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Trang Thi Hanh Do,1 Quyen Thi Tu Bui,2 Bui Thi Thu Ha,3 Thi Minh Le,3 Vui Thi Le,3 Quynh-Chi Thai Nguyen,3 Kimberly Joyce Lakin,4 Tung Thanh Dang,5 Loi Van Bui,5 Thien Cong Le,5 An Thi Ha Tran,5 Hien Thi Thu Pham,5 Tuan Van Nguyen5 1Faculty of Environmental and Occupational Health, Hanoi University of Public Health, Hanoi, Vietnam; 2Faculty and Fundamental Sciences, Hanoi University of Public Health, Hanoi, Vietnam; 3Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam; 4Nossal Institute for Global Health, Melbourne School of Population and Global Health, Melbourne, Victoria, Australia; 5The National Institute of Mental Health, Bach Mai Hospital, Hanoi, VietnamCorrespondence: Quyen Thi Tu Bui, Department of Biostatistics, Faculty of Fundamental Sciences, Hanoi University of Public Health, 1A Duc Thang Street, Bac Tu Liem District, Hanoi, Vietnam, Tel +84 912 225 245, Fax +84 24 6266 2385, Email btq@huph.edu.vnPurpose: Detection of antenatal common mental disorders in low-resource settings like Vietnam is important and requires a reliable, valid and practical screening tool. Currently, there is no such tool validated for use among pregnant women in Vietnam. This study aims to assess the validity of the Vietnamese version of the 20-item Self Reporting Questionnaire (SRQ-20) by evaluating its reliability, factorial structure, and performance in detecting common mental disorder (CMD) symptoms, thereby identifying the optimum cut-off score for CMD screening among pregnant women in Vietnam.Participants and Methods: A total of 210 pregnant women from four rural communes participated in a face-to-face interview using the Vietnamese version of the SRQ-20, followed by a clinical diagnostic interview based on ICD-10 diagnostic criteria of CMDs. The reliability of the SRQ-20 was assessed by calculating the scale’s Cronbach’s alpha to measure internal consistency. Factor analyses were undertaken to examine the factor structure of the instrument. The Receiver Operating Characteristic (ROC) curve analysis was performed to assess the performance of the SRQ-20 against the clinical diagnosis and to identify the optimum cut-off score.Results: Internal consistency was good, with a Cronbach’s alpha of 0.87. Factor analyses resulted in a 4-factor solution. The area under the ROC curve (AUC) for detection of CMDs was 0.90. The optimum cut-off score of the SRQ-20 for detection of CMD symptoms among Vietnamese pregnant women was 5/6.Conclusion: The Vietnamese version of the SRQ-20 has the capacity to detect CMDs among pregnant women effectively and is recommended for use as a screening tool for CMDs in antenatal care settings in Vietnam.Keywords: SRQ-20, screening, common mental disorders, pregnant women, Vietnam

Bui TT Ha,1 Pham V Tac,2 Duong M Duc,1,3 Doan TT Duong,1 Le M Thi1 1Department of Reproductive Health, Hanoi School of Public Health, 2Department of Personnel and Organization, Ministry of Health, Ba Dinh, Ha Noi, Vietnam; 3International Maternal and Child Health (IMCH), Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden Background: In Vietnam, four or more antenatal care (ANC4+) visits/services among pregnant women have not been officially reported in the health system. Moreover, the factors associated with the use of ANC4+ services have not been studied in previous studies. In this study, we conducted an exploratory analysis to identify the rate of utilization of ANC4+ services and factors associated with use of ANC4+ services among pregnant women in rural areas of Vietnam.Methods: The study was conducted in eight provinces in the South Central Coast region of Vietnam between August 2013 and May 2014. A total of 907 women, who delivered in the past 1 year, participated in the study. Multivariate logistic regression model was used to examine the association between all potential factors and utilization of ANC4+ services.Results: The rate of utilization of ANC4+ services by women in eight South Central Coast provinces was 53.9%. Factors negatively associated with using ANC4+ services were belonging to ethnic minority groups having lower education, doing informal works, having lower income, having lower knowledge on ANC4+ services, and receiving no financial support from the husband. In particular, financial support from the husband was considered important in improving the use of ANC4+ services by women in rural areas.Conclusion: The study asserted an inadequacy for ANC4+ utilization and can contribute to missed opportunities to achieve better maternal outcomes for women in rural areas of Vietnam. The necessity of introducing ANC4+ services in the national guidelines on maternal health care should be disseminated to health policy-makers. Strategies to increase ANC4+ utilization should focus on knowledge improvement and on poor, low-income, and ethnic minority women. Keywords: pregnant women, antenatal care services, ethnic minority, male involvement, South Central Coast provinces, Vietnam

