Sir Hd m CUA NGU&I CH6NG KHI VU MANG THAI VA SINH CON
TAI 8 TINH DUYEN HAI NAM TRUNG DO
Bill TH! THU H A , D O A N THI ThOY DUX7NG - Trudng Dai hgc Y te Cong cpng NGUYEN HANH NGUYEN - V7#n dSn so. sd'c khde vi phit triin PHAM V A N T A C , LE LAN HU'ONG - Vy To chOv cin bd. Bd Yti T 6 M T A T
Vai trd cua nam trong sue khde sinh sin tgi Vidt Nam thudng t$p tmng vio ki hogch hda gia dlnh, phdng chdng cic bdnh ISy tmyin dudng tlnh dijc.
Nghidn cdu niy tim hidu cie yiu ti lidn quan tdi s y /id trg cOa nam tmng chSm sdc trudc sinh vi sd dung dfch vg sinh dd. Thiit kit nghidn cuv dt ngang vdi 907 bi mg ed eon dudi 1 tuoi td 9-12/2013 tgi 32 xa 6 8 tlnh duydn hii nam trung bd- 1/3 s6 ddl tugng li phg nd din tdc thiiu s6, nghdo, tuil dudi 25vS cd trinh dd hgc vin thip. Kit qui nghidn cdu cho thdy tf Id nam gidi hd trg vg di khim thai li 80%, tim kiim djch vg li 38,6%, hi trg kinh phi li 61,7% vi eie chim sdc khic cho phu nu mang thai li 76%. Cie ydu ti lidn quan vdi thiiu ho trg ehSm sdc khi mang thai td phia ngudi chong bao gdm trinh dd hgc vin thdp. tuii edn tri vi thu nhip It han vg. Phg nd c6 chong hi trg ffi khim thai cd tf Id dl khim thai du 3 ldn, di tgi easdy ti vi su dung bidn phip trinh thai cao gip 2,5 lin so vdi nhdm khdng duge ho trg. Kit qud nghidn cdu nhin mgnh tim quan trgng cua cic ydu td niy trong cic chuang trinh can thldp vd lim mg an toin.
Td khda: hi trg cOa nam gidi, sde khde bi mg, ChSm sdc trudc sinh, nam tmng bd-
SUMMARY
Male involvement in mpmduetive health cam in Viet Nam has been focused on family planning, prevention and earn of sexually tmnsmitted diseases.
The study exploms the factors associated with male involvement in ANC and the utilization of matemal health cam services. A cmss-sectional survey was conducted among 907 mothers of childmn under 1 year old between September and December 2013 In the South Centml Coast. Thiriy two clusters wem selected for data collection using structumd questionnaim One third of mspondents wem the ethnic minorities, the poor, under 25 years old and has primary and lower educations. This study determined the pementage of males who fmquently accompanied their pariners for ANC (80%), looked for health cam sen/Ices (38,6%), financial suppori (61.7%) and other cams for pmgnant women (76,0).
Factors found associated with less fmquently accompanied their partners on antenatal visits - under secondary level education, among the poor, and aged under 25 years and woman who wem the breadwinner of the family. Woman who had partner's frequently accompanied on antenatal visits was mom likely to have at least 3 ANC, delivery at health facility, and using contmception (about 2.5 times)
than who are not having frequently accompanied.
These factors should be emphatically considemd during matemal health progmm development
Keywords: Mate involvement, matemal earn, ANC, South center coast
DAT VAN Dt
Chidn lugc qudc gia ve chdm sflc sdc khde sinh sdn eua h l u hdt cdc qudc gia trfin thd gidi deu uu tifin tdp trung vdo gidm t u vong vd tdn tdt do mang thai vd sinh nd. Sy tham gia cua nam gidi vdo cde chidn lugc ndy luon lufin dugc n h i n mgnh vdi vai trfl Id ngudi ldnh dao vd Id ngudi quydt djnh chinh trong gia dinh, cgng ddng cQng nhu xdy dyng vd thyc thi ehinh sdch. Tuy nhifin. trong cdc djch vy chdm sdc sdc khde bd me, nam gidi thudng chua dugc chO y den, it dugc cung e l p thfing tin vd it dugc quan tdm den khi xdy dung ehinh sdch vd tridn f(hai ehuang trinh(l).
