Strengthening primary health care in low- and middle-income countries: generating evidence through evaluation.

Since the publication of the World Health Report 2008, there has been renewed interest in the potential of primary health care (PHC) to deliver global health policy agendas. The WHO Western Pacific Regional Strategy 2010 states that health systems in low- and middle-income countries (LMICs) can be strengthened using PHC values as core principles. This review article explores the development of an evidence-based approach for assessing the effectiveness of PHC programs and interventions in LMICs.

Vietnamese women's struggle to access antiretroviral drugs in a context of free treatment.

This qualitative study aims to explore how HIV positive women living in a northern province of Vietnam experience seeking antiretroviral (ARV) treatment in the public health system, and how they address obstacles encountered along the way. Despite the fact that antiretroviral drugs were freely provided, they were not always accessible for women in need. A variety of factors at the population and health system level interacted in ways that often made access to ARV drugs a complicated and time-consuming process.

Contraceptive use among HIV-positive women in Quang Ninh province, Vietnam.

Objective: To investigate contraceptive use among HIV-positive women in Ha long city and Cam Pha town of Quang Ninh, a Northern province of Vietnam.

Methods: Cross-sectional questionnaire study among HIV-positive women identified through the district HIV/AIDS register. Information on socioeconomic characteristics and contraceptive use before and after HIV diagnosis was obtained through structured questionnaires.

Pursuing treatment and moral worth: HIV-infected women in a northern province of Vietnam living with antiretroviral therapy.

There is a need to understand how social and cultural expectations of being a woman shape the challenges women face when trying to access antiretroviral therapy (ART) and to continue the treatment over time. Based on a 7-month prospective study of 15 HIV-infected women, the particular challenges met by these women in northern Vietnam are discussed in this article. We argued that, by taking ART to maintain their health and to fulfill their responsibilities to family and community, the women managed to reclaim the "moral worth" they had lost as a result of having HIV infection.

Quality of reproductive health services at commune health stations in Viet Nam: implications for national reproductive health care strategy.

This paper presents a qualitative study conducted in 2009 of provider and patient perceptions of primary level reproductive health services provided by commune health stations (CHSs), and the implications for Viet Nam's 2011-2020 National Strategy for Reproductive Health Care. In the three provinces of Thai Nguyen, Thua Thien Hue, and Vinh Long, we interviewed the heads of CHSs, held focus group discussions with midwives and women patients, and observed facilities. Half the 30 CHSs visited were in poor physical condition; the rest were newly renovated.

Antiretroviral therapy: unmet need and associated socio-demographic characteristics among HIV-positive women in Haiphong, Vietnam.

In Vietnam, ARV access has been scaled up since 2005 in high HIV prevalence areas in order to meet increasing demands for HIV treatment. This paper aims to estimate ARV unmet need and its associated socio-demographic characteristics among HIV-positive women in Haiphong, Vietnam. A cross-sectional study using structured questionnaires and CD4 cell count was conducted with 353 HIV-positive women recruited from groups of people living with HIV/AIDS (PLWHA), by snowball technique through member of PLWHA groups and the local AIDS management system (Provincial AIDS Center (PAC)).

The impact of social franchising on the use of reproductive health and family planning services at public commune health stations in Vietnam.

Background: Service franchising is a business model that involves building a network of outlets (franchisees) that are locally owned, but act in coordinated manner with the guidance of a central headquarters (franchisor). The franchisor maintains quality standards, provides managerial training, conducts centralized purchasing and promotes a common brand. Research indicates that franchising private reproductive health and family planning (RHFP) services in developing countries improves quality and utilization.

Burden of premature mortality in rural Vietnam from 1999-2003: analyses from a Demographic Surveillance Site.

Background: Assessing the burden of disease contributes towards evidence-based allocation of limited health resources. However, such measures are not yet commonly available in Vietnam. Taking advantage of the FilaBavi Demographic Surveillance Site (FilaBavi DSS) in Vietnam, this study aimed to establish the feasibility of applying the Years of Life Lost (YLL) technique in the context of a defined DSS, and to estimate the importance of the principal causes of premature mortality in a rural area of Vietnam between 1999 and 2003.

Socio-economic status inequality and major causes of death in adults: a 5-year follow-up study in rural Vietnam.

Objectives: This study aimed to analyse the associations between cause-specific mortality in adults (aged 20 years and above) and socio-economic status (SES) in a rural setting of Vietnam during a time of economic transition.

Study Design: The study was carried out as part of the FilaBavi demographic surveillance system, with a dynamic cohort of 50,000 inhabitants from January 1999 to December 2003.

Methods: Causes of death in the adult population were derived using verbal autopsy.

Applying verbal autopsy to determine cause of death in rural Vietnam.

Aims: Verbal autopsy (VA) is an attractive method for ascertaining causes of death in settings where the proportion of people who die under medical care is low. VA has been widely used to determine causes of childhood and maternal deaths, but has had limited use in assessing causes in adults and across all age groups. The objective was to test the feasibility of using VA to determine causes of death for all ages in Bavi District, Vietnam, in 1999, leading to an initial analysis of the mortality pattern in this area.