequities, explaining causal pathways in order to inform policy and programmatic decision-making. At the international level, the sustainable development goals (SDGs) reflect an attempt to bring together these themes and the complexities involved in defining a comprehensive development framework. However, to date, much less has been done to address the monitoring challenges, that is, how data generation, analysis and use are to become routine tasks. Objective: To test proposed indicators of social determinants of health (SDH), gender, equity, and human rights with respect to their relevance in tracking progress in universal health coverage and population health (level and distribution). Design: In an attempt to explore these monitoring challenges, indicators covering a wide range of social determinants were tested in four country case studies (Bangladesh, Brazil, South Africa, and Vietnam) for their technical feasibility, reliability, and validity, and their communicability and usefulness to policy-makers. Twelve thematic domains with 20 core indicators covering different aspects of equity, human rights, gender, and SDH were tested through a review of data sources, descriptive analyses, key informant interviews, and focus group discussions. To test the communicability and usefulness of the domains, domain narratives that explained the causal pathways were presented to policy-makers, managers, the media, and civil society leaders. Results: For most countries, monitoring is possible, as some data were available for most of the core indicators. However, a qualitative assessment showed that technical feasibility, reliability, and validity varied across indicators and countries. Producing understandable and useful information proved challenging, and particularly so in translating indicator definitions and data into meaningful lay and managerial narratives, and effectively communicating links to health and ways in which the information could improve decision-making. Conclusions: This exercise revealed that for monitoring to produce reliable data collection, analysis, and discourse, it will need to be adapted to each national context and institutionalised into national systems. This will require that capacities and resources for this and subsequent communication of results are increased across countries for both national and international monitoring, including the successful implementation of the SDGs. [ABSTRACT FROM AUTHOR]

Introduction: Achieving a fair and equitable distribution of health in the population while progressing toward universal health coverage (UHC) is a key focus of health policy in Vietnam. This paper describes health barriers experienced by women (and children by inference) in Vietnam, and measures how UHC, with reference to maternal health services and child mortality rates, is affected by selected social determinants of health (SDH), termed 'barriers'. Methods: Our study uses a cross-sectional design with data from the 2011 Vietnam Multiple Indicator Cluster Survey. The study sample includes 11,663 women, aged 15-49 years. Weighted frequency statistics are cross-tabulated with socioeconomic characteristics of the population to describe the extent and distribution of health barriers experienced by disadvantaged women and children in Vietnam. A subset of women who had a live birth in the preceding two years (n_1,383) was studied to assess the impact of barriers to UHC and health. Six multiple logistic regressions were run using three dependent variables in the previous two years: 1) antenatal care, 2) skilled birth attendants, and 3) child death in the previous 15 years. Independent predictor variables were: 1) low education (incomplete secondary education), 2) lack of access to one of four basic amenities. In a second set of regressions, a constructed composite barrier index replaced these variables. Odds ratios (ORs) and 95% confidence intervals (95% CI) were used to report regression results. Results: In Vietnam, about 54% of women aged 15-49 years in 2011, had low education or lacked access to one of four basic amenities. About 38% of poor rural women from ethnic minorities experienced both barriers, compared with less than 1% of rich urban women from the ethnic majority. Incomplete secondary education or lack of one of four basic amenities was a factor significantly associated with lower access to skilled birth attendants (OR_0.28, 95% CI: 0.14-0.55; OR-0.19, 95% CI: 0.05-0.80) and a higher risk of having had a child death in the previous two years (OR-1.71, 95% CI: 1.28_2.30; OR-1.59, 95% CI: 1.20-2.10). Conclusions: Our study shows the need for accelerating education and infrastructure investments for ethnic minority communities living in rural areas so as to be able to contribute to equity-oriented progress toward UHC. [ABSTRACT FROM AUTHOR]

Background: There is strong evidence that breastfeeding (BF) significantly benefits mothers and infants in various ways. Yet the proportion of breastfed babies in Vietnam is low and continues to decline. This study fills an important evidence gap in BF practices in Vietnam. Objective: This paper examines the trend of early initiation of BF and exclusive BF from 2000 to 2011 in Vietnam and explores the determinants at individual and contextual levels. Design: Data from three waves of the Multiple Indicator Cluster Survey were combined to estimate crude and adjusted trends over time for two outcomes -- early initiation of BF and exclusive BF. Three-level logistic regressions were fitted to examine the impacts of both individual and contextual characteristics on early initiation of BF and exclusive BF in the 2011 data. Results: Both types of BF showed a decreasing trend over time after controlling for individual-level characteristics but this trend was more evident for early initiation of BF. Apart from child's age, individual-level characteristics were not significant predictors of the BF outcomes, but provincial characteristics had a strong association. When controlling for individual-level characteristics, mothers living in provinces with a higher percentage of mothers with more than three children were more likely to have initiated early BF (odds ratio [OR]: 1.06; confidence interval [CI]: 1.02-1.11) but less likely to exclusively breastfeed their babies (OR: 0.94; CI: 0.88-1.01). Mothers living in areas with a higher poverty rate were more likely to breastfeed exclusively (OR: 1.07; CI: 1.02-1.13), and those who delivered by Caesarean section were less likely to initiate early BF. Conclusions: Our results suggest that environmental factors are becoming more important for determining BF practices in Vietnam. Intervention programs should therefore not only consider individual factors, but should also consider the potential impact of contextual factors on BF practices. [ABSTRACT FROM AUTHOR]