Tgi Vidt Nam dd cd mflt sd nghifin cdu vd vai trd eua nam gidi trong kd hogch hfia gia d1nh(2), trong chuang trinh ehdm sfic ede bfinh vifim nhifim dudng sinh sdn(3) nhung vai trd cua nam gidi trong chdm sflc sde fchde bd mg khi mang thai vd sinh eon cfln bd ngd. Bdi vidt ndy nhdm (i) mfl td sy hd trg ciia nam gidi trong vific chdm sflc phy nd khi mang thai, sinh con vd sau sinh tgi 8 linh duyen hdi Nam Tmng Bd (ii) xdc <^nh mflt sd ydu td lifin quan ddn s y hd trg cua nam gidi; (iii) xdc djnh mdi lifin quan gida s y hd trg cua nam gidi vd sd dyng dich vy ehdm sflc trudc, trong vd sau smh cua bd mg.
D 6 | T U ' Q ' N G V A PHU'ONG P H A P NGHIEN CLTU Ddy Id mfit phdn thuflc nghifin edu "Mflt sd ydu td lifin quan den binh d i n g gidi trong chdm sflc sue khoe smh san tgi 8 tinh Duydn hai Nam Trung Bfi" do Trudng Dgi hgc Y td cdng edng vd Vy Td ehde edn bfi, Bfl Y td phdi hgp thyc hifin. Ddi tugng nghifin cuu Id bd me cfl con dudi 1 ludi tgi 32 xd thuflc 6 ttnh duyfin hai Nam Tmng Bfi dugc lya chpn theo phuang phdp chgn m l u nhidu giai dogn. Tgi mdi tinh ehpn 2 huyfin, mdt huydn mien nui vd 1 huyfin ddng bing ven bidn, tgi mdi huyfin chgn ngdu nhifin hai xd, sd bd mg tgi mdi xd dugc chpn dya theo li Ifi ddn sd Nghifin cuu dugc thidt kd md ta cdt ngang cfi phdn tich. Cdc bd mg dugc phdng vdn b i n g bdng hdi t u thdng 9 - 12/2013. Sd lifiu dugc nhfip b i n g phdn mdm Epi Info, Idm sgch vd phdn tieh b i n g phdn mdm STATA 10.0.
Cdc bidn dugc dua vdo phdn tich gdm cfl thflng tin chung eua vg vd chdng (tudi, ddn tdc, trinh dd hgc v i n . nghd nghidp), kinh td hd gia dlnh, ngudi kidm tidn chlnh trong gia dinh, cdc chd dd vd sdc khde
Y HOC THVC HANH (913) - S 6 4/2014
sinh sdn dugc hai v g chdng trao ddi vdi nhau, ngudi chm frdch nhifim chinh trong chdm sdc sdc khde srnh sdn, s y hfi trg cda ngudi chdng khi v g mang thai vd sinh con, khdm thai t d ba Idn t r d ifin, sinh con tgi ca s d y td vd hi#n dang s u dung bifin phdp tranh thai.-
K E T QUA
1. D^c didm ddi t u v n g nghien c d u Tdng sd 907 bd me cd con dudi mgt tudi hifin dang sinh sdng tai 8 tinh Duyfin hai Nam Tmng Bg da tham gia nghien cdu. Tudi trung binh cua ddi tugng nghifin edu Id 27 tuoi, trong do han mdt nua phy n u cfl eon dudi 1 tudi nam trong dd tudi t d 25 - 34 Khoang 1/3 trong sd dfl d u d i 25 tudi, ddng chO y la cfi 7,5% sd phy n u cfi eon dudi 1 tudi Id vj thdnh nifin vd 12% phu n d cfl con dudi 1 tudi t d 35 tudi trd len.
Tudi tmng binh eua chdng ddi tugng nghifin cdu la 31 vd trfin 70% ddi tuang nghien cdu cd chdng trong dfl tudi 20-34 f B a n g i ; .