Studies have shown family planning adoption is likely to be more effective for women when men are actively involved. The transtheoretical model of behavior change was used to examine men's involvement in general contraception and intrauterine device (IUD) use by their wives. The study was carried out in rural Vietnam with 651 eligible participants. Cons of IUD use for men in precontemplation and contemplation/preparation were significantly higher than those in the action/maintenance stages, whereas the reverse was true for pros of IUD. The self-efficacy for convincing wife to have IUD in precontemplation was significantly lower than for those in higher stages. Women's education and ages, spontaneous recall of modern contraceptive method, cons for IUD, and self-efficacy for contraception and for convincing wives to get IUD inserted (or continue use) were significant predictors of men's readiness to accept IUD. Interventions are targeted to reduce cons and increase self-efficacy for IUD use. [ABSTRACT FROM AUTHOR]

We tested a social-cognitive intervention to influence contraceptive practices among men living in rural communes in Vietnam. It was predicted that participants who received a stage-targeted program based on the Transtheoretical Model (TTM) would report positive movement in their stage of motivational readiness for their wife to use an intrauterine device (IUD) compared to those in a control condition. A quasi-experimental design was used, where the primary unit for allocation was villages. Villages were allocated randomly to a control condition or to two rounds of intervention with stage-targeted letters and interpersonal counseling. There were 651 eligible married men in the 12 villages chosen. A significant positive movement in men's stage of readiness for IUD use by their wife occurred in the intervention group, with a decrease in the proportions in the precontemplation stage from 28.6 to 20.2% and an increase in action/maintenance from 59.8 to 74.4% (P < 0.05). There were no significant changes in the control group. Compared to the control group, the intervention group showed higher pros, lower cons and higher self-efficacy for IUD use by their wife as a contraceptive method (P < 0.05). Interventions based on social-cognitive theory can increase men's involvement in IUD use in rural Vietnam and should assist in reducing future rates of unwanted pregnancy. [ABSTRACT FROM AUTHOR]

Various studies have shown that family planning adoption is likely to be more effective for women when men are actively involved. Male involvement in family planning is an instance of behavior change. The Transtheoretical Model of behavior change was used to examine men's involvement in general contraception and intrauterine device (IUD) use by their wives. The study tested whether the constructs of the model, decisional balance and self-efficacy, are sensitive to differences in stages of change. Reliable scales to test decisional balance and self-efficacy were developed. The study was carried out in rural Vietnam with 201 eligible participants. The staging algorithm identified that 25.8% of men were in the precontemplation stage, 10.5% of men were in the contemplation/preparation stages and 63.7% of men were in the action/maintenance stages. Disadvantages of IUD use for men in precontemplation were significantly higher than those in the action/maintenance stages, while the reverse was true for self-efficacy for convincing their wives to use an IUD. Interventions that are targeted to stage of change, that seek to reduce cons and that increase self-efficacy have the potential to influence male involvement in IUD adoption by their wives. [ABSTRACT FROM AUTHOR]

Background: Approximately 15% of women in low-and middle-income countries experience common perinatal mental disorders. Yet, many women, even if diagnosed with mental health conditions, are untreated due to poor quality care, limited accessibility, limited knowledge, and stigma. This paper describes how mental health-related stigma influences pregnant women's decisions not to disclose their conditions and to seek treatment in Vietnam, all of which exacerbate inequitable access to maternal mental healthcare., Methods: A mixed-method realist study was conducted, comprising 22 in-depth interviews, four focus group discussions (total participants n = 44), and a self-administered questionnaire completed by 639 pregnant women. A parallel convergent model for mixed methods analysis was employed. Data were analyzed using the realist logic of analysis, an iterative process aimed at refining identified theories. Survey data underwent analysis using SPSS 22 and descriptive analysis. Qualitative data were analyzed using configurations of context, mechanisms, and outcomes to elucidate causal links and provide explanations for complexity., Results: Nearly half of pregnant women (43.5%) would try to hide their mental health issues and 38.3% avoid having help from a mental health professional, highlighting the substantial extent of stigma affecting health-seeking and accessing care. Four key areas highlight the role of stigma in maternal mental health: fear and stigmatizing language contribute to the concealment of mental illness, rendering it unnoticed; unconsciousness, normalization, and low literacy of maternal mental health; shame, household structure and gender roles during pregnancy; and the interplay of regulations, referral pathways, and access to mental health support services further compounds the challenges., Conclusion: Addressing mental health-related stigma could influence the decision of disclosure and health-seeking behaviors, which could in turn improve responsiveness of the local health system to the needs of pregnant women with mental health needs, by offering prompt attention, a wide range of choices, and improved communication. Potential interventions to decrease stigma and improve access to mental healthcare for pregnant women in Vietnam should target structural and organizational levels and may include improvements in screening and referrals for perinatal mental care screening, thus preventing complications., (© 2024. The Author(s).)