Background: Knowledge of the aggregate effects of multiple socioeconomic vulnerabilities is important for shedding light on the determinants of growing health inequalities and inequities in maternal healthcare. Objective: This paper describes patterns of inequity in maternal healthcare utilization and analyzes associations between inequity and multiple socioeconomic vulnerabilities among women in Vietnam. Design: This is a repeated cross-sectional study using data from the Vietnam Multiple Indicator Cluster Surveys 2000, 2006, and 2011. Two maternal healthcare indicators were selected: (1) skilled antenatal care and (2) skilled delivery care. Four types of socioeconomic vulnerabilities -- low education, ethnic minority, poverty, and rural location -- were assessed both as separate explanatory variables and as composite indicators (combinations of three and four vulnerabilities). Pairwise comparisons and adjusted odds ratios were used to assess socioeconomic inequities in maternal healthcare. Results: In all three surveys, there were increases across the survey years in both the proportions of women who received antenatal care by skilled staff (68.6% in 2000, 90.8% in 2006, and 93.7% in 2011) and the proportions of women who gave birth with assistance from skilled staff (69.9% in 2000, 87.7% in 2006, and 92.9% in 2011). The receipt of antenatal care by skilled staff and birth assistance from skilled health personnel were less common among vulnerable women, especially those with multiple vulnerabilities. Conclusions: Even thoughVietnam has improved its coverage of maternal healthcare on average, policies should target maternal healthcare utilization among women with multiple socioeconomic vulnerabilities. Both multisectoral social policies and health policies are needed to tackle multiple vulnerabilities more effectively by identifying those who are poor, less educated, live in rural areas, and belong to ethnic minority groups. [ABSTRACT FROM AUTHOR]

Background: Despite progress made by the Millennium Development Goal (MDG) number 7.C, Vietnam still faces challenges with regard to the provision of access to safe drinking water and basic sanitation. Objective: This paper describes household trends in access to improved water sources and sanitation facilities separately, and analyses factors associated with access to improved water sources and sanitation facilities in combination. Design: Secondary data from the Vietnam Multiple Indicator Cluster Survey in 2000, 2006, and 2011 were analyzed. Descriptive statistics and tests of significance describe trends over time in access to water and sanitation by location, demographic and socio-economic factors. Binary logistic regressions (2000, 2006, and 2011) describe associations between access to water and sanitation, and geographic, demographic, and socioeconomic factors. Results: There have been some outstanding developments in access to improved water sources and sanitation facilities from 2000 to 2011. In 2011, the proportion of households with access to improved water sources and sanitation facilities reached 90% and 77%, respectively, meeting the 2015 MDG targets for safe drinking water and basic sanitation set at 88% and 75%, respectively. However, despite these achievements, in 2011, only 74% of households overall had access to combined improved drinking water and sanitation facilities. There were also stark differences between regions. In 2011, only 47% of households had access to both improved water and sanitation facilities in the Mekong River Delta compared with 94% in the Red River Delta. In 2011, households in urban compared to rural areas were more than twice as likely (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.9-2.5) to have access to improved water and sanitation facilities in combination, and households in the highest compared with the lowest wealth quintile were over 40 times more likely (OR: 42.3; 95% CI: 29.8-60.0). Conclusions: More efforts are required to increase household access to both improved water and sanitation facilities in the Mekong River Delta, South East and Central Highlands regions of Vietnam. There is also a need to address socio-economic factors associated with inadequate access to improved sanitation facilities. [ABSTRACT FROM AUTHOR]

Background: Understanding factors associated with domestic violence-supportive attitudes among Vietnamese women is important for designing effective policies to prevent this behavior. Previous studies have largely overlooked risk factors associated with domestic violence-supportive attitudes by women in Vietnam. Objective: This paper explores and identifies socioeconomic factors that contribute to domestic violence--supportive attitudes amongVietnamesewomenusing data fromthe Multiple Indicator Cluster Surveys (MICS). Design: Secondary data from two cross-sectional studies (MICS 3, 2006, and MICS 4, 2011) with representative samples (9,471 and 11,663 women, respectively) in Vietnam were analyzed. The prevalence of supportive attitudes toward domestic violence and associations with age, residence region, area, education level, household wealth index, ethnicity, and marital status were estimated using descriptive statistics and multivariate Poisson models, giving estimates of relative risk. Results: Overall, the prevalence of acceptance of domestic violence declined between 2006 and 2011 in Vietnam (65.1% vs. 36.1%). Socioeconomic factors associated with women's condoning of domestic violence were age, wealth, education level, and living area. In particular, younger age and low educational attainment were key factors associated with violence-supportive attitudes, and these associations have become stronger over time. Conclusion: Higher educational attainment in women is an important predictor of women's attitudes toward domestic violence. To date, Doi Moi and the Vietnamese government's commitment to the Millennium Development Goals may have positively contributed to lowering the acceptance of domestic violence. Tailored interventions that focus on education will be important in further changing attitudes toward domestic violence. [ABSTRACT FROM AUTHOR]

Background: Understanding factors associated with domestic violence-supportive attitudes among Vietnamese women is important for designing effective policies to prevent this behavior. Previous studies have largely overlooked risk factors associated with domestic violence-supportive attitudes by women in Vietnam. Objective: This paper explores and identifies socioeconomic factors that contribute to domestic violence-supportive attitudes among Vietnamese women using data from the Multiple Indicator Cluster Surveys (MICS). Design: Secondary data from two cross-sectional studies (MICS 3, 2006, and MICS 4, 2011) with representative samples (9,471 and 11,663 women, respectively) in Vietnam were analyzed. The prevalence of supportive attitudes toward domestic violence and associations with age, residence region, area, education level, household wealth index, ethnicity, and marital status were estimated using descriptive statistics and multivariate Poisson models, giving estimates of relative risk. Results: Overall, the prevalence of acceptance of domestic violence declined between 2006 and 2011 in Vietnam (65.1% vs. 36.1%). Socioeconomic factors associated with women's condoning of domestic violence were age, wealth, education level, and living area. In particular, younger age and low educational attainment were key factors associated with violence-supportive attitudes, and these associations have become stronger over time. Conclusion: Higher educational attainment in women is an important predictor of women's attitudes toward domestic violence. To date, Doi Moi and the Vietnamese government's commitment to the Millennium Development Goals may have positively contributed to lowering the acceptance of domestic violence. Tailored interventions that focus on education will be important in further changing attitudes toward domestic violence. [ABSTRACT FROM AUTHOR]

