Acceptance and willingness to pay for COVID-19 vaccines among pregnant women in Vietnam.

OBJECTIVES: The aim of this study was to assess acceptance of COVID-19 vaccination and the willingness to pay (WTP) for it, and investigate associated factors among pregnant women in Vietnam. METHODS: Cross-sectional survey of pregnant women in two obstetric hospitals in Hanoi and Ca Mau provinces, Vietnam. Data on acceptance and WTP for COVID-19, demographic characteristics, maternal characteristics, and risk perceptions toward COVID-19 were collected. Multivariate logistic and linear regression models were performed to identify factors associated with the acceptance and WTP for the vaccine. RESULTS: Of 651 pregnant women, 60.4% accepted to receive the vaccine, and 82.6% of the total pregnant women were willing to pay for a COVID-19 vaccine with the mean amount of WTP of USD 15.2 (SD ± 27.4). The most common reason for refusing vaccination was "Worry about the safety of the vaccine" (66.9%) in Hanoi and "The preventive effect of COVID-19 is low" (45.2%) in Ca Mau. A higher income, having children, self-perceived risk of COVID-19 infection, and perceived risk to friends were associated with a higher likelihood of acceptance and WTP for the vaccine. CONCLUSIONS: Implementing COVID-19 vaccination and resource mobilisation among pregnant women in Vietnam is feasible, although communication programmes to improve risk perception and awareness about vaccine should be developed for facilitating acceptance of the vaccine.

A MEA is a MEA is a MEA? Sequential decision making and the impact of different managed entry agreements at the manufacturer and payer level, using a case study for an oncology drug in England.

BACKGROUND: In a typical single-payer setting that uses an explicit cost-effectiveness (CE) threshold in its decision-making, the payer aims to maximize the net-monetary-benefit (NMB) given the CE threshold, whilst the manufacturer aims to maximize the expected discounted-cash-flow (DCF) resulting from the sales of that technology. Managed entry agreements (MEAs) are tools that are used to improve access to expensive technologies that would otherwise not be deemed to be cost-effective to payers. While simple discount on the list price is the most commonly applied MEA type, there are different forms, each having a different impact on the cost-effectiveness of the technology, on the lifetime DCF-per-patient and on the decision uncertainty. We aim to analyze the sequential decision-making (SDM) of different MEAs (i.e. simple discount, free treatment initiation, lifetime treatment acquisition cost-capping [LTTACC], performance-based money-back guarantee [MBG]) at the manufacturer and at the payer level, respectively. METHODS: We first model the SDM of the manufacturer and the payer as a sequential game and explain the challenges to find an equilibrium analytically. Then we propose a heuristic computational method to follow for each of the MEA types, based on practice. To demonstrate this SDM on a case study, a UK-based cost-utility analysis using a three-state, partitioned-survival-model was constructed to determine the cost-effectiveness of regorafenib versus best-supportive-care for the second-line treatment of hepatocellular carcinoma. The optimal agreement terms that would maximise the lifetime DCF-per-patient for each MEA, whilst remaining below the CE-threshold (£50,000/QALY gained) were obtained in the deterministic base-case. Robustness for each optimized MEA was then assessed using probabilistic sensitivity and scenario analyses, the value of information (VoI), and HTA-risk analyses. RESULTS: As expected, the introduction of all MEAs improved the probabilistic ICER and NMB values to (almost) acceptable levels, compared to the "no-MEA" case (ICER ~ £78,000/QALY-gained). The expected DCFs across the explored MEAs were all similar, whilst the payer strategy & uncertainty burden (PSUB) for regorafenib decreased in all MEAs explored. VoI analyses revealed that regorafenib mean-dose-intensity and time-on-treatment (ToT) parameters attributed most to the decision uncertainty. LTTACC provided the smallest PSUB and the most robust NMB estimates under parametric uncertainty. For scenarios assuming increased regorafenib ToT or mean-dose-intensity, LTACC again provided acceptable cost-effectiveness outcomes, whereas for scenarios assuming decreased regorafenib progression-free/overall survival effectiveness, only MBG resulted in plausible ICER values. In scenarios, where the source of uncertainty was not targeted by MEA parameters (e.g. the scenario assuming higher progressed disease resource utilization), all investigated MEA types resulted in unacceptable cost-effectiveness outcomes. CONCLUSION: Each MEA type has a different implication. The impact of different MEAs on the NMB is more noteworthy than on the DCF, in relative terms, hence payers will benefit from the early participation of the MEA design rather than leaving this up to the prerogative of the manufacturer. While simple discount might be practical for implementation purposes, other MEAs can provide additional benefits to the payer in terms of increased NMB, reduced decision risk and reduced uncertainty. MEA performance should be investigated not only under parametric uncertainty, but also under-identified structural uncertainty, and the barriers of implementation should be considered thoroughly before choosing the most appropriate MEA type.