The prevalence of common perinatal mental disorders in Vietnam ranges from 16.9% to 39.9%, and substantial treatment gaps have been identified at all levels. This paper explores constraints to the integration of maternal and mental health services at the primary healthcare level and the implications for the health system's responsiveness to the needs and expectations of pregnant women with mental health conditions in Vietnam. As part of the RESPONSE project, a three-phase realist evaluation study, we present Phase 1 findings, which employed systematic and scoping literature reviews and qualitative data collection (focus groups and interviews) with key health system actors in Bac Giang province, Vietnam, to understand the barriers to maternal mental healthcare provision, utilization and integration strategies. A four-level framing of the barriers to integrating perinatal mental health services in Vietnam was used in reporting findings, which comprised individual, sociocultural, organizational and structural levels. At the sociocultural and structural levels, these barriers included cultural beliefs about the holistic notion of physical and mental health, stigma towards mental health, biomedical approach to healthcare services, absence of comprehensive mental health policy and a lack of mental health workforce. At the organizational level, there was an absence of clinical guidelines on the integration of mental health in routine antenatal visits, a shortage of staff and poor health facilities. Finally, at the provider level, a lack of knowledge and training on mental health was identified. The integration of mental health into routine antenatal visits at the primary care level has the potential help to reduce stigma towards mental health and improve health system responsiveness by providing services closer to the local level, offering prompt attention, better choice of services and better communication while ensuring privacy and confidentiality of services. This can improve the demand for mental health services and help reduce the delay of care-seeking., (© The Author(s) 2024. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.)

Competing Interests: Declaration of competing interest No declarations of interest.

The study aimed to investigate differences in the prevalence of gynecological healthcare service utilization in 12 ethnic minority groups and associated socio-demographic correlates with gynecological healthcare service utilization in Vietnam. Based on the national survey on healthcare utilization among 6912 people in 12 ethnic minorities, 900 women aged 21-49 years were included in the final analysis. Prevalence of gynecological healthcare service utilization in 12 ethnic minority groups was measured, based on the question "Have you ever used any gynecological healthcare services?" Socio-demographic characteristics including region, ethnicity, age, marital status, literacy level, education level, languages spoken, occupation, religion, household economy status, using contraception, and distance to the nearest healthcare facility were examined. The association between gynecological healthcare service utilization and socio-demographic characteristics was assessed by using logistic regression. The results showed that the prevalence of gynecological healthcare service utilization was 62.0% (95% CI: 58.7-65.2%), which ranged from 36.5 (Mnong) to 87.7% (Bru Van Kieu). Bru Van Kieu women had significantly higher odds of gynecological healthcare service utilization (OR = 9.42, 95% CI = 3.71-23.91), compared to those in Khmer ethnicity. Besides, Ba Na, Cham Ninh Thuan, and Dao women also had significantly higher odds of gynecological healthcare service utilization (Ba Na: OR = 5.73, 95% CI = 2.15-15.26; Cham Ninh Thuan: OR = 4.24, 95% CI = 1.79-10.06; Dao: OR = 3.43, 95% CI = 1.49-7.90), compared to those in Khmer ethnicity. Getting married, being older, being not poor, and using contraception had significantly higher odds of using gynecological healthcare services. Health education specialists and healthcare workers should be aware of these issues so that they can provide appropriate gynecological healthcare services and ensure high coverage of routine gynecological exams in ethnic minority women in reproductive age., (© 2022. W. Montague Cobb-NMA Health Institute.)

