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Kien, Vu Duy
Publications (10 of 14) Show all publications
Kien, V. D., Van Minh, H., Giang, K. B., Ng, N., Nguyen, V., Tuan, L. T. & Eriksson, M. (2018). Views by health professionals on the responsiveness of commune health stations regarding non-communicable diseases in urban Hanoi, Vietnam: a qualitative study. BMC Health Services Research, 18, Article ID 392.
Open this publication in new window or tab >>Views by health professionals on the responsiveness of commune health stations regarding non-communicable diseases in urban Hanoi, Vietnam: a qualitative study
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2018 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, article id 392Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Primary health care plays an important role in addressing the burden of non-communicable diseases (NCDs) in low- and middle-income countries. In light of the rapid urbanization of Vietnam, this study aims to explore health professionals' views about the responsiveness of primary health care services at commune health stations, particularly regarding the increase of NCDs in urban settings.

METHODS: This qualitative study was conducted in Hanoi from July to August 2015. We implemented 19 in-depth interviews with health staff at four purposely selected commune health stations and conducted a brief inventory of existing NCD activities at these commune health stations. We also interviewed NCD managers at national, provincial, and district levels. The interview guides reflected six components of the WHO health system framework, including service delivery, health workforce, health information systems, access to essential medicines, financing, and leadership/governance. A thematic analysis approach was applied to analyze the interview data in this study.

RESULTS: Six themes, related to the six building blocks of the WHO health systems framework, were identified. These themes explored the responsiveness of commune health stations to NCDs in urban Hanoi. Health staff at commune health stations were not aware of the national strategy for NCDs. Health workers noted the lack of NCD informational materials for management and planning. The limited workforce at health commune stations would benefit from more health workers in general and those with NCD-specific training and skills. In addition, the budget for NCDs at commune health stations remains very limited, with large differences in the implementation of national targeted NCD programs. Some commune health stations had no NCD services available, while others had some programming. A lack of NCD treatment drugs was also noted, with a negative impact on the provision of NCD-related services at commune health stations. These themes were also reflected in the inventory of existing NCD related activities.

CONCLUSIONS: Health professionals view the responsiveness of commune health stations to NCDs in urban Hanoi, Vietnam as weak. Appropriate policies should be implemented to improve the primary health care services on NCDs at commune health stations in urban Hanoi, Vietnam.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Commune health station, Non-communicable disease, Responsiveness, Urban, Vietnam
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-150609 (URN)10.1186/s12913-018-3217-4 (DOI)000434084400003 ()29855320 (PubMedID)2-s2.0-85047956256 (Scopus ID)
Available from: 2018-08-14 Created: 2018-08-14 Last updated: 2018-08-14Bibliographically approved
Kien, V. D., Van Minh, H., Giang, K. B., Dao, A., Weinehall, L., Eriksson, M. & Ng, N. (2017). Socioeconomic inequalities in self-reported chronic non-communicable diseases in urban Hanoi, Vietnam. Global Public Health, 12(12), 1522-1537
Open this publication in new window or tab >>Socioeconomic inequalities in self-reported chronic non-communicable diseases in urban Hanoi, Vietnam
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2017 (English)In: Global Public Health, ISSN 1744-1692, E-ISSN 1744-1706, Vol. 12, no 12, p. 1522-1537Article in journal (Refereed) Published
Abstract [en]

This study measures and decomposes socioeconomic inequalities in the prevalence of self-reported chronic non-communicable diseases (NCDs) in urban Hanoi, Vietnam. A cross-sectional survey of 1211 selected households was carried out in four urban districts in both slum and non-slum areas of Hanoi city in 2013. The respondents were asked if a doctor or health worker had diagnosed any household members with an NCD, such as cardiovascular diseases, chronic respiratory, diabetes or cancer, during last 12 months. Information from 3736 individuals, aged 15 years and over, was used for the analysis. The concentration index (CI) was used to measure inequalities in self-reported NCD prevalence, and it was also decomposed into contributing factors. The prevalence of chronic NCDs in the slum and non-slum areas was 7.9% and 11.6%, respectively. The CIs show gradients disadvantageous to both the slum (CI = -0.103) and non-slum (CI = -0.165) areas. Lower socioeconomic status and aging significantly contributed to inequalities in the self-reported NCDs, particularly for those living in the slum areas. The findings confirm the existence of substantial socioeconomic inequalities linked to NCDs in urban Vietnam. Future policies should target these vulnerable areas.