COVID-19 Preparedness and Response: Validation of a Rapid Assessment Tool to Evaluate Priorities of Health Workers at the Grassroots Level.

Since the initial phases of the COVID-19 outbreak, international recommendations for disease control have been readily available. However, blind implementation of these recommendations without grassroot-level support could result in public distrust and low adherence. This study evaluated the use of a public health priorities survey to rapidly assess perceptions of local health workers. A cross-sectional study using a web-based survey was conducted among 5,847 health workers and medical students from January to February 2020 to evaluate the level of prioritization of various public health measures. Measures with the highest levels of prioritization were "Early prevention, environmental sanitation, and improvement of population health" and "Mobilization of community participation in disease control," which were concordant with policies implemented by the Vietnamese government. This study also demonstrated a high level of internal validity among survey items and shared ranking of priorities among all occupational groups. The use of this public health priorities survey was found to be effective in identifying priorities as identified by grassroots health workers to provide real-time feedback to the national government. However, future iterations of this survey should consider limiting the use of each prioritization score to ensure that responses represent the reality of source limitations and consider focusing on medical professionals and community workers due medical students' limited experience with Vietnam's healthcare infrastructure.

Cross-cultural adaptation and measurement properties of Youth Quality of Life Instrument-Short Form (YQOL-SF) in a developing South-East Asian country.

This study was performed to evaluate the measurement properties of Youth Quality of Life-Short Form (YQOL-SF) in assessing the quality of life (QOL) among general youths in Vietnam. An online cross-sectional study was conducted to validate the YQOL-SF. Factor analysis (including exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was utilized to determine the factorial structure of this tool. The psychometric properties (reliability and validity) of the new factorial model were assessed. The factor analysis revealed the two-factor model of YQOL-SF including factor 1 "Belief in self and family", and factor 2 "Environment and relationships". Cronbach's alpha value showed excellent internal consistency in both factors (0.911 and 0.910, respectively). Results also indicated good convergent, divergent, concurrent, and know-group validity of the two-factor model. Our study provided a promising model with different domains that were proved to be essential for the assessment of quality of life among Vietnamese youth aged 16-24. Our two-factor model affirmed that a balance between detail and length of the assessment is important to consider when selecting YQOL-SF for youths' QOL assessment. It helped reduce the risk of redundancy and encourages high survey completion rates among participants.

Perception Toward Exposure Risk of COVID-19 Among Health Workers in Vietnam: Status and Correlated Factors.

Background: Hospital staff are at the frontline for the prevention and control of COVID-19. Understanding their perception of exposure risk is, therefore, important during the early phase of this pandemic. In this study, we evaluated the perception regarding risk of exposure to COVID-19 among Vietnamese hospital staff in Vietnam. Method: A cross-sectional online study was carried out to collect demographic data and risk exposure perception during the second week of the national lockdown in April 2020 in Vietnam. Seven hundred and forty two hospital staff were recruited using the snowball sampling to answer 5-point Likert scale questions regarding their risk exposure perception. Exploratory factor analysis (EFA) was used to examine the construct validity of the questionnaire. Pearson coefficient analysis and multivariable regression models were applied to identify factors associated with the perceived COVID-19 exposure risk. Results: Participants perceived a high risk of being infected with SARS-CoV-2 (score = 3.4, SD = 0.8). They also perceived the workplace response to COVID-19 as inadequate (score = 2.0, SD = 0.5). In particular, participants who worked in the emergency or intensive care departments were more likely to perceive an exposure risk, compared to those in infectious disease control departments (Coef. = -0.38, 95%CI: -0.74; -0.02). Participants from central regions perceived a lower risk of exposure to COVID-19 than those from northern regions (OR = 0.52, 95%CI: 0.28-0.96). Nurses were less likely than doctors to report being at risk of exposure to COVID-19 (OR = 0.56, 95%CI: 0.33-0.95). Conclusions: We identified a high level of perceived risk regarding COVID-19 exposure among hospital staff during the unprecedented lockdown period in Vietnam. A comprehensive approach, incorporating improved risk communications, safety training and psychological support programs, for all hospital staff, including nurses and those residing in high population density areas, might further strengthen the national effort to control the pandemic.