Cde ddc trung ve dan tflc, hgc v i n vd nghd nghifip eua ddi tugng nghifin edu khd tuang ddng vdi cdc ddc trung cua ngudi ehdng vdi khoang 1/3 la ngudi ddn tflc thieu sd, han 50% cfl trinh do hgc van t d Tmng hoc CCT s d trd xudng vd khoang 40% cfl nghd nghifip Id Idm rufing. S y khae bifit Idn n h i t ve nghe nghiep dfl Id cfi khoang 24,7% ddi tugng nghifin cdu Idm npi try trong khi ty lg ndy d ngudi chdng Id 1,1%, vd 30,5% ngudi chdng Idm mudn so vdi 8,5%
d ngudi vg (Bing 1).
Vd tinh trgng kinh td cOa ddi tuang nghifin edu (sd li$u khflng the hifin trong bang), gan mfit nua ddi tugng nghien euu (47,2%) cfl tinh trang kinh id gia dinh thuflc hfl nghfio vd can nghfio. Ben canh dd, vai trfl kinh td trong gia dinh chu ydu thufic vd ngudi chdng vdi khoang 3/4 ddi tugng nghifin cdu (76%) cd chdng Id ngudi kidm tien chinh trong gia dinh vd cOng cfl khoang 82% doi tugng nghifin cdu cfl thu nhdp it han so vdi ehdng.
2. SLF hA t r ^ cOa c h d n g t r o n g chdm sdc tnr6c;
trong vd s a u sinh
Ty lfi phy n d d u g c nhdn h6 trg cua chdng tron^
qud trinh mang thai, sinh n d vd sau sinh Id khd cao (94.8%). Tuy nhifin ty Id ndy cd s y khdcbidt rO khi xdt ddn tdng khia cgnh cua s y hfi trg. S y hfl trg phd bidn n h i t cOa ngudi chdng Id dua v g di khdm thai (94,7%), vdi 81,2% phy n d nh§n d u g c s y hd trg ndy mgt each thudng xuydn; tidp theo dd Id hd trg chdm sfic trong qud trinh mang thai, sinh vd sau sinh (76%); ty lfi cd hfl t r g vd kinh td khoang 61,7% vd chl CO 38,6% phy n d d u g c chdng hd trg trong vide tim kiem djch vy y td chdm sdc sdc khde khi mang ttiai vd sinh n d (BSng 2).
Trong sd nhdng phy n d d u g c nhdn hd try ttr chdng, khoang g i n 1/3 Id d u g c nhdn ca 4 s y hfi trg bao gdm chdm sdc, hd trg kinh td. tim kidm djch vy vd dua di khdm thai; ty Id nhdn d u g c 3 s y hfi trg la 27,4% vd cd khoang 16% nh$n d u g c duy nhit 1 su hfi trg (Bing 2).
Bang 2. S y hd trg cOa chdng trong chdm sflc trudc, trong vd sau sinh
Banq 1. Thflnq tin chunq D|c diem
TUDI
<19 20-24 25-29 30-34 35 tudi trd ifin
Dan tfic Dan tfic thieu so
Kinh Trinh dfi hpc vin Tidu hpctrdxufinq
THCS THPT Cao danq trd len
Nqhe nqhiep Lam rufinq/iam ray
CB nhS nudc Bufin ban
Npi trp LAm thue/lao donq qian don
Khac
ve doi luanc Vg (n=907, %)
7.5 26.6 30,9 23,2 11,9 31,5 68,5 33,5 36,1 17,5 12,9 38,6 5,2 11,7 24,7 8,5 11,4
nqhlfin cuu Chdng (n=879, %)
1 7 13.4 27,7 31,2 26,1 31,2 68,8 32,0 32,7 22,6 12,7 40.3 7,5 6,1 1,1 30.5 14,5
Sy hd trg 06 hdtrg Logi h5 trg Ho trg tim kidm dich vu y td
Duadi khdm thai Thudnq xuy§n Thinh thoinq Hfi trg kmh pht Cham sfic tru'dc, tronq vS sau sinh
Mdc dfi hfl trp Nhin dupc 1 sy h5 trg trfin Nhgn dupc 2 sy hfi trg trfin Nhin dupc 3 sy h5 trg trfin Nhgn dygc ca 4 sy hd trg trfin
T9 Ifi (%) 94,6 38.6 94.7 81,2 13,5 61,7 76,0 16.2 26.4 27.4 30.0 3. Mdt s d yfiu t d lifin quan dfin s y hfi trg* cOa chdng trong chdm sdc tru'dc, trong vd sau sinh
Hfi trg tim kiem djch vy y td: Nhdng phy nir c6 tuoi dudi 25 hoic c 6 chong dudi 25 tuii, cd trinh dp hgc vdn t d THCS trd Ifin, d nhd Idm ndi trg ho$c ed chdng Idm bufin bdn thi It dugc chdng hfi trg hon trong vi^c tim kidm djch vy (p<0.05). Cdc ydu td khdc nhu ddn t$c, thu nhdp hd gia dinh, ngudi kidm tidn chinh khflng cfl s y khdc bidt cd y nghTa thdng kfi (bang 3).
