Home delivery in Luong Son, Hoa Binh

Background: There are about 600.000 deaths related to pregnancy and delivery in the world every year. In Vietnam, the rate of maternal death is 165/100.00. The majority of maternity and new born deaths occurred in the first week after delivery, especially 24 hours after delivery. Objective: To investigate the status of delivery and various factors related to home delivery and propose recommendations to reduce the rate of home delivery in Luong Son, Hoa Binh. Subject and method: The cross sectional study using a structured questionnaire with women who gave birth in 2003 was conducted in two communes of Luong Son district. Result: The home delivery rate was high (31.5%) and only 36.1% women decided themselves where to deliver. The main reasons for home delivery was perception related to last home delivery was normal, therefore this delivery should be at home (53.8%). Among 108 women interviewed, only 72% gave birth with the assistance of health professionals and 28% delivered with none health professional assistance. The rate of obstetric complications and new born death was relatively high among those that had homebirths. Conclusion: In order to increase the delivery rate at health care facilities and with the assistance of health professionals, there is required the cooperation of stakeholders for improving infrastructure, economic development, health education for increasing awareness of people on safe delivery. The public should change their perception, custom and behavior toward homebirths. Besides, the health sector should better manage the maternal health care program, monitor the pregnant women, plan the delivery dates and advocate their families (husbands and parent in laws) to take the women to deliver at the health care facilities.

The roles of Village Health Works (VHWs) and the influencing factors

Background: VHWs play an important role in primary health care. The Chuongmy district, Hatay province had only 50% of VHWs compared to the national rate of 90%. \r\n', u'Objectives: This study aims to describe the current activities of VHWs in Chuongmy district and identify the related factors. \r\n', u'Subjects and methods: The study adopted the cross sectional design, combined qualitative and quantitative data collection techniques with VHWs and the leaders of local authority and health facilities. \r\n', u'Results: VHWs play an important role in implementing health programs and health care activities in the villages. Almost all tasks and functions of VHWs were carried out in the villages but with different rate and quality. The major activities that VHWs carried out were preventive medicine and treatment of common diseases. Nevertheless, the quality of many activities should be improved. The performance and stability of VHWs depend on different factors such as training, income, qualification, support monitoring and supervision of local authority and health sectors. \r\n', u'Conclusions: The local authority and health sectors should have policies to provide update training to VHWs, incentives to retain them to work and enhance the supportive supervision of VHWs activities. \r\n', u'