Bullying experience in urban adolescents: Prevalence and correlations with health-related quality of life and psychological issues.

This study examined the 3-month rate of bullying experience, associated factors, and measure the relationships between bullying experience with health-related quality of life and different mental disorders among secondary school students. We performed a cross-sectional study in four secondary schools in Hanoi, Vietnam. Bullying experience was evaluated by using questions about eighteen specific-bullying behaviors. EuroQol-5 dimensions-5 levels (EQ-5D-5L) and Depression, Anxiety, and Stress Scale- 21 items (DASS-21) were used to measure health-related quality of life (HRQOL) and mental health of participants, respectively. Among 712 secondary school students, the 3-month prevalence of physical, social aggression, verbal, and sexual bullying experience were 8.4%; 31.2%; 11.9%, and 2.7%, respectively. Being bullied were negatively associated with levels of classmates and family support, as well as levels of school security. Being overweight or obese was related to a higher likelihood of suffering social aggression compared to normal BMI. Being bullied was significantly associated with the decrement of HRQOL, and the increased risk of depression, anxiety, and stress among adolescents. Findings of this study suggested that holistic approaches involving family, peers, and schools, along with enhancing school security, are potential approaches to reduce the impact of bullying on adolescents' life and well-being.

Cyberbullying Among School Adolescents in an Urban Setting of a Developing Country: Experience, Coping Strategies, and Mediating Effects of Different Support on Psychological Well-Being.

Background: This study examined the cyberbullying experience and coping manners of adolescents in urban Vietnam and explored the mediating effect of different support to the associations between cyberbullying and mental health issues. Methods: A cross-sectional study was performed on 484 students at four secondary schools. Cyberbullying experience, coping strategies, psychological problems, and family, peer, and teacher support were obtained. Structural equation modeling was utilized to determine the mediating effects of different support on associations between cyberbullying and psychological problems. Results: There were 11.6 and 28.3% of students who reported that they experienced and observed at least one cyberbullying act in the last 3 months, respectively. Among the victims, only 48.2% tried to stop the perpetrators. Meanwhile, the majority of observers belonged to the "Intervene" group who tried to report cyberbullying acts or help victims. Family support was found to partially mediate associations between cyberbullying experience and observation with levels of psychological problems among adolescents. Conclusion: The 3-month rate of cyberbullying experience and observation among urban adolescents aged 11-14 was low. However, current coping strategies against cyberbullying were not sufficient. Family support is an important factor that should be considered for designing interventions to mitigating the impacts of cyberbullying on the mental health of adolescents.

Smartphone Use and Willingness to Pay for HIV Treatment-Assisted Smartphone Applications among HIV-Positive Patients in Urban Clinics of Vietnam.

This study aimed to examine the effectiveness of Human Immunodeficiency Virus (HIV)-assisted smartphone applications in the treatment of HIV/AIDS patients in Vietnam. A cross-sectional study was performed in two urban outpatient clinics in Hanoi from May to December 2019. A simple random sampling method and a structured questionnaire were used to recruit 495 eligible participants and to collect data. Multivariable modified Poisson regression and multivariable linear regression models were employed to investigate the factors associated with the willingness to pay (WTP) and amount of money patients were willing to pay. Approximately 82.8% of respondents were willing to pay for the hypothetical applications, with the mean amount the participants were willing to pay of Vietnam Dong (VND) 72,100/month. Marital status (separate/divorced/widow: Odds ratio (OR) = 1.28, 95% confidence interval (CI) = (1.09; 1.50) and having spouse/partner: OR = 1.18, 95% CI = (1.03; 1.36)) and using health services (OR = 1.03, 95% CI = (1.01; 1.04)) were positively associated with nominating they would be WTP for the app, whereas the duration of antiretroviral treatment (ART) (OR = 0.98, 95% CI = (0.96; 0.99)) had a negative association. The frequency of using health services (ß = 0.04, 95% CI = (-0.07; -0.01)) was negatively associated with the amount of WTP. High levels of WTP revealed the feasibility of implementing smartphone-based apps for HIV treatment. This study implied the necessity to consider a co-payment system to reach populations who were in need but where such applications may be unaffordable in lieu of other treatment-associated expenses. Developers also need to pay attention to privacy features to attract single people living with HIV/AIDS and additional measures to initiate people with a long duration on ART into using the applications.