Background: Autism Spectrum Disorders (ASDs) are common behavioral syndromes but limited critical evidence in Vietnam. This study aimed to identify ante-, peri- and neonatal factors for ASDs amongst children in Vietnam., Methods: This population-based study applied the cross-sectional design with a multistage sampling in 21 urban and rural districts in seven cities/provinces in Vietnam during 2017-2018. Overall, 42,551 children age 18 to 30 months were enrolled in the study. Two phases of assessment using Modified Checklist for Autism in Toddlers (M-CHAT) for screening and diagnostic assessment using Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for confirmation. We employed univariate and binary logistic regression to identify., Results: Our study showed a fast-growing trend of ASDs amongst children age 18 and 30 months (75.8 per 10,000 individuals). Nine ante-, peri-, and neonatal factors were associated with ASDs: five factors of antenatal period (history of miscarriage/abortion or stillbirth, children conceived by assisted reproduction technologies, having cold, flu or acquiring virus during pregnancy, having gestational diabetes, toxemia, high blood pressure or pre-eclampsia during pregnancy, and having stress or mental disorders during pregnancy); one factors of perinatal period (mode of delivery); and three factors of neonatal period (jaundice, respiratory distress, and newborn seizures)., Conclusion: This first large-scale survey in Vietnam confirms some prenatal, perinatal, and postnatal factors with ASDs amongst children age 18 and 30 months. Future interventions should focus on these factors to early diagnosis and intervention to improve functional outcomes for risky children., Competing Interests: Conflict of interest The authors declare that there is no conflict of interest., (Copyright © 2023 Vui et al. Published by Tehran University of Medical Sciences.)

Aim: This paper is aimed to assess nurses' perceptions of patient safety culture in four public general hospitals in Hanoi, Vietnam., Background: Patient safety culture is a vital component in ensuring high quality and safe patient care. Assessment of nurses' perceptions on existing hospital patient safety culture (PSC) is the first step to promote PSC., Methods: The cross-sectional study surveyed 705 nurses utilizing the validated Hospital Survey on Patient Safety Culture (HSOPSC) in an online format., Results: The average positive response rate was high at 72.8 % and varied from 52.9 % to 93.4 %. The strongest areas are teamwork within units (93.7 %) and supervisor/manager expectations and actions promoting patient safety (85.0 %). The areas for improvement are staffing (52.9 %) and non-punitive response to error (57.6 %). The communication openness, staffing, frequency of events reported, lengths of services in hospital and unit are significant factors that predict the overall patient safety grade., Conclusions: Initiatives are necessary to improve response to errors, staffing, and error reporting. Nurse managers could develop and implement interventions and program to improve patient safety, including providing education related to patient safety culture, encouraging staff to notify incidents and avoiding punitive responses., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background: Breastfeeding brings benefits to both mothers and children in the short term and long term. Unnecessary cesarean sections can bring risks to both parties. This study was undertaken to examine the relationship between exclusive breastfeeding intention and cesarean delivery., Methods: We analyzed data collected from 554 single mothers who delivered in Dong Anh General District Hospital or Hanoi Obstetrics and Gynecology Hospital, Vietnam, in 2020-2021. The relationship between exclusive breastfeeding intention and cesarean delivery for nonmedical reasons was adjusted for maternal education, maternal age, parity, history of fetal loss, having at least eight antenatal contacts, hospital of delivery, child sex, and birth weight., Results: Antenatally, 34.8% (184/529) of mothers intended to breastfeed exclusively until 6 months and 30.8% (84/274) underwent cesarean section for a nonmedical reason. After adjusting for other factors, mothers who intended to breastfeed exclusively until 6 months were less likely to undergo cesarean delivery for nonmedical reasons (OR = 0.55, 95% CI: 0.31-0.96, p = 0.034)., Conclusions: This study adds to the growing evidence related to unnecessary cesarean sections and routine over-medicalization of normal birth in the urban areas of Vietnam. The association between breastfeeding intentions and a lower rate of cesarean section suggests that education on breastfeeding could be a useful intervention for reducing the rate of cesarean sections and improving maternal and child health.

