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Open Access Highly Accessed Research article

Causes and determinants of inequity in maternal and child health in Vietnam

Mats Målqvist1*, Dinh Thi Phuong Hoa2 and Sarah Thomsen3

Author Affiliations

1 International Maternal and Child Health (IMCH), Department of Women’s and Children’s Health, Uppsala University, Akademiska sjukhuset, Uppsala, SE-751 85, Sweden

2 Hanoi School of Public Health, Hanoi, Vietnam

3 Division of Global Health (IHCAR), Department of Public Health, Karolinska Institutet, Solna, Sweden

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BMC Public Health 2012, 12:641  doi:10.1186/1471-2458-12-641

Published: 11 August 2012

Abstract

Background

Inequities in health are a major challenge for health care planners and policymakers globally. In Vietnam, rapid societal development presents a considerable risk for disadvantaged populations to be left behind. The aim of this review is to map the known causes and determinants of inequity in maternal and child health in Vietnam in order to promote policy action.

Methods

A review was performed through systematic searches of Pubmed and Proquest and manual searches of “grey literature.” A thematic content analysis guided by the conceptual framework suggested by the Commission on Social Determinants of Health was performed.

Results

More than thirty different causes and determinants of inequity in maternal and child health were identified. Some determinants worth highlighting were the influence of informal fees and the many testimonies of discrimination and negative attitudes from health staff towards women in general and ethnic minorities in particular. Research gaps were identified, such as a lack of studies investigating the influence of education on health care utilization, informal costs of care, and how psychosocial factors mediate inequity.

Conclusions

The evidence of corruption and discrimination as mediators of health inequity in Vietnam calls for attention and indicates a need for more structural interventions such as better governance and anti-discriminatory laws. More research is needed in order to fully understand the pathways of inequities in health in Vietnam and suggest areas for intervention for policy action to reach disadvantaged populations.

Keywords:
Maternal health; Child health; Equity; Vietnam