Dua di khim thai thudng xuydn: Chdng hd trg dua di khdm thai thudng xuyfin cfl s y khdc bi§t rfl theo cac ddc trung nhdn k h i u xd hdi cua chdng, vg vd dae didm kinh td gia dinh. Phy n d ho$c chdng dudi 25 ludi. Id ngudi ddn ldc thidu sd, cd trinh dd hgc v i n dudi THPT, hay Idm mOng thi it di khdm thai (p<0,05). Phy n d d cdc hd gia dlnh nghdo vd c9n nghfio cfl it d u g c chdng d u a di khdm thai thudng xuyfin han. Phy n d Id ngudi kidm tidn chinh trong gia dinh hay cd thu nhdp cao han chdng it dugc chdng dua di khdm thai thudng xuydn han h i n cdc nhflm khde(p<0,01).
Y HOC THVC HANH (913) - s6 4/20M_
Bdng 3: &/ hd trp cua ngu<ri chAng Iheo c4c nhOm a6i tirong NOi d u n g
T u 6 i c u a v 9 24 tu6i trd xudng
25 tudi trd t6n Ddn t ^ c u a v c DSn tdc thiSu s6
ianh Trinh a o hpc vSn c u a vp"
r w C S vd (/J^p /JOT rWPT" vd cao tian N q h ^ nghigp cua v<?
Nditrv Ldm rudnq/ISm riy
LSm mudn Budn bdn CB ntiS ntf&c
KhSc Tu6i cua chtna
24 tudi trd xuonq 25 tudi trd ISn DSn tOc CLia ch 6ng DSn tdc Ihi&u sd
Kinf]
HQC vSn cua c h 6 n q THCS vS tfiip tian
THPT vS cao han Nqh^ nqhiep cua c h 6 n q
Ndi tra Ldm rudnqASm riy
LSm mudn Bu6n bSn CB ntiS nuifyc
KtiSc Thu nh^p hO qia flinh HC nqfido vS cSn nqhSo Ttiu nti$p trunq binh trd ISn
Ngu-i-i ki6m l i ^ n c h i n h Bin thin
Chdnq Va chdnq nhw nhau
KhSc Thu nh$p cua ch6nq so vdt va
It han Nhiiu han B$nq nhau
H f t t r g r t l m k i ^ m djch VU V t6 (%) p<0.001
29.1 4 3 . 5 36,7 39,5 P<0.01
4 1 . 8 31.2 p<0,001
29,0 4 4 , 5 44,2 36,8 34,0 38,8 p<0.001
28.6 41,4 36,8 39,4 41,4 36,0 p<0,05
41,2 40,3 25,9 42,4 40,2 37,9 39,3 25,6 40,7 34,8 28,2 28,2 41,6 29,7
Otra di k h ^ thai t h i r t m q xuyen (%}
p<0,01 76,1 83,3 p<0,001
69,9 85,8 P<0.01
78,6 85,9 p<0,001
87,5 74,0 85,7 80,2 83.0 85,4 p<0,05
76,7 83,5 p<0,001
67,8 86.7 p<0,01
79,6 87,8 p<0,01
50,0 78,5 84,7 90,7 83,3 87,4 p<0,01
76,6 84,6 p<0,01
62,8 82,3 82,2 69,2 p<0,001
64.1 83,1 81,3
Hd trqr ldnh p f i i ( % )
58,3 6 3 . 6 6 5 , 0 60,2 p<0,001
66,1 51,8 p<0,001
50.5 70,9 66,2 53,8 61.7 60.2 60,9 63,0 64,7 60,4 p<0,05
65,5 57,6 p<0,05
30,0 68,1 60,5 50,0 63,6 59.8 61,2 62.2 p<0,01
46,5 65,2 51,1 53,9 p<0,001
51.3 65.6 46,2
C h d m s 6 c khi m a n g thai, sinh vd s a u sinh (%)