Place, publisher, year, edition, pages
Abingdon: Routledge, 2017
Keywords
decomposition, Inequality, non-communicable diseases, urban, Vietnam
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-114393 (URN)10.1080/17441692.2015.1123282 (DOI)000414798200006 ()26727691 (PubMedID)
Available from: 2016-01-18 Created: 2016-01-18 Last updated: 2018-06-07Bibliographically approved
Kien, V. D., Van Minh, H., Giang, K. B., Mai, V. Q., Tuan, N. T. & Quam, M. B. (2017). Trends in childhood measles vaccination highlight socioeconomic inequalities in Vietnam. International Journal of Public Health, 62, S41-S49
Open this publication in new window or tab >>Trends in childhood measles vaccination highlight socioeconomic inequalities in Vietnam
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2017 (English)In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 62, p. S41-S49Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To describe trends in measles vaccine coverage rates and their association with socioeconomic characteristics among children from age 12 to 23 months in Vietnam from the year 2000 to 2014.

METHODS: Data were drawn from the Vietnam Multiple Indicator Cluster Surveys in years 2000, 2006, 2011, and 2014. Concentration indices were used to determine the magnitude of socioeconomic inequalities in measles vaccine coverage. Associations between measles vaccine coverage and relevant social factors were assessed using logistic regression.

RESULTS: Socioeconomic inequalities in measles vaccine coverage rates decreased during 2000-2014. Children belonging to ethnic minority groups, having mothers with lower education, and belonging to the poorest group were less likely to receive measles vaccine; although, their vaccine coverage rates did increase with time. Measles vaccine coverage declined among children of mothers with more education and belonging to the wealthiest socioeconomic group.

CONCLUSIONS: Understanding the social factors influencing adherence to recommend childhood vaccination protocols is essential. Attempts to regain and retain herd immunity must be guided by an understanding of these social factors if they are to succeed.

Keywords
Socioeconomic inequality, Measles, Vaccine coverage, Children, Vietnam
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-126979 (URN)10.1007/s00038-016-0899-4 (DOI)000396886800007 ()27695901 (PubMedID)
Note

Supplement 1: Health and social determinants of health in Vietnam: local evidence and international implications’

Available from: 2016-10-24 Created: 2016-10-24 Last updated: 2018-06-09Bibliographically approved
Giang, K. B., Oh, J., Kien, V. D., Hoat, L. N., Choi, S., Lee, C. O. & Van Minh, H. (2016). Changes and inequalities in early birth registration and childhood care and education in Vietnam: findings from the Multiple Indicator Cluster Surveys, 2006 and 2011. Global Health Action, 9(1), Article ID 29470.
Open this publication in new window or tab >>Changes and inequalities in early birth registration and childhood care and education in Vietnam: findings from the Multiple Indicator Cluster Surveys, 2006 and 2011
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2016 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 9, no 1, article id 29470Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Early birth registration, childhood care, and education are essential rights for children and are important for their development and education. This study investigates changes and socioeconomic inequalities in early birth registration and indicators of care and education in children aged under 5 years in Vietnam.

DESIGN: The analyses reported here used data from the Vietnam Multiple Indicator Cluster Surveys (MICS) in 2006 and 2011. The sample sizes in 2006 and 2011 were 2,680 and 3,678 for children under 5 years of age. Four indicators of childcare and preschool education were measured: birth registration, possession of books, preschool education attendance, and parental support for early childhood education. The concentration index (CI) was used to measure inequalities in gender, maternal education, geographical area, place of residence, ethnicity, and household wealth.

RESULTS: There were some improvements in birth registration (86.4% in 2006; 93.8% in 2011), preschool education attendance (57.1% in 2006; 71.9% in 2011), and parental support for early childhood education (68.9 and 76.8%, respectively). However, the possession of books was lower (24.7% in 2006; 19.6% in 2011) and became more unequal over time (i.e. CI=0.370 in 2006; CI=0.443 in 2011 in wealth inequality). Inequalities in the care and education of children were still persistent. The largest inequalities were for household wealth and rural versus urban areas.