Background: There is strong evidence that breastfeeding (BF) significantly benefits mothers and infants in various ways. Yet the proportion of breastfed babies in Vietnam is low and continues to decline. This study fills an important evidence gap in BF practices in Vietnam. Objective: This paper examines the trend of early initiation of BF and exclusive BF from 2000 to 2011 in Vietnam and explores the determinants at individual and contextual levels. Design: Data from three waves of the Multiple Indicator Cluster Survey were combined to estimate crude and adjusted trends over time for two outcomes - early initiation of BF and exclusive BF. Three-level logistic regressions were fitted to examine the impacts of both individual and contextual characteristics on early initiation of BF and exclusive BF in the 2011 data. Results: Both types of BF showed a decreasing trend over time after controlling for individual-level characteristics but this trend was more evident for early initiation of BF. Apart from child's age, individual-level characteristics were not significant predictors of the BF outcomes, but provincial characteristics had a strong association. When controlling for individual-level characteristics, mothers living in provinces with a higher percentage of mothers with more than three children were more likely to have initiated early BF (odds ratio [OR]: 1.06; confidence interval [CI]: 1.02-1.11) but less likely to exclusively breastfeed their babies (OR: 0.94; CI: 0.88-1.01). Mothers living in areas with a higher poverty rate were more likely to breastfeed exclusively (OR: 1.07; CI: 1.02-1.13), and those who delivered by Caesarean section were less likely to initiate early BF. Conclusions: Our results suggest that environmental factors are becoming more important for determining BF practices in Vietnam. Intervention programs should therefore not only consider individual factors, but should also consider the potential impact of contextual factors on BF practices. [ABSTRACT FROM AUTHOR]

Background: Despite progress made by the Millennium Development Goal (MDG) number 7.C, Vietnam still faces challenges with regard to the provision of access to safe drinking water and basic sanitation. Objective: This paper describes household trends in access to improved water sources and sanitation facilities separately, and analyses factors associated with access to improved water sources and sanitation facilities in combination. Design: Secondary data from the Vietnam Multiple Indicator Cluster Survey in 2000, 2006, and 2011 were analyzed. Descriptive statistics and tests of significance describe trends over time in access to water and sanitation by location, demographic and socio-economic factors. Binary logistic regressions (2000, 2006, and 2011) describe associations between access to water and sanitation, and geographic, demographic, and socioeconomic factors. Results: There have been some outstanding developments in access to improved water sources and sanitation facilities from 2000 to 2011. In 2011, the proportion of households with access to improved water sources and sanitation facilities reached 90% and 77%, respectively, meeting the 2015 MDG targets for safe drinking water and basic sanitation set at 88% and 75%, respectively. However, despite these achievements, in 2011, only 74% of households overall had access to combined improved drinking water and sanitation facilities. There were also stark differences between regions. In 2011, only 47% of households had access to both improved water and sanitation facilities in the Mekong River Delta compared with 94% in the Red River Delta. In 2011, households in urban compared to rural areas were more than twice as likely (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.9-2.5) to have access to improved water and sanitation facilities in combination, and households in the highest compared with the lowest wealth quintile were over 40 times more likely (OR: 42.3; 95% CI: 29.8-60.0). Conclusions: More efforts are required to increase household access to both improved water and sanitation facilities in the Mekong River Delta, South East and Central Highlands regions of Vietnam. There is also a need to address socio-economic factors associated with inadequate access to improved sanitation facilities. [ABSTRACT FROM AUTHOR]

Introduction: Achieving a fair and equitable distribution of health in the population while progressing toward universal health coverage (UHC) is a key focus of health policy in Vietnam. This paper describes health barriers experienced by women (and children by inference) in Vietnam, and measures how UHC, with reference to maternal health services and child mortality rates, is affected by selected social determinants of health (SDH), termed 'barriers'. Methods: Our study uses a cross-sectional design with data from the 2011 Vietnam Multiple Indicator Cluster Survey. The study sample includes 11,663 women, aged 15-49 years. Weighted frequency statistics are crosstabulated with socioeconomic characteristics of the population to describe the extent and distribution of health barriers experienced by disadvantaged women and children in Vietnam. A subset of women who had a live birth in the preceding two years (n = 1,383) was studied to assess the impact of barriers to UHC and health. Six multiple logistic regressions were run using three dependent variables in the previous two years: 1) antenatal care, 2) skilled birth attendants, and 3) child death in the previous 15 years. Independent predictor variables were: 1) low education (incomplete secondary education), 2) lack of access to one of four basic amenities. In a second set of regressions, a constructed composite barrier index replaced these variables. Odds ratios (ORs) and 95% confidence intervals (95% CI) were used to report regression results. Results: In Vietnam, about 54% of women aged 15-49 years in 2011, had low education or lacked access to one of four basic amenities. About 38% of poor rural women from ethnic minorities experienced both barriers, compared with less than 1% of rich urban women from the ethnic majority. Incomplete secondary education or lack of one of four basic amenities was a factor significantly associated with lower access to skilled birth attendants (OR =0.28, 95% CI: 0.14-0.55; OR =0.19, 95% CI: 0.05-0.80) and a higher risk of having had a child death in the previous two years (OR = 1.71, 95% CI: 1.28-2.30; OR = 1.59, 95% CI: 1.20-2.10). Conclusions: Our study shows the need for accelerating education and infrastructure investments for ethnic minority communities living in rural areas so as to be able to contribute to equity-oriented progress toward UHC. [ABSTRACT FROM AUTHOR]

This paper explores the critical potentials of Vietnamese social science. The research starts by looking at post-war political and social changes, and the present climate of debate to get at the meaning of party leadership and party ideology on the macro level. Section 4 analyzes two social science journals to ascertain the concrete outcome of party control and ideological steering. Section 5 discusses the talk with social scientists and representatives of the State Commission for Science and Technology (SCST) and the Vietnam Committee for Social Sciences (VCSS) to elucidate attitudes to social science exchange. The author held three seminars in the VCSS on a paper about Sweden to explore possible cognitive differences between Sweden and Vietnam as to presumptions and evaluations. To get an idea of the of the conditions for empirical and critical social science in Vietnam, for two months the author followed up a Swedish study of the living and working conditions of forestry workers, comparing this with a corresponding study made by a Vietnamese research team. These and other concrete explorations are the base for some concluding remarks concerning future social science exchange between Vietnam and Sweden.

