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Purpose Undifferentiated embryonal sarcoma of the liver (UESL) is a rare malignant lesion in adults. Here, we present an extremely rare case of UESL in a pregnant woman. However, this was the first case, wherein one surgery covered all the procedures needed to be performed, including delivery of the neonate, hysterectomy, and resection of the left liver lobe to ensure the safety of both the mother and the newborn. Case presentation A 32-year-old woman at 37-weeks age of gestation was admitted at Bach Mai Hospital (Hanoi, Vietnam) due to epigastric pain, chest pain, and breathing difficulty. Blood tests showed an increased total alpha-fetoprotein level of 1085 ng/mL. Fetal ultrasound showed a fetal heart rate of 127 beats/minute, biparietal diameter of 92 mm, femur length of 70 mm, and fetal weight of 3287 g. Magnetic resonance imaging indicated a large tumor (12 × 14 × 18 mm) in the left liver, with organ signals increased on T2-weighted and decreased on T1-weighted. The mass was lobulated, developed along a downward pattern, and did not invade the portal vein. The surgeries performed were cesarean section, hysterectomy due to the inelasticity of the uterus, and left hepatectomy to ensure the safety of both the mother and newborn. The operation was performed safely and without any complications, and the patient was discharged from the hospital after 10 days. Conclusion This case report with distinct characteristics has been the first case ever reported in Vietnam, as well as in the literature. We believe that this case report will be useful for the clinical evidence pool and for educational purposes.

The COVID-19 pandemic is a global health crisis and threatening human lives, especially vulnerable groups. This study aimed to estimate the prevalence of self-reported anxiety and to examine associated factors among the Vietnamese population during the COVID-19 pandemic. A cross-sectional study in Vietnam was conducted in April 2020. An online survey was used to do the rapid assessment. Among 1,249 participants, the prevalence of self-reported anxiety was 8.5%. In the multivariable regression models, significant factors for self-reported anxiety were people aged 60 years old or older, rural areas, and COVID-related music-video-watching. Implications for social work practice were also discussed.

Background: The National Hypertention Prevention and Control has been set as the Vietnam national health target program, 2008 to 2020 and functions and responsibilities of commune health centers (C...

Background: Vietnamese children older than six are not covered by Health Insurance Scheme for strabismus, ptosis, refractive error. Consequently, they are not getting appropriate treatment. Health ...

This paper aims to assess the level of job satisfaction among healthcare staffs at commune health stations and explore the determinants at the individual and contextual levels. Data on 1,666 health...

The burden of non-communicable diseases (NCDs) continues to grow in Vietnam, and reducing the burden of NCDs is a national priority. This study explored perspective of community health workers (CHWs), known as Village Health Workers (VHWs) in Vietnam, and public health leaders towards potential of expanding VHWs' role to deliver NCDs prevention and control services, and determined barriers and facilitators. We conducted focus group discussions (FGDs) with VHWs (

Vietnam’s health system continues to make great progress in improving its capacities and performance. However, despite the many significant achievements that have been made, this paper summaries 11 health system research papers from different perspectives with the aim of providing scientific evidence for policy actions in Vietnam. Health system research is ultimately concerned with improving the health of people and communities, by enhancing the efficiency and effectiveness of the health system as an integral part of the overall process of socioeconomic development, with full involvement of all actors. We hope the findings from this cluster of papers provide some insights into issues of importance for the continued advancement and strengthening of the health system in Vietnam and can be considered a valid and reliable resource to inform planning, management and policy-making decisions.

