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Maternal, neonatal, and child health systems under rapid urbanization: a qualitative study in a suburban district in Vietnam

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Authors
Heo, Jongho; Kim, Seung Yun; Yi, Jinseon; Yu, Soo-Young; Jung, Da Eun; Lee, Sangmi; Jung, Ju Youn; Kim, Hyunsuk; Do, Ngan; Lee, Hwa-Young; Nam, You-Seon; Hoang, Van Minh; Luu, Ngoc Hoat; Lee, Jong-Koo; Tran, Thi Giang Huong; Oh, Juhwan
Issue Date
2020-02-05
Publisher
BMC
Citation
BMC Health Services Research. 2020 Feb 05;20(1):90
Keywords
Access, MNCHQuality of serviceUrbanizationAntenatal careDelivery
Abstract
Background
Vietnam has been successful in increasing access to maternal, neonatal, and child health (MNCH) services during last decades; however, little is known about whether the primary MNCH service utilization has been properly utilized under the recent rapid urbanization. We aimed to examine current MNCH service utilization patterns at a district level.

Methods
The study was conducted qualitatively in a rural district named Quốc Oai. Women who gave a birth within a year and medical staff at various levels participated through 43 individual in-depth interviews and 3 focus group interviews.

Results
Primary MNCH services were underutilized due to a failure to meet increased quality needs. Most of the mothers preferred private clinics for antenatal care and the district hospital for delivery due to the better service quality of these facilities compared to that of the commune health stations (CHSs). Mothers had few sociocultural barriers to acquiring service information or utilizing services based on their improved standard of living. A financial burden for some services, including caesarian section, still existed for uninsured mothers, while their insured counterparts had relatively few difficulties.

Conclusions
For the improved macro-efficiency of MNCH systems, the government needs to rearrange human resources and/or merge some CHSs to achieve economies of scale and align with service volume distribution across the different levels.
ISSN
1472-6963
Language
English
URI
http://hdl.handle.net/10371/168779
DOI
doi.org/10.1186/s12913-019-4874-7
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)Journal Papers (저널논문_의학과)
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