Background: Dengue fever (DF) is a vector-borne disease that is sensitive to weather and climate variability. To date, however, this relationship in coastal northern Vietnam has not been well documented. Objectives: This paper aims to examine the associations between meteorological variables and dengue incidence in Haiphong, Vietnam, over the period 2008-2012. Methods: Monthly data on dengue incidence from all commune health stations and hospitals of Haiphong (with a total population of -1.8 million) were obtained in accordance with the WHO's recommendations over a 5-year period (2008-2012). Temperature, rainfall, and humidity were recorded as monthly averages by local meteorological stations. The association between ecologic weather variables and dengue cases was assessed using a Poisson regression model. The estimation of regression parameters was based on the method of maximum likelihood using the R program package. Results: From 2008 through 2012, 507 cases of dengue were reported. The risk of dengue was increased by sevenfold during the September-December period compared with other months over the period 2008-2012.DF cases in Haiphong were correlated with rainfall and humidity. In themultivariable Poisson regression model, an increased risk of dengue was independently associated with months with a higher amount of rainfall (RR-1.06; 95% CI 1.00-1.13 per 50 mm increase) and higher humidity (RR-1.05; 95% CI 1.02-1.08 per 1% increase). Conclusion: These data suggest that rainfall and relative humidity could be used as ecological indicators of dengue risk in Haiphong. Intensified surveillance and disease control during periods with high rainfall and humidity are recommended. This study may provide baseline information for identifying potential long-term effects and adaptation needs of global climate change on dengue in the coming decades. [ABSTRACT FROM AUTHOR]

Background: Seasonal variation affects food availability. However, it is not clear if it affects dietary intake and nutritional status of children in Vietnam. Objectives: This paper aims at examining the seasonal variation in nutrition status and dietary intake of children aged 24-59 months. Design: A repeated cross-sectional study design was used to collect data of changes in nutritional status and diets of children from 24 to 59 months through four seasons in Chiem Hoa district, Tuyen Quang province, a predominately rural mountainous province of northern Vietnam. The quantitative component includes anthropometric measurements, 24 hours dietary recall and socio-economic characteristics. The qualitative component was conducted through focus group discussions (FGDs) with mothers of the children surveyed in the quantitative component. The purpose of FGDs was to explore the food habits of children during the different seasons and the behaviours of their mothers in relation to the food that they provide during these seasons. Results: The prevalence of underweight among children aged 24-59 months is estimated at around 20-25%; it peaked in summer (24.9%) and reached a low in winter (21.3%). The prevalence of stunting was highest in summer (29.8%) and lowest in winter (22.2%). The prevalence of wasting in children was higher in spring and autumn (14.3%) and lower in summer (9.3%). Energy intake of children was highest in the autumn (1259.3 kcal) and lowest in the summer (996.9 kcal). Most of the energy and the nutrient intakes during the four seasons did not meet the Vietnamese National Institute of Nutrition recommendation. Conclusions: Our study describes some seasonal variation in nutrition status and energy intake among children in a mountainous area northern Vietnam. Our study indicated that the prevalence of stunting and underweight was higher in summer and autumn, while the prevalence of wasting was higher in spring and autumn. Energy intake did not always meet national recommendations, especially in summer. [ABSTRACT FROM AUTHOR]

Background: While there is accumulated evidence showing the rapid rise of the burden caused by noncommunicable diseases (NCDs) in Vietnam, information on the extent to which households in the country suffer financial catastrophe or impoverishment caused by the diseases is still largely lacking. This paper aims to examine the self-reported prevalence of major chronic diseases among a population in rural Vietnam and to analyse the household financial burden associated with these diseases. Methods: A cross-sectional survey of 800 randomly selected households was carried out in Vo Nhai District, Thai Nguyen Province, in 2010. Face-to-face interviews were conducted with key informants of selected households on diagnosed chronic NCDs, health care utilization and health expenditure of all household members. The World Health Organization's definitions of catastrophic expenditure and impoverishment were used. Both descriptive and analytical statistics were applied. Results: The prevalence of chronic NCDs in households and individuals was 29.3 and 33.4%, respectively. The catastrophic health expenditure and impoverishment rates among the households who have at least one member with a chronic disease were 14.6 and 7.6%, respectively. These rates were significantly higher than the corresponding figures among the households whose members were free from the diseases (4.2 and 2.3%, respectively). The odds of experiencing catastrophic health expenditure and impoverishment among the household with NCD patients were 3.2 and 2.3 times greater than that of other households. Conclusion: Findings from this study indicate that the epidemiological and household financial burdens caused by chronic diseases in Vietnam are now substantial and need immediate mitigation measures. [ABSTRACT FROM AUTHOR]

Background: While there is accumulated evidence showing the rapid rise of the burden caused by non-communicable diseases (NCDs) in Vietnam, information on the extent to which households in the country suffer financial catastrophe or impoverishment caused by the diseases is still largely lacking. This paper aims to examine the self-reported prevalence of major chronic diseases among a population in rural Vietnam and to analyse the household financial burden associated with these diseases. Methods: A cross-sectional survey of 800 randomly selected households was carried out in Vo Nhai District, Thai Nguyen Province, in 2010. Face-to-face interviews were conducted with key informants of selected households on diagnosed chronic NCDs, health care utilization and health expenditure of all household members. The World Health Organization's definitions of catastrophic expenditure and impoverishment were used. Both descriptive and analytical statistics were applied. Results: The prevalence of chronic NCDs in households and individuals was 29.3 and 33.4%, respectively. The catastrophic health expenditure and impoverishment rates among the households who have at least one member with a chronic disease were 14.6 and 7.6%, respectively. These rates were significantly higher than the corresponding figures among the households whose members were free from the diseases (4.2 and 2.3%, respectively). The odds of experiencing catastrophic health expenditure and impoverishment among the household with NCD patients were 3.2 and 2.3 times greater than that of other households. Conclusion: Findings from this study indicate that the epidemiological and household financial burdens caused by chronic diseases in Vietnam are now substantial and need immediate mitigation measures. [ABSTRACT FROM AUTHOR]

The events of the early 1930s in Vietnam left an important legacy to France's literature of enquiry and protest. Writers, essayists and journalists enquired on behalf of their audiences, and in the process developed France's littérature coloniale. By showing an interest in the colonial 'other' and identifying discrepancies between imperial ideology and colonial reality, they formed a new body of thought. This new colonial humanism arguably changed metropolitan sensibilities towards the French civilizing mission. Nevertheless, while they are critical of colonial abuses and in favour of reforms, the authors discussed in this paper do not really question the French colonial project. [ABSTRACT FROM AUTHOR]