CONCLUSION: Although there have been some improvements in this area, inequalities still exist. Policy efforts in Vietnam should be directed towards closing the gap between different socioeconomic groups for the care and education of children under 5 years old.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-118312 (URN)10.3402/gha.v9.29470 (DOI)000377802300014 ()28156888 (PubMedID)
Note

Special Issue: Millennium Development Goals in Vietnam: the Progress and Social Determinants

Available from: 2016-03-15 Created: 2016-03-15 Last updated: 2018-06-07Bibliographically approved
Kien, V. D. (2016). Inequalities in non-communicable diseases in urban Hanoi, Vietnam: health care utilization, expenditure and responsiveness of commune health stations. (Doctoral dissertation). Umeå: Umeå universitet
Open this publication in new window or tab >>Inequalities in non-communicable diseases in urban Hanoi, Vietnam: health care utilization, expenditure and responsiveness of commune health stations
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Non-communicable diseases (NCDs) are the leading causes of morbidity and mortality among adults in Vietnam. Little is known about the magnitude of socioeconomic inequalities in NCDs and other NCD-related factors in urban areas, in particular among the poor living in slum areas. Understanding these disparities are essential in contributing to the knowledge, needed to reduce inequalities and close the related health gaps burdening the disadvantaged populations in urban areas. 

Objective: To examine the burden and health system responsiveness to NCDs in Hanoi, Vietnam and investigate the role of socioeconomic inequalities in their prevalence, subsequent healthcare utilization and related impoverishment due to health expenditures. 

Methods: A cross-sectional study was conducted among 3,736 individuals aged 15 years and over who lived in 1211 randomly selected households in 2013 in urban Hanoi, Vietnam. The study collected information on household’s characteristics, household expenditures, and household member information. A qualitative approach was implemented to explore the responsiveness of commune health stations to the increasing burden of NCDs in urban Hanoi. In-depth interview approach was conducted among health staff involved in NCD tasks at four commune health stations in urban Hanoi. Furthermore, NCD managers at relevance district, provincial and national levels were interviewed. 

Results: The prevalence of self-reported NCDs was significantly higher among individuals in non-slum areas (11.6%) than those in slum areas (7.9%). However, the prevalence of self-reported NCDs concentrated among the poor in both slum and non-slum areas. In slum areas, the poor needed more health care services, but the rich consumed more health care services. Among households with at least one household member reporting diagnosis of NCDs, the proportion of household facing catastrophic health expenditure and impoverishment were the greater in slum areas than in non-slum areas. Poor households in slum areas were more likely to face catastrophic health expenditure and impoverishment. The poor in non-slum areas were also more likely to face impoverishment if their household members experienced NCDs. Health system responses to NCDs at commune health stations in urban Hanoi were weak, characterized by the lack of health information, inadequate human resources, poor financing, inadequate quality and quantity of services, lack of essential medicines. The commune health stations were not prepared to respond to the rising prevalence of NCDs in urban Hanoi. 

Conclusion: This thesis shows the existence of socioeconomic inequalities in the prevalence of self-reported NCDs in both non-slum and slum areas in urban Hanoi. NCDs associated with the inequalities in health care utilization, catastrophic health expenditure and impoverishment, particular in slum areas. Appropriate interventions should focus more on specific population groups to reduce the socioeconomic inequalities in the NCD prevalence and health care utilization related to NCDs to prevent catastrophic health expenditure and impoverishment among the households of NCD patients.  The functions of commune health stations in the urban setting should be strengthened through the development of NCDs service packages covered by the health insurance.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2016. p. 76
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1845
Keywords
socioeconomic inequalities, non-communicable diseases, health care utilization, catastrophic health expenditure, impoverishment, health system, commune health stations, Hanoi, Vietnam
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Epidemiology
Identifiers
urn:nbn:se:umu:diva-126045 (URN)978-91-7601-564-3 (ISBN)
Public defence
2016-10-21, Betula, Building 6M, Norrlands University Hospital, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2016-09-30 Created: 2016-09-27 Last updated: 2018-06-07Bibliographically approved
Van Minh, H., Oh, J., Giang, K. B., Kien, V. D., Nam, Y.-S., Lee, C. O., . . . Hoat, L. N. (2016). Multiple vulnerabilities and maternal healthcare in Vietnam: findings from the Multiple Indicator Cluster Surveys, 2000, 2006, and 2011. Global Health Action, 9, Article ID 29386.
Open this publication in new window or tab >>Multiple vulnerabilities and maternal healthcare in Vietnam: findings from the Multiple Indicator Cluster Surveys, 2000, 2006, and 2011
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2016 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 9, article id 29386Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Knowledge of the aggregate effects of multiple socioeconomic vulnerabilities is important for shedding light on the determinants of growing health inequalities and inequities in maternal healthcare.

