This study empirically investigates the effects of ASEAN Trade in Goods Agreement (ATIGA) tariffs on nontariff measures (NTMs) in Vietnam from 2012 to 2018. Our findings reveal the following: First, our gravity estimation demonstrates that although the reduction of ATIGA tariffs increases Vietnam's imports, the introduction of certain NTM types, particularly price control and finance measures, decreases them. Second, the reduction of ATIGA tariffs tends to introduce price control measures in particular. Third, when ATIGA tariffs decrease, the pre‐shipment inspection, nonautomatic licensing, and finance measures are more likely to be eliminated for products in which Vietnam has high export competitiveness. Fourth, both ATIGA tariffs and ASEAN+1 free trade agreement tariffs have significant effects on the introduction of NTMs in Vietnam. Finally, we found that the reduction in ATIGA tariffs also results in decreasing most favored nation tariffs.

Antibiotic use in livestock production is one of the drivers of antibiotic resistance and a shift towards better and reduced antibiotic usage is urgently required. In Vietnam, where there are frequent reports of the misuse and overuse of antibiotics, little attention has been paid to farmers who have successfully changed their practices. This qualitative study aims to understand the transition process of Vietnamese chicken farmers toward reduced antibiotic usage. We conducted semi-structured interviews with 18 chicken farmers, 13 drug sellers, and 5 traders using participatory tools and a socio-anthropological approach. We explored the farmers' histories, current and past antibiotic usage, methods used to reduce antibiotic use, and motivations and barriers to changing practices. Through the thematic analysis of the farmers' transcripts, we identified technical, economic, and social factors that influence change. Out of eighteen farmers, we identified ten farmers who had already reduced antibiotic usage. The main motivations included producing quality chickens (tasty and safe) while reducing farm expenditures. Barriers were related to poor biosecurity in the area, market failures, and the farmers' lack of knowledge. Innovation led to overcome these obstacles included the local development of handmade probiotics and the organization of farmer cooperatives to overcome economic difficulties and guarantee product outlets. Knowledge was increased by workshops organized at the communal level and the influence of competent veterinarians in the area. We showed that the transition process was influenced by several components of the system rather than by any individual alone. Our study demonstrated that local initiatives to reduce antibiotic use in Vietnamese chicken production do exist. As changes depend on the system in which stakeholders are embedded, systemic lock-ins must be removed to allow practices to change. The promotion of locally-developed solutions should be further encouraged.

The COVID-19 pandemic has amplified mental health problems and highlighted inequitable gaps in care worldwide. In response there has been an explosion of digital interventions such as smartphone applications ("apps") to extend care. The objective of this trial is to evaluate the effectiveness and cost-effectiveness of a digital depression intervention (VMood), delivered via a smartphone app. VMood is adapted from an in-person intervention that was delivered by non-specialist providers and shown to be effective in the Vietnamese context in our previous trial (2016-2019). A stepped-wedge, randomized controlled trial will be conducted across eight provinces in Vietnam. Adults aged 18 years and over will be recruited through community-based primary care centres and screened for depression using the embedded Patient Health Questionnaire-9 (primary outcome measure). Participants scoring 10-19, indicating depression caseness, will be randomly allocated to the intervention or control group until the target of 336 is reached. Secondary outcome measures will examine the effect of the intervention on commonly co-occuring anxiety, quality of life and work productivity, along with use of alcohol and tobacco products. Assessments will be administered through an online survey platform (REDCap) at baseline, and at every 3 months until 3 months post-intervention. Intervention-group participants will receive VMood for a 3-month period, with online support provided by social workers. Control-group participants will receive a limited version of the app until they cross into the intervention group. Generalized Linear Mixed-effect Models for clustered measures will be used for all outcomes data. We will conduct a cost-effectiveness analysis alongside the trial to capture VMood's costs and benefits. This trial will provide evidence on the effectiveness and cost-effectiveness of a digital mental health intervention adapted from an in-person intervention. This trial will also contribute important information to the growing and promising field of digital mental health. Trail regulation. Registered at ClinicalTrials.gov, identifier [NCT05783531].