Disability is shown to be both a cause and a consequence of poverty. However, relatively little research has investigated the economic cost of living with a disability. This study reports the results of a study on the extra cost of living with disability in Vietnam in 2011. The study was carried out in eight cities/provinces in Vietnam, including Hanoi and Ho Chi Minh cities (two major metropolitan in Vietnam) and six provinces from each of the six socio-economic regions in Vietnam. Costs are estimated using the standard of living approach whereby the difference in incomes between people with disability and those without disability for a given standard of living serves as a proxy for the cost of living with disability. The extra cost of living with disability in Vietnam accounted for about 8.8-9.5% of annual household income, or valued about US$200-218. Communication difficulty was shown to result in highest additional cost of living with disability and self-care difficulty was shown to lead to the lowest levels of extra of living cost. The extra cost of living with disability increased as people had more severe impairment. Interventions to promote the economic security of livelihood for people with disabilities are needed.

Expanding effective coverage in Vietnam will require better use of available resources and placing higher priority on primary care. The way providers are currently paid does not give priority to primary care and does not reflect the costs of delivering services. This paper aims to estimate the unit costs of primary care visits at commune health stations (CHS) in selected areas in Vietnam. Seventy-six CHS from two provinces in northern Vietnam were studied. Costs were calculated from the perspective of the CHS using the top-down costing using the step-down cost accounting technique in order to estimate the full cost of delivering services. On average, the cost of one outpatient visit in mountainous, rural and urban CHSs was VND 49,521 (US$2.40), VND 41,375 (US$2.01) and VND 39,794 (US$1.93), respectively. Personnel costs accounted for the highest share of total costs followed by medicines. The share of operating costs was minimal. On average, CHSs recover 18.9% of their total cost for an outpatient visit from social insurance payments or fees that can be charged patients. The results provide valuable information for policy-makers as they revise the provider payment methods to better reflect the costs of services and give greater priority to primary care.

This study aimed to assess alcohol use and alcohol consumption-related problems in different sociodemographic groups in a rural district in Vietnam. Interviews were completed between March 2004 and July 2004. The Alcohol Use Disorder Identification Test (AUDIT) was applied to interview 3423 people, who were randomly selected in a rural district (1695 men and 1728 women). People who had an AUDIT score greater than 7 (in men) or greater than 5 (in women) were identified as having alcohol consumption-related problems. Prevalences and adjusted odds ratios of alcohol use and alcohol consumption-related problems were estimated for different subgroups of the population. Weekly and daily "binge drinking" among men were 5.7 and 3.6%, while binge drinking in women was virtually nonexistent. The prevalence of alcohol consumption-related problems was 25.5% among men and 0.7% among women. The differences between sociodemographic groups were not strong, but women who were separated, divorced, or widowed as well as those with higher education had significantly higher rates of alcohol consumption-related problems than married women and those with lower education. This study indicates an urgent need for alcohol intervention programs focused on men. However, further monitoring of alcohol use and problems among women is important to follow-up changes in consumption pattern. The study's limitations are discussed.

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

Vietnam has made impressive progress toward improving the health status of the population, with progress that equals or surpasses that of many neighboring countries. Life expectancy in Vietnam is 72.8 years (70.2 for men and 75.6 for women), a level that is considerably higher than that in many countries with similar levels of GDP per capita. From 1990 to 2009, the infant mortality rate fell from 44.4% to 16.0%, the under-five mortality rate dropped from 58.0% to 24.5%, and the maternal mortality ratio declined from 233 to 69 maternal deaths per 100,000 live births. Estimated to be around 18% in 2010, the rate of under-five malnutrition has also fallen dramatically. These improvements are attributable to a widespread health care delivery network, increasing numbers of qualified health workers, and expanding national public health programs. (Published: 25 February 2013) Citation: Glob Health Action 2013, 6 : 20443 - http://dx.doi.org/10.3402/gha.v6i0.20443