OBJECTIVE: This paper describes patterns of inequity in maternal healthcare utilization and analyzes associations between inequity and multiple socioeconomic vulnerabilities among women in Vietnam.

DESIGN: This is a repeated cross-sectional study using data from the Vietnam Multiple Indicator Cluster Surveys 2000, 2006, and 2011. Two maternal healthcare indicators were selected: (1) skilled antenatal care and (2) skilled delivery care. Four types of socioeconomic vulnerabilities - low education, ethnic minority, poverty, and rural location - were assessed both as separate explanatory variables and as composite indicators (combinations of three and four vulnerabilities). Pairwise comparisons and adjusted odds ratios were used to assess socioeconomic inequities in maternal healthcare.

RESULTS: In all three surveys, there were increases across the survey years in both the proportions of women who received antenatal care by skilled staff (68.6% in 2000, 90.8% in 2006, and 93.7% in 2011) and the proportions of women who gave birth with assistance from skilled staff (69.9% in 2000, 87.7% in 2006, and 92.9% in 2011). The receipt of antenatal care by skilled staff and birth assistance from skilled health personnel were less common among vulnerable women, especially those with multiple vulnerabilities.

CONCLUSIONS: Even though Vietnam has improved its coverage of maternal healthcare on average, policies should target maternal healthcare utilization among women with multiple socioeconomic vulnerabilities. Both multisectoral social policies and health policies are needed to tackle multiple vulnerabilities more effectively by identifying those who are poor, less educated, live in rural areas, and belong to ethnic minority groups.

Place, publisher, year, edition, pages
co-action, 2016
Keywords
healthcare; skilled antenatal care; skilled delivery; multiple socioeconomic vulnerabilities; inequity; inequality
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-118311 (URN)10.3402/gha.v9.29386 (DOI)26950561 (PubMedID)
Available from: 2016-03-15 Created: 2016-03-15 Last updated: 2018-06-07Bibliographically approved
Giang, K. B., Chung, L. H., Minh, H. V., Kien, V. D., Giap, V. V., Hinh, N. D., . . . Yang, J.-C. (2016). Relative Importance of Different Attributes of Graphic Health Warnings on Tobacco Packages in Viet Nam. Asian Pacific Journal of Cancer Prevention, 17, 79-84
Open this publication in new window or tab >>Relative Importance of Different Attributes of Graphic Health Warnings on Tobacco Packages in Viet Nam
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2016 (English)In: Asian Pacific Journal of Cancer Prevention, ISSN 1513-7368, Vol. 17, p. 79-84Article in journal (Refereed) Published
Abstract [en]

Graphic health warnings (GHW) on tobacco packages have proven to be effective in increasing quit attempts among smokers and reducing initial smoking among adolescents. This research aimed to examine the relative importance of different attributes of graphic health warnings on tobacco packages in Viet Nam. A discrete choice experimental (DCE) design was applied with a conditional logit model. In addition, a ranking method was used to list from the least to the most dreadful GHW labels. With the results from DCE model, graphic type was shown to be the most important attribute, followed by cost and coverage area of GHW. The least important attribute was position of the GHW. Among 5 graphic types (internal lung cancer image, external damaged teeth, abstract image, human suffering image and text), the image of lung cancer was found to have the strongest influence on both smokers and non-smokers. With ranking method, the image of throat cancer and heart diseases were considered the most dreadful images. GHWs should be designed with these attributes in mind, to maximise influence on purchase among both smokers and non-smokers.