Although Vietnam has achieved significant improvements in maternal, newborn, and children's health, outcomes for ethnic minorities living in remote mountainous areas continue to lag. Interventions that leverage the extensive mobile networks in the country have been proposed as a way to overcome some of these challenges. A cluster randomised controlled trial (cRCT) was conducted to assess the effectiveness of an intervention comprising tailored SMS messages for promoting antenatal care knowledge and behaviours amongst ethnic minority (EM) pregnant women. The cRCT was implemented across eight intervention communes (640 women) and four control communes (315 women) in Northern Vietnam. Maternal health-related knowledge and behaviour outcomes and self-rated health status were assessed through questionnaires administered pre- and post-intervention. Difference-in-difference and logistic regression analysis found that the intervention group showed significant improvements in awareness about the danger signs of pregnancy and the importance of nutritional supplements. Significant improvements were seen in antenatal care-seeking behaviours and the intake of nutritional supplements. Mobile messaging-based behaviour change interventions can significantly improve maternal health-related knowledge and care-seeking amongst women residing in marginalised, hard-to-reach populations.

Outbreaks in vaccine-preventable diseases among children have increased, primarily among under- or unvaccinated subgroups. The influence and interaction of a child's school community on parental health care decisions, such as vaccination, has not been explored. Our study examined childhood coronavirus disease 2019 (COVID-19) vaccine hesitancy within the context of school communities. This study combines data from 4 independent research studies funded by the National Institutes of Health Rapid Acceleration of Diagnostics Underserved Populations Return to School Initiative. We examined focus group data to better understand the apprehension surrounding parental and child COVID-19 vaccination among underserved school populations. Across all study sites, 7 main themes emerged with regard to COVID-19-related vaccination concerns for children: (1) potential side effects, (2) vaccine development, (3) misinformation (subthemes: content of vaccine and negative intent of the vaccine), (4) vaccine effectiveness, (5) timing of vaccine administration/availability for children, (6) fear of needles, and (7) mistrust. School settings offered unique access to youth and family perspectives in underserved communities. Our studies highlighted several factors contributing to COVID-19 vaccine hesitancy in school communities, which align with existing literature on vaccine hesitancy. These concerns centered primarily on potential harm of vaccines, as well as misinformation, mistrust, and timing of vaccines. Related recommendations for increasing vaccination rates are provided. Developing specific strategies that address parent and child concerns will be critical to reducing health inequities related to COVID-19 vaccination.

Traditional pork shops play an essential role in delivering pork, the most popular food in Vietnam, to consumers. Studies have shown the need for investment in training and equipment to improve the safety of pork sold at traditional shops. However, it remains unclear how consumers perceived improvement to the hygiene in pork shops and if they are ready to pay premium prices for safer products. This study used an experimental approach to determine consumers' perception and assessment of improved pork shops and their willingness to pay (WTP) for pork products. A total of 152 respondents in two provinces in Vietnam joined in a Becker–DeGroot–Marschak (BDM) mechanism experiment to collect data on WTP for pork from typical and upgraded pork shops. A questionnaire was used to record consumers' perceptions and assessments of the pork shops and products. Overall, consumers were willing to pay 20% more for upgraded fresh pork than for what is currently available on the market. Consumers trusted in the effectiveness of the upgraded intervention and the quality of pork at the pork shop, which increased their WTP for the upgraded pork. Concerns about contaminated pork had a negative impact on the WTP for typical pork, while the high frequency of pork consumption and the existence of elderly family members led to higher WTP for both products. The findings indicate the potential economic benefit of upgrading pork shops, which would be an important driver to motivate sellers to improve food safety.

Background: Personal worries about COVID-19 transmission can have significant health effects on both physical and mental health. The project objectives were to determine the prevalence and factors influencing personal worries about COVID-19 transmission among adult Vietnamese men and women in 2021. Methods: A cross-sectional survey was conducted in 2021 among adults living in Hanoi City and Ho Chi Minh City, Vietnam in which a total of 447 individuals completed the questionnaire survey. A 5-point Likert scale was used to measure whether survey respondents were worried about being infected with COVID-19, whether family/friends will catch COVID-19, and about spreading the virus to others. The rating scores were then used to categorize study participants as “worried” (score 1-3) and “not worried” (score 4-5). Results: The study found that slightly more than two-thirds of the study sample were worried about being infected with COVID-19. Additionally, approximately four in every five respondents were worried that family/friends would catch COVID-19 or were concerned about spreading the virus to others. Individuals who did not engage in outdoor activities during the prior two weeks exhibited higher worry about being infected with COVID-19 compare to whom did. People living with someone at high risk for COVID-19 and worrying about losing their home had concerns that family/friends would catch COVID-19 more than whom did not. Men and individuals without a medical history of chronic disease and health insurance were less likely to express worries about spreading the COVID-19 virus to others compared to women and those with these chronic conditions and with insurance. Conclusion: Our findings emphasize the interplay between individual risk perception and broader social determinants of health in shaping attitudes and behaviors related to COVID-19 prevention and control.