Background: Globally, ageing impacts all countries, with a majority of older persons residing in lower- and middle-income countries now and into the future. An understanding of the health and well-being of these ageing populations is important for policy and planning; however, research on ageing and adult health that informs policy predominantly comes from higher-income countries. A collaboration between the WHO Study on global AGEing and adult health (SAGE) and International Network for the Demographic Evaluation of Populations and Their Health in developing countries (INDEPTH), with support from the US National Institute on Aging (NIA) and the Swedish Council for Working Life and Social Research (FAS), has resulted in valuable health, disability and well-being information through a first wave of data collection in 2006-2007 from field sites in South Africa, Tanzania, Kenya, Ghana, Viet Nam, Bangladesh, Indonesia and India. Objective: To provide an overview of the demographic and health characteristics of participating countries, describe the research collaboration and introduce the first dataset and outputs. Methods: Data from two SAGE survey modules implemented in eight Health and Demographic Surveillance Systems (HDSS) were merged with core HDSS data to produce a summary dataset for the site-specific and cross-site analyses described in this supplement. Each participating HDSS site used standardised training materials and survey instruments. Face-to-face interviews were conducted. Ethical clearance was obtained from WHO and the local ethical authority for each participating HDSS site. Results: People aged 50 years and over in the eight participating countries represent over 15% of the current global older population, and is projected to reach 23% by 2030. The Asian HDSS sites have a larger proportion of burden of disease from non-communicable diseases and injuries relative to their African counterparts. A pooled sample of over 46,000 persons aged 50 and over from these eight HDSS sites was produced. The SAGE modules resulted in self-reported health, health status, functioning (from the WHO Disability Assessment Scale (WHODAS-II)) and well-being (from the WHO Quality of Life instrument (WHOQoL) variables). The HDSS databases contributed age, sex, marital status, education, socio-economic status and household size variables. Conclusion: The INDEPTH WHO-SAGE collaboration demonstrates the value and future possibilities for this type of research in informing policy and planning for a number of countries. This INDEPTH WHO- SAGE dataset will be placed in the public domain together with this open-access supplement and will be available through the GHA website (www.globalhealthaction.net) and other repositories. An improved dataset is being developed containing supplementary HDSS variables and vignette-adjusted health variables. This living collaboration is now preparing for a next wave of data collection. Keywords: ageing; survey methods; public health; burden of disease; demographic transition; disability; well-being; health status; INDEPTH WHO-SAGE (Published: 27 September 2010) Citation: Global Health Action Supplement 2, 2010. DOI: 10.3402/gha.v3i0.5302 Access the supplementary material to this article: INDEPTH WHO-SAGE questionnaire (including variants of vignettes), a data dictionary and a password-protected dataset (see Supplementary files under Reading Tools online). To obtain a password for the dataset, please send a request with ‘SAGE data’ as its subject, detailing how you propose to use the data, to global.health@epiph.umu.se

Background: Chronic non-communicable diseases (NCDs) are the leading cause of morbidity, mortality, and disability worldwide. More than 80% of chronic disease deaths occur in low-income and middle-income countries. Epidemiological data on the burden of chronic NCD and the risk factors which predict them are lacking in most low-income countries. The INDEPTH Network (http://www.indepth-network.org) which includes the Health and Demographic Surveillance System (HDSS) with many surveillance sites in lowmiddle income countries provided an opportunity to establish surveillance of the major chronic NCD risk factors in 2005 using a standardised approach. Objective: This paper presents the conceptual framework and research design of the chronic NCD risk factor surveillance within nine rural INDEPTH HDSS settings in Asia. Methods: This multi-site study was designed as a baseline cross-sectional survey with sufficient sample size to measure trends over time. In each of nine HDSS sites in five Asian countries, a sample of 2,000 men and women aged 25-64 years, using the WHO STEPwise approach to Surveillance (http://who.int/chp/steps), was selected using stratified random sampling (in each 10-year interval) from the HDSS sampling frame. Results: A total of 18,494 men and women from the nine sites were interviewed with an overall response rate of 98%. The major NCDs risk factors included self-reported information on tobacco and alcohol consumption, fruit and vegetable intake, physical activity patterns, and measured body weight, height, waist circumference, and blood pressure. A series of training sessions were conducted for research scientists, supervisors, and surveyors in each site. Data quality was ensured through spot check, re-check, and data validation procedures, including accuracy and completeness of data obtained. Standardised data entry programme, created using the EPIDATA software, was used to ensure uniform database structure across sites. The data merging and analysis were done using STATAVersion 10. Conclusion: This multi-site study confirmed the feasibility of conducting chronic NCD risk factor surveillance in the low and middle-income settings by integrating the chronic NCDs risk factor surveillance into an existing HDSS data collection and management setting. This collaborative work has provided reliable epidemiological data as a basis for developing chronic NCD prevention and control activities. Keywords: chronic non-communicable diseases; risk factor surveillance; INDEPTH Network; low-middle income countries; WHO STEPS (Published: 28 September 2009) Citation: Global Health Action Supplement 1, 2009. DOI: 10.3402/gha.v2i0.1984