Background: Early detection of autism spectrum disorders (ASDs) is essential given the under-reported cases in low- and middle-income countries. This first national representative survey was conducted to explore the prevalence of ASDs amongst 18 and 30 months in seven provinces in Vietnam., Design and Methods: During 2017- 2018, a national cross-sectional and population-based survey for autism spectrum disorder (ASD) amongst 40,243 children aged 18 to 30 months was conducted in 7 provinces representing the socio-economic regions of Vietnam. M-CHAT was used to screen children and then confirmed by diagnostic assessment using DSM-IV criteria., Results: The prevalence of ASDs amongst children aged 18 and 30 months in Vietnam was high (0.758% or 1 in 132 children). Urban setting, male gender, and hereditable genes were associated with ASD prevalence., Conclusions: ASDs amongst children aged 18 and 30 months in Vietnam tend to be increasing and are similar to this rate in other middle-income countries but lower than that in Western countries. This under-recognized public health problem amongst children should be addressed by early detection and intervention for families with affected children.

Introduction: Community engagement (CE) is an effective public health strategy for improving health outcomes. There is limited published knowledge about effective approaches to CE in ensuring effective responses to COVID-19 throughout lockdowns, travel restrictions and social distancing. In this paper, we contribute to bridging this gap by highlighting experience of CE in Vietnam, specifically focusing on migrant workers in Vietnam., Methods: A cross-sectional qualitative study design was used with qualitative data collection was carried out during August-October 2020. Two districts were purposefully selected from two large industrial zones. Data was collected using in-depth interviews (n = 36) with individuals and households, migrants and owners of dormitories, industrial zone factory representatives, community representatives and health authorities. Data was analyzed using thematic analysis approach. The study received ethics approval from the Hanoi University Institutional Review Board., Results: The government's response to COVID-19 was spearheaded by the multi-sectoral National Steering Committee for the Prevention and Control of COVID-19, chaired by the Vice Prime Minister and comprised different members from 23 ministries. This structure was replicated throughout the province and local levels and all public and private organizations. Different activities were carried out by local communities, following four key principles of infection control: early detection, isolation, quarantine and hospitalization. We found three key determinants of engagement of migrant workers with COVID-19 prevention and control: availability of resources, appropriate capacity strengthening, transparent and continuous communication and a sense of trust in government legitimacy., Discussion and Conclusion: Our results support the current literature on CE in infection control which highlights the importance of context and suggests that future CE should consider five key components: multi-sectoral collaboration with a whole-of-community approach to strengthen governance structures with context-specific partnerships; mobilization of resources and decentralization of decision making to encourage self-reliance and building of local capacity; capacity building through training and supervision to local institutions; transparent and clear communication of health risks and sensitization of local communities to improve compliance and foster trust in the government measures; and understanding the urgent needs ensuring of social security and engaging all parts of the community, specifically the vulnerable groups., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Health systems responsiveness is a key objective of any health system, yet it is the least studied of all objectives particularly in low-income and middle-income countries. Research on health systems responsiveness highlights its multiple elements, for example, dignity and confidentiality. Little is known, however, about underlying theories of health systems responsiveness, and the mechanisms through which responsiveness works. This realist synthesis contributes to bridging these two knowledge gaps., Methods and Analysis: In this realist synthesis, we will use a four-step process, comprising: mapping of theoretical bases, formulation of programme theories, theory refinement and testing of programme theories using literature and empirical data from Ghana and Vietnam. We will include theoretical and conceptual pieces, reviews, empirical studies and grey literature, alongside the primary data. We will explore responsiveness as entailing external and internal interactions within health systems. The search strategy will be purposive and iterative, with continuous screening and refinement of theories. Data extraction will be combined with quality appraisal, using appropriate tools. Each fragment of evidence will be appraised as it is being extracted, for its relevance to the emerging programme theories and methodological rigour. The extracted data pertaining to contexts, mechanisms and outcomes will be synthesised to identify patterns and contradictions. Results will be reported using narrative explanations, following established guidance on realist syntheses., Ethics and Dissemination: Ethics approvals for the wider RESPONSE (Improving health systems responsiveness to neglected health needs of vulnerable groups in Ghana and Vietnam) study, of which this review is one part, were obtained from the ethics committees of the following institutions: London School of Hygiene and Tropical Medicine (ref: 22981), University of Leeds, School of Medicine (ref: MREC19-051), Ghana Health Service (ref: GHS-ERC 012/03/20) and Hanoi University of Public Health (ref: 020-149/DD-YTCC).We will disseminate results through academic papers, conference presentations and stakeholder workshops in Ghana and Vietnam., Prospero Registration Number: CRD42020200353. Full record: https://www.crd.york.ac.uk/prospero/display&#95;record.php?ID=CRD42020200353., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)