Keywords
Graphic health warnings, characteristics, relative importance, discrete choice experiment, Vietnam
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-127195 (URN)10.7314/APJCP.2016.17.S1.79 (DOI)27087187 (PubMedID)
Note

Issue sup1

Available from: 2016-11-02 Created: 2016-11-02 Last updated: 2018-06-09Bibliographically approved
Kien, V. D., Minh, H., Giang, K., Dao, A., Tuan, L. & Ng, N. (2016). Socioeconomic inequalities in catastrophic health expenditure and impoverishment associated with non-communicable diseases in urban Hanoi, Vietnam. International Journal for Equity in Health, 15, Article ID 169.
Open this publication in new window or tab >>Socioeconomic inequalities in catastrophic health expenditure and impoverishment associated with non-communicable diseases in urban Hanoi, Vietnam
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2016 (English)In: International Journal for Equity in Health, ISSN 1475-9276, E-ISSN 1475-9276, Vol. 15, article id 169Article in journal (Refereed) Published
Abstract [en]

Background: The catastrophic health expenditure and impoverishment indices offer guidance for developing appropriate health policies and intervention programs to decrease financial inequity. This study assesses socioeconomic inequalities in catastrophic health expenditure and impoverishment in relation to self-reported non-communicable diseases (NCD) in urban Hanoi, Vietnam. Methods: A cross-sectional survey was conducted from February to March 2013 in Hanoi, the capital city of Vietnam. We estimated catastrophic health expenditure and impoverishment using information from 492 slum household and 528 non-slum households. We calculated concentration indexes to assess socioeconomic inequalities in catastrophic health expenditure and impoverishment. Factors associated with catastrophic health expenditure and impoverishment were modelled using logistic regression analysis. Results: The poor households in both slum and non-slum areas were at higher risk of experiencing catastrophic health expenditure, while only the poor households in slum areas were at higher risk of impoverishment because of healthcare spending. Households with at least one member reporting an NCD were significantly more likely to face catastrophic health expenditure (odds ratio [OR] = 2.4; 95 % confidence interval [CI], 1.8-4.0) and impoverishment (OR = 2.3; 95 % CI, 1.1-6.3) compared to households without NCDs. In addition, households in slum areas, with people age 60 years and above, and belonging to the poorest socioeconomic group were significantly associated with increased catastrophic health expenditure, while only households that lived in slum areas, and belonging to the poor or poorest socioeconomic groups were significantly associated with increased impoverishment because of healthcare spending. Conclusion: Financial interventions to prevent catastrophic health expenditure and impoverishment should target poor households, especially those with family members suffering from NCDs, with older members and those located in slum areas in Hanoi Vietnam. Potential interventions derived from this study include targeting and monitoring of health insurance enrolment, and developing a specialized NCD service package for Vietnam's social health insurance program.

Keywords
Inequality, Catastrophic health expenditure, Impoverishment, Urban, Poverty, Vietnam
National Category
Public Health, Global Health, Social Medicine and Epidemiology Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:umu:diva-126001 (URN)10.1186/s12939-016-0460-3 (DOI)000385876500001 ()27737663 (PubMedID)
Available from: 2016-09-26 Created: 2016-09-26 Last updated: 2018-06-07Bibliographically approved
Minh, H. V., Ngan, T. T., Mai, V. Q., My, N. T., Chung, L. H., Kien, V. D., . . . Giang, K. B. (2016). Tobacco Control Policies in Vietnam: Review on MPOWER Implementation Progress and Challenges. Asian Pacific Journal of Cancer Prevention, 17, 1-9
Open this publication in new window or tab >>Tobacco Control Policies in Vietnam: Review on MPOWER Implementation Progress and Challenges
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2016 (English)In: Asian Pacific Journal of Cancer Prevention, ISSN 1513-7368, Vol. 17, p. 1-9Article in journal (Refereed) Published
Abstract [en]

