Nguyen Van Huy

Smoking Among Vietnamese Medical Students: Prevalence, Costs, and Predictors

This cross-sectional study investigated smoking patterns and predictors among Vietnamese medical students. In total, 4720 medical students from 3 universities, each located in South, Central, and North Vietnam, were interviewed using an adapted Global Youth Tobacco Survey Questionnaire. Ideas on smoking behavior and tobacco control derived from group discussions with students and from unstructured interviews with student managers and university directors. Overall, the current smoking rate was 25.0% and dominant in men at 43.7%. Most started smoking when just entering university (18 +/- 3.3 years). Male students from the central region had the highest smoking rate (35.1%), whereas their northern counterparts had the greatest smoking magnitude: age of smoking initiation (18.6 +/- 3.5), number of cigarettes per day (4.4 +/- 4.5), number of smoking days per month (16.5 +/- 11.6), and proportion of smoking cost among total expenses per month (10.9% +/- 11.9%). Smoking tended to increase across academic years, being highest in years 5 to 6 (35.0%). In contrast, the practice of ever quitting and the intention of quitting tended to decline from years 1-2 to years 5-6 (from 82.2% to 71.5%, P < .05, and from 70.8% to 51.5%, P < .001, respectively). Positive attitudes toward smoking (odds ratio = 1.4, P < .05), negative beliefs on hazards of smoking (odds ratio = 1.7), and daily exposure to family smokers (odds ratio = 2.0, P < .05) and to social smokers (odds ratio = 4.5, P < .05) were main predictors of smoking. Qualitative results suggest that nonsmoking university regulations played a critical role in tobacco control among medical students. Nonsmoking regulations and penalties for students who smoke need to be formulated at medical universities. The message that medical students must make a nonsmoking role model for community should be systematically promoted.This cross-sectional study investigated smoking patterns and predictors among Vietnamese medical students. In total, 4720 medical students from 3 universities, each located in South, Central, and North Vietnam, were interviewed using an adapted Global Youth Tobacco Survey Questionnaire. Ideas on smoking behavior and tobacco control derived from group discussions with students and from unstructured interviews with student managers and university directors. Overall, the current smoking rate was 25.0% and dominant in men at 43.7%. Most started smoking when just entering university (18 ± 3.3 years). Male students from the central region had the highest smoking rate (35.1%), whereas their northern counterparts had the greatest smoking magnitude: age of smoking initiation (18.6 ± 3.5), number of cigarettes per day (4.4 ± 4.5), number of smoking days per month (16.5 ± 11.6), and proportion of smoking cost among total expenses per month (10.9% ± 11.9%). Smoking tended to increase across academic years, being high...This cross-sectional study investigated smoking patterns and predictors among Vietnamese medical students. In total, 4720 medical students from 3 universities, each located in South, Central, and North Vietnam, were interviewed using an adapted Global Youth Tobacco Survey Questionnaire. Ideas on smoking behavior and tobacco control derived from group discussions with students and from unstructured interviews with student managers and university directors. Overall, the current smoking rate was 25.0% and dominant in men at 43.7%. Most started smoking when just entering university (18 ± 3.3 years). Male students from the central region had the highest smoking rate (35.1%), whereas their northern counterparts had the greatest smoking magnitude: age of smoking initiation (18.6 ± 3.5), number of cigarettes per day (4.4 ± 4.5), number of smoking days per month (16.5 ± 11.6), and proportion of smoking cost among total expenses per month (10.9% ± 11.9%). Smoking tended to increase across academic years, being highest in years 5 to 6 (35.0%). In contrast, the practice of ever quitting and the intention of quitting tended to decline from years 1-2 to years 5-6 (from 82.2% to 71.5%, P < .05, and from 70.8% to 51.5%, P < .001, respectively). Positive attitudes toward smoking (odds ratio = 1.4, P < .05), negative beliefs on hazards of smoking (odds ratio = 1.7), and daily exposure to family smokers (odds ratio = 2.0, P < .05) and to social smokers (odds ratio = 4.5, P < .05) were main predictors of smoking. Qualitative results suggest that nonsmoking university regulations played a critical role in tobacco control among medical students. Nonsmoking regulations and penalties for students who smoke need to be formulated at medical universities. The message that medical students must make a nonsmoking role model for community should be systematically promoted.