Knowledge and Self-Protective Practices Against COVID-19 Among Healthcare Workers in Vietnam.

Background: In middle-income countries such as Vietnam, where healthcare resources are already constrained, protecting healthcare workers (HCWs) is essential for ensuring the sustainability of COVID-19 response in Vietnam. This study was conducted to assess the knowledge and practices regarding the prevention of the COVID-19 among the HCWs in Vietnam to identify the ways of disseminating information to maximize the safety of these essential workers. Methods: An online cross-sectional study, using respondent-driven sampling, was conducted in Vietnam with 742 participants within 2 weeks. The validity of the questionnaire was examined by exploratory factor analysis. Descriptive statistics were used to identify the level of knowledge and practices among the HCWs to prevent the COVID-19. Inferential statistics and regression modeling were used to identify the associated factors with results. Results: Vietnamese HCWs had a high level of knowledge with more than 75% of the participants demonstrating awareness of all the modes of transmission aside from air. The mean knowledge score was 3.7 ± 0.8 (range 1-5). Nearly all the participants relied on the Ministry of Health (98.3%) and the internet (95.5%) for information regarding the COVID-19. The participants endorsed a moderately high level of self-protective practices with mean scores of 4.2 and 3.6 (band score 1-5) for the precautionary and psychological measures, respectively. Nurses were more likely to practice the precautionary measures than doctors and the HCWs at the central level were more likely to practice the psychological measures than those at the district level. Conclusion: Future education initiatives should consolidate the latest literature in an accessible format, focusing initially on the gaps of knowledge regarding aerosol transmission. These initiatives should primarily focus on the doctors, especially those in emergency and intensive care departments.

An Asia-Pacific study on healthcare workers' perceptions of, and willingness to receive, the COVID-19 vaccination.

OBJECTIVE: In the fight against COVID-19, vaccination is vital in achieving herd immunity. Many Asian countries are starting to vaccinate frontline workers; however, expedited vaccine development has led to hesitancy among the general population. We evaluated the willingness of healthcare workers to receive the COVID-19 vaccine. METHODS: From 12 to 21 December 2020, we recruited 1720 healthcare workers from 6 countries: China, India, Indonesia, Singapore, Vietnam and Bhutan. The self-administrated survey collected information on willingness to vaccinate, perception of COVID-19, vaccine concerns, COVID-19 risk profile, stigma, pro-socialness scale, and trust in health authorities. RESULTS: More than 95% of the healthcare workers surveyed were willing to vaccinate. These respondents were more likely to perceive the pandemic as severe, consider the vaccine safe, have less financial concerns, less stigmatization regarding the vaccine, higher pro-socialness mindset and trust in health authorities. A high perceived pandemic risk index, low vaccine harm index and high pro-socialness index were independent predictors in multivariable analysis. CONCLUSIONS: The majority of healthcare workers in Asia are willing to receive COVID-19 vaccination. Perceived COVID-19 susceptibility, low potential risk of vaccine harm and pro-socialness are the main drivers. These findings may help formulate vaccination strategies in other countries.

Corrigendum: Anxiety and Depression Among People Under the Nationwide Partial Lockdown in Vietnam.

[This corrects the article DOI: 10.3389/fpubh.2020.589359.].

Psychosocial Impacts of COVID-19 on Healthcare Workers During the Nationwide Partial Lockdown in Vietnam in April 2020.

