Tập 2 Số 01 (2018): Volume 2, N01-2018

Le Van Loc 1 , Hoang Khanh Chi 2* 1 Department of Health Yen Bai Province 2 Hanoi University of Public Health Objectives:  To describe the compliance with some regulations on private health care practice of private healthcare facilities in Yen Bai City, in 2017. Methods:  This was a cross sectional study. Location and time of study: Yen Bai city, Yen Bai province from March to September 2017. Subject of the study: private healthcare facilities and people who are responsible for the facilities in Yen Bai City. Main findings:  The proportion of private healthcare facilities meeting the general regulatory standards of private health care practice reachs over 90%. However, some standards were not met such as medical waste treatment (24.7%), available emergency transport vehicles inside and outside the facility (55.8%), insuffcient number of drugs in the anti-shock box case (28.6%) and emergency medicine cabinets (55.8%). Conclusions:  Provincial Health Department and District Health Offce should reinforce monitoring and supervising to ensure suffcient medical equipments at private healthcare facilities and sanction the facilities for disobeying the regulations. For private healthcare facilities, they should perceive the nessecary of medical equipments for emergency needs as well as ensure its availability as defned by the state regulations. Keywords:  Private healthcare facilities, healthcare inspection, local healthcare.   *Corresponding author:  Hoang Khanh Chi Work place: Hanoi University of Public Health Email:  hkc@huph.edu.vn

Do Thi Hanh Trang 1* , Ta Anh Tuan 2 , Truong Thi Kim Duyen 2 1  Hanoi University of Public Health 2  National Pediatric Hospital   Objective:  To assess the situtation of ventilator-assosciated pneumonia prevention practice and to explore the relation between demographic, work environment-related and professional training factors with ventilator-associated pneumonia prevention practice among nurses working at ICUs at the National Pediatric Hospitals. Methods:  Cross-sectional design was used. Data were collected from 161 nurses working at all four ICUs of the hospital through using a selfadministered questionnaire and an observation checklist. Main findings:  62,1% of the nurses met the criteria for good ventilator-associated prevention practice. The correlates of the practice included education qualifcation, work experience, type of ICU where the nurses were working, average number of patients taken care of by the nurses in one shift, collaboration with doctors in ventilator-associated pneumonia prevention, and the number of trainings in hospital infection prevention. Conclusions:  The hospital should enhance measures to improve nurses’ ventilatorassociated prevention practice with special attention paid to continuous training and effective human resources management in order to lower work pressure and encourage collaboration between nurses and doctors in care, assuring safety and effective treatment for patients. Keywords:  practice, ventilator-associated pneumonia, nurse.   *Corresponding author:  Do Thi Hanh Trang Work place: Hanoi University of Public Health Email:  dtht@huph.edu.vn

Bui Dong Tien 1* , Ha Van Nhu 2 1 Binh Dan Hospital 2 Hanoi University of Public Health Objectives:  to describe the knowledge and behaviors of looking for infertility treatment services and some influencing factors of the out-patients at the Department of Male Sexual Medicine, Binh Dan Hospital in 2017. Methods:  We conducted a cross-sectional descriptive study on 154 male out-patients at the Department of Male Sexual Medicine, Binh Dan Hospital from February to June 2017, using the cluster sampling method. The knowledge of male infertility was investigated at the cutting point of 70%. The qualitative data were collected from 13 indepth interviews with department heads, doctors at the Department of Male Sexual Medicine and 10 patients to identify affective factors. Main findings:  the rate of out-patients with adequate knowledge of male infertility was 18.2%. About the cause of male infertility, 71.4% of outpatients known about taking unknown medicine; 42.9% known about exposure to pesticides; 24.7% with alcohol and drug abuse; 24% with STDs and 23.4% with smoking. Regarding the behaviors of looking for infertility treatment services: 33.8% chose traditional medicines; private clinics (17.9%). The affective factors included: Lack of information on treatment facilities, geographic distance, worry about long waiting time, treatment costs. Conclusions: patients’ knowledge on male infertility was very poor, especially knowledge about the harm caused by drinking alcohol and smoking. Patients tended to choose traditional medicine or private clinic for treatment. Therefore, it was necessary to increase the dissemination of knowledge about male infertility and information about infertility treatment facilities. Keywords:  male infertility, knowledge, practice, Binh Dan hospital   *Corresponding author:  Bui Dong Tien Work place:  Binh Dan Hospital Email:  dongtien1962@yahoo.vn