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

Background: Socio-economic growth in many low and middle-income countries has resulted in more available, though not equitably accessible, healthcare. Such growth has also increased demands from citizens for their health systems to be more responsive to their needs. This paper shares a protocol for the RESPONSE study which aims to understand, co-produce, implement and evaluate context-sensitive interventions to improve health systems responsiveness to health needs of vulnerable groups in Ghana and Vietnam., Methods: We will use a realist mixed-methods theory-driven case study design, combining quantitative (household survey, secondary analysis of facility data) and qualitative (in-depth interviews, focus groups, observations and document and literature review) methods. Data will be analysed retroductively. The study will comprise three Phases. In Phase 1, we will understand actors' expectations of responsive health systems, identify key priorities for interventions, and using evidence from a realist synthesis we will develop an initial theory and generate a baseline data. In Phase 2, we will co-produce jointly with key actors, the context-sensitive interventions to improve health systems responsiveness. The interventions will seek to improve internal (i.e. intra-system) and external (i.e. people-systems) interactions through participatory workshops. In Phase 3, we will implement and evaluate the interventions by testing and refining our initial theory through comparing the intended design to the interventions' actual performance., Discussion: The study's key outcomes will be: (1) improved health systems responsiveness, contributing to improved health services and ultimately health outcomes in Ghana and Vietnam and (2) an empirically-grounded and theoretically-informed model of complex contexts-mechanisms-outcomes relations, together with transferable best practices for scalability and generalisability. Decision-makers across different levels will be engaged throughout. Capacity strengthening will be underpinned by in-depth understanding of capacity needs and assets of each partner team, and will aim to strengthen individual, organisational and system level capacities., Competing Interests: The authors have declared that no competing interests exist.

The aim of this study was to report the prevalence of self-reported non-communicable diseases among ethnic minority populations in Vietnam and related factors. A total of 5033 individuals aged 15 years and older who belonged to ethnic minority populations from 12 provinces in Vietnam completed a household survey. The overall prevalence of self-reported non-communicable diseases was 12.4% (95% CI: 11.5%-13.4%). Cardiovascular diseases were the most prevalent, followed by diabetes. Ethnicity was shown to have an independently significant correlation to having any non-communicable diseases. Older people, near-poor and non-poor people had significantly higher odds of having non-communicable diseases as compared to younger and poor people., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2020.)

Background: Achieving access to clean water and basic sanitation remains as major challenges in Vietnam, especially for vulnerable groups such as minority people, despite all the progress made by the Millennium Development Goal number 7.C., Objectives: The study aimed to describe the access to improved water sources and sanitation of the ethnic minority people in Vietnam based on a national survey and to identify associated factors., Methods: A cross-sectional study was conducted in 2019 with a sample size of 1385 ethnic minority households in 12 provinces in Vietnam. Multivariate logistic regression modeling was performed to examine the probability of having access to improved water sources and sanitation and sociodemographic status at a significance level of P  < .05., Results: The access to improved water sources and sanitation was unequal among the ethnic minority people in Vietnam, with the lowest access rate in the northern midland and mountainous and Central Highland areas and the highest access rate in the Mekong Delta region. Some sociodemographic variables that were likely to increase the ethnic minority people's access to improved water sources and/or sanitation included older age, female household heads, household heads with high educational levels, religious households, and households in not poor status., Conclusion and Recommendations: The study suggested more emphasis on religion for improving the ethnic minority's access to improved water sources and sanitation. Besides, persons of poor and near-poor status and with low educational levels should be of focus in future water and sanitation intervention programs., Competing Interests: Declaration of conflicting interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2020.)

Purpose: There is increasing interest in the understanding of key influences over successful implementation of health policies within ever-changing contexts of national health systems. The epidemiological transition in Vietnam, combined with an urgent need for improving efficiency of the national health system under the government's administrative reforms, form important facilitators of restructuring the public health system. This paper explored the implementation processes of policy on establishment of the Centers for Diseases Control (CDC) in Vietnam during 2016-2019., Methods: The study employed a cross-sectional and mixed methods design. Staff surveys were collected at 55 out of 63 provinces and in-depth interviews, focus groups were conducted in three purposefully selected provinces. Quantitative data were analysed using descriptive statistics and qualitative data were analyzed thematically. The innovation implementation framework guided the study., Results: After 3 years of introduction, 82.5% of provinces had established the CDCs. Implementation of CDC establishment policy was influenced by 1) management support; 2) alignment between policy and practice; 3) values towards CDC,; and 4) implementation climate. Other external key influencers included political, social, and cultural factors., Conclusion: Our study provides a framework and evidence to guide future inquiry into the factors that affect the relationship between policy implementation and other contextual factors in healthcare organizations., Competing Interests: All authors declare no conflicts of interest in this paper., (© 2020 Ha et al.)