Background: The psychosocial impact of COVID-19 is greater among healthcare workers (HCWs) than the general population. This study aims to identify psychosocial problems faced by HCWs in Vietnam during the national partial lockdown between 1 and 22 April 2020 and to identify risk factors associated with psychosocial issues among this population. Methods: A cross-sectional study was conducted in the second week of April 2020 during the national lockdown in Vietnam. Snowball sampling technique was used to recruit participants through web-based surveys. The Impact of Events Scale-Revised (IES-R) was used to assess the impact of COVID-19 on HCWs through online surveys. Results: Of the 349 HCWs, we found 22.6% reported psychosocial problems. Most of participants reported having exposure to COVID-19 daily (48.7%). The majority of them also felt that their job put them at risk of SARS-CoV-2 infections (90.3%) and expressed fear of potential infection (85.7%). Despite COVID-19 risks, 95.4% of participants, however, expressed their willingness to continue working at their current health facility. In addition, 94.8% of participants believed if they or their family members had been infected, their agency leaders would have provided them with appropriate medical care. Lastly, HCWs who worked in the internal medicine department who did not take care of COVID-19 patients or expressed fear of becoming infected were more likely to have higher total IES-R scores. Conclusion: Our findings suggest that the support of healthcare leaders and assurance of care might be helpful in mitigating the psychological effects of COVID-19 among HCWs in Vietnam. These resources should be tailored to HCWs who are working in different areas of health services, including staff who are not working directly with COVID-19 patients. In addition, psychosocial health resources should be provided for not only physicians but also nursing staff.

Impacts of COVID-19 on the Life and Work of Healthcare Workers During the Nationwide Partial Lockdown in Vietnam.

Background: Healthcare workers are frontline responders facing a disproportionate increase in occupational responsibilities during the COVID-19 pandemic. Added work-related stress among healthcare personnel may lead to personal and work-related repercussions, such as burnout or decreased quality of care for patients; however, little is known about how the COVID-19 pandemic affects the daily work and life of these workers. This study aimed to evaluate the personal and occupational impacts of the COVID-19 induced partial lockdown in Vietnam among hospital staff. Methods: A cross-sectional web-based study was carried out to collect demographic data and the personal and job impacts of respondents during the second week of national lockdown in April 2020. Snowball sampling technique was applied to recruit 742 hospital staff. The exploratory factor analysis (EFA) was used to examine the validity of the instrument. Results: Of the 742 respondents, 21.2% agreed that "working attitude well-maintained," followed by 16.1% of respondents who reported that there were "enough employees at work." Only 3.2% of respondents agreed that "their work was appreciated by society." Furthermore, healthcare workers in the central region were less likely to have experienced "Avoidance of disclosure and discrimination related to COVID-19" than other areas (Coef. = - 0.25, CI: -0.42 to -0.07). Being women also had a negative association with scores in "Avoidance of disclosure and discrimination related to COVID 19" domain (Coef. = -0.27, CI: -0.43 to -0.12) while having a positive association with "negative attitude towards working conditions" domain (Coef. = 0.19, CI: 0.09 to 0.3). In addition, working in administrative offices (Coef. = 0.20; 95% CI = 0.05 to 0.36) and infectious departments (Coef. = 0.36; 95% CI = 0.09 to 0.63) had a positive association with "Increased work pressure due to COVID 19" domain. Conclusion: These findings revealed marginal impacts of the COVID-19 pandemic on the work and life of hospital staff in Vietnam. Furthermore, this study highlighted the importance of implementing preventive strategies during the nationwide partial lockdown to manage hospital admissions and the burden on healthcare workers. Finally, this study characterizes targeted demographics that may benefit from appreciation by employers and society during a national pandemic.

Do inequalities exist in housing and working conditions among local and migrant industrial workers in Vietnam? Results from a multi-site survey.

BACKGROUND: While internal migrants in Vietnam have been a key driving force in the country's rapid economic development, they also face many vulnerabilities. Our study seeks to explore possible inequalities in housing and working conditions between local and internal migrant industrial workers in Vietnam. METHODS: Cross-sectional surveys were conducted with 1200 industrial workers in four regions of Vietnam. Dependent variables included housing conditions (satisfaction with convenience of accommodation, sanitation and water of accommodation, and accommodation in general) and working conditions (satisfaction with income, monthly income, number of hazardous working conditions, and work-related stress measured through the modified Effort-Reward Imbalance Questionnaire). The primary independent variable is migrant status. Covariates included region, gender, education, marital status, accommodation status, living arrangements, industry, age, monthly income, experience, and working hours. RESULTS: Of the sample, 24.7% (n=296) were migrants. Overall, no differences were found regarding housing conditions by migrant status. In adjusted regression models, migrants reported higher numbers of hazardous working conditions (ß=0.07, 95%CI=0.01-0.13, p=.01) and higher monthly income (ß=0.05, 95%CI=0.01-0.09, p=.02). DISCUSSION: Recent state-level changes in the Vietnamese household registration system may explain the lack of differences in housing conditions by migrant status. Future research should utilize longitudinal designs to examine impacts over time of state policy on migrants' housing conditions as well as well-being. Regarding working conditions, findings highlight the need for stronger social protection policy and better information channels on occupational health and safety for migrants. Further research, including qualitative studies, is needed to explore why migrants face more hazardous working conditions.

