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'

Knowledge, attitude and behavior on ectopic pregnancy of married women in Chi Linh, Hai Duong

Background: The incidence of Ectopic Pregnancy (EP) is increasing worldwide, especially in developing countries. It is among main causes of morbidity and mortality in childbearing women. The EP incidence in Chi Linh district, Hai Duong province is about 0.22%. Objectives: To identify the knowledge, attitude and practice of married women for EP in Chi Linh district and propose interventions to improve the early diagnosis of EP. Subjects and method: The cross-sectional study was conducted in 2005, combined questionnaires-based interviews to in-depth interviews and focal group discussion. Results: A total of 998 women participated in the study. Most of them were in 25-34 and 35-44 years old age groups (35.0%). 45.8% have never had surgical abortions and 27.4% has had a surgical abortion at least once. Most of the participants knew only one sign of abnormal pregnancy (abdominal pain: 42.0%, nausea: 41.5% and vaginal hemorrhage: 19.2%). About 2/3 of participants have never heard of EP and bout 2/3 of them considered it as a serious problem. 42.5% of women did not know any sign of EP. 76% did not know about the risk factors of EP. Main information source on EP came from friends (49.6%), television (15.2%), publications (10.8%) and health workers (5.9%).The usage of quick test for pregnancy was not common. Conclusion: Predisposing factors showed that the married women and health workers were aware of the need for early prenatal examination and the dangers of EP. The enabling factors showed that some impacts are needed to improve the knowledge of health workers con prenatal examination and counseling. Reinforcing factors showed that the extensive introduction of available health service is needed to improve the access of local women.

Assessment of applicability and practicability of public health competencies: the view of MPH graduates

Background: Although Hanoi School of Public Health was established in the year 2001, 187 Masters of Public Health (MPH) graduated up to 2006. In order to improve the quality of training and find out the applicability of public health of these people, this study was carried out. Objectives: To assess the applicability as well as the frequency of the public health competencies that the alumni performed at current work. Subjects and method: 187 graduates were invited to complete a self - administered questionnaire and in-depth interviews were conducted with 8 alumni as well as a focus group discussion with 14 alumni, using group nominal technique. Results: In total, 79.1% (148) of the MPH graduates completed and returned the questionnaire. The most commonly selected of the 34 pre - identified public health competencies were: applying computer skills (66.4%), planning and managing health programs (47.9%), communicating with the community and/or mobilizing the community to participate in health care (43.2%). Although giving good comments for training program, ex-graduates still had problems when analyzing data and making decision in public health. Conclusions: These findings suggested that the training program should be reviewed and revised to meet the needs of its graduates who enter diverse situations and positions.

Factors influencing domestic violence among rural women in Vietnam

Background: Domestic violence is a common occurrance in every country, culture and all levels of society, and about 20%-50% of women worldwide are victims of domestic violence. In Vietnam, domestic violence had broad range of influences and has serious impacts. Objectives: To identify the factors influencing domestic violence in Yen Phong district, Bac Ninh province. Subjects and method: A cross-sectional study was conducted in 2006 on 452 married women aged 19 to 45 years, with structured questionnaire and in-depth interviews and focus group discussion. Results and conclusion: the lifetime prevalence of domestic violence was 42% and the prevalence in the past 12 month was 22.6%. The most frequent domestic violence was mental, followed by physical and sexual violence. The first 15 years of marriage was the most turbulent period of violence. There were significant relationships between lifetime violence and the education, occupation, economic status, but there was no relationship for violence in the past 12 months. The women, whose husbands were drunk, gambling and unfaithful, were more likely to be facing domestic violence than the others. The acceptance of violence by women was significantly related to violence. Those who perceived the violence by husbands were very severe then were less likely to be faced by violence than the other. In order to prevent the domestic violence, it is necessary to promote the health education, improving the awareness of women and men on gender equity and equality.