Aiga Hirotsugu, Nguyen Vinh Duc, Nguyen Cuong Dinh, Nguyen Tho Thi Thi, Nguyen Lien Thi Phuong
Human Development Department, Japan International Cooperation Agency (JICA), 3rd floor, Nibancho Center Building, 5-25 Niban-cho, Chiyoda-ku, Tokyo, 102-8012, Japan.
Department of Global Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, NW, 7th floor, Washington DC, 20052, USA.
BMC Public Health. 2016 Feb 9;16:129. doi: 10.1186/s12889-016-2788-4.
Maternal and Child Health (MCH) Handbook, an integrated MCH home-based record, was piloted in four provinces of Vietnam (Dien Bien, Hoa Binh, Thanh Hoa and An Giang). The study is aimed at assessing the changes in pregnant women's behavior towards the frequencies of their antenatal care service utilizations and their subsequent breastfeeding practices up to six months of age, through the MCH Handbook intervention. This is because the levels of pregnant women's knowledge, attitude and practices (KAP) towards their antenatal care service utilizations and exclusive breastfeeding practices have been previously neither analyzed nor reported in relation to MCH home-based records in the country.
To compare pre-intervention baseline in 2011, post-intervention data were collected in 2013. Structured interviews were conducted with randomly selected 810 mothers of children 6-18 months of age in the four provinces. A focus group discussion among mothers in each of four provinces was conducted.
There was no significant difference in pregnant women's knowledge about the need for ≥3 antenatal care visits between pre- and post-interventions. Yet, the proportion of pregnant women who made ≥3 antenatal care visits in post-intervention was significantly higher than in pre-intervention. Thus, MCH Handbook is likely to have contributed to practicing ≥3 antenatal care visits, by changing their attitude. The proportion of mothers who know the need for exclusive breastfeeding necessary during the initial six months significantly increased between pre- and post-interventions. The proportion of those practicing exclusive breastfeeding significantly increased between pre- and post-interventions, too. Thus, MCH Handbook is likely to have contributed to the increase in both knowledge about and practices of exclusive breastfeeding.
The results of study imply that MCH Handbook contributed to the increase in pregnant women's practices of ≥3 antenatal care visits and in their knowledge about and practice of exclusive breastfeeding. While there is room for improvement in the level of its data recording, the study confirmed that MCH Handbook plays a catalytic role in ensuring a continuum of maternal, newborn and child care. Note that this study is the first study that attempted to estimate pregnant women's behavioral changes through MCH Handbook intervention in Vietnam.
妇幼保健手册是一份综合的家庭式妇幼保健记录，已在越南的四个省份（奠边、和平、清化和安江）进行试点。本研究旨在通过妇幼保健手册干预措施，评估孕妇在产前检查服务利用频率及后续至六个月龄母乳喂养习惯方面行为的变化。这是因为该国此前尚未针对基于家庭的妇幼保健记录，分析和报告孕妇在产前检查服务利用及纯母乳喂养习惯方面的知识、态度和行为水平。
为比较2011年干预前的基线情况，于2013年收集了干预后的数据。对四个省份中随机抽取的810名6至18个月儿童的母亲进行了结构化访谈。在四个省份分别组织了母亲焦点小组讨论。
干预前后孕妇对≥3次产前检查必要性的知识水平无显著差异。然而，干预后进行≥3次产前检查的孕妇比例显著高于干预前。因此，妇幼保健手册可能通过改变孕妇态度，促使她们进行≥3次产前检查。干预前后，知道最初六个月需要纯母乳喂养的母亲比例显著增加。纯母乳喂养的母亲比例在干预前后也显著增加。因此，妇幼保健手册可能有助于提高对纯母乳喂养的认识和实践。
研究结果表明，妇幼保健手册有助于增加孕妇进行≥3次产前检查的次数，以及她们对纯母乳喂养的认识和实践。虽然其数据记录水平仍有改进空间，但该研究证实，妇幼保健手册在确保孕产妇、新生儿和儿童连续护理方面发挥了催化作用。请注意，本研究是越南首次尝试通过妇幼保健手册干预措施评估孕妇行为变化的研究。