Bui Dong Tien 1* , Ha Van Nhu 2 1 Binh Dan Hospital 2 Hanoi University of Public Health Objectives:  to describe the knowledge and behaviors of looking for infertility treatment services and some influencing factors of the out-patients at the Department of Male Sexual Medicine, Binh Dan Hospital in 2017. Methods:  We conducted a cross-sectional descriptive study on 154 male out-patients at the Department of Male Sexual Medicine, Binh Dan Hospital from February to June 2017, using the cluster sampling method. The knowledge of male infertility was investigated at the cutting point of 70%. The qualitative data were collected from 13 indepth interviews with department heads, doctors at the Department of Male Sexual Medicine and 10 patients to identify affective factors. Main findings:  the rate of out-patients with adequate knowledge of male infertility was 18.2%. About the cause of male infertility, 71.4% of outpatients known about taking unknown medicine; 42.9% known about exposure to pesticides; 24.7% with alcohol and drug abuse; 24% with STDs and 23.4% with smoking. Regarding the behaviors of looking for infertility treatment services: 33.8% chose traditional medicines; private clinics (17.9%). The affective factors included: Lack of information on treatment facilities, geographic distance, worry about long waiting time, treatment costs. Conclusions: patients’ knowledge on male infertility was very poor, especially knowledge about the harm caused by drinking alcohol and smoking. Patients tended to choose traditional medicine or private clinic for treatment. Therefore, it was necessary to increase the dissemination of knowledge about male infertility and information about infertility treatment facilities. Keywords:  male infertility, knowledge, practice, Binh Dan hospital   *Corresponding author:  Bui Dong Tien Work place:  Binh Dan Hospital Email:  dongtien1962@yahoo.vn

Hoang Minh Phuong, Le Nguyet Ha* National Hospital of Pediatrics Objectives:  Finance is one of the most important determinants of the operation of hospitals. Strengthening of the fnancial management; effective use of fnancial resources are the basis for ensuring the survival and development of the hospital, which promotes competition and progress in the operation of hospitals. Methods:  Cross-sectional design, qualitative and quantitative combination. Place and time of study: National Hospital of Pediatrics, from 2014 to 2016. Subjects: The management of revenue and expenditure of the National Hospital of Pediatrics. Main findings:  The study on the fnancial management at the National Hospital of Pediatrics shows that the fnancial autonomy worth encouraging: the revenue of the next year is higher than that of the previous year; the income of staff continuously increases; equipment was replenished and replaced while funding from state budget was reduced. Implementation of the fnancial autonomy policy creates certain impacts on the supply, use and payment of health services. Financial management of the hospital has contributed signifcantly to the building and development of the hospital, improving the quality of medical services, reducing the burden on the state budget. Conclusion :  Financial management by autonomy mechanism in order for National Hospital for Pediatric to take initiative in fnancial revenues and expenditures, promote the advantages and role of the No.1 pediatric speciality hospital in the whole country to meet the demand of community for medical care and treatment and fulfll the assigned mission. Key words:  Financial management, autonomy mechanism, fnancial autonomy.   *Corresponding author:  Le Nguyet Ha Work place:  National Hospital of Pediatrics Email:  nguyetha0411@gmail.com

Nguyen Duc Thanh 1* , Le Dinh Vinh 2 , Bui Thi My Anh 1 , Chu Huyen Xiem 1 1 Hanoi University of Public Health 2 Dak Lak Center for HIV/AIDS prevention   Objectives:  describe the readiness and analyse barriers to implement Circular 15/2015/TT-BYT. Methods:  A cross-section study combined quantitative and qualitative research was conducted by 142 interviews of patients receiving ARV treatment at 03 OPCs, 07 in-depth interviews and 04 group discussions in DakLak province in 2017. Main findings:  the management, implementation and service provision groups have made preparations for the implementation of Circular 15/2015/TT-BYT through various measures like increasing health insurance rate, ensuring benefts for patients. In this group, the biggest obstacle was strengthening of HIV/AIDS prevention centre so that they had enough facilities and human resources to sign health insurance contracts with Social insurance Agency. For the benefciaries - HIV/AIDS patients, they need more impact to increase the proportion of health insurance from 42.3% to over 70% as orientation. For the benefciaries - HIV/AIDS patients, they need more impact to increase the proportion of health insurance from 42.3% to over 70% as orientation. This group also encountered many barriers that prevent patients from buying and using health insurance, such as having no money to buy and pay for health insurance, limited knowledge of health insurance with 55% of respondents not qualifed and the biggest obstacle is still stigma and discrimination with HIV/AIDS. Conclusions:  to improve readiness of The Circular 15/2015/TT-BYT implementation, the leaders and managers should implement measures to promote health insurance information, reduce stigma and strengthen policies to support patients to buy health insurance. Keywords:  health insurance, HIV/AIDS patient.   *Corresponding author:  Nguyen Duc Thanh Work place: Hanoi University of Public Health Email:  ndt@huph.edu.vn

