Social and behavioral determinants of attitudes towards and practices of hepatitis B vaccine birth dose in Vietnam.

BACKGROUND: Hepatitis B virus (HBV) infection is a significant public health issue in Vietnam. Our goal was to understand the determinants of attitudes towards and practices of hepatitis B vaccine birth dose (HepB-BD) in certain regions of Vietnam. METHOD: A rapid qualitative assessment was conducted in three geographically diverse provinces that reported low coverage (<50%) of HepB-BD. Using purposive sampling of participants, 29 focus group discussions and 20 in-depth interviews were held with caregivers (n = 96), healthcare providers (n = 75), and healthcare administrators (n = 16). Summary notes from these were translated, and inductive coding was used to derive themes. The SAGE Vaccine Hesitancy Determinants Matrix was used as a theoretical framework to organize barriers and facilitators associated with the themes into three levels of influence. RESULTS: At the individual and group level, caregivers who had higher levels of knowledge about HepB-BD sought the vaccine proactively, while others with lower knowledge faced barriers to the vaccine. Some caregivers reported a negative attitude toward health services because of a language barrier or had generalized concerns about HepB-BD due to media reporting of the past adverse events. Distress arising from potential adverse events was equally common among healthcare providers. At the contextual level, the physical environment made it difficult for caregivers to access healthcare facilities and for providers to conduct outreach. Home births posed a challenge for timely administration of HepB-BD, while health facility births facilitated it. Vaccination-specific barriers included misinterpretation of pre-vaccination screening criteria and asking for the consent of caregivers. Inadequate resources for service delivery negatively influenced HepB-BD attitudes and practices. CONCLUSION: Given the diversity of barriers associated with attitudes towards and practices of HepB-BD in the three provinces, tailored interventions will be necessary for both demand- and supply-side factors. Rural areas, often with more home births and geographic barriers, may require focused attention.

Knowledge and Determinants of Health Consequences of Cigarette Smoking Among Vietnamese Adults, 2015.

Background. Vietnam was one of 16 countries that implemented the second round of the GATS (Global Adult Tobacco Survey) in 2015. Aims. To assess knowledge and determinants of health consequences of different types of cigarette smoking among Vietnamese adults. Methods. A cross-sectional study among adults aged 15 years combined with using 15% of the master sample from the national sampling frame of the population and housing census was conducted. Multilevel analysis using Poisson regression was undertaken. Results. Knowledge on the health consequences of cigarette smoking has not significantly improved in the GATS-2015. Adults believe that active smoking had more of an impact on health than secondhand smoking and 24.5% and 43% of them answered that smoking light and e-cigarettes, respectively, causes less harm than regular cigarettes, and 17.3% and 18.1% of adults are not aware of the difference between them, respectively. Conclusion. Household and community's role had little impact in the adult knowledge of smoking health consequences. It is necessary to disseminate information on the "other tobacco product" and to improve public knowledge on specific health consequences, to enhance household and community's role in conveying health education messages to individuals.