Barriers in providing maternal health care services in a mountainous area.

PURPOSE: While programs had been implemented by both the government and non-governmental organizations to address inequity in maternal health care in mountainous areas in Vietnam, the expected outcomes were not fully reached due to existing barriers from health workers mainly providing the health services. This study explores prominent issues faced by health workers in delivering maternal care in Cao Bang, focusing on their impact on the local population's daily lives and overall development. METHODS: A qualitative study was conducted with 15 participants working as health managers, commune health workers, commune midwives, and village health workers in selected communes of a mountainous and border district located in the Northeast Cao Bang province. RESULTS: Main barriers include the incompetent healthcare workforce, ineffective use of facility resources, lack of work commitment, and unscientific traditional beliefs. CONCLUSION: Future community programs should implement strict policies, defined rights, and clear responsibilities for health workers handling these obstacles to optimize the quality of maternal health care services in these remote areas.

Illuminating the breast cancer survival rates among Southeast Asian women: A systematic review and meta-analysis spanning four decades.

In Southeast Asia, breast cancer is the most prevalent cancer among women and ranks as the second leading cause of cancer-related deaths. This systematic review and meta-analysis, encompassing 27 observational cohort studies with a minimum one-year follow-up period, aimed to examine temporal trends in breast cancer survival rates. Among the subset of five out of eleven Southeast Asian nations with available data, our analysis revealed pooled survival rates of 88.8 % at 1 year, 73.8 % at 3 years, 70.8 % at 5 years, and 49.3 % at 10 years for breast cancer patients. The mean age at diagnosis was 50.77±10.07 years, with 52.81 % of patients presenting with positive lymph nodes. Notably, stages I and II remained predominant even five years post-diagnosis. Although an overall amelioration in survival rates transpired over the preceding four decades, a noticeable exception pertained to the 3-year rate, demonstrating limited improvement. These findings underscore the pressing need for enhanced research efforts, particularly in countries within the region that lack survival data, to enable accurate estimations. Furthermore, our review also emphasizes the crucial need for future comprehensive, well-designed studies to delve into the factors behind survival rate disparities in Southeast Asia and the younger age at diagnosis compared to other regions.

Sugar-sweetened beverages consumption increases the risk of metabolic syndrome and its components in adults: Consistent and robust evidence from an umbrella review.

BACKGROUND & AIMS: Sugar-sweetened beverages (SSBs) are potential modifiable risk factors for reducing the risk of metabolic syndrome (MetS); however, there is a lack of an umbrella review that robustly synthesizes the evidence. This review aims to synthesize the evidence linking habitual SSBs intake with MetS in adults, emphasizing the need for policy and regulatory actions. METHODS: Four databases were comprehensively searched for relevant meta-analyses of prospective studies up to July 2023. Two authors independently conducted the screening for eligibility, data extraction, and quality assessment. The outcome of interest was MetS in adults, encompassing its component conditions. The present review was registered with PROSPERO (CRD42023402549). RESULTS: Of the 16 eligible meta-analyses identified, 30 summary estimates were obtained for the impact of SSBs consumption on obesity, type 2 diabetes, hypertension, and MetS. Seven were rated as 'High' methodological quality, with the rest classified as 'Moderate' and 'Low' quality, consisting of three and six references, respectively. A comparison of the highest and lowest levels of SSBs consumption revealed an increased risk of 18% (95% CI: 13%-24%), 12% (95% CI: 11%-14%), 29% (95% CI: 25%-32%), and 29% (95% CI: 7%-52%) for obesity, hypertension, type 2 diabetes, and MetS, respectively. Consistently, the findings from dose-response analyses are in agreement with and corroborate the existing evidence that SSBs are a significant risk factor for the development of MetS and its related conditions. Noticeably, the quality of evidence was predominantly deemed as highly suggestive and convincing. Moreover, consensus on specific criteria to identify studies related to SSBs in literature searching was lacking, and most primary studies were conducted in developed countries and Europe. CONCLUSIONS: Our findings suggest that more rigorous and targeted policy interventions are warranted to curtail SSBs consumption, in order to alleviate the global burden of MetS.

Barriers to COVID-19 contact tracing: View from frontline healthcare students in Vietnam.

In the context of the complicated continuous waves of the COVID-19 pandemic in Vietnam, contact tracing, along with social distancing and lock-down, proved its crucial role in the suppression of epidemic spreading and management. With the high demand for responsiveness, healthcare students were constantly involved in the process, and challenges have emerged along the way. This study aims to identify the barriers faced by healthcare students while performing the contact tracing task at the frontline of the pandemic. A qualitative study was conducted in July 2021 in a health center in Binh Duong province, Vietnam. A total of 20 healthcare students were invited through random recruitment of participants and interviewed until the principle of saturation was reached. Three main barriers were identified including ineffective work management of local managers, lack of capability of human resources and facilities, and uncooperative attitude of local residents. Given the existing barriers, cooperative, innovative strategies, shared data systems, and timely public awareness campaigns, especially among primary health centers of the healthcare system, are imperative to reduce the workload and optimize the efficacy of healthcare students' support.

The Use of Video in Delivering Maternal Health Education in Mountainous Areas: A Qualitative Exploration of the Experience of Health Workers.

BACKGROUND: Health education via DVD/video has been demonstrated as a novel method to encourage a positive change and improvement in patients' health behaviors. A community health project was implemented in Cao Bang, a mountainous area of Vietnam, for health workers to use tablets, portable projectors, and television to disseminate health education messages via designed video clips. METHOD AND OBJECTIVES: A qualitative study using semi-structured individual and group interviews was conducted with 25 health workers in Trung Khanh district to explore their experience of using video in providing health education. RESULTS: The video was confirmed to be an accessible, interactive, and flexible tool supporting health education activities in this mountainous area. However, some health workers in the mountainous area struggled due to a lack of technological skills and responsibility for their work. CONCLUSIONS FOR PRACTICE: More training on using technology for health professionals and incorporating video-based health education activities into labor contract-based responsibilities can alleviate present obstacles.