Causes and Determinants of Inequity in Maternal and Child Health in Vietnam

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2012 Aug 14

PMID 22883138

Citations 27

Authors

Mats Malqvist

Dinh Thi Phuong Hoa

Sarah Thomsen

Affiliations

Soon will be listed here.

Abstract

Background: Inequities in health are a major challenge for health care planners and policymakers globally. In Vietnam, rapid societal development presents a considerable risk for disadvantaged populations to be left behind. The aim of this review is to map the known causes and determinants of inequity in maternal and child health in Vietnam in order to promote policy action.

Methods: A review was performed through systematic searches of Pubmed and Proquest and manual searches of "grey literature." A thematic content analysis guided by the conceptual framework suggested by the Commission on Social Determinants of Health was performed.

Results: More than thirty different causes and determinants of inequity in maternal and child health were identified. Some determinants worth highlighting were the influence of informal fees and the many testimonies of discrimination and negative attitudes from health staff towards women in general and ethnic minorities in particular. Research gaps were identified, such as a lack of studies investigating the influence of education on health care utilization, informal costs of care, and how psychosocial factors mediate inequity.

Conclusions: The evidence of corruption and discrimination as mediators of health inequity in Vietnam calls for attention and indicates a need for more structural interventions such as better governance and anti-discriminatory laws. More research is needed in order to fully understand the pathways of inequities in health in Vietnam and suggest areas for intervention for policy action to reach disadvantaged populations.

Citing Articles

Knowledge of Medical Education on Maternal and Child Primary-Care Among Physicians: A Cross-Sectional Study.

Sarma H, Giang P, Kelly M, Van Anh T, Rao C, Hoa N Int J Public Health. 2024; 69:1606536.

PMID: 39027014 PMC: 11254614. DOI: 10.3389/ijph.2024.1606536.

Equity in prenatal healthcare services globally: an umbrella review.

Ladak Z, Grewal N, Kim M, Small S, Leber A, Hemani M BMC Pregnancy Childbirth. 2024; 24(1):191.

PMID: 38468220 PMC: 10926563. DOI: 10.1186/s12884-024-06388-0.

Considering equity and cost-effectiveness in assessing a parenting intervention to promote early childhood development in rural Vietnam.

Baek Y, Ademi Z, Tran T, Owen A, Nguyen T, Luchters S Health Policy Plan. 2023; 38(8):916-925.

PMID: 37552643 PMC: 10506530. DOI: 10.1093/heapol/czad057.

Adapting and Scaling a Digital Health Intervention to Improve Maternal and Child Health Among Ethnic Minority Women in Vietnam Amid the COVID-19 Context: Protocol for the dMOM Project.

McBride B, ONeil J, Nguyen P, Linh D, Trinh H, Vu N JMIR Res Protoc. 2023; 12:e44720.

PMID: 37058576 PMC: 10167587. DOI: 10.2196/44720.

Measurement and Decomposition of the Health Poverty of Rural Residents in China.

Jia H, Sai X, Su Y, Huang Y Int J Environ Res Public Health. 2022; 19(19).

PMID: 36232182 PMC: 9566343. DOI: 10.3390/ijerph191912876.

References

Moestue H, Huttly S . Adult education and child nutrition: the role of family and community. J Epidemiol Community Health. 2008; 62(2):153-9. DOI: 10.1136/jech.2006.058578. View

Lindelow M, Serneels P . The performance of health workers in Ethiopia: results from qualitative research. Soc Sci Med. 2005; 62(9):2225-35. DOI: 10.1016/j.socscimed.2005.10.015. View

Szreter S, Woolcock M . Health by association? Social capital, social theory, and the political economy of public health. Int J Epidemiol. 2004; 33(4):650-67. DOI: 10.1093/ije/dyh013. View

Gwatkin D, Bhuiya A, Victora C . Making health systems more equitable. Lancet. 2004; 364(9441):1273-80. DOI: 10.1016/S0140-6736(04)17145-6. View

Stringhini S, Thomas S, Bidwell P, Mtui T, Mwisongo A . Understanding informal payments in health care: motivation of health workers in Tanzania. Hum Resour Health. 2009; 7:53. PMC: 2711965. DOI: 10.1186/1478-4491-7-53. View

Hart J . The inverse care law. Lancet. 1971; 1(7696):405-12. DOI: 10.1016/s0140-6736(71)92410-x. View

Ensor T, Witter S . Health economics in low income countries: adapting to the reality of the unofficial economy. Health Policy. 2001; 57(1):1-13. DOI: 10.1016/s0168-8510(01)00125-7. View

Sen A . Why health equity?. Health Econ. 2002; 11(8):659-66. DOI: 10.1002/hec.762. View

Renju J, Andrew B, Nyalali K, Kishamawe C, Kato C, Changalucha J . A process evaluation of the scale up of a youth-friendly health services initiative in northern Tanzania. J Int AIDS Soc. 2010; 13:32. PMC: 2944311. DOI: 10.1186/1758-2652-13-32. View

10.

Minh Thang N, Popkin B . In an era of economic growth, is inequity holding back reductions in child malnutrition in Vietnam?. Asia Pac J Clin Nutr. 2003; 12(4):405-10. View

11.

Axelson H, Bales S, Minh P, Ekman B, Gerdtham U . Health financing for the poor produces promising short-term effects on utilization and out-of-pocket expenditure: evidence from Vietnam. Int J Equity Health. 2009; 8:20. PMC: 2694203. DOI: 10.1186/1475-9276-8-20. View

12.

Malqvist M, Nga N, Eriksson L, Wallin L, Hoa D, Persson L . Ethnic inequity in neonatal survival: a case-referent study in northern Vietnam. Acta Paediatr. 2010; 100(3):340-6. DOI: 10.1111/j.1651-2227.2010.02065.x. View

13.

Rheinlander T, Samuelsen H, Dalsgaard A, Konradsen F . Perspectives on child diarrhoea management and health service use among ethnic minority caregivers in Vietnam. BMC Public Health. 2011; 11:690. PMC: 3189136. DOI: 10.1186/1471-2458-11-690. View

14.

Trinh L, Dibley M, Byles J . Determinants of antenatal care utilization in three rural areas of Vietnam. Public Health Nurs. 2007; 24(4):300-10. DOI: 10.1111/j.1525-1446.2007.00638.x. View

15.

Ekman B, Liem N, Duc H, Axelson H . Health insurance reform in Vietnam: a review of recent developments and future challenges. Health Policy Plan. 2008; 23(4):252-63. DOI: 10.1093/heapol/czn009. View

16.

Anderson I, Axelson H, Tan B . The other crisis: the economics and financing of maternal, newborn and child health in Asia. Health Policy Plan. 2010; 26(4):288-97. DOI: 10.1093/heapol/czq067. View

17.

Khe N, Toan N, Xuan L, Eriksson B, Hojer B, Diwan V . Primary health concept revisited: where do people seek health care in a rural area of Vietnam?. Health Policy. 2002; 61(1):95-109. DOI: 10.1016/s0168-8510(01)00198-1. View

18.

Hong T, Dibley M, Tuan T . Factors affecting utilization of health care services by mothers of children ill with diarrhea in rural Vietnam. Southeast Asian J Trop Med Public Health. 2003; 34(1):187-98. View

19.

Victora C, Huttly S, Fuchs S, Olinto M . The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. Int J Epidemiol. 1997; 26(1):224-7. DOI: 10.1093/ije/26.1.224. View

20.

Bui Q, Le Linh C, Rahman Z . Child health status and maternal and child care in Quangtri Province, Vietnam. Asia Pac J Public Health. 2009; 20 Suppl:228-35. View