In Vietnam, the WHO Framework Convention on Tobacco Control (WHO FCTC) took effect in March 2005 while MPOWER has been implemented since 2008. This paper describes the progress and challenges of implementation of the MPOWER package in Vietnam. We can report that, in term of monitoring, Vietnam is very active in the Global Tobacco Surveillance System, completing two rounds of the Global Adult Tobacco Survey (GATS) and three rounds of the Global Youth Tobacco Survey (GYTS). To protect people from tobacco smoke, Vietnam has issued and enforced a law requiring comprehensive smoking bans at workplaces and public places since 2013. Tobacco advertising and promotion are also prohibited with the exception of points of sale displays of tobacco products. Violations come in the form of promotion girls, corporate social responsibility activities from tobacco manufacturers and packages displayed by retail vendors. Vietnam is one of the 77 countries that require pictorial health warnings to be printed on cigarette packages to warn about the danger of tobacco and the warnings have been implemented effectively. Cigarette tax is 70% of factory price which is equal to less than 45% of retail price and much lower than the recommendation of WHO. However, Vietnam is one of the very few countries that require manufacturers and importers to make "compulsory contributions" at 1-2% of the factory price of cigarettes sold in Vietnam for the establishment of a Tobacco Control Fund (TCF). The TCF is being operated well. In 2015, 67 units of 63 provinces/cities, 22 ministries and political-social organizations and 6 hospitals received funding from TCF to implement a wide range of tobacco control activities. Cessation services have been starting with a a toll-free quit-line but need to be further strengthened. In conclusion, Vietnam has constantly put efforts into the tobacco control field with high commitment from the government, scientists and activists. Though several remarkable achievements have been gained, many challenges remain. To overcome those challenges, implementation strategies that take into account the contextual factors and social determinants of tobacco use in Vietnam are needed.

Keywords
Tobacco policy, MPOWER, WHO Framework Convention on Tobacco Control, Vietnam
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-127196 (URN)10.7314/APJCP.2016.17.S1.1 (DOI)27087176 (PubMedID)
Note

Issue sup1

Available from: 2016-11-02 Created: 2016-11-02 Last updated: 2018-06-09Bibliographically approved
Kien, V. D., Lee, H.-Y., Nam, Y.-S., Oh, J., Giang, K. B. & Van Minh, H. (2016). Trends in socioeconomic inequalities in child malnutrition in Vietnam: findings from the Multiple Indicator Cluster Surveys, 2000-2011. Global Health Action, 9, Article ID 29263.
Open this publication in new window or tab >>Trends in socioeconomic inequalities in child malnutrition in Vietnam: findings from the Multiple Indicator Cluster Surveys, 2000-2011
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2016 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 9, article id 29263Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Child malnutrition is not only a major contributor to child mortality and morbidity, but it can also determine socioeconomic status in adult life. The rate of under-five child malnutrition in Vietnam has significantly decreased, but associated inequality issues still need attention.

OBJECTIVE: This study aims to explore trends, contributing factors, and changes in inequalities for under-five child malnutrition in Vietnam between 2000 and 2011.

DESIGN: Data were drawn from the Viet Nam Multiple Indicator Cluster Survey for the years 2000 and 2011. The dependent variables used for the study were stunting, underweight, and wasting of under-five children. The concentration index was calculated to see the magnitude of child malnutrition, and the inequality was decomposed to understand the contributions of determinants to child malnutrition. The total differential decomposition was used to identify and explore factors contributing to changes in child malnutrition inequalities.

RESULTS: Inequality in child malnutrition increased between 2000 and 2011, even though the overall rate declined. Most of the inequality in malnutrition was due to ethnicity and socioeconomic status. The total differential decomposition showed that the biggest and second biggest contributors to the changes in underweight inequalities were age and socioeconomic status, respectively. Socioeconomic status was the largest contributor to inequalities in stunting.

CONCLUSIONS: Although the overall level of child malnutrition was improved in Vietnam, there were significant differences in under-five child malnutrition that favored those who were more advantaged in socioeconomic terms. The impact of socioeconomic inequalities in child malnutrition has increased over time. Multifaceted approaches, connecting several relevant ministries and sectors, may be necessary to reduce inequalities in childhood malnutrition.

Place, publisher, year, edition, pages
Co-Action Publishing, 2016
Keywords
trend, malnutrition, inequality, decomposition, Vietnam
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-118310 (URN)10.3402/gha.v9.29263 (DOI)000377802300005 ()26950558 (PubMedID)
Note

Special Issue: Millennium Development Goals in Vietnam : the Progress and Social Determinants

Available from: 2016-03-15 Created: 2016-03-15 Last updated: 2018-06-07Bibliographically approved
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