Psychological distress among mountainous farmers in Vietnam: a cross-sectional study of prevalence and associated factors.

BACKGROUND: Psychological distress has been known as a major health problem among farmers across the world. In Vietnam, approximately 50% of farmers have lived in rural and mountainous areas. Yet, little has been known about how psychological distress impacts mountainous farmers' health. OBJECTIVES: This study aimed to examine the prevalence and risk factors related to psychological distress among mountainous farmers in Vietnam. DESIGN AND SETTING: A cross-sectional study was performed from August to September 2018 in Moc Chau district, Vietnam. A structured questionnaire and face-to-face interviews were used for data collection. PARTICIPANTS: A random sample of 197 farmers aged at least 18 years, spoke Vietnamese, was not suffering from severe diseases and residing in Moc Chau at the time of the survey were recruited. PRIMARY AND SECONDARY OUTCOME MEASURES: The Kessler Psychological Distress Scale (K6) was employed to measure psychological distress. The tobit and logistic regressions were applied to indicate associated factors. RESULTS: The prevalence of psychological distress was 38.2% (95% CI 31.3% to 45.5%). Having a greater comorbidities (OR=6.17; 95% CI 1.44 to 26.43), drinking alcohol (OR=3.86; 95% CI 1.02 to 14.59) and obtaining health information from health workers (OR=3.77; 95% CI 1.22 to 11.66) were positively associated with the prevalence of psychological distress. By contrast, being overweight (OR=0.29; 95% CI 0.09 to 0.93), adopting books as the primary source of health information (OR=0.11; 95% CI 0.01 to 0.8), and receiving a higher number of home visits by community health workers (CHWs) (OR=0.38; 95% CI 0.14 to 0.99) were negatively associated with the prevalence of psychological distress. CONCLUSION: This study highlighted a high prevalence of psychological distress among mountainous farmers. Providing routine psychological and physical health screening, developing CHWs to provide clinical support and raising health awareness are critical implications for reducing psychological distress in this population.

Studies of Novel Coronavirus Disease 19 (COVID-19) Pandemic: A Global Analysis of Literature.

Novel coronavirus disease 19 (COVID-19) is a global threat to millions of lives. Enormous efforts in knowledge production have been made in the last few months, requiring a comprehensive analysis to examine the research gaps and to help guide an agenda for further studies. This study aims to explore the current research foci and their country variations regarding levels of income and COVID-19 transmission features. This textual analysis of 5780 publications extracted from the Web of Science, Medline, and Scopus databases was performed to explore the current research foci and propose further research agenda. The Latent Dirichlet allocation was used for topic modeling. Regression analysis was conducted to examine country variations in the research foci. Results indicate that publications are mainly contributed by the United States, China, and European countries. Guidelines for emergency care and surgical, viral pathogenesis, and global responses in the COVID-19 pandemic are the most common topics. There is variation in the research approaches to mitigate COVID-19 problems in countries with different income and transmission levels. Findings highlighted the need for global research collaborations among high- and low/middle-income countries in the different stages of pandemic prevention and control.

The operational readiness capacities of the grassroots health system in responses to epidemics: Implications for COVID-19 control in Vietnam.

BACKGROUND: There is a paucity of data on the operational readiness capacities of the grassroots health system in Vietnam while it plays a vital role as a first-line defense against health emergencies, including the coronavirus disease (COVID-19). This study, therefore, aims to assess the operational readiness capacities of the grassroots health system in response to epidemics and provides implications for controlling COVID-19 in Vietnam. METHODS: An online cross-sectional study using the respondent-driven sampling technique was conducted with 6029 health professionals and medical students in Vietnam from December 2019 to February 2020. The operational readiness capacities of the health system were assessed by the sufficiency of health professionals, administrative and logistics staffs, equipment and facilities, and general capacity of health professionals. Kruskal-Wallis test, Fisher exact test and χ2 test were employed to identify the differences among variables. Tobit and censored regression models were operated to determine associated factors. RESULTS: The operational readiness capacities of the grassroots health system for four assessed criteria were at moderate levels, ranging from 6.3 to 6.8 over 10. In Vietnam, the grassroots health system in rural areas, in the South, and at the district level were more likely to be vulnerable compared to their counterparts. CONCLUSIONS: According to empirical data, this study reveals the vulnerability of the grassroots health system in Vietnam and provides the rationality of prompt and vigorous actions of the Vietnamese Government against COVID-19. Findings also offer useful insights for effective strategies to strengthen the grassroots health system in the long term. In the short term, practicing precautionary measures and mobilizing human resources, as well as medical equipment, are needed to successfully contain COVID-19 in Vietnam.