Nguyen Dinh Hoang 1* , Nguyen Thanh Huong 2 1 Phu My District Health Centre - Binh Dinh 2 Hanoi University of Public Health   Objective:  This study was conducted to provide an overall picture and then shed some light on measures to improve motivation among health workers in Phu My district health centre – Binh Dinh in 2017. Methods:  This is a descriptive cross-sectional design applying a mix of qualitative and quantitative methods. Firstly, qualitative data was collected via self-administered questionnaire among the entire 295 health workers. Motivation to work was measured by a seven-component scale with 23 items. Then, quantitative data were collected from 10 in-depth interviews and 5 focus groups discussions among managers, representatives from departments, teams and commune health stations. Main findings:  health worker motivation was low (57.5%); this percentage at district was lower than communelevels (54.9% and 60.2% respectively), clinical and subclinical departments were lower than preventive and administrative ones (47.7% and 61.4%). Motivation among managers (60.8%) was higher than health practitioners (54.2%). Several solutions to improve work motivation were appropriate deployment according to workload, capacity; acknowledging and encouraging health workersat both district and commune levels; higher salary and bonus could also be given especially to clinical and subclinical workers at district level; improving working environment and facilities; developing a clear career path and implementing effectively human resources policies to attract talents for district level. Conclusions:  Health worker motivation at both district and commune levels was low, so priority should be given to implement several solutions to improve especially for health workers at district level. Keywords:  work motivation, health worker, solutions, district health centre, commune health station.   *Corresponding author:  Nguyen Dinh Hoang  Work place:  Phu My District Health Centre - Binh Dinh Email:  ndhck2@gmail.com

Nguyen Nhat Linh 1* , Nguyen Minh Tuan 2 , Nguyen Thanh Huong 1 1 Hanoi University of Public Health 2 Department Medical Equipment and Construction, Ministry of Health   Objective:  This paper aims to describe availability of some core medical equipment and health service providing at grassroots level in Vietnam. Methods:  The paper used data collected from the World bank’s 2015 Vietnam district and commune health facility survey in 246 Commune health centres (CHC) and 78 district hospitals. Main findings:  only 5.1% hospitals and 17.1% CHC had all kind of core medical equipment. Prevalence of non-functional equipment was 6.5% in CHC and 5.2% in district hospital. Besides, the mostly un-provided health services in district hospital were reproductive (25.6%) and child health services (23.1%); while it was diabetes treatment in CHC (14%). Discussions:  It is nessesary to invest in medical equipment and medical equipment management in the grassroots level of care. In addition, further researches are required to fnalize the guidance on the on the appropriate medical equipment portfolio for commune and district health facilities. Keywords:  core medical equipment, grass root, health facilities, availability, functional status.   *Corresponding author:  Nguyen Nhat Linh Work place: Hanoi University of Public Health Email:  nnl@huph.edu.vn

Le Thi Thu Ha 1* , Nguyen Thi Nhung 1 , Nguyen Thanh Ha 1 , Do Thi Hanh Trang 1 , Do Thi Thu Ha 2 1  Hanoi University of Public Health 2  Preventive Medicine Center of Cau Giay District Objective:  The study was conducted among 1695 pupils in grades 3-5 of two elementary schools in Hanoi from October 2017 to December 2017 with aiming to “determine the nutritional status of elementary school students in 2017”. Methods:  The study design was cross-sectional. Main findings:  the average weight of students was 33,8 ± 8,5 kg and average height was 134,7 ± 7,7 cm, there was signifcant difference between male and female students. Meanwhile, the percentage of overweight- obesity were high (47,9%), the percentage overweight of students in Ly Thai To was 49% (26.6% of overweight and 22.4% of obesity) and Mai Dich school was 47,3% (28.0% of overweight and 19.3% of obesity). Conclusions:  The average weight of students in two schools is higher than the growth target of Vietnam, but average height is lower than recommended. The prevalence of overweight-obesity is increasing with age. The percentage overweight- obesity of male students was higher than female students. Keywords:  elementary schools pupils, Nutritional status, malnutrition, overweight- obesity.   *Corresponding author:  Le Thi Thu Ha Work place: Hanoi University of Public Health Email:  ltth@huph.edu.vn

