Use of Maternal Health Care Services and Ethnicity: A Cross-Sectional Analysis of Vietnam

Abstract

Rationale: Generally, health outcomes in Vietnam are significantly better than those of other low-income countries. Similarly, the health care system provides most services to citizens at time of need. However, considerable inequalities persist with ethnic minorities - making up some 15 percent of the total population - continuing to experience worse health and less health service use compared with the majority group. Inequalities in access and utilization are particularly strong in maternal health care services such as antenatal care, skilled birth attendance, and clinic delivery.

Objectives: The aim of the study is to analyze the extent to which ethnicity determines maternal health care use while controlling for other factors, including individual, household, and contextual, that may also explain use of maternal services.

Methodology: The study uses cross-sectional national health survey data from 2001/02. The data contain information at the individual, household, and community levels on several socioeconomic, geographical, and policy indicators, including ethnicity, living conditions, and policy program participation. Analytical methods include multivariate regression analysis of specified models.

Results: Ethnicity is a strong and robust factor determining maternal health care use in Vietnam also while controlling for other potential factors. Belonging to the ethnic majority group determines use of these services in a positive and significant way. There is no indication that policy programs contribute to the use of maternal health services.

Conclusions: The use of maternal health care services, including antenatal care, skilled birth attendance, and delivering at a clinic are important factors that determine birth outcomes. Increased use of all types of maternal services leads to improved survival chances of both mother and child. In Vietnam, the use of these services is highly related to ethnicity such that ethnic minority women use significantly less of these services compared with that of ethnic majority women. Further analysis will contribute to a better understanding of the exact mechanisms behind these results.

Keywords: Maternal health care, ethnicity, Vietnam