Email updates

Keep up to date with the latest news and content from BMC Public Health and BioMed Central.

Open Access Research article

Maternal health care professionals' perspectives on the provision and use of antenatal and delivery care: a qualitative descriptive study in rural Vietnam

Sophie Graner1*, Ingrid Mogren1, Le Q Duong2, Gunilla Krantz3 and Marie Klingberg-Allvin45

Author Affiliations

1 Department of Clinical Science, Obstetrics and Gynecology, Umeå University, 901 87 Umeå, Sweden

2 Population Services/Vietnam, Hanoi, Vietnam

3 Department of Community Medicine and Public Health, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

4 IHCAR, Karolinska Institutet, Stockholm, Sweden

5 School of Health and Social Sciences Dalarna University, Falun; Sweden

For all author emails, please log on.

BMC Public Health 2010, 10:608  doi:10.1186/1471-2458-10-608

Published: 14 October 2010

Abstract

Background

High quality maternal health care is an important tool to reduce maternal and neonatal mortality. Services offered should be evidence based and adapted to the local setting. This qualitative descriptive study explored the perspectives and experiences of midwives, assistant physicians and medical doctors on the content and quality of maternal health care in rural Vietnam.

Method

The study was performed in a rural district in northern Vietnam. Four focus group discussions with health care professionals at primary health care level were conducted. The data was analysed using qualitative manifest and latent content analysis.

Result

Two main themes emerged: "Contextual conditions for maternal health care" and "Balancing between possibilities and constraints". Contextual conditions influenced both pregnant women's use of maternal health care and health care professionals' performance. The study participants stated that women's uses of maternal health care were influenced by economical constraints and cultural norms that impeded their autonomy in relation to childbearing. Structural constraints within the health care system included inadequate financing of the primary health care, resulting in lack of human resources, professional re-training and adequate equipment.

Conclusion

Contextual conditions strongly influenced the performance and interaction between pregnant women and health care professionals within antenatal care and delivery care in a rural district of Vietnam. Although Vietnam is performing comparatively well in terms of low maternal and child mortality figures, this study revealed midwives' and other health care professionals' perceived difficulties in their daily work. It seemed maternal health care was under-resourced in terms of staff, equipment and continuing education activities. The cultural setting in Vietnam constituting a strong patriarchal society and prevailing Confucian norms limits women's autonomy and reduce their possibility to make independent decisions about their own reproductive health. This issue should be further addressed by policy-makers. Strategies to reduce inequities in maternal health care for pregnant women are needed. The quality of client-provider interaction and management of pregnancy may be strengthened by education, human resources, re-training and provision of essential equipment.