This paper presents a qualitative study conducted in 2009 of provider and patient perceptions of primary level reproductive health services provided by commune health stations (CHSs), and the implications for Viet Nam's 2011–2020 National Strategy for Reproductive Health Care. In the three provinces of Thai Nguyen, Thua Thien Hue, and Vinh Long, we interviewed the heads of CHSs, held focus group discussions with midwives and women patients, and observed facilities. Half the 30 CHSs visited were in poor physical condition; the rest were newly renovated. However, the model of service delivery was largely unchanged from ten years before. Many appeared to fall short in meeting patient expectations in terms of modern medical equipment and technology, range of drug supplies, and levels of staff expertise. As a result, many women were turning to private doctors and public hospitals, at least in urban areas, or seeking medication from pharmacies. To make CHS clinics sustainable, promotion of access to reproductive health services should be undertaken concurrently with quality improvement. A responsive payment scheme must also be developed to generate revenues. Efforts should be made to reduce the unnecessary use of more costly services from private clinics and higher level public facilities. Cet article présente une étude qualitative réalisée en 2009 sur les perceptions chez les prestataires et les patients des services de santé génésique de niveau primaire assurés par les centres de santé communaux (CSC) et leurs conséquences pour la Stratégie nationale de soins de santé génésique 2011–2020 du Viet Nam. Dans les trois provinces de Thai Nguyen, Thua Thien Hue et Vinh Long, nous avons interrogé les chefs des CSC, organisé des discussions par groupe d'intérêt avec des sages–femmes et des patientes, et observé les installations. La moitié des 30 CSC visités étaient en mauvais état ; les autres venaient d'être rénovés. Néanmoins, lemodèle de prestation de services n'avait presque pas changé depuis dix ans. Beaucoup de CSC ne semblaient pas répondre aux attentes des patientes du point de vue de la modernité de l'équipement médical et de la technologie, du choix de médicaments disponibles et du niveau de compétence du personnel. Beaucoup de femmes s'adressaient donc à des médecins privés et des hôpitaux publics, au moins dans les zones urbaines, ou demandaient des médicaments dans les pharmacies. Pour que les CSC deviennent viables, la promotion de l'accès aux services de santé génésique doit être entreprise conjointement avec l'amélioration de la qualité. Un plan de paiement réactif doit aussi être mis au point pour créer des recettes. Il faut s'efforcer de réduire le recours inutile aux services coûteux de médecins et de centres privés ou d'installations publiques de niveau supérieur. En este artículo se presenta un estudio cualitativo realizado en 2009 de las percepciones del personal de salud y pacientes en cuanto a los servicios de salud reproductiva proporcionados en el primer nivel de atención por estaciones de salud comunitarias (CHS por sus siglas en inglés) y las implicaciones para la Estrategia Nacional de Servicios de Salud Reproductiva en Vietnam, del 2011 al 2020. En las tres provincias de Thai Nguyen, Thua Thien Hue y Vinh Long, entrevistamos la dirección de las CHS, realizamos discusiones en grupos focales con parteras profesionales y mujeres pacientes y observamos las unidades de salud. La mitad de las 30 CHS visitadas se encontraban en malas condiciones físicas; el resto había sido renovado recientemente. Sin embargo, hubo muy pocos cambios en el modelo de prestación de servicios creado diez años atrás. En muchas de las CHS hubo considerable insatisfacción por parte de las pacientes en cuanto al equipo médico moderno y la tecnología, la variedad de medicamentos y los niveles de conocimientos y experiencia del personal. Por consiguiente, muchas mujeres estaban acudiendo a médicos particulares y hospitales públicos, por lo menos en las zonas urbanas, o buscando medicamentos en las farmacias. Para lograr la sostenibilidad de las CHS, se debe promover el acceso a los servicios de salud reproductiva a la vez que se mejora la calidad. Además, se debe elaborar un esquema de pago receptivo para generar ingresos y se deben realizar esfuerzos por reducir el uso innecesario de servicios costosos proporcionados por médicos y clínicas particulares y unidades públicas de nivel superior. [ABSTRACT FROM AUTHOR]

Aim: Policymaking in Vietnam has traditionally been the preserve of the political elite, not open to the scrutiny of those outside the Communist Party. This paper aims to analyse Vietnam's HIV policy development in order to describe and understand the policy content, policy-making processes, actors and obstacles to policy implementation. Methods: Nine policy documents on HIV were analysed and 17 key informant interviews were conducted in Hanoi and Quang Ninh Province, based on a predesigned interview guide. Framework analysis, a type of qualitative content analysis, was applied for data analysis. Results: Our main finding was that during the last two decades, developments in HIV policy in Vietnam were driven in a top-down way by the state organs, with support and resources coming from international agencies. Four major themes were identified: HIV policy content, the policy-making processes, the actors involved and human resources for policy implementation. Vietnam's HIV policy has evolved from one focused on punitive control measures to a more rights-based approach, encompassing harm reduction and payment of health insurance for medical costs of patients with HIV-related illness. Low salaries and staff reluctance to work with patients, many of whom are drug users and female sex workers, were described as the main barriers to low health staff motivation. Conclusion: Health policy analysis approaches can be applied in a traditional one party state and can demonstrate how similar policy changes take place, as those found in pluralistic societies, but through more top-down and somewhat hidden processes. Enhanced participation of other actors, like civil society in the policy process, is likely to contribute to policy formulation and implementation that meets the diverse needs and concerns of its population. [ABSTRACT FROM AUTHOR]

