Search

Your search keyword '"Phuong Hoa, Dinh Thi"' showing total 2 results
Start Over Author "Phuong Hoa, Dinh Thi"
2 results on '"Phuong Hoa, Dinh Thi"'

1. Inequalities in reproductive, maternal, newborn and child health in Vietnam: a retrospective study of survey data for 1997-2006

Author

Axelson, Henrik, Gerdtham, Ulf, Ekman, Bjorn, Phuong Hoa, Dinh Thi, Alfven, Tobias, Axelson, Henrik, Gerdtham, Ulf, Ekman, Bjorn, Phuong Hoa, Dinh Thi, and Alfven, Tobias

Abstract

Background: Vietnam has achieved considerable success in economic development, poverty reduction, and health over a relatively short period of time. However, there is concern that inequalities in health outcomes and intervention coverage are widening. This study explores if inequalities in reproductive, maternal, newborn and child health and nutrition changed over time in Vietnam in 1997-2006, and if inequalities were different depending on the type of stratifying variable used to measure inequalities and on the type of outcome studied. Methods: Using data from four nationally representative household surveys conducted in 1997-2006, we study inequalities in reproductive, maternal, newborn and child health and nutrition outcomes and intervention coverage by computing concentration indices by living standards, maternal education, ethnicity, region, urban/rural residence, and sex of child. Results: Inequalities in maternal, newborn and child health persisted in 1997-2006. Inequalities were largest by living standards, but not trivial by the other stratifying variables. Inequalities in health outcomes generally increased over time, while inequalities in intervention coverage generally declined. The most equitably distributed interventions were family planning, exclusive breastfeeding, and immunizations. The most inequitably distributed interventions were those requiring multiple service contacts, such as four or more antenatal care visits, and those requiring significant support from the health system, such as skilled birth attendance. Conclusions: Three main policy implications emerge. First, persistent inequalities suggest the need to address financial and other access barriers, for example by subsidizing health care for the poor and ethnic minorities and by support from other sectors, for example in strengthening transportation networks. This should be complemented by careful monitoring and evaluation of current program design and implementation to ensure effective a

Published
2012

2. Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings.

Author

Bergström, Anna, Skeen, Sarah, Duc, Duong M., Zelaya Blandon, Elmer, Estabrooks, Carole, Gustavsson, Petter, Phuong Hoa, Dinh Thi, Källestål, Carina, Målqvist, Mats, Nguyen Thu Nga, Persson, Lars-Åke, Pervin, Jesmin, Peterson, Stefan, Rahman, Anisur, Selling, Katarina, Squires, Janet E., Tomlinson, Mark, Waiswa, Peter, Wallin, Lars, and Blandon, Elmer Zelaya

Subjects
MEDICAL care research, EVIDENCE-based medicine, DECISION making in clinical medicine, PUBLIC health, LOW-income countries, MIDDLE-income countries, DEVELOPING countries, HEALTH planning, QUESTIONNAIRES, RESEARCH evaluation, RESEARCH funding, PROFESSIONAL practice, HUMAN services programs, EVALUATION of human services programs
Abstract

Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose.Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries.Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge.Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs. [ABSTRACT FROM AUTHOR]

Published
2015
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results