The Status of First Aid and Its Associations with Health Outcomes among Patients with Traffic Accidents in Urban Areas of Vietnam.

While it is well-evident that proper first aid would significantly promote survival and later treatment outcomes, little attention has been paid to improving its capacity in Vietnam. Thus, we conducted this study to assess the status of first aid and its associations with health outcomes among patients in traffic accidents in urban areas of Vietnam. We conducted a cross-sectional study on 413 patients in traffic accidents from October to December 2018 at six hospitals in Thai Binh province. Socio-demographics, first aid characteristics, and health outcomes were collected via face-to-face interviews using a structured questionnaire. We used a chi-square test to determine the differences in health outcomes among those who received first aid and those without. In addition, a multivariable regression was performed to determine the factors associated with first aid. The results indicated that less than half of the patients received first aid (48.1%), and only one fourth received first aid within 10 min after an accident. The proportions of having problems with mobility, self-care, usual activities, and pain/discomfort were significantly lower among those who received first aid compared to those without it. The regression model showed that those with multiple injuries were less likely to receive first aid.

Anxiety and Depression Among People Under the Nationwide Partial Lockdown in Vietnam.

This study aimed to evaluate the psychological effects of the partial lockdown on the people in Vietnam during the COVID-19 pandemic. An online questionnaire regarding attitudes toward COVID-19 along with psychological parameters, including the Impact of Event Scale-Revised (IES-R) Depression, Anxiety, Stress Scale-21 (DASS-21) was conducted. From a total of 1,382 questionnaires, the respondents reported low prevalence of depression (4.9%), anxiety (7.0%), and stress (3.4%). The mean DASS-21 scores recorded were also markedly lower compared to similar studies conducted in China, Italy, and Iran. Respondents who reported severe PTSD had significantly higher depression, anxiety, and stress levels. Factors that were associated with an increased level of depression, stress, and anxiety were being single, separated, or widowed, a higher education level, a larger family size, loss of jobs and being in contact with potential COVID-19 patients. Contrary to expectations, the level of depression, stress, and anxiety observed has been low. Our findings can aid in future research on the impact of a partial lockdown and guide mental health professionals in Vietnam and other countries in the preparation of better care for populations under such circumstances.

Perceptions and Attitudes Toward COVID-19-Related National Response Measures of Vietnamese: Implications for Pandemic Prevention and Control.

Introduction: Public perceptions and attitudes toward preventive and control measures are vital to ensure the success of national response strategies in combating COVID-19. This study assessed perceptions and attitudes via the importance of national response measures to COVID-19 among people under the nationwide partial lockdown of Vietnam. Methods: An online cross-sectional survey was conducted on 1382 people in Vietnam mainly public administration and health workers with relatives. Perceptions and attitudes toward seven national response measures to COVID-19 epidemics were assessed. Multivariable Tobit regression models were employed to identify factors associated with the perceptions. Results: The proportion of participants strongly agreeing with the measure "Isolate people from abroad and people in contact with people infected with COVID 19" was the highest (96.9%), following by the measure "Obligatory to wear face masks in public places" (96.8%), and "Blockade of places having new cases" (92.9%). Living in the Southern region, having a family with more than 5 people, and having post-graduate education were negatively correlated to the levels of perceived importance of "Social distancing and community screening" measures. Meanwhile, having post-graduate education (Coef. = -0.04; 95%CI: -0.07; -0.01), working as white-collar workers (Coef. = -0.04; 95%CI: -0.08; -0.01), and having fixed-term, full-time employment (Coef. = -0.07; 95%CI: -0.10; -0.03) were inversely associated with the levels of perceived importance of the "Mandatory quarantine and personal protective equipment" measures. Conclusion: This study informed highly positive perceptions and attitudes toward the national response measure to combat the COVID-19 in Vietnam. Contextualized strategies to maintain and improve these perceptions are warranted to ensure the success of preventive measures in the future.