Background: To effectively and efficiently respond to the growing health needs of older people, it is critical to have an indepth understanding about their health status, quality of life (QoL) and related factors. This paper, taking advantage of the INDEPTH WHO-SAGE study on global ageing and adult health, aims to describe the pattern of health status and QoL among older adults in a rural community of Viet Nam, and examine their associations with some socio-economic factors. Methods: The study was carried out in the Bavi District, a rural community located 60 km west of Hanoi, the capital, within the Epidemiological Field Laboratory of Bavi (FilaBavi). Face-to-face household interviews were conducted with people aged 50 years and over who lived in the FilaBavi area. The interviews were performed by trained surveyors from FilaBavi using a standard summary version SAGE questionnaire. Both descriptive and analytical statistics were used to examine the patterns of health status and QoL, and associations with socio-economic factors. Results: Higher proportions of women reported both poor health status and poor QoL compared to men. Age was shown to be a factor significantly associated with poor health status and poor QoL. Higher educational level was a significant positive predictor of both health status and QoL among the study subjects. Higher economic status was also associated with both health status and QoL. The respondents whose families included more older people were significantly less likely to have poor QoL. Conclusion: The findings reveal problems of inequality in health status and QoL among older adults in the study setting by sex, age, education and socio-economic status. Given the findings, actions targeted towards improving the health of disadvantaged people (women, older people and lower education and economic status) are needed in this setting. [ABSTRACT FROM AUTHOR]

Amateur films, home movies, home videos - whatever they might be called - have been described as providing authentic, alternative, and personalised views of life, on subjects ranging from simple family rituals to cataclysmic events such as natural disasters and war. The importance of these records as resources for historical and social research is increasingly being acknowledged by the academic community, as well as by commercial program makers who have long been aware of their potential. This paper focuses on one collection, the amateur films shot by Australian troops during their deployment in Vietnam. These films present a view of the Vietnam War distinctly different to the perspective offered by official records and other sources of information, and they offer an insight into the soldiers' own perspective which is not necessarily available elsewhere. As such, they represent a significant research resource in their own right, providing rich primary material for a wide range of researcher activities. [ABSTRACT FROM AUTHOR]

Strategic environmental assessment (SEA) application to city development strategy (CDS) reveals the strategic nature of both instruments and their potential multiplier effect on enhancing synergies for sustainable development. The adequacy of the two strategic tools for a complementary approach to integration towards sustainable development raises an outstanding opportunity to walk the talk in view of enhancing sustainable development. In Vietnam, SEA and CDS are being considered jointly in the context of urban development projects and public administration reform. The main features of the link between SEA and CDS are described in this paper, after introducing the SEA and CDS concepts. [ABSTRACT FROM AUTHOR]

HIV transmission in Vietnam is strongly linked to drug injection, but there is the potential for an epidemic driven by sexual behaviour. HIV-education programmes to date focus largely on personal responsibility and fail to address adequately other aspects of HIV-related risks in social contexts. Based on ethnographic fieldwork conducted in 2002, this paper examines the association between HIV-related risks (unsafe drug use and unsafe sex) and gender relations among injecting drug users. Three patterns of relationships are analysed: between injecting drug users and their injecting partners; between injecting drug users and their smoking partners; and between injecting drug users and their non-using partners. Data shows that intimate relations play an important role in managing HIV-related risks among injecting drug users. HIV prevention must pay due attention to the specific contexts of injecting drug users' lives. Some implications of these findings are discussed and relevant recommendations are proposed. [ABSTRACT FROM AUTHOR]

This paper presents selected findings from a larger study on reproductive tract infections (RTIs) among women seeking abortion in Northern Vietnam. In particular it focuses on women's experience of RTIs within the context of their perceptions of female physiology and what women do to prevent and treat RTIs. The approach used was a combination of the quantitative and the qualitative: 748 structured interviews were undertaken before, and 701 after, abortion; and in-depth interviews were carried out with 20 women and 20 healthcare providers. Both healthcare providers and women believed that RTIs are an essential and normal part of womanhood. Reproductive tract infections were associated with laziness, being unclean and hesitance in using health facilities for help with gynecological problems. Women used various forms of self-treatment, including some that may be medically harmful. Women's preventive and treatment strategies were often supported and sometimes even promoted by healthcare providers. We assess women's strategies for RTI prevention and treatment in the context of the current Vietnamese health system and from a gender perspective. These strategies highlight inadequacies in the public healthcare system, while also pointing to important cultural paradoxes in the understanding of womanhood in contemporary Vietnam. [ABSTRACT FROM AUTHOR]

Male sexual health concerns are often construed in the medical literature as linked only to genital and reproductive difficulties and malfunctions. However, in reality, male sexual health concerns encompass a broader range of issues and should not be so narrowly conceived. This paper explores men's perceptions of sexual health concerns in Muong Khen, a rural town in northwestern Vietnam. Data were collected through observation, in-depth interviews and focus group discussions. Findings suggest that men's sexual health concerns are strongly related to worries about economic problems, excessive drinking, men's beliefs about how their bodies work and the hegemonic notion that a man should be responsible for his family's economic well-being. [ABSTRACT FROM AUTHOR]

