Abstract
This study aimed to determine the barriers to the use of maternal care and family planning (MCFP) services by the disadvantaged Kinh people and Katu ethnic minority people in the remote and mountainous area of Nam Dong District in Central Vietnam. A survey was conducted using a random sample of 420 mothers with at least one child under the age of 5 years. These data were supplemented by interviews with key informants, focus group discussions and observations. Many barriers were identified. The difficulty of the terrain made travel to healthcare centers difficult. The cost of treatment was a barrier for the poorest people. The quality of the services and facilities, as well as the management of these services was perceived to be unsatisfactory. Traditional practices were often described as being contrary to the doctor's advice, and were presented as the reason for unsafe and unassisted home deliveries. Communication was difficult because of the minority languages of the client groups, the prevalence of illiteracy, and the absence of mass communication in this region. Finally, consulting a male healthcare worker was reported to bring the women shame. There is an urgent need for the MCFP services to build both clinical capacity and health promotion activities in a way that is gender sensitive, cognisant of traditional practices and accessible by both illiterate and minority language speaking people.
Highlights
This study aimed to determine the barriers to the use of maternal care and family planning (MCFP) services by the disadvantaged Kinh people and Katu ethnic minority people in the remote and mountainous area of Nam Dong District in Central Vietnam
The communication skills of staff in health services in Vietnam are not effective 2,3 and this has widened the gap in access to healthcare between rich and poor groups
The problems and issues involved in enhancing the accessibility of MCFP services in Central Vietnam are diverse and broad
Summary
This study aimed to determine the barriers to the use of maternal care and family planning (MCFP) services by the disadvantaged Kinh people and Katu ethnic minority people in the remote and mountainous area of Nam Dong District in Central Vietnam. The rate of reproductive health problems in Vietnam remains high[1], especially in mountainous and remote regions where healthcare facilities are often difficult for clients to access1(Fig 1). Vulnerable are the Kinh poor and other ethnic minority groups, for whom the lack of quality health services and the specific knowledge and skills of healthcare workers compound the considerable problems of the terrain. Traditional health behavior, culture-specific practices and the cost of treatment are added barriers to the effective use of healthcare services. Experienced and inexperienced women come to assist with the delivery and the inexperienced women learn how to assist from the experienced In this way traditional birth knowledge is passed from generation to generation, and the women see no reason to make use of professional healthcare facilities
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