| 1. |
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- 2019
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Tidskriftsartikel (refereegranskat)
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| 4. |
- Bjornvold, M., et al.
(författare)
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FOXP3 polymorphisms in type 1 diabetes and coeliac disease
- 2006
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Ingår i: J Autoimmun. - : Elsevier BV. - 0896-8411. ; 27:2, s. 140-4
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Tidskriftsartikel (refereegranskat)abstract
- The FOXP3 gene encodes a transcription factor thought to be essential for the development and function of T regulatory cells. Two previous studies have tested common polymorphisms in FOXP3 for association with type 1 diabetes (T1D) with conflicting results. The aim of our study was to see whether there is any evidence of association between the FOXP3 polymorphisms previously reported to be associated with T1D, in a Caucasian population regarding T1D and coeliac disease (CD). We further looked for evidence of interaction between FOXP3 polymorphisms and HLA-DR3 in conferring susceptibility to T1D. Initially, we analysed two microsatellites in the FOXP3 gene in 363 T1D nuclear families. Our results indicated an association between FOXP3 and T1D (global p=0.004) and a possible interaction between FOXP3 and the HLA-DR3-DQ2 susceptibility haplotype. We then genotyped an additional independent set of 826 T1D patients and 1459 controls as well as one CD dataset consisting of 325 families. A similar tendency was revealed in the CD family material (pnc=0.055 for the associated allele). On the other hand, we were unable to reproduce our initial findings in the T1D case-control dataset (global p=0.6). Our results suggest that the tested FOXP3 markers do not have any major impact on susceptibility for these diseases.
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| 5. |
- Do, Loan Minh, et al.
(författare)
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Preschool overweight and obesity in urban and rural Vietnam: differences in prevalence and associated factors
- 2015
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9880 .- 1654-9716. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Childhood obesity may soon be an equally important health threat as undernutrition and infectious diseases. Accurate information about prevalence and risk factors of obesity in children is important for the design of prevention. Objective: The aim of this study was to estimate prevalence of overweight and obesity for preschool children in two Vietnamese areas, one urban and one rural, and to identify risk factors. Design: A cross-sectional study was conducted in urban Dong Da and rural Ba Vi districts, Hanoi, Vietnam. Totally, 2,677 children, 1,364 urban and 1,313 rural, were weighed and measured. Caregivers were interviewed. Background information about children and families was obtained from regular household surveys. Results: The prevalence of overweight and obesity combined were 21.1% (95% CI 18.9-23.3) in the urban area and 7.6% (95% CI 6.2-9.2) in the rural. Multiple logistic regression revealed that at the individual level, in both sites, the risk increased with increased child age. The identified urban risk factors were being a boy, consuming large amounts of food, eating fast, and indoor activity less than 2 hours per day. The rural risk factors were frequent consumption of fatty food. At the family level, significant association was found in rural areas with frequent watching of food advertisements on television. Conclusions: Overweight and obesity are emerging problems in Vietnam, particularly in the urban context. Prevention programs should focus on education about healthy eating habits at early preschool age and need to be tailored separately for urban and rural areas since the risk factors differ. Non-healthy food advertisement needs to be restricted.
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| 6. |
- Domínguez-Gil, B., et al.
(författare)
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The Reality of Inadequate Patient Care and the Need for a Global Action Framework in Organ Donation and Transplantation
- 2022
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Ingår i: Transplantation. ; 106:11, s. 2111-2117
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Transplant therapy is considered the best and often the only available treatment for thousands of patients with organ failure that results from communicable and noncommunicable diseases. The number of annual organ transplants is insufficient for the worldwide need. METHODS: We elaborate the proceedings of the workshop entitled "The Role of Science in the Development of International Standards of Organ Donation and Transplantation," organized by the Pontifical Academy of Sciences and cosponsored by the World Health Organization in June 2021. RESULTS: We detail the urgency and importance of achieving national self-sufficiency in organ transplantation as a public health priority and an important contributor to reaching relevant targets of the United Nations Agenda for Sustainable Development. It details the elements of a global action framework intended for countries at every level of economic development to facilitate either the establishment or enhancement of transplant activity. It sets forth a proposed plan, by addressing the technical considerations for developing and optimizing organ transplantation from both deceased and living organ donors and the regulatory oversight of practices. CONCLUSIONS: This document can be used in governmental and policy circles as a call to action and as a checklist for actions needed to enable organ transplantation as treatment for organ failure. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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| 7. |
- Lebares, C. C., et al.
