Do Mai
Department of International Health and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
J Biosoc Sci. 2009 May;41(3):289-308. doi: 10.1017/S0021932009003320. Epub 2009 Mar 2.
The private sector in health care in Vietnam has been increasingly competing with the government in primary health care services. However, little is known about the use of skilled birth attendance or about choice of public and private sectors among those who opt for skilled attendants. Using data from the Vietnam 2002 Demographic and Health Survey, this study examines factors related to women's decision-making of whether to have a skilled birth attendant at a recent childbirth, and if they did, whether it was a public or private sector provider. The study indicates that the use of the private sector for delivery services was significant. Women's household wealth, education, antenatal care and community's wealth were positively related to skilled birth attendance, while ethnicity and order of childbirth were negatively related. Order of childbirth was positively associated with skilled birth attendance in the private sector. Among service environment factors, increased access to public sector health centres was associated with an increased likelihood of skilled birth attendance in general, but a lowered chance of that in the private sector. Further studies are needed to assess the current situation in the private sector, the demand for delivery services in the private sector, and its readiness to provide quality services.
越南医疗保健领域的私营部门在初级医疗保健服务方面与政府的竞争日益激烈。然而,对于熟练接生服务的使用情况,以及在选择熟练接生人员的人群中,他们对公共部门和私营部门的选择情况,我们知之甚少。本研究利用越南2002年人口与健康调查的数据,考察了与女性近期分娩时是否选择熟练接生人员的决策相关的因素,以及如果她们选择了,选择的是公共部门还是私营部门的接生服务提供者。研究表明,私营部门提供分娩服务的情况显著。女性的家庭财富、教育程度、产前护理以及社区财富与熟练接生服务呈正相关,而种族和分娩顺序则呈负相关。分娩顺序与私营部门的熟练接生服务呈正相关。在服务环境因素方面,总体而言,增加进入公共部门医疗中心的机会与熟练接生服务可能性的增加相关,但在私营部门则降低了这种可能性。需要进一步研究来评估私营部门的现状、私营部门对分娩服务的需求以及其提供优质服务的准备情况。