The COVID-19 pandemic is spreading fast globally. Vietnam's strict containment measures have significantly reduced the spread of the epidemic in the country. This was achieved through the use of emergency control measures in the epidemic areas and integration of resources from multiple sectors including health, mass media, transportation, education, public affairs, and defense. This paper reviews and shares specific measures for successful prevention and control of COVID-19 in Vietnam, which could provide useful learning for other countries.

Two-component systems (TCSs) have been identified as participants in mediating plant response to water deficit. Nevertheless, insights of their contribution to plant drought responses and associated regulatory mechanisms remain limited. Herein, a soybean response regulator (RR) gene RR34 , which is the potential drought-responsive downstream member of a TCS, was ectopically expressed in the model plant Arabidopsis for the analysis of its biological roles in drought stress response. Results from the survival test revealed outstanding recovery ratios of 52%-53% in the examined transgenic lines compared with 28% of the wild-type plants. Additionally, remarkedly lower water loss rates in detached leaves as well as enhanced antioxidant enzyme activities of catalase and superoxide dismutase were observed in the transgenic group. Further transcriptional analysis of a subset of drought-responsive genes demonstrated higher expression in GmRR34 -transgenic plants upon exposure to drought, including abscisic acid (ABA)-related genes NCED3 , OST1 , ABI5 , and RAB18 . These ectopic expression lines also displayed hypersensitivity to ABA treatment at germination and post-germination stages. Collectively, these findings indicated the ABA-associated mode of action of GmRR34 in conferring better plant performance under the adverse drought conditions.

Introduction: The objectives of this study are to estimate the prevalence of multimorbidity (MM) among adults in the Central Highland Region (a poor region) of Vietnam in 2017 and to identify the sociodemographic correlates of these conditions., Methods: We used data from a cross-sectional study conducted in 2018 on health status among people in four provinces in the Central Highlands Region (Tay Nguyen) of Vietnam. A sample of 1680 adults (aged 15 years and older) were randomly selected for this study. Respondents were asked whether they had been told by a health worker that they had cancer, heart and circulatory conditions, chronic joint problems, chronic pulmonary diseases, chronic kidney problems, chronic digestive problems, psychological illness, diabetes, and/or other chronic conditions., Results: The prevalence of MM among the study participants was 16.4% (95% confidence interval (CI): 14.6%-18.2%). By looking at the 95% CIs, the differences in MM prevalence between the groups classified by gender, age, education, and occupation were not statistically significant. Only the difference in MM prevalence between farmers and government staff was statistically significant. Multivariate logistic analyses show education and occupations were shown to be significant correlates of MM., Conclusion: MMs were quite common among the adult populations in the study area, especially among people with lower socioeconomic status. Given the evidence, actions to reduce levels of MM in the setting are clearly urgent. The interventions should address all people in society, with focus on disadvantaged groups, like those with lower education and farmers., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: There is an increasing consensus globally that the education of health professionals is failing to keep pace with scientific, social, and economic changes transforming the healthcare environment. This catalyzed a movement in reforming education of health professionals across Bangladesh, China, India, Thailand, and Vietnam who jointly volunteered to implement and conduct cooperative, comparative, and suitable health professional education assessments with respect to the nation's socio-economic and cultural status, as well as domestic health service system., Methods: The 5C network undertook a multi-country health professional educational study to provide its countries with evidence for HRH policymaking. Its scope was limited to the assessment of medical, nursing, and public health education at three levels within each country: national, institutional, and graduate level (including about to graduate students and alumni)., Results: This paper describes the general issues related to health professional education and the protocols used in a five-country assessment of medical, nursing, and public health education. A common protocol for the situation analysis survey was developed that included tools to undertake a national and institutional assessment, and graduate surveys among about-to-graduate and graduates for medical, nursing, and public health professions. Data collection was conducted through a mixture of literature reviews and qualitative research., Conclusions: The national assessment would serve as a resource for countries to plan HRH-related future actions.