(författare)
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Exploration of Individual and System-Level Well-being Initiatives at an Academic Surgical Residency Program A Mixed-Methods Study
- 2021
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Ingår i: Jama Network Open. - : American Medical Association (AMA). - 2574-3805. ; 4:1
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE Physician well-being is a critical component of sustainable health care. There are few data on the effects of multilevel well-being programs nor a clear understanding of where and how to target resources. OBJECTIVE To inform the design of future well-being interventions by exploring individual and workplace factors associated with surgical trainees' well-being, differences by gender identity, and end-user perceptions of these initiatives. DESIGN, SETTING, AND PARTICIPANTS This mixed-methods study among surgical trainees within a single US academic surgical department included a questionnaire in January 2019 (98 participants, including general surgery residents and clinical fellows) and a focus group (9 participants, all clinical residents who recently completed their third postgraduate year [PGY 3]) in July 2019. Participants self-reported gender (man, woman, nonbinary). EXPOSURES Individual and organizational-level initiatives, including mindfulness-based affective regulation training (via Enhanced Stress Resilience Training), advanced scheduling of time off, wellness half-days, and the creation of a resident-driven well-being committee. MAIN OUTCOMES AND MEASURES Well-being was explored using validated measures of psychosocial risk (emotional exhaustion, depersonalization, perceived stress, depressive symptoms, alcohol use, languishing, anxiety, high psychological demand) and resilience (mindfulness, social support, flourishing) factors. End-user perceptions were assessed through open-ended responses and a formal focus group. RESULTS Of 98 participants surveyed, 64 responded (response rate, 65%), of whom 35 (55%) were women. Women vs men trainees were significantly more likely to report high depersonalization (odds ratio [OR], 5.50; 95% CI, 1.38-21.85) and less likely to report high mindfulness tendencies (OR, 0.17; 95% CI, 0.05-0.53). Open-ended responses highlighted time and priorities as the greatest barriers to using well-being resources. Focus group findings reflected Job Demand-Resource theory tenets, revealing the value of individual-level interventions to provide coping skills, the benefit of advance scheduling of time off for maintaining personal support resources, the importance of work quality rather than quantity, and the demoralizing effect of inefficient or nonresponsive systems. CONCLUSIONS AND RELEVANCE In this study, surgical trainees indicated that multilevel well-being programs would benefit them, but tailoring these initiatives to individual needs and specific workplace elements is critical to maximizing intervention effects.
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| 8. |
- Ascher, K., et al.
(författare)
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A fibered power theorem for pairs of log general type
- 2016
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Ingår i: Algebra & Number Theory. - : Mathematical Sciences Publishers. - 1937-0652 .- 1944-7833. ; 10:7, s. 1581-1600
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Tidskriftsartikel (refereegranskat)abstract
- Let f : (X, D) -> B be a stable family with log canonical general fiber. We prove that, after a birational modification of the base (B) over tilde -> B, there is a morphism from a high fibered power of the family to a pair of log general type. If in addition the general fiber is openly canonical, then there is a morphism from a high fibered power of the original family to a pair openly of log general type.
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| 9. |
- Do, L. M., et al.
(författare)
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Prevalence and incidence of overweight and obesity among Vietnamese preschool children: a longitudinal cohort study
- 2017
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Ingår i: BMC Pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: A plateau in childhood overweight and obesity has been reported in some developed countries while in almost all developing countries this problem is on the rise. The aim of this paper is to describe the changes in prevalence of overweight and obesity within a cohort of preschool children followed for 3 years, and to estimate and compare the incidences in urban and rural children of Hanoi, Vietnam. Methods: A longitudinal study of a cohort of 2677 children aged 3 to 6 years old at the beginning of the study was conducted in urban DodaLab and rural FilaBavi, Hanoi, Vietnam. Overall, 2602 children, 1311 urban and 1291 rural, were followed for 3 years with identical measurements of weight and height in 2013, 2014 and 2016. Standard methods were used to estimate prevalence and incidence as well as confidence intervals. Results: During the three-year follow-up, the overall estimated prevalence of overweight increased from 9.1% to 16.7%. For the urban children, the increase was considerably higher. The overall prevalence of obesity decreased from 6.4% to 4.5% with less decrease in the urban children. In the group of children who were overweight and obese at the start of the study, 41.4% and 30.7%, respectively, remained in the same state three years later. The incidence of overweight and obesity during the three years were 12.4% and 2.7%, respectively. Boys were more likely to develop obesity than girls. Conclusions: Already in preschool age, the prevalence of overweight is high and it continues to increase with age, especially in the urban area. Prevention and intervention programs need to start at early preschool age and actions in urban areas deserve priority.