Nguyen Thanh Ha 1* , Tran Giang Tuyen 2 1 Hanoi University of Public Health 2 Vocational School of Health Soc Trang, Soc Trang province Objective:  To analysis of relationship between diet and eating habits with overweight obesity in pupils of some primary schools in Soc Trang city. Methods:  A cross-sectional study with using anthropometric measurements to determine the overweight and obesity rate in 1305 pupils and case-control studies to determine the relationship between diet and eating habits and overweight - obesity. Main findings:  The results show that overweight and obesity rate is 18.8%, in which overweight rate is 11.6% and obesity rate is 7.2%. There was a statistically signifcant association between fasting food, snacking and eating four or more meals per day, preferring fatty foods, sweet food and fast food with overweight and obesity (OR=3.9, 2.8; 1.5; 1.4; 2.8 and 1.7 respectively, p <0.05). Recommendations:  Appropriate nutritional education should be developed and delivered for children, parents and teachers to prevent overweight and obesity in children. Keywords:  overweight, obesity, diet, and eating habit. *Corresponding author:  Nguyen Thanh Ha Work place: Hanoi University of Public Health Email:  nth1@huph.edu.vn

Tran Huu Bich*, Hoang Thi Thu Thuy Hanoi University of Public Health Objective:  To describe exclusive breastfeeding practices and identify association between exclusive breastfeeding and infant development at 9 months. Methods:  Cross-sectional study was conducted on a population of 210 infants aged 9 months and mothers in 25 communes in two districts of Hai Duong province. Infant development was assessed using self-administered Age and Stage Questionnaire (ASQ-3) tools by the mother. Exclusive breastfeeding practices from 4 to 6 months were reported by mother’s recall method since birth. Main findings:  Exclusive breastfeeding rate from 4-6 months was 11.9%. The mean of general ASQ was 206 ± 42. The differences of the means between EBF and non EBF groups for general ASQ and problem solving domain were 10.3 (p=0,31) and 6.5 (p<0.05 after controlling for potential confounding factors). Conclusions:  Exclusive breastfeeding was associated ability of problem solving of children measured by ASQ-3. The positive association between EBF and infant development should be further studied with a stronger research design. Health staff may still use this result as an evidence in promoting exclusive breastfeeding. Key words:  Exclusive breastfeeding, infant development, ASQ-3, Vietnam.   *Corresponding author:  Tran Huu Bich Work place: Hanoi University of Public Health Email:  thb@huph.edu.vn

Ho Thi Thu Van 1 , Hoang Duc Luan 2 , La Ngoc Quang 3* 1  Krong Bong District Health Center, Dak Lak 2  Medical College of Phu Tho 3  Hanoi University of Public Health   Objectives:  Describe the knowledge and practice of malnutrition prevention among M’Nong ethnic mothers in Yang Mao commune, Krong Bong district, Dak Lak province. Method:  A cross-sectional descriptive study design was used with 181 mothers of children aged 0-24 months. Main findings:  General knowledge on malnutrition prevention was 40.9%. Of which: breastfeeding knowledge: 74.0%, complementary feeding: 81.8%, child care: 21.5%. Overall practice was 27.6%. Of which: breastfeeding practices: 91.7%, complementary feeding: 72.4%, child care: 67.4%. Signifcant statistical factors were found: mothers with lower secondary education had 2.5 times less knowledge about child nutrition care than mothers who graduation from junior high school or higher; mothers had two children having poor knowledge of child nutrition care were 1.8 times more likely than mothers with one child and those with poor knowledge of child care were twice as likely compared to non-poor mothers. Conclusions:  Knowledge and practice of M’Nong ethnic minority mothers with children under 24 months old in Yang Mao commune on malnutrition control are low with the related factors such as education level, number children in the family. Key words:  Knowledge, Practice, Malnutrition, Related factors, Dak Lak   *Corresponding author:  La Ngoc Quang Work place: Hanoi University of Public Health Email:  lnq@huph.edu.vn