Smoking Among Vietnamese Health Professionals: Knowledge, Beliefs, Attitudes, and Health Care Practice

The study aimed to investigate smoking patterns and compare knowledge, beliefs, and attitudes, as well as explore predictors of smoking status among Vietnamese health professionals. A global survey questionnaire on tobacco use among health professionals by the World Health Organization and the Centers for Disease Control and Prevention was adapted for data collection. Data from 2151 health workers from the 3 largest hospitals-each of which is located in South, Central, and North Vietnam, respectively-were collected using quantitative methods. Both descriptive and inferential statistics were used in the data analysis. Smoking prevalence among Vietnamese health professionals is 13.4%, dominant among male health professionals compared with female counterparts (35.6% vs 1.8%), and significantly varies by regions. Physicians and dentists display a greater smoking proportion than nurses (23.0%, 10.5%, and 7.7%, respectively). The findings highlight the importance of improving and promoting beliefs of health pro...The study aimed to investigate smoking patterns and compare knowledge, beliefs, and attitudes, as well as explore predictors of smoking status among Vietnamese health professionals. A global survey questionnaire on tobacco use among health professionals by the World Health Organization and the Centers for Disease Control and Prevention was adapted for data collection. Data from 2151 health workers from the 3 largest hospitals—each of which is located in South, Central, and North Vietnam, respectively—were collected using quantitative methods. Both descriptive and inferential statistics were used in the data analysis. Smoking prevalence among Vietnamese health professionals is 13.4%, dominant among male health professionals compared with female counterparts (35.6% vs 1.8%), and significantly varies by regions. Physicians and dentists display a greater smoking proportion than nurses (23.0%, 10.5%, and 7.7%, respectively). The findings highlight the importance of improving and promoting beliefs of health professionals about being role models for their patients by not smoking. Special attention should be given to the following slogan: “Health professionals should act as nonsmoking role models for their patients and the public.” This message should be incorporated into cigarette restriction regulations and policies at hospitals and recognized as one of the effective measures in cigarette control in the hospital context.

Early sexual initiation and multiple sexual partners among Vietnamese women: analysis from the Multiple Indicator Cluster Survey, 2011

Introduction Under current HIV transmission mechanisms operating in Vietnam, women are seen as victims of their male partners. Having multiple sexual partners is one of the well-known risk factors for HIV infection. However, little is known about womens risky sexual behaviour and their vulnerability to HIV in Vietnam. This study aims to explore association between early sexual initiation and the number of lifetime sexual partners in Vietnamese women. Although the Vietnamese culture is socially conservative in this area, identifying womens risky sexual behaviour is important for the protection of women at risk of HIV and other sexually transmitted diseases. Design A total of 8,791 women, who reported having had sexual intercourse, were included in this analysis of data from the 2011 Multiple Indicator Cluster Survey in Vietnam. Data were collected using two-stage strata sampling, first at the national level and second across six geographical regions (n=8,791). Multivariable logistic regressions describe association between early initiation of a sexual activity and lifetime multiple sexual partners. Results Early sexual intercourse was significantly associated with having lifetime multiple sexual partners. Women who were aged 19 or younger at first sexual intercourse were over five times more likely to have multiple sexual partners, compared with women whose first sexual intercourse was after marriage; aged 10–14 years (OR=5.9; 95% CI=1.9–18.8) at first intercourse; and aged 15–19 years (OR=5.4; 95% CI=4.0–7.2) at first intercourse. There was significant association with having multiple sexual partners for women of lower household wealth and urban residence, but the association with educational attainment was not strong. Conclusions The study results call for health and education policies to encourage the postponement of early sexual activity in young Vietnamese women as protection against risky sexual behaviour later in life.

Secular trends in HIV knowledge and attitudes among Vietnamese women based on the Multiple Indicator Cluster Surveys, 2000, 2006, and 2011: what do we know and what should we do to protect them?

Background In Vietnam, women are at risk of HIV infection due to many factors. However, there is limited evidence about what women know and how they behave to protect themselves from HIV. Objective The objective of this study was to investigate the trends in comprehensive HIV/AIDS knowledge, attitude, and associated factors among Vietnamese women from 2000 to 2011. Design Data from three waves of the Vietnam Multiple Indicator Cluster Surveys (years 2000, 2006, and 2011) were used. Logistic regression methods examined factors associated with each of two dependent variables, HIV/AIDS knowledge and attitude toward HIV/AIDS. Results Although there was an increasing trend in basic HIV/AIDS knowledge and positive attitude toward the disease, in Vietnamese women in the general population over the survey years, the prevalence of women with basic HIV/AIDS knowledge and positive attitude toward HIV/AIDS was low. Multivariable models indicated that women who had higher levels of education, lived in urban areas, had higher economic status, and knew about places of HIV-related services were more likely to have good HIV/AIDS knowledge (e.g. in 2011, AORs=3.01; 1.27; 1.88; 2.03, respectively). Women with higher educational attainment, knew about HIV services, and had better HIV knowledge were more likely to report positive attitude toward HIV/AIDS (e.g. in 2011, AORs=2.50; 1.72; 2.23, respectively). Conclusions This study recommends that public health programs for the control of HIV, such as behavioral change communication campaigns or social policies for women, should focus not only in improving the quality of existing HIV/AIDS counseling and testing services but also on expanding coverage to increase accessibility to these services for women in rural areas. In addition, efforts to raise the level of knowledge about HIV/AIDS and improve attitude toward the disease should be undertaken simultaneously. The results of this study can help inform HIV control policies and practices in other developing countries.

