1. Multiple vulnerabilities and maternal healthcare in Vietnam: findings from the Multiple Indicator Cluster Surveys, 2000, 2006, and 2011
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Chul Ou Lee, Hoang Van Minh, Vu Duy Kien, Tran Thi Huong, Luu Ngoc Hoat, Juhwan Oh, Kim Bao Giang, You Seon Nam, and This paper was written as part of collaborative project on strengthening health system in Viet Nam which is being implemented by Hanoi Medical University, University of Medicine and Pharmacy of Ho Chi Minh City, Viet Nam and LEE Jong-wook Center for Globa
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Rural Population ,Program evaluation ,inequality ,Ethnic group ,0302 clinical medicine ,Pregnancy ,Surveys and Questionnaires ,Health care ,Ethnicity ,Medicine ,030212 general & internal medicine ,Socioeconomics ,media_common ,education.field_of_study ,Multiple Indicator Cluster Surveys ,lcsh:Public aspects of medicine ,Health Policy ,healthcare ,Public Health, Global Health, Social Medicine and Epidemiology ,multiple socioeconomic vulnerabilities ,Vietnam ,Female ,Original Article ,Public Health ,0305 other medical science ,Adult ,Inequality ,media_common.quotation_subject ,Population ,Developing country ,03 medical and health sciences ,Environmental health ,Humans ,Maternal Health Services ,Healthcare Disparities ,education ,Socioeconomic status ,030505 public health ,skilled antenatal care ,business.industry ,Public Health, Environmental and Occupational Health ,skilled delivery ,inequity ,lcsh:RA1-1270 ,Patient Acceptance of Health Care ,Delivery, Obstetric ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,Cross-Sectional Studies ,Socioeconomic Factors ,Special Issue: Millennium Development Goals in Vietnam: the Progress and Social Determinants ,business - Abstract
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 though Vietnam 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.Keywords: healthcare; skilled antenatal care; skilled delivery; multiple socioeconomic vulnerabilities; inequity; inequality(Published: 29 February 2016)Citation: Glob Health Action 2016, 9: 29386 - http://dx.doi.org/10.3402/gha.v9.29386This paper is part of the Special Issue: Millennium Development Goals in Vietnam: the Progress and Social Determinants. More papers from this issue can be found at www.globalhealthaction.net
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- 2016