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| 10. |
- Do, Loan Minh, et al.
(författare)
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Vietnamese mother's conceptions of childhood overweight: findings from a qualitative study
- 2016
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9880 .- 1654-9716. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Childhood overweight and obesity is a new and emerging problem in Vietnam. The so far observed prevalence increases have pointed to the need for public health intervention strategies with parents as crucial resources for change. Objective: The aim of this study was to understand mothers' conceptions of childhood overweight. Design: Four focus group discussions were conducted with a total of 33 mothers of preschool children, 4-6 years old, living in urban and rural districts of Hanoi, Vietnam. The discussions were audio taped and transcribed verbatim. The obtained data were analyzed using the principles of phenomenography. Results: Four main categories with 13 subcategories emerged in the process of analysis. The first category, called 'Concept of overweight', contained mothers' views on childhood overweight. A major concern was the negative aspects of overweight such as impaired social interaction and health problems. The second category, 'Identification of overweight', described the ways mothers use to recognize overweight in children: own experience, growth chart, and public or health care system's information. The third category, 'Causes of overweight', showed mothers' understanding of factors possibly contributing to overweight development: unhealthy food and lifestyle, genetic susceptibility, parent's lack of knowledge, and limited time to take care of children as well as economic improvement. The fourth category, 'Management of overweight', described the ways mothers use to manage a child's weight problem: control of their food intake, increasing their physical activity, and encouraging their child self-control. However, they find such strategies difficult to implement and their intentions are sometimes challenged by the child's grandparents. Conclusions: The study gives an understanding of the mothers' conceptions of four important and practically useful aspects of overweight in children. The findings highlight the roles of media and the health care system in enhancing a social awareness of the problem and the need for prevention. Growth charts need to be used more regularly and consciously in child health care for early detection of children at risk and as a tool for information to parents. When designing intervention programs, the entire extended families, especially grandparents and their roles, need to be considered.
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| 11. |
- Dunlavy, Andrea, et al.
(författare)
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Health outcomes in young adulthood among former child refugees in Denmark, Norway and Sweden: A cross-country comparative study
- 2023
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Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 51:3, s. 330-338
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Tidskriftsartikel (refereegranskat)abstract
- Aims: This study aimed at comparing several health outcomes in young adulthood among child refugees who settled in the different immigration and integration policy contexts of Denmark, Norway and Sweden. Methods: The study population included refugees born between 1972 and 1997 who immigrated before the age of 18 and settled in the three Nordic countries during 1986-2005. This population was followed up in national registers during 2006-2015 at ages 18-43 years and was compared with native-born majority populations in the same birth cohorts using sex-stratified and age-adjusted regression analyses. Results: Refugee men in Denmark stood out with a consistent pattern of higher risks for mortality, disability/illness pension, psychiatric care and substance misuse relative to native-born majority Danish men, with risk estimates being higher than comparable estimates observed among refugee men in Norway and Sweden. Refugee men in Sweden and Norway also demonstrated increased risks relative to native-born majority population men for inpatient psychiatric care, and in Sweden also for disability/illness pension. With the exception of increased risk for psychotic disorders, outcomes among refugee women were largely similar to or better than those of native-born majority women in all countries. Conclusions: The observed cross-country differences in health indicators among refugees, and the poorer health outcomes of refugee men in Denmark in particular, may be understood in terms of marked differences in Nordic integration policies. However, female refugees in all three countries had better relative health outcomes than refugee men did, suggesting possible sex differentials that warrant further investigation.
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| 12. |
- Godoy-Ramirez, K., et al.