Determinants of early childhood morbidity and proper treatment responses in Vietnam: results from the Multiple Indicator Cluster Surveys, 2000–2011

Background Despite significant achievements in health indicators during previous decades, Vietnam lags behind other developing countries in reducing common early childhood illnesses, such as diarrhea and respiratory infections. To date, there has been little research into factors that contribute to the prevalence and treatment of childhood morbidity in Vietnam. Objective This study examines the determinants of diarrhea and ‘illness with a cough’ and treatments for each of the conditions among young children in Vietnam, and describes trends over time. Design Data from the Vietnam Multiple Indicator Cluster Surveys in 2000, 2006, and 2011 were used. Multivariable logistic regressions were undertaken to investigate factors associated with these childhood illnesses and proper treatment patterns. Results Between 2000 and 2011, the prevalence of diarrhea among children under the age of five declined from 11 to 7%, while having illness with a cough increased to 40% in 2011 after falling from 69 to 28% between 2000 and 2006. During the same period, the prevalence of oral rehydration therapy (ORT) for treating diarrhea increased from 13 to 46%, whereas the rate of seeking formal treatment for illnesses with a cough fell from 24 to 7%. Multivariable models indicated that children who were older than 2 years (odds ration [OR]: 0.44, 95% confidence interval [CI]: 0.37–0.53, p<0.001), male (OR: 1.21, 95% CI: 0.64–2.37, p<0.05), living in rural areas (OR: 1.28, 95% CI: 1.00–1.64, p<0.05), or of Kinh ethnicity (OR: 0.70, 95% CI: 0.56–0.87, p<0.01) were more likely to suffer from diarrhea. Ethnic differences and higher household wealth were factors significantly associated with having illness with a cough. In particular, the effect of level of wealth on illness with a cough varied in each wave. Mothers with higher levels of education had higher odds of seeking ORT compared with mothers with the lowest level of education. Seeking formal treatment for children who have illness with a cough was associated with being in a household in the richest wealth quintile (OR: 0.56, 95% CI: 0.34–0.91, p<0.05). Conclusions This study demonstrates the importance of identifying different risk factors for these two illnesses and also factors associated with healthcare-seeking behaviors in order to reduce the burden of childhood morbidity in Vietnam. Policies aimed at tackling childhood morbidities should include comprehensive strategies that impact on socioeconomic and environmental factors.

Factors associated with HIV testing among male motorbike taxi drivers in urban Vietnam

Using the Attitude-Skills-Knowledge (ASK) model, this study examined the prevalence of, and factors associated with, human immunodeficiency virus (HIV) testing among male motorbike taxi drivers (MMTDs). In a cross-sectional design, using quantitative approaches, 291 MMTDs were recruited from 135 sites across 13 districts in Hanoi, Vietnam, for a face-to-face interview. Applying the ASK model modified as a central theory, logistic regression was used to identify determinants of HIV testing. Although many MMTDs engaged in multiple risk behaviours for HIV, only 20.6% had been tested for HIV during the past 12 months. The tested model included one factor of the ASK model, HIV prevention knowledge (adjusted odds ratio [AOR] = 4.76; 95% confidence interval [CI] = 2.12–10.7) and five additional factors: being married (AOR = 3.13; 95% CI = 1.25–4.78), preferring sex with men or with both men and women (AOR = 8.72; 95% CI = 1.48–51.5), having lower number of lifetime sex partners (AOR = 0.66; 95% CI = 0.49–0.88), higher number of past year sex partners (AOR = 2.97: 95% CI = 1.21–7.31) and discussing condom use when having sex with partners (AOR = 0.08; 95% CI = 0.01–7.31). This modified ASK model provided better fit than the ASK model, as it explained more variance in HIV testing (47 vs. 29.8%). Recognising factors associated with HIV testing among MMTDs enables us to create suitable public health intervention strategies.