73,5 77,3 76.2 75.9 74,6 79,0 69,6 78.6 77.9 71,7 83,0 80,6 73,7 78,3 74.6 76,6 75,9 80,7 80,0 79,4 75,8 74,1 84,9 74,0 73,4 78,3 p<0,001
51,2 78,3 76,3 61,5 p<0,001
76.9 78.3 71,4 H 6 trgr kinh phi: Tj? Id phij nd diiQc ciidng h6 trcr
v6 kinh phi cd si/ khAc bi$t c6 ^ nghTa tiieo trinh do /jpc \/&n, f3$c diSm nghS nghidp va vai trd kinh te ttong gia dlnh. Ngudi vp* hay chdng cd trinh do hoc vin tr6n THCS, ho$c C(5 nghi nghidp ndi tr^ hay budn bSn c6tyl$ chdng hd tny kinh ti it han. Va cung tmng t{f nhw si/ ti6 trQ dira di kh^m thai, phu nd Mim tiSn chlnh trong gia dlnh ho§c cd thu nh$p cao hm chdng thl t^ 1$ nh$n cfupc hd trr; thip nhk, nhdng phu nd cd chdng Id ngudi kiim tiin chinh vi cMflff kiim tiin nhiiu han thl cd ty 1$ duo'c nh$n hd bvcao nhit (p<0.001).
Chjim 86c tripdv, trong vei sau sinh: Vi$c nh$n
^ATC h6 tip trong chSm sdc trudc. trong vd sau sinh
chicd khdc biet theo vai trd kinh ti trong gia 6inh. Kit qua tuung dong vdi c&c ph^n tich trudc. Phu nd cd vai tro kinh te chinh nh$n 6ifiyc hd trr; ndy It hon so vdi c&c phu nd cd vai trd kiim tiin b$ng chdng ho$c it han chong (p<0.001).
4. Ngu'd'i chdng dira va dl khdm thai thu'd'ng xuyen vi sd dung cSc djch vu chSm s6c trunSrc, trong vd sau sinh
Cac chi so chSm s6c si>c khoe bS m? di/ge dira vSo phan tich gom c6 ty le b& m? di kh^m thai ti> 3 l^n trff len, de tai co" so" y t^ vS sd dyng bi$n phSp tranh thai. Ket qua cho t h i y e^c ty 1$ nSy tirang doi t6t, tren 90% phy nu- khdm thai ti> 3 \kn tro ifin. d4n 97% phy nO sinh con tgi co sa y t^, tuy nhifin chl c6
V HQC THUC HANH (913) - S 6 4/2014
70% phy nif c6 con du'di 1 tufii hifin dang sir dyng bien phdp trdnh thai (bang 4).
Phdn tich tuwng quan hai bien cho thay phu nQ- d u v c chfing dua di kh^m thai thu'dng xuyen c6 kha ndng di khdm thai tir 3 lan tro len cao g i p 2,4 \kn so vd'i phu nO' khdng d u v c chfing dira di kham thai hoac du-a Si khdm thai khdng thirdng xuyfin (95%CI:1,47 - 3.8, p=0.000). Phy nS d y o c chfing du'a di khSm thai
thu&ng xuyfin c6 kha ndng d^n dfi tai co s d y t6 cao g i p 2,5 l i n so vdi phu nO khflng du'p'c khfing du-a di khSm thai thu'dng xuyfin (95%CI; 1,18 - 5,4, p=0,013). Phu nO' du-g-c chfing du'a di khdm thai thu'dng xuyfin hifin cung dang siJ dyng bifin phdp trdnh thai nhi^u g i p 2,5 l i n so vdi phy nO khfing Quae chfing dua di kham thai thu-dng xuyen.
