Impact of intervention on prevention of mother-to child transmission of HIV

Background: Success in preventing HIV transmission from mother to child has been confirmed, however intervention remains difficult in both services and access barriers due to discrimination and stigma. Objectives: To clarify the HIV prevalence in pregnant women and evaluate the indicators related to the impact of intervention on prevention of mother-to child transmission of HIV. Subjects and method: This study was carried out in 5 districts in 5 provinces that implemented the Prevention of Mother to Child Transmission (PMTCT) Project. The interventions included the training to provide knowledge, skills on counseling, testing and supervision on PMTCT. The data were collected from designed-questionaires. Results:The results showed there are 100% of pregnant women that came for antenatal visits, had voluntary test counseling. The prevalence of HIV (+) among pregnant women was 0,43%. There were 57 infants born to mothers with HIV (+); received prophylaxis treatment. At the time of the study, there were 31 infants at 18 months of age that received HIV test and all of them were confirmed as negative. Conclusion: Intervention on PMTCT was effectively achieved and should be expanded nationally. Communication, counseling is very important to encourage pregnant women with HIV (+); visit for antenatal care, followed up by health facility and strict adherence to the PMCT schedule to diminish the chance of transmission to their infants.

Delivery care in Chi Linh District,Hai Duong province

Background: Maternal and child healthcare is a leading priority in the health care strategy of Viet Nam. Motherhood safety is amongst contents of reproductive healthcare strategy to ensure safe delivery, reduce maternal and neonatal morbidity as well as mortality. Aims: To discover the utilization of delivery care and related factors to women in selecting location for delivery. Subjects and method: The study was carried out in Chillilab \u2013 Demographic and Epidemiological Surveillance was set up in Chi Linh district, Hai Duong province by the School of Public Health. A combination of quantitative and qualitative methods was used in collecting the data. Results: 97% of pregnant women chose public health facilities as their delivery place and 2.5% of pregnant women had homebirths. The main reasons for delivery in hospitals were trust on care quality and sufficient equipment for emergency care. The complicated delivery rate was 14% and Cesarean section delivery was 12%. Hospitalized deliveries were more common in the women with higher education and/or better economic status. Conclusion: There should be improved healthcare communications to encourage all women to give birth at health facilities. Improving the quality of delivery care in community health stations is important to give opportunities for deprived women to receive safer deliveries.

Perinatal care services for women of ethnic minority in the Tay Nguyen High Land

Background: In past decades, Viet Nam achieved many accomplishments in maternal and child health care. However, these successes vary for each area in the country. Tay Nguyen is a high land and has many economic, social and health care difficulties. Objective: To evaluate the knowledge, practice of seeking out pregnancy, delivery and newborn care services of the ethnic minority women in four provinces in Tay Nguyen and to analyze the various factors related to health care behavior. Subjects and method: This was a descriptive, cross-sectional study, using both quantitative and qualitative methods to collect data. The study included 768 women living in 8 communes of 4 provinces in Tay Nguyen (Dak Lak, Dak Nong, Gia Lai, and Kon Tum). Results: 70% of pregnant women went to health facilities for antenatal care visits, but only 42% of them visited three or more times as recommended by the Ministry of Health. 19% of women thought that the antenatal care visits were unnecessary and 16% did not know about antenatal care. 64% of the deliveries occurred at home. Conclusion: Health education and communication in perinatal care need to be improved. It is important to bring health services to the communities to fill the gap in health care services for ethnic minority women.

The mortality during the 24 hours after admission at Nghe An Pediatric Hospital

Background: Pediatric emergency at the inter-hospital transfer lines is a serious problem in the care and treatment of children. 24 hours mortality after admission rose higher than previously.\r\n', u'Objectives: The aim of the study was to determine the 24 hours mortality and to analyze the causes of 24 hours mortality.\r\n', u'Subjects and methods: The study was carried out on 189 patients, who died during 24 hours after admission at Nghe An Pediatric hospital from July 2002 to June 2004.\r\n', u'Results: The results showed that the 24 hour mortality consisted of 77% of all deaths in the hospital. The neonatal mortality rate among the admitted patients was the highest. The most common causes of deaths were: respiratory and neurological diseases with 48% of the total (24% each) followed by injury (15%). Asphyxia/premature ranked third (9%). Surgical diseases consisted of 8.5% and infectious diseases contributed 6% of all deaths. \r\n', u'Conclusion: The interventions at hospital should prioritize the improvement of knowledge and skills on neurological, respiratory, trauma and surgical emergency care. The urgent need is also to train staff and to supply equipment for neonatal care. \r\n', u'

Perinatal care services and neonatal mortality in Quang Ninh province

Background: In Vietnam, although there were interventions in perinatal and neonatal care services, the neonatal mortality reduced slowly, accounting for >50% of under-5-year-old mortality rate and >70% of under-1-year-old mortality rate. \r\n', u'Objectives: Discover the status of prenatal, perinatal, and postnatal care services, and analyze the relationships between healthcare services and neonatal mortality in Quang Ninh province. Subjects and method: Information on births and neonatal deaths between January and December 2005 in Quang Ninh province was collected. The perinatal care services including antenatal, delivery and post partum cares were described. The relationship between neonatal deaths and places of delivery was analyzed in order to uncover the risk of death in newborns delivered at home. Results: 76% of pregnant women received 3 or more antenatal care visits. More than 90% of deliveries took place at health facilities, of them, 16% occurred in community health stations. Only 49% of mothers received post partum care visits, with 82% of them received the visits in the first week after delivery. There were 17,519 births and 284 neonatal deaths in 2005. The neonatal mortality rate was lowest in cases born in community health stations (7.5/1.000) and highest in home birth cases (39/1.000). Conclusion: Further improvement in safe motherhood and neonatal survival can be achieved by increasing the accessibility of women to perinatal cares during pregnancy, delivery. \r\n', u'

The trend of child mortality in the 3 decades from 1970-2000 in Bavi district, Hatay province

Background: In Vietnam, the three decades from 1970 to 2000 was a period having three variable periods of social and economic development:before, during and after the war against America. These changes affect child mortality.\r\n', u'Objectives: The aim of the study is to get a better understanding of the trends in neonatal, infant and child mortality rate in the 3 decades from 1970 to 2000.\r\n', u'Subjects and methods: A retrospective interview with all the women aged 15-54 years old in Bavi district, Northern Vietnam (n=14.329) was conducted.\r\n', u'Results:The results showed a dramatic reduction in infant and under five mortality rate (47%) over time while the neonatal mortality rate showed a small reduction (17%), thus made its proportion of the total child mortality increased. The factors of ethnic minority character and education of the mother were clearly related to child mortality. Children of ethnic minority mothers have 1.5 times higher risk of dying compared with Kinh mothers. Mothers with low education have 2.3 times and 1.5 times higher risk of neonatal deaths and under 5 mortality, respectively compared with mothers with higher education.\r\n', u'Conclusion: Interventions to reduce child mortality should be focused on improving neonatal care and concentrated on maternal groups with low level of education and of ethnic minorities. \r\n', u'\r\n', u'