Patient satisfaction with health care services at a national institute of ophthalmology

Little is known about how patients in developing countries, such as Vietnam, are satisfied with eye care services. The purpose of this study was to assess the satisfaction with health services and its associated factors among patients attending a national institute of ophthalmology in Vietnam. In a cross-sectional study utilizing quantitative methods, 500 inpatients and their relatives attending a national institute of ophthalmology in Vietnam were approached for data collection. The results indicated that under 50% of the patients were satisfied with eye care services. However, when classified by level of satisfaction, only 6.8% were very satisfied with all domains of care. There was no significant difference in satisfaction by gender and income, while significant differences by department, residence, and education were found. Patients who were from rural areas, were better educated, and used the services of the glaucoma department, were more satisfied with eye care than those from urban areas, were less educated, and used the services of treatment-on-demand department. Multivariable regression detected 2 main factors, gender and location, associated with patient satisfaction. Patients who were female and came from rural and remote areas were more likely to be satisfied than patients who were male and living in urban areas. The study suggests that to continue to improve health care quality, it is important to eliminate differences in providing eye care services regardless of whether patients are male or female, and whether they come from a rural or urban area.

WHO's Service Availability and Readiness Assessment of primary health care services of commune health centers in a rural district of Northern Vietnam

The objective of this study was to assess the availability and readiness of the primary health care (PHC) services of commune health centers (CHCs) in Quoc Oai, a rural district of Northern Vietnam based on the World Health Organizations Service Availability and Readiness Assessment (SARA) tool. The study was done in 2 steps. First, the heads of the 21 CHCs of Quoc Oai district were interviewed using SARA, a quantitative survey, and the responses were then validated by direct observations of each facility. The results showed that although the average number of health staffs in each CHC met the national standards (at least 5 staffs per CHC), its allocation within each CHC was not properly met because some CHCs had only 2 health staffs. Several health equipment and facilities were not fully available in many CHCs, and although the majority of the PHC services were available at the CHCs, their readiness remained limited. Several significant correlates between the availability of health care workers and the availability of the facilities and the PHC services were observed, suggesting that they depend upon and affect one another in the health system. Using the SARA-based inventory, the study helps health managers and policy makers to prioritize efforts and allocate resources more appropriately. To be effective, attention should be given to how to make facilities, services, and human resources for health ready for PHC activities-more investment and support from the system (from higher to lower level) and the government.

The roles of, activities of, and competencies for, community nursing services in rural Vietnam: Implications for policy decisions

Community health workforce plays a vital role in providing primary health care services as per the needs of residents; however, few studies have examined how nurses work within commune health centers (CHCs). Using qualitative methods including interviews and focus group discussions with key stakeholders, this study explores the roles, activities, and competencies required of community nursing services in rural districts within Vietnam. Two primary roles were identified: CHC nursing and family nursing. For the latter, in addition to providing people with general health care and health communication, they were expected to also deliver psychological care. CHC nursing fulfilled more roles and required four specific competencies: clinical care, communication, management, and planning/coordination activities. Despite these various roles serving people within a community, few ongoing efforts at either the local or national level are aimed at supporting these nurses. The study highlights the need for policy decisions via either developing a new job position policy or adapting the existing policy by integrating new roles into the existing positions of CHC nurses in Vietnam.

Factors Associated With Risky Alcohol Consumption Among Male Street Laborers in Urban Vietnam

ABSTRACT Background: Alcohol consumption is of global concern. However, drinking patterns and associated factors remain under-investigated, especially among low socioeconomic groups such as street laborers. Objective: Using the social cognitive model as a framework for the study we aimed to identify factors associated with risky alcohol consumption. Methods: In a cross-sectional study using structured questionnaires, 450 male street laborers searching for casual works in Hanoi, Vietnam were interviewed. A logistic regression was applied in order to detect predictors of risky alcohol drinking. Results: During the last month, 45% of the participants reported daily consumption while the other 55% consumed weekly or less. Among the drinkers (416 out of 450, 92%), 27% were identified as high-risk drinkers who reported more than 14 standard drinks per week, while only 8% were lifetime abstainers. The multivariable logistic regression showed that older age, higher income were positively associated with a higher likelihood of drinking alcohol, while high school level negatively. The environmental predictor was the higher level of peer connection. The association between drinking and risky behavior was found positive with regards to the number of sexual partners. Conclusions: The study suggests that male street laborers are vulnerable to health risks. Decision makers should note that a significant proportion of this target group exceeds the guidelines for alcohol use and this should be included in future interventions or further research. A multisectoral approach together with an important strategy of education is needed to control alcohol use.