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

• Published in: BMC health services research 2020-02, Vol.20 (1), p.90-90, Article 90
• Main 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
• Format: Article
• Language: English
• Subjects: Access; Access control; Antenatal care; Child; Child health; Child health services; Childrens health; Consent; Content analysis; Cost of living; Data collection; Delivery; Demographic aspects; Economies of scale; Efficiency; Facilities and Services Utilization - statistics & numerical data; Female; Finance; Focus Groups; Health care access; Health care delivery; Health care industry; Health services; Health Services Accessibility; Humans; Immunization; Infant, Newborn; Interviews; Maternal & child health; Maternal health services; Maternal-Child Health Services; Medical care quality; Medical care utilization; Medical personnel; Medical research; MNCH; Newborn babies; Newborn infants; Obstetrics; Pregnancy; Prenatal care; Primary Health Care; Public health; Public sector; Qualitative Research; Quality of service; Society; State budgets; Suburban areas; Suburban Population; Surveys; Teams; Urban areas; Urbanization; Vietnam
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-019-4874-7

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. 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. 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. 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.