In Viet Nam, abortion has been legal up to 22 weeks of pregnancy since the 1960s. There are about one million induced abortions every year. First trimester abortion is provided at central, provincial, district and commune level, while second trimester abortion is provided only at central and provincial level. For second trimester abortion, dilatation and evacuation (D&E) has been introduced at some central and provincial hospitals, and medical abortion protocols have been included in the draft National Standards and Guidelines currently being updated. However, Kovac's, an unsafe method, is still often used at many provincial hospitals. While access to first trimester abortion services is not difficult, there are still many barriers to second trimester abortion, especially for young, unmarried women. In order to prevent unwanted pregnancies, increase access to safe abortion and improve quality of care, the Vietnamese Ministry of Health is working with others to establish national policies and developing effective models for women-friendly comprehensive abortion care, including post-abortion family planning. This paper, based on published information, interviews and observations by the second author of service delivery in 2006–2008, provides an overview of second trimester abortion services in Viet Nam and ongoing plans for improving them. Au Viet Nam, depuis les années 60, l'avortement est légal jusqu'à 22 semaines de grossesse. Près d'un million d'avortements y sont pratiqués chaque année. L'avortement du premier trimestre est assuré aux niveaux central, provincial, du district et de la commune. Pour l'avortement du deuxième trimestre, certains hôpitaux centraux et provinciaux ont introduit la méthode par dilatation et évacuation, et le projet de normes et directives nationales qui est actuellement mis à jour inclut des protocoles d'avortement médicamenteux. Néanmoins, même si elle n'est pas sûre, la méthode Kovac est encore souvent utilisée dans beaucoup d'hôpitaux provinciaux. Alors que l'accès à l'avortement du premier trimestre est aisé, de nombreux obstacles demeurent à l'avortement du deuxième trimestre, en particulier pour les jeunes femmes célibataires. Afin d'éviter les grossesses non désirées, élargir l'accès à l'avortement médicalisé et relever la qualité des soins, le Ministère vietnamien de la santé collabore avec d'autres institutions pour définir des politiques nationales et établir des modèles efficaces de services d'avortement centrés autour des femmes, notamment de planification familiale post-avortement. Cet article, fondé sur des informations publiées, des entretiens et l'observation de la prestation de services par les auteurs en 2006-2008, décrit les services d'avortement du deuxième trimestre au Viet Nam et les projets en cours pour les améliorer. En Viet Nam, el aborto es legal hasta las 22 semanas de embarazo desde la década de los sesenta. Cada año se inducen aproximadamente un millón de abortos. A nivel central, provincial, distrital y comunal, se proporcionan servicios de aborto en el primer trimestre, mientras que los de segundo trimestre son proporcionados sólo a nivel central y provincial. Para este último, la dilatación y evacuación (D&E) ha sido introducida en algunos hospitales centrales y provinciales, y los protocolos de aborto con medicamentos se han incluido en la versión preliminar de las Normas y Directrices Nacionales, en proceso de actualización. Sin embargo, Kovac, un método inseguro, aún se utiliza con frecuencia en muchos hospitales provinciales. Aunque no es difícil acceder a los servicios de aborto en el primer trimestre, todavía existen muchas barreras al aborto en el segundo trimestre, especialmente para las mujeres jóvenes y solteras. A fin de evitar embarazos no deseados, ampliar el acceso al aborto seguro y mejorar la calidad de la atención, el Ministerio de Salud de Viet Nam está trabajando con otros para establecer políticas nacionales y crear modelos eficaces para la atención integral del aborto centrada en la mujer, que incluyan la planificación familiar postaborto. En este artículo, basado en información publicada, entrevistas y observaciones de los autores de la prestación de servicios en 2006–2008, se proporciona una visión general de los servicios de aborto en el segundo trimestre en Viet Nam y de los planes en curso para mejorarlos. [ABSTRACT FROM AUTHOR]

Access to safe second trimester abortion services is poor in many countries, sometimes despite liberal laws and policies. Addressing the myriad factors hindering access to safe abortion care requires a multi-pronged strategy. Workshops aimed at clarifying values are useful for addressing barriers to access stemming from misinformation, stigmatisation of women and providers, and negative attitudes and obstructionist behaviours. They engage health care providers and administrators, policymakers, community members and others in a process of self-examination with the goal of transforming abortion-related attitudes and behaviours in a direction supportive of women seeking abortion. This is especially important for women seeking second trimester abortion, which tends to be even more stigmatised than first trimester abortion. This paper reports on some promising experiences and results from workshops in Viet Nam, Nepal and South Africa. Some recommendations that emerge are that values clarification should be included in abortion training, service delivery and advocacy programmes. Evaluations of such interventions are also needed. Dans beaucoup de pays, l'accès aux services d'avortement du deuxième trimestre est médiocre, parfois en dépit de lois et de politiques libérales. Pour s'attaquer aux multiples facteurs qui entravent l'accès à des soins sécurisés, il faut appliquer une stratégie à plusieurs volets. Des ateliers destinés à clarifier les valeurs et transformer les attitudes sont utiles pour lever les obstacles créés par les idées fausses, la stigmatisation à l'égard des femmes et des prestataires de services et aussi par les attitudes négatives et les comportements obstructionnistes. Ils engagent les soignants et les administrateurs, les décideurs, les membres de la communauté et d'autres catégories dans un processus d'auto-examen qui a pour but de réorienter leurs attitudes et leurs comportements, de façon à soutenir les femmes qui souhaitent avorter. C'est particulièrement important pour celles qui veulent avorter au deuxième trimestre, car elles sont en général encore plus stigmatisées que celles qui le font au premier trimestre. Cet article décrit des expériences prometteuses et les résultats positifs d'ateliers au Viet Nam, au Népal et en Afrique du Sud. La clarification des valeurs devrait être incluse dans la formation à l'avortement, la prestation des services et les programmes de plaidoyer. Des évaluations de ces interventions sont également nécessaires. Muchos países carecen de acceso a servicios seguros de aborto en el segundo trimestre, a veces pese a leyes y políticas liberales. Para tratar los diversos factores que obstaculizan el acceso a los servicios de aborto seguro se necesita una estrategia de múltiples facetas. Los talleres de aclaración de valores y transformación de actitudes sirven para eliminar las barreras al acceso que surgen de información errónea, estigmatización de mujeres y prestadores de servicios, actitudes negativas y comportamientos obstruccionistas. En estos talleres, los administradores y prestadores de servicios de salud, formuladores de políticas, miembros de la comunidad y otros participan en un proceso de autoexamen con el objetivo de transformar sus actitudes y comportamientos respecto al aborto con el fin de brindar apoyo a las mujeres que buscan un aborto. Esto es de particular relevancia para aquéllas que necesitan servicios de aborto en el segundo trimestre, que tiende a ser aun más estigmatizado que el aborto en el primer trimestre. En este artículo se informa sobre experiencias y resultados prometedores de talleres en Vietnam, Nepal y Sudáfrica. Algunas recomendaciones que emergen son que la aclaración de valores debe incluirse en la capacitación, la prestación de servicios y los programas de promoción y defensa relacionados con el aborto. También es necesario evaluar dichas intervenciones. [ABSTRACT FROM AUTHOR]

This paper examines the process of transformation of domestic trade in the early independent Democratic Republic of Vietnam, focusing on the grain sector. It argues that, after the severe food crisis of the spring of 1955, the regime called for structural changes and tried to establish a predominant socialist trade system, without however resorting to a state monopoly, but failed to implement the new institutions of socialist trade. The study further shows that this failure, together with other domestic policy issues, compelled the leaders of the DRV to tolerate de facto until about the second half of 1959 a modus vivendi between the state grain sector and the private economic actors. It also demonstrates that these institutional arrangements and innovative procurement policies were in fact quite successful: the food supplies, sold through the public distribution system and the market channels, were on the whole adequate; and the state procurement of paddy increased noticeably. However, because of heated debates in the Political Bureau, partly due to the failure of the state policy, this compromise came to an abrupt end in April 1959 and was followed by a rapid and drastic shift towards the construction of socialism. As a result, private trade had practically disappeared by the end of 1960. [ABSTRACT FROM AUTHOR]