Background: Low fruit and vegetable consumption is among the top 10 risk factors contributing to mortality worldwide. WHO/FAO recommends intake of a minimum of 400 grams (or five servings) of fruits and vegetables per day for the prevention of chronic diseases such as heart diseases, cancer, diabetes, and obesity. Objective: This paper examines the fruit and vegetable consumption patterns and the prevalence of inadequate fruit and vegetable consumption (less than five servings a day) among the adult population in rural surveillance sites in five Asian countries. Data and methods: The analysis is based on data from a 2005 cross-site study on non-communicable disease risk factors which was conducted in nine Asian INDEPTH Health and Demographic Surveillance System (HDSS) sites. Standardised protocols and methods following the WHO STEPwise approach to risk factor surveillance were used. The total sample was 18,429 adults aged 25-64 years. Multivariate logistic regression analysis was performed to assess the association between socio-demographic factors and inadequate fruit and vegetable consumption. Results: Inadequate fruit and vegetable consumption was common in all study sites. The proportions of inadequate fruit and vegetable consumption ranged from 63.5% in men and 57.5% in women in Chililab HDSS in Vietnam to the whole population in Vadu HDSS in India, and WATCH HDSS in Bangladesh. Multivariate logistic regression analysis in six sites, excludingWATCH and Vadu HDSS, showed that being in oldest age group and having low education were significantly related to inadequate fruit and vegetable consumption, although the pattern was not consistent through all six HDSS. Conclusions: Since such a large proportion of adults in Asia consume an inadequate amount of fruits and vegetables, despite of the abundant availability, education and behaviour change programmes are needed to promote fruit and vegetable consumption. Accurate and useful information about the health benefits of abundant fruit and vegetable consumption should be widely disseminated.Keywords: fruit; vegetables; inadequate consumption; risk factors surveillance; non-communicable diseases; INDEPTH; WHO STEPS(Published: 28 September 2009)Citation: Global Health Action Supplement 1, 2009. DOI: 10.3402/gha.v2i0.1988

This article presents a useful short survey of techniques developed for honey analysis since 1900, mainly in the United States. It was prepared in connection with research on Apis dorsata honey, results of which are published in the current issue of Journal of Apicultural Research, in a paper by Hoang Van Minh together with the other four authors of this summary. Working in the Philippines, they needed an assessment of methods currently available and, because of accessibility of sources, American publications predominate.Professor Steinkraus and Professor Morse are on the staff at Cornell University (at Geneva and Ithaca respectively) in New York State. The other authors are at the University of the Philippines, College of Agriculture, Laguna.

SummaryA study was made of the chemical composition of seven samples of Apis dorsata honey and of one composite sample of Apis mellifera honey, all collected in the Philippines.Carbohydrate made up 90–98% of the total solids of A. dorsata honey; monosaccharides were the predominant sugars, and there was more D-fructose but less D-glucose than in A. mellifera honeys. Melezitose was present in only one sample. In general, A. dorsata honey contained less polysaccharides than A. mellifera honey; kojibiose was present, and possibly trehalose.All honeys were acid. No correlation was found between pH and ash content, and no difference between the ash content of A. dorsata honey (0·17%) and A. mellifera honey. A. dorsata honey contained as much as three times as much nitrogen as A. mellifera honey, but less lactone.