Despite the expansion of prenatal care, maternal and child mortality is high in Vietnam, especially among those with limited financial resources.
A new thesis at the Nordic School of Public Health NVH is showing that there are large differences in maternal health given in the Vietnamese countryside and the cities.
– The study reveals inadequate use of prenatal care among the rural poor, says Dr Tran Khanh Toan, whose thesis is defended on September the 10th.
The Nordic School of Public Health NHV has since many years collaborated with Hanoi university and conducts studies in Vietnam. Dr Tran Toan Khan will defend his thesis Antenatal and delivery care utilization in urban and rural contexts in Vietnam at NHV 13.00 o clock September the 10th.
Pregnant women need adequate maternal and obstetric care, and access to such, have increased in Vietnam. Although maternal and child mortality has nog declined to the extent that would have been expected.
This study is the first study ever done on differences between the situation in the countryside and in the cities. Rural women do not use antenatal care in the degree that is recommended. The recommendations for safe pregnancy and childbirth identified were followed only by less than e fifth of the women in the rural areas.
– Essentially, this is due to poor education, low economic status and that they use private health care options, says Dr. Tran Toan Khanh.
However, all women, both in rural and urban areas use the ultrasound on average 4.5 times during their pregnancy.
Increasing use of caesarean section
Although the basic supply in maternal health and obstetric care are available in rural areas and is recommended for normal pregnancies most of the women is giving birth at the central hospitals.
The use of caesarean is increasing; today 38.5 percent of the urban woman get cesarean section. This greatly exceeds what can be expected due to medical reasons.
– The use of caesarean is related to favorable socio-economic conditions and also occurs more often among women who are pregnant with boys. In Vietnam the families very much is wanting boys so they do what they believe will secure the boy’s health.
Further on the thesis is showing that the national maternal health programs need to be designed differently when it comes to rural and urban needs. The focus should be to strengthen services in rural areas and to control unjustified use of technology, such as ultrasound examinations and cesarean, especially in the cities.
– There is a need for increased knowledge and changing attitudes of all involved, patients as well as caregivers, says Tran Khanh Toan.