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Nhan đề: Maternal health care utilization in Viet Nam: increasing ethnic inequity.
Tác giả: Målqvist, Mats
Lincetto, Ornella
Du, Nguyen Huy
Burgess, Craig
Hoa, Dinh Thi Phuong
Từ khoá: Health care
Ethnic inequity
Viet Nam
Tùng thư/Số báo cáo: Bulletin of the World Health Organization, Apr2013;Volume 91 Issue 4, Page 254–261
Tóm tắt: -- Objective: To investigate changes that took place between 2006 and 2010 in the inequity gap for antenatal care attendance and delivery at health facilities among women in Viet Nam. -- Methods: Demographic, socioeconomic and obstetric data for women aged 15–49 years were extracted from Viet Nam’s Multiple Indicator Cluster Survey for 2006 (MICS3) and 2010–2011 (MICS4). Multivariate logistic regression was performed to determine if antenatal care attendance and place of delivery were significantly associated with maternal education, maternal ethnicity (Kinh/Hoa versus other), household wealth and place of residence (urban versus rural). These independent variables correspond to the analytical framework of the Commission on Social Determinants of Health. -- Findings: Large discrepancies between urban and rural populations were found in both MICS3 and MICS4. Although antenatal care attendance and health facility delivery rates improved substantially between surveys (from 86.3 to 92.1% and from 76.2 to 89.7%, respectively), inequities increased, especially along ethnic lines. The risk of not giving birth in a health facility increased significantly among ethnic minority women living in rural areas. In 2006 this risk was nearly five times higher than among women of Kinh/Hoa (majority) ethnicity (odds ratio, OR: 4.67; 95% confidence interval, CI:2.94–7.43); in 2010–2011 it had become nearly 20 times higher (OR: 18.8; 95% CI: 8.96–39.2). -- Conclusion: Inequity in maternal health care utilization has increased progressively in Viet Nam, primarily along ethnic lines, and vulnerable groups in the country are at risk of being left behind. Health-caredecision-makers should target these groups through affirmative action and culturally sensitive interventions.
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