(författare)
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Exploring childhood immunization among undocumented migrants in Sweden - following qualitative study and the World Health Organizations Guide to Tailoring Immunization Programmes (TIP)
- 2019
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Ingår i: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 171, s. 97-105
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: National vaccination coverage in Sweden is high. Recurrent outbreaks of measles and rubella however highlight some immunity gaps in the population. Current knowledge about immunization status of undocumented migrant children is scant. The World Health Organization/Europe has developed the Guide to Tailoring Immunization Programmes (TIP) to assist countries in diagnosing barriers and motivators to vaccination in communities with low vaccination coverage. Based on the TIP guide, the objective of this study was to explore determinants to vaccination among undocumented immigrants, using qualitative approach. Study design: The study consisted of three steps: (i) an initial workshop for problem statement; (ii) qualitative research for increased understanding of the vaccination practices of children in the undocumented community; and (iii) a second workshop to incorporate the qualitative interview findings together with data from key stakeholders into a conceptual framework. Methods: This was a qualitative study featuring interviews of seven undocumented parents recruited at non-governmental clinics, three nurses at Child Health Centers, and information from key stakeholders retrieved at workshops as part of the TIP process. Results: The content analysis revealed two main themes: parental fear of being questioned and parental acceptance of child immunization. Undocumented parents had a positive view and attitude toward childhood immunization but expressed strong fear of being asked for identification papers at healthcare facilities. Owing to lack of knowledge on entitlements of the undocumented among health personnel, parents were incorrectly rejected when seeking care for their children. Frequent mobility among undocumented may limit access to complete the immunization schedule. Undocumented parents mistrust healthcare providers and avoid health facilities, further delaying childrens' access to health care, including immunization services. Conclusions: The findings of this study confirm the complexity of barriers that undocumented parents face regarding childhood immunization. The TIP guide offers a valuable process for a deeper understanding of the determinants of immunization challenges among undocumented migrants. (C) 2019 The Authors. Published by Elsevier Ltd on behalf of The Royal Society for Public Health.
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| 13. |
- Kleijn, David, et al.
(författare)
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Delivery of crop pollination services is an insufficient argument for wild pollinator conservation.
- 2015
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Ingår i: Nature Communications. - : Springer Science and Business Media LLC. - 2041-1723. ; 6
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Tidskriftsartikel (refereegranskat)abstract
- There is compelling evidence that more diverse ecosystems deliver greater benefits to people, and these ecosystem services have become a key argument for biodiversity conservation. However, it is unclear how much biodiversity is needed to deliver ecosystem services in a cost-effective way. Here we show that, while the contribution of wild bees to crop production is significant, service delivery is restricted to a limited subset of all known bee species. Across crops, years and biogeographical regions, crop-visiting wild bee communities are dominated by a small number of common species, and threatened species are rarely observed on crops. Dominant crop pollinators persist under agricultural expansion and many are easily enhanced by simple conservation measures, suggesting that cost-effective management strategies to promote crop pollination should target a different set of species than management strategies to promote threatened bees. Conserving the biological diversity of bees therefore requires more than just ecosystem-service-based arguments.
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| 14. |
- Nguyen, Huong T, et al.
(författare)
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Factors associated with physical growth of children during the first two years of life in rural and urban areas of Vietnam
- 2013
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Ingår i: BMC Pediatrics. - 1471-2431. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background Differences between urban and rural settings can be seen as a very important example of gaps between groups in a population. The aim of this paper is to compare an urban and a rural area regarding child growth during the first two years of life as related to mother’s use of antenatal care (ANC), breastfeeding and reported symptoms of illness. Methods The studies were conducted in two Health and Demographic Surveillance Sites, one rural and one urban in Hanoi, Vietnam. Results We found that children in the urban area grow faster than those in the rural area. There were statistical associations between growth and the education of the mother as well as household resources. There were positive correlations between the number of ANC visits and child growth. We also saw a positive association between growth and early initiation (first hour of life) of breastfeeding but the reported duration of exclusive breastfeeding was not statistically significantly related to growth. Reporting symptoms of illness was negatively correlated to growth, i.e. morbidity is hampering growth. Conclusions All predictors of growth discussed in this article, ANC, breastfeeding and illness, are associated with social and economic conditions. To improve and maintain good conditions for child growth it is important to strengthen education of mothers and household resources particularly in the rural areas. Globalization and urbanization means obvious risks for increasing gaps not least between urban and rural areas. Improvement of the quality of programs for antenatal care, breastfeeding and integrated management of childhood illness are also needed in Vietnam.
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| 15. |
- Nguyen, Thi Hong, 1962, et al.