Bdnq 4. Chonq dua v(7 ffi khdm thai thu-crnq xuyen vd si> dunq dich Idm me an todn St> dgng djch vg
6i khdm thai ti^ 3 ISn tra' Ign C6 Kh6ng De tai ca sa v te
C6 Khflng SO dgnq bi$n phdp trdnh thai
Cfl Ktiflnq
N (%) 907 90.5 9,5 907 96,7 3.3 907 70 30
Chflnq difa di kham thai thifdnq xuygn C6(%)
92.2 7,8 97,4 2.6 73.9 26.1
Khflnq{%) 83,3 16.7 93.7 6,3 52,3 47,7
OR (95%CI) 2,37(1,47-3,8)
1 2,54(1,18-6.4)
1 2.59(1.84-3.64)
P 0.000
0.013
0,000
BAN LUAN
Nghifin ciru du'p'c thyc hien trfin nhom doi tug'ng phy nd cd eon du'di 1 tufii tai cdc xd mien nui, ven bi^n duyfin hai Nam Trung bo, khoang 1/3 trong so dd Id phy nu- ngudi dan tfic thifiu so, thudc hfl ngheo vd can nghfio. Tyy nhifin k6t qua nghifin cii'u cho thay cdc ehi sfi ve si> dyng dich vy lam me an todn deu khd cao, ti le bd m? di khdm thai tCr 3 ian trd len, de tgi Cff sd y tfi vd si> dyng bifin phdp trdnh thai deu cao lu'ong du'ffng vdi sfi Mfiy cua todn qu6e(4).
Hdi nghi Qufic t4 ve Ddn sfi vd PhSt trien (ICPD) dd thdng qua chu-ffng trinh hdnh ddng toan e^u nhan mgnh can phai ed sy cdng b i n g gidi trong chdm soc sdc khde sinh san. Ngudi chfing cd the tham gia vao nhifiu cdc hoat ddng chdm sdc sire khde smh san nhu hd trp' ban tinh. vp- nhu mdt doi tdc binh d i n g . Id ngudi cha cd trdch nhifim eOng nhu s u dyng cdc djch vy chdm sde sue khde sinh san cua nam gidi (5).
Kfit qua nghien eiru eho thay ngudi chfing khd tich eye trang vific chia se vdi vp' klii vp* mang thai vd sinh cpn vdi nhifiu hinh thirc khde nhau nhu hd trp- tim kifim dich vu y te, dua di khdm thai, hd trp' kinh phi va eham sdc khi mang thai, khi sinh vd sau smh Ti le nam gidi d khu vyc nay dua vp' di khdm thai khd cao (95%), cao hffn nhifiu so vdi mdt so nghien ciru tai cac nude khdc. Vi dy nhu tai Nepal, ti lfi ndy chl khoang 39% (6) hay tai Uganda, ti Ifi nay khoang 42% (7) hay tai Cameroon, ti le ndy chi khoang 18% (8).
Nam gidi trong dd tufii tir 25 tufii trd xuong it di eung vp- di kham thai eung da dup'c bao cdo qua nhifiu nghifin euu khde (6, 7). Mdi lien quan gilj-a thu nhdp t h i p vd it dua vp' di khdm thai cung giong nhu nghifin cuu d Nepal (6). Nam gidi cd trinh dp hpc van cao dua vp' di kham thai nhifiu hon tuong t y nhu phdt hifin Uganda d (7) nhung lai ngup'c lai vdi ket qua tim t h i y d Nepal (6).
Sy tham gia cua nam gidi se gdp p h i n eai thifin cdc ehi sfi vfi sCr dyng bifin phdp trdnh thai, tinh due
an toan, s u dung djch vu y tfi va g i i m gdnh n|ing tii vong vd tdn tat lien quan dfin sire khde sinh s i n (5).
Trong nghifin euu ndy ehiing tdi t h i y phy niJ' dup'c chfing dua di khdm thai thudng xuyfin cd xu hudng sir dung djch vy chdm sdc trudc, trong vd sau sinh g i p 2.3 - 2,6 l i n phy nd khfing dup'c chfing dua di kham thai thudng xuyfin.