Abstract While Viet Nam is aging rapidly, there are few studies on cognitive function of older adults. We aimed to study status of cognitive function among older adults in Viet Nam and examine factors associated with cognitive function. The baseline data of the Longitudinal study of Ageing and Health in Viet Nam conducted in 2018/2019 was used for the study. LSAHV was a nationally representative survey of those aged 60 and above and computer-assisted personal interview (CAPI) using a tablet was conducted for data collection. The number of older person included in the study was 5,530. Cognitive function was measured by Short Portable Mental Status Questionnaire (SPMSQ). Factors such as demographic, socioeconomic, health behavior and daily activities such as reading newspaper were examined for their association with cognitive function by linear regression analyses. We found that better cognitive function was associated with engaging in physical activity in both male and female, listening to radio and receiving material support from children in male, and reading in female. Poorer cognitive function was associated with IADL limitation and financial support in both male and female, obesity in male, and hypertension and hearing loss in female. Our study provides an understanding of the associated factors with cognitive function of older people in Viet Nam. Some of the factors examined are modifiable and can be improved to prevent cognitive decline. It is also important to consider sex differences in planning and implementation of interventions and programs to prevent cognitive decline in Viet Nam.

Abstract Multimorbidity increases the risks of disability and death and are prevalent among older adults. Evidence shows that sleep might play an important role in multimorbidity. However, previous research studies sleep quality and quantity in isolated manners, where in reality sleep quality and quantity are likely to affect each other. Besides, no study has been done to understand such relationship among older adults in low- and middle- income counties where the prevalence of multimorbidity increases rapidly. This study investigated the relationship between sleep deficiency (i.e., poor and insufficient sleep) and multimorbidity among community-dwelling older adults in the Philippines and Vietnam. Cross-sectional data were obtained from the Longitudinal Study of Ageing and Health in the Philippines (N = 3,562) and the Longitudinal Study of Ageing and Health in Vietnam (N = 3,936). Multimorbidity was defined by having two or more of chronic conditions (i.e., heart disease, heart attack, cardiovascular disease, hypertension, diabetes, lung diseases, renal diseases, liver diseases, and arthritis). Sleep deficiency was conceptualized as self-reported short sleep duration (< 6 hours), having trouble with falling asleep or maintaining sleep, and/or experiencing non-restorative sleep. Logistic regression was used to analyze the data adjusting for demographics, body mass index, sleep medications, naps, mental health, and lifestyle. The results showed that having deficient sleep was significantly related to increased odds of experiencing multimorbidity by about 81% in the Philippines and Vietnam. Our findings revealed that treating sleep deficiency among older adults in the Philippines and Vietnam can potentially reduce the risks of multimorbidity.

Abstract Introduction: To increase the detection of unknown atrial fibrillation (AF), general practitioners have started screening their patients using small devices. It is thought that can also be utilised as they have regular access to patients. Aims: This qualitative study aimed to explore perceptions and barriers of dental staff for screening of AF using a hand-held electronic device in primary dental care. Setting: A large mixed NHS and private general dental practice in the Northwest of England Methods: Views from staff included dentists, dental therapists, dental nurses, and managers. Interviews were semi-structured, face-to-face, audio recorded and transcribed verbatim. The interviews continued until there were no new themes or patterns emerging from the data and thematic saturation had been achieved. Results: Eleven participants were interviewed, and main themes generated were methodology for screening, acceptability for screening within the practice, attitudes to screening, and implementation of screening. Overall, participants were positive about implementing screening in a dental practice but expressed concerns about time and remuneration. Staff also gave encouraging feedback regarding the simplicity of the portable screening device. Conclusions: Participants felt that AF screening was a good concept but may be challenging to implement in NHS Dentistry, especially due to the pandemic.