(författare)
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Physical growth during the first year of life. A longitudinal study in rural and urban areas of Hanoi, Vietnam
- 2012
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Ingår i: Bmc Pediatrics. - : Springer Science and Business Media LLC. - 1471-2431. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Good infant growth is important for future health. Assessing growth is common in pediatric care all over the world, both at the population and individual level. There are few studies of birth weight and growth studies comparing urban and rural communities in Vietnam. The first aim is to describe and compare the birth weight distributions and physical growth (weight and length) of children during their first year in one rural and one urban area of Hanoi Vietnam. The second aim is to study associations between the anthropometric outcomes and indicators of the economic and educational situations. Methods: Totally 1,466 children, born from 1st March, 2009 to June 2010, were followed monthly from birth to 12 months of age in two Health and Demographic Surveillance Sites; one rural and one urban. In all, 14,199 measurements each of weight and length were made. Birth weight was recorded separately. Information about demographic conditions, education, occupation and economic conditions of persons and households was obtained from household surveys. Fractional Polynomial models and standard statistical methods were used for description and analysis. Results: Urban infants have higher birth weight and gain weight faster than rural infants. The mean birth weight for urban boys and girls were 3,298 grams and 3,203 grams as compared to 3,105 grams and 3,057 grams for rural children. At 90 days, the urban boys were estimated to be 4.1% heavier than rural boys. This difference increased to 7.2% at 360 days. The corresponding difference for girls was 3.4% and 10.5%. The differences for length were comparatively smaller. Both birth weight and growth were statistically significantly and positively associated with economic conditions and mother education. Conclusion: Birth weight was lower and the growth, weight and length, considerably slower in the rural area, for boys as well as for girls. The results support the hypothesis that the rather drastic differences in maternal education and economic conditions lead to poor nutrition for mothers and children in turn causing inferior birth weight and growth.
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| 16. |
- Sguazzin, M., et al.
(författare)
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Determining neutron-induced reaction cross sections through surrogate reactions at storage rings
- 2023
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Ingår i: Journal of Physics: Conference Series. - 1742-6588 .- 1742-6596. ; 2586:1
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Konferensbidrag (refereegranskat)abstract
- Determining the cross sections of neutron-induced reactions on short-lived nuclei is imperative to rate calculations in stellar nucleosynthesis and applications of nuclear physics. It is also an immense experimental challenge due to the radioactivity of the targets involved. Our goal is to circumvent this obstacle by using surrogate reactions in inverse kinematics at the heavy-ion storage rings of GSI/FAIR. We present here preliminary results from the first proof of principle experiment, where a beam of 208Pb impinged on a H2 gas jet target in the Experimental Storage Ring (ESR).
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| 17. |
- Sguazzin, M., et al.
(författare)
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Indirect measurements of neutron -induced reaction cross sections at heavy -ion storage rings
- 2023
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Ingår i: 15TH INTERNATIONAL CONFERENCE ON NUCLEAR DATA FOR SCIENCE AND TECHNOLOGY, ND2022. - 2100-014X. ; 284
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Konferensbidrag (refereegranskat)abstract
- Neutron-induced reaction cross sections of unstable nuclei are essential for understanding the synthesis of heavy elements in stars and for applications in nuclear technology. However, their measurement is very complicated due to the radioactivity of the targets involved. We propose to circumvent this problem by using the surrogate reaction method in inverse kinematics, where the nucleus formed in the neutroninduced reaction of interest is produced by a reaction involving a radioactive heavy -ion beam and a stable, light target nucleus. The probabilities as a function of the compound -nucleus excitation energy for y -ray emission, neutron emission and fission, which can be measured with the surrogate reaction, are particularly useful to constrain model parameters and to obtain more accurate predictions of the neutron-induced reaction cross sections of interest. Yet, the full development of the surrogate method is hampered by numerous longstanding target issues, which can be solved by combining surrogate reactions with the unique and largely unexplored possibilities at heavy -ion storage rings. In this contribution, we describe the developments we are carrying out to measure for the first time simultaneously y-ray emission, neutron emission and fission probabilities at the storage rings of the GSI/FAIR facility. In particular, we will present the first results of the proof of principle experiment, which we performed in June 2022 at the Experimental Storage Ring (ESR)
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| 18. |
- Sguazzin, M., et al.
(författare)
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Indirect measurements of neutron-induced reaction cross sections at storage rings
- 2023
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Ingår i: NUCLEAR PHYSICS IN ASTROPHYSICS - X, NPA-X 2022. - : EDP Sciences. - 2100-014X. ; 279
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Konferensbidrag (refereegranskat)abstract
- Neutron-induced reaction cross sections of unstable nuclei are essential for understanding the synthesis of heavy elements in stars. However, their measurement is very difficult due to the radioactivity of the targets involved. We propose to circumvent this problem by using for the first time the surrogate reaction method in inverse kinematics at heavy-ion storage rings. In this contribution, we describe the developments we have done to perform surrogate-reaction studies at the storage rings of GSI/FAIR. In particular, we present the first results of the proof of principle experiment, which we conducted recently at the Experimental Storage Ring (ESR).