Tuy nhifin nghifin ciru cQng cdn cd mdt sfi han ehe. T?l mfii xd, dfii tup'ng nghifin ciru dup'c trgm y tfi mdi dfin dfi tham gia vdo nghien cu'u, nhdm ngudi ndy ed thfi g i n tram y tfi hon vd siK dyng djch vy y tfi nhieu hon so vdi cdc doi tup'ng khdng dup'c mdi tham gia nghifin ciru. Phy n u dan t^c thieu sfi biet dpe, ndi Vifit cung cd kha ndng tham gia nghifin euu nhifiu hon so vdi ngudi khdng biet dpc, ndi tifing Viet.
K^T LUAN
Nghifin ciru dup'c thyc hifin tai cde xd mifin niii vd hai dao d khu vyc duyen hai nam trung bd trfin nhdm phy nd cd con dudi 1 tufii, ti le ngudi ddn tfie thieu so tuong dfii cao (trfin 30%), va g i n mdt nira thudc sd hd nghfio vd c^n nghdo. Ket qua eho t h i y sy hd trp' eua ngudi chfing khi vp' mang thai vd sinh no tuong dfii tot. Den 95% sfi phy ud dup'c chfing dua di khdm thai trpng sfi dd tren 80% dup'c chfing dua di khdm thai thudng xuyen Phy nfr dup'c chfing dua di kham thai thudng xuyfin cd xu hudng s u dung djch vy Cham sdc trude. trong vd sau smh g i p 2,3 - 2.6 l i n phy n u khdng dup'c chfing dua di khdm thai thudng xuyen
TAI LIEU THAM KHAO
1. WHO. Programming for male involvement in reproductive health. The meeting of WHO Regional Advisers in Reproductive Health WHO/PAHO;
Washington DC2002.
2. Ha BTT, Jayasunya R, Owen N. Male involvement in family planning in njral Vietnam: an application of the Transtheoretical Model. Health Education Research. 2003 April 1,2003;18(2) 171-80.
Y HOC THlJC HANH (913) - s 6 4/2014
3. Nguyen Thu Nam. Yfiu tfi gidi trong chuwng trinh chdm sdc cdc bfinh vifim nhiem dudng anh san. Tap chi Ddn sfi vd Phdt tnin. 2005:2.
4. Ministry of Health. Health-related Millennium Development Goals Viet Nam. Health equity analysis 2012.
5. Pachauri S. Male involvement in reproductive health care. Joumal of the Indian Medical Association 2001 Mar;99(3):138-41. PubMed PMID: 11478756 Epub 2001/08/02. eng.
6. Bhatta DN. Involvement of males in antenatal care, birth preparedness, exclusive breast feeding and immunizations for children in Kathmandu. Nepal. BMC
Pregnancy and Childbirth. 2013;13(1):14. PubMed PMID: doi:10.1186/1471-2393-13-14.
7. Nantamu D. P. Factors associated with male involvement in maternal health care senrices in Jinja district.
Uganda: Makerere University of Pubic Health; 2011.
8. Nkuoh GN, Meyer DJ, Tlh PM, Nkfusai J. Baniers to men's partk:ipation in antenatal and prevention of mother-to-child HIV transmission care in Cameroon, Africa. Joumal of midv^ery & women's health. 2010 Jul- Aug;55{4):363-9. PubMed PMID: 20630363. Epub 2010/07/16. eng.
DANH GIA THOC TRANG SlTDUNG DjCH VU CHAM SOC Sl)C KHOE SINH SAN CUA CAC DA ME TAI 8 TINH VUNG DUYEN HAI NAM TRUNG DO NAM 2013-2014
NGUYEN TUAN HUNG, PHAM THf NGA, NGUYEN V A N H ^ U , N G U Y I N X U A N S O N , N G U Y I N LAN Hl/ONG vd cgng sy
Vu To chdc cdn bd. B^ Y t4 T6M TAT
Miic ti§u: Md td thuv tr^ng nhu cau sd dung dich v(j CSSKSS cua cdc bd m? vOng Duy§n hdi Nam Tmng bd: Xdc djnh nhdng h^n chi vd 6e xuat giai phdp cdi thi$n vi$c cung cip dich vu tai cdc dia phuung trdn. Bdi twgng vd phwong phdp: Nghidn cdu md td cit ngang, kit hg'p dinh tlnh vd dinh tugng.