Doan Thi Thuy Duong*, Dao Quang Tien, Le Thu Giang, Phi Quynh Trang, Nguyen Hoang Nam Hanoi University of Public Health   Objective:  The study is to describe reason and perception of youth users of e-cigarettes in Hanoi in 2017. Methods:  The research used a qualitative research method with a phenomenological approach, using a snowball technique to select samples. A total number of 11 persons from 18 to 30 years old, who used e-cigarettes, were living and working in Hanoi participated in the research. Of those, 8 persons were current used e-cigarettes, others used to be. Main findings:  Among smokers, attempts to quit smoking were reported as a reason for starting using e-cigarette. Other reason for trying e-cigarettes were curiosity, being offered by someone, being attracted by e-liquid flavors and taste, and of vaping tricks of smoke, or to show off. Smokers found that e-cigarettes are likely to be much less, if at all, harmful to users or bystanders. It was better to not addicted in any drugs, however, addicted in e-cigarettes were more likely to be accepted by other people, such as family members, friends than in smoke or any other drugs. Conclusion:  There are lack of information on e-cigarettes, particularly information on the effect of e-cigarettes in quitting smokes and on health of users. More research on these issues need to studies and disseminated. Keywords:  e-cigarettes, youth, Ha Noi, smoking   *Corresponding author:  Doan Thi Thuy Duong Work place: Hanoi University of Public Health Email:  dttd@huph.edu.vn

han Thanh Hoa 1* , Nguyen Cong Cuu 1 , Nguyen Thi To Uyen 1 , Pham Viet Cuong 2 1 Dong Thap Medical College 2 Hanoi University of Public Health   Objectives:  The study was conducted with two objectives: describe knowledge, attitude and practice of parents/caregivers and assessing the effectiveness of parent’s education in child drowning prevention in two primary schools in Cao Lanh district, Dong Thap province, 2016. Method:  A pre-post intervention design without control study was conducted on 405 participants at 2 primary schools. Parents and caregivers were selected and communicated through various education forms. Main findings:  Knowledge of drowning prevention of parrent and caregiver before the intervention was 20.7% and has increased by 79% after intervention, the knowledge intervention effectiveness index is 28.1%. The majority of parents/caregivers have good attitudes toward drowning prevention, with an intervention effectiveness index of 25.9% and practices of child care provirdes for drowning prevention, with intervention effectiveness index is 69%. The difference between knowledge, attitudes, practice of parrents and caregivers before and after intervention were signifcant increased with p <0.05. Conclusions:  The intervention has showed the effectiveness in increasing parrents and caregiver’s knowledge, attitudes and practices on child drowning prevention. The effectiveness indexs of knowledge, attitude and practice have signifcantly increased compared to before intervention. Keywords:  Drowning, knowledge, practice, prevention of drowning.   *Corresponding author:   Phan Thanh Hoa Work place:  Dong Thap Medical College

Duong Thi Thanh 1* , Le Thi Hai Ha 2 , Tran Thi Mai Oanh 3 , Nguyen Thanh Huong 2 1 International Centre for Tropical Agriculture 2 Hanoi University of Public Health 3 Health Strategy and Policy Institute   Objective:  This study was conducted to investigate the prevalence of bullying victimization and indentify associated factors of only bullying victimization among students of Tien Chau secondary school in Phuc Yen town of Vinh Phuc province. Methods:  The study employed a cross-sectional study. Self-administered questionnaire was used to collect the information of 429 students (grade 6 to 9) in Tien Chau secondary school in April 2017. Main findings:  Analyses of bullying victimization showed nearly six in ten students (59.4%) were engaged in bullying roles as victim. Of these students, neary one in three (30.8%) were victim only. Analyses of multiple logistic regression showed related factors of only bullying victimization including individual factors such as grade level, students at higher level of grade had higher odd of being victimised by their peers than those who are at lower grade level (OR = 1.43; 95%CI: 1.08 – 1,9), middle level of psychological distress (OR = 3.07; 95%CI: 1.48 – 6.35), having suicidal ideation (OR = 9.13; 95%CI: 4.68 – 17.82), high level of academic stress (OR = 2.17; 95%CI: 1.2 – 3.29); low level of family support (OR = 2.55; 95%CI: 1.23 – 3.29). Conclusions:  Schools and families should pay more attention at academic stress and mental health problems among students because of their signifcant asociations with bullying victimization. Further research should pay attention at the relationships between academic stress and bullying victimization. Families should provide more emotional supports, spend more times to talk with their children as well as help them to make decisions in order to prevent bullying victimization. Keywords:  bullying, victimization, adolescent student, associated factors, mental health.   *Corresponding author:  Duong Thi Thanh Work place:  International Centre for Tropical Agriculture Email:  duongthanhvp@gmail.com