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| 19. |
- Smith Jervelund, Signe, et al.
(författare)
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Introduction
- 2020
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Ingår i: Coming of Age in Exile. Health and Socio-Economic inequalities in Young Refugees in the Nordic Welfare Societies. - Copenhagen : University of Copenhagen, Department of Public Health. - 9788797277904 ; , s. 11-15
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 20. |
- Tran, TK., et al.
(författare)
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Factors associated with antenatal care adequacy in rural and urban contexts-results from two health and demographic surveillance sites in Vietnam
- 2012
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background Antenatal Care (ANC) is universally considered important for women and children. This study aims to identify factors, demographic, social and economic, possibly associated with three ANC indicators: number of visits, timing of visits and content of services. The aim is also to compare the patterns of association of such factors between one rural and one urban context in northern Vietnam. Methods Totally 2,132 pregnant women were followed from identification of pregnancy until birth in two Health and Demographic Surveillance Sites (HDSS). Information was obtained through quarterly face to face interviews. Results Living in the rural area was significantly associated with lower adequate use of ANC compared to living in the urban area, both regarding quantity (number and timing of visits) and content. Low education, living in poor households and exclusively using private sector ANC in both sites and self employment, becoming pregnant before 25 years of age and living in poor communities in the rural area turned out to increase the risk for overall inadequate ANC. High risk pregnancy could not be demonstrated to be associated with ANC adequacy in either site. The medical content of services offered was often inadequate, in relation to the national recommendations, especially in the private sector. Conclusion Low education, low economic status, exclusive use of private ANC and living in rural areas were main factors associated with risk for overall inadequate ANC use as related to the national recommendations. Therefore, interventions focussing on poor and less educated women, especially in rural areas should be prioritized. They should focus the importance of early attendance of ANC and sufficient use of core services. Financial support for poor and near poor women should be considered. Providers of ANC should be educated and otherwise influenced to provide sufficient core services. Adherence to ANC content guidelines must be improved through enhanced supervision, particularly in the private sector.
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| 21. |
- Tran, Toan K, et al.
(författare)
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Urban - rural disparities in antenatal care utilization: a study of two cohorts of pregnant women in Vietnam.
- 2011
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Ingår i: BMC health services research. - : Springer Science and Business Media LLC. - 1472-6963. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: The use of antenatal care (ANC) varies between countries and in different settings within each country. Most previous studies of ANC in Vietnam have been cross-sectional, and conducted in rural areas before the year 2000. This study aims to compare the pattern and the adequacy of ANC used in rural and urban Vietnam following two cohorts of pregnant women. METHODS: A comparative study with two cohorts comprising totally 2132 pregnant women were followed in two health and demographic surveillance sites, one rural and one urban in Hanoi province, Vietnam. The women were quarterly interviewed using a structured questionnaire until delivery. The primary information obtained was the number and the content of ANC visits. RESULTS: Almost all women reported some use of ANC. The average number of visits was much lower in the rural setting (4.4) than in the urban (7.7). In the rural area, 77.2% of women had at least three visits and 69.1% attended ANC during the first trimester. The corresponding percentages for the urban women were 97.2% and 97.2%. Only 20.3% of the rural women compared to 81.1% of the urban women received all core ANC services. As a result, the adequate use of ANC was 5.2 times in the urban than in the rural setting (78.3% compared to 15.2%). Nearly all women received ultrasound examination during pregnancy with a mean value of 6.0 scans per woman in the urban area and 3.5 in the rural. Most rural women used ANC at commune health centres and private clinics while urban women mainly visited public hospitals. Expenditure related to ANC utilization for the urban women was 7.1 times that for the urban women. CONCLUSION: The women in the rural area attended ANC later, had fewer visits and received much fewer services than urban women. The large disparity in ANC adequacy between the two settings suggests special attention for the ANC programme in rural areas focusing on its content. Revision and enforcement of the national guidelines to improve the behaviour and practice of both users and providers are necessary. Key words: Antenatal care, adequacy, disparities, urban - rural comparison, Vietnam.
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| 22. |
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