oil tugng nghidn cdu gdm: Nhdm Ldnh d?o qudn ly, Nhdm cdc dan vj cung cip djch vu, Odi tugng thu hudng djch vy (Phij nd trong dd tudi smh dd). Nghidn cdu dugc tiin hdnh (9/ 8 tlnh vCing Duydn hSi Nam Tmng bd td 6/2013 din thdng 3/2014. K4t qud:
Trong s6 940 phij nd tham gia NC 15,32% khdng biit chd. Ty Id khdm thai 3 lin dOng 3 ky cua phu nd c6 thai cd si/ cdi thi$n rd rdt. Ty 1$ 6in tr^m y ti xa sinh iJd tin cd thai giin ddy nhit Id 20.53%. Khdng din CO sd y ti 6i sinh: do t$p qudn chiim ty 10 cao nhit (32,73%), di l^i khd khdn 25,45%, xa co sd y ti 18.18%, khdng cd tiin din ca sd y ti 9.09%. Ty 1$
bd mp dugc chdm sdc sau ad 81,17%. Ty 14 Phu nd khdng Ctugc khdm phij khoa Id 11,28%. Kit lu§n:
Nhin chung dd d^t dugc kit qud khd tdt trong cdc dich vu: ChSm sdc vd qudn ly thai ngh&n, chdm sdc sdc khde phu nd, chSm sdc sdc khde trd em. Tuy nhi6n cdn nhiiu rdo cdn lidn quan tdi khd ndng tiip c$n dich vu cho cdc bd mp Id ngudi ddn tdc thieu sd.
Td khda: djch vu CSSKSS, phu nu mang thai, chdm sdc sdc khde, smh <3d
SUMMARY
Assessment of the use of reproductive health care services among mothers in 8 provinces in the South Central coastal area 2013-2014
Objectives: to describe the situation of needs to use sen/ices of reproductive health care among rnothers in the South Central Coast; to identify limttations and propose solutions to improve sen/ice delivery at the areas. Subjects and methods: a
cross-sectional descriptive study with quantitative and qualitative methods. Subjects of the study include:
Management-Leadership Group, service provider Group, sen/ice beneficiaries (i//omen of childbeahng age). The study was conducted in eight provinces in the South Central Coast from Jun 2013 to Mar 2014 Results: among 940 women who participated in the study: 15.32 % are illiterate. Percentage of three antenatal care visits in gestation of the pregnant women has markedly improved. The proportion of women giving birth at commune health stations In the most recent pregnancy was 20.53%. Do not go to health facilities for childbirth: by habits was the highest (32.73%), difficulty walking 25 45 %, far from medical facilities 18.18 %, not have enough money to deliver at health facilities 9.09 %. The rate of maternal postpartum care was 81.17% . The percentage of women has not received gynecological examination was 11 28 %. Conclusion: Overall, the results are quite good in the sen/ices: pregnancy care management, women's health care, children's health care. However, there are many bamers related to access to health services for Ethnic minority women
Keywords: reproductive health care sen/ices, pregnant women, health care, reproductive
DAT V A N D £
Tai cdc qufic gia dang phdt trien vific mang thai, sinh con Id nhijng nguyfin nhdn hdng d i u gdy t u vong vd benh t^t cho phy n u trong dfi tufii sinh dfi, nd chiem it nhit mfit p h i n ba tfing sfi gdnh n$ng bfinh tat toan c i u vd t u vong sdm d nhO'ng phu nd dfi tufii sinh san. Theo bdo cdo eua Tfi chire Y tfi thfi gidi ndm 2004 ve thye trang CSSKBM, tre sff sinh vd trfi dudi 5 tufii cua khu vi/c Ddng Nam A. ty lfi tCr vong m^ (MMR) d cdc qufic gia ndy vdn cdn d mirc cao Cde nguyfin nhdn chu yeu v i n xoay quanh cde v i n dfi tai bien san khoa nhu chay mdu, nhifim triing, v d
Y HOC THUC HANH (913) - SO 4/2014