Gender inequality is now widely acknowledged as an important factor in the spread and entrenchment of poverty. This article examines the World Development Report 2000/01 as the World Bank's blueprint for addressing poverty in the twenty-first century, together with several more recent Poverty Reduction Strategy Papers (PRSPs), with a view to analysing the manner in which gender is incorporated into the policy-making process and considering whether it constitutes a new approach to gender and poverty. It is argued that the World Bank's approach to poverty is unlikely to deliver gender justice, because there remain large discrepancies between the economic and social policies that it prescribes. More specifically, the authors contend that the Bank employs an integrationist approach which encapsulates gender issues within existing development paradigms without attempting to transform an overall development agenda whose ultimate objective is economic growth as opposed to equity. Case studies from Cambodia and Vietnam are used to illustrate these arguments. [ABSTRACT FROM AUTHOR]

Vietnam has advanced far beyond most other developing countries and, indeed, surpasses many developed countries in adopting a legal framework based on gender equality, and in creating institutions and programmes to support women's advancement. Inegalitarian gender norms have also persisted, however. The Vietnam Women's Union promotes women's educational, political and economic advancement but simultaneously exhorts women to pay attention to their Confucian role of maintaining family hierarchy and harmony. This paper presents findings from qualitative research examining gender relations at the grassroots level in central Vietnam. It argues that the Vietnam Women's Union could support women more effectively by promoting greater diversity in gender norms and by initiating a public discussion to address the pressures women face in trying to achieve ideals that are often experienced as contradictory and unattainable. [ABSTRACT FROM AUTHOR]

This paper presents the findings of a qualitative study of women's perceptions of reproductive tract infection in two communes in northern Viet Nam. The objective of the study was to gain information concerning women's perceptions of reproductive tract infection and their associated symptoms and help seeking behaviours. Focus group discussions, in-depth interviews, free listings and pile sortings were conducted with approximately 230 women. Although infections are perceived to be common and to cause much discomfort, there is little consistency in the reporting of symptoms, causes and consequences of infection. Perceived causes are predominantly associated with dampness and exposure to dirty water, although there is also a perceived association with medical procedures such as IUD insertion and abortion. Little attention is paid to the risk of sexual transmission. Treatment is generally with guava liquid and 'hygienic washes' at home, with women only consulting a health care provider if symptoms persist or worsen. The findings highlight the need for further training of providers to understand better the perceptions of women; the expansion of information activities, particularly to include accurate information on reproductive physiology, the causes of infection and the possibility of sexual transmission; and strengthening the quality of IUD and abortion services. [ABSTRACT FROM AUTHOR]

Comprehensive national educational change is a complex and often difficult process. In countries such as Viet Nam where the government exercises tight control over social and economic development strategies, wide scale changes to an education system are often not possible. Viet Nam's increasing engagement with private sector development has, however, enabled greater flexibility for improving and strengthening its education system. In response to Viet Nam's transition to a market economy, educational planners have had to consider strategies for making the education system more responsive to current and future labour demands. Accordingly, beginning in the early 1990s, the Government of Viet Nam put in place policies to enable the education system to 'modernise'. Guided by the principle that an investment in education is an investment in economic development, the government has pursued and continues to pursue an agenda of educational reform by means of curriculum reform. Early evidence indicates that despite an initial rapid development and implementation of change-driven policies and strategic directions, the pace of reform is slowing down. The thesis of this paper is that a programme of substantial education change and innovation in Viet Nam is actually a programme of cautious reform based on select targeting of particular school populations, in this case, populations in the larger cities, economic priority zones and urban areas. [ABSTRACT FROM AUTHOR]

This paper compares the changing strategies of women and their families during the economic transition in China and Vietnam. Employment strategies to improve the family's well-being have resulted in increased rural-urban migration by men and young women, while middle-aged, married women remain in the countryside taking care of the farms and children. Although women have been able to take advantage of new opportunities for employment in nonstate firms and their own entrepreneurial endeavors, their employment strategies are limited by increasing discrimination in hiring and layoffs. Moreover, the policy problems play out within the family in changing bargaining power, including decisions about education and health care. [ABSTRACT FROM AUTHOR]

With the collapse of the communist states of Eastern Europe and the disintegration of the old Soviet Union, is it only the capitalist model which remains? Or is there another way which is neither capitalist nor the old Marxist? Is there a third way for economic and political development? Possibly a better way? Vietnam is trying very hard to find the answer to these questions and if any country deserved to find that better way, it would be Vietnam. Thirteenth largest country in the world with a population of 67 million in 1991, up 2.5 million in two years, it is also one of the poorest. This paper considers the future of socialism in Vietnam in the light of the economic and political reforms which have been taking place, particularly since 1986. It also looks at the major current problems, the impact of the collapse of the former communist regimes and the possible way ahead. [ABSTRACT FROM AUTHOR]

Background: Breast cancer incidence has been increasing consistently in Vietnam. Thus far, there have been no analytical reviews of research produced within this area. Objectives: We sought to analyse the nature andextent of empirical studies about breast cancer in Vietnam, identifying areas for future research and systemsstrengthening. Methods: We undertook a scoping study using a five-stage framework to review published and grey literature in English and Vietnamese on breast cancer detection, diagnosis and treatment. We focused specifically on research discussing the health system and service provision. Results: Our results show that breast cancer screening is limited, with no permanent or integrated national screening activities. There is a lack of information on screening processes and on the integration of screening services with other areas of the health system. Treatment is largely centralised, and across all services there is a lack of evaluation and data collection that would be informative for recommendations seeking to improve accessibility and quality of breast cancer services. Conclusions: This paper is the first scoping review of breast cancer services in Vietnam. It outlines areas for future focus for policy makers and researchers with the objective of strengthening service provision to women with breast cancer across the country while also providing a methodological example for how to conduct a collaborative scoping review. [